Iran Journal of Nursing

1. Introduction
Patient safety is one of the essential components of health care systems and is one of the crucial pillars of quality in these organizations. Combining patient safety strategies with patient care processes will reduce incidents and reduce the likelihood of injury. Healthcare providers can improve a patient's safety status by interacting with patients and their families, controlling procedures, learning from mistakes, and communicating effectively with others on the health care team. Doing these activities can minimize the damage to patients and reduce the cost of care. 
The increase in incidents in health centers has led to the concern of health service providers, officials in this field, and the people. Given that nurses spend more time caring for patients than other health care providers, they should be considered the leading group for planning to prevent and reduce medical errors. 
Increasing reporting and sharing of error information increases patient safety and prevents medical errors from recurring. Detailed disclosure of adverse events can maintain trust between health care providers and patients and reduce disputes and allegations of medical abuse. Therefore, considering the importance of patient safety, the researcher has decided to conduct a study to determine nurses' perception of the disclosure of patient safety.
2. Materials and Methods
This descriptive cross-sectional study was conducted from October to March 2020 in Tehran. The study population consisted of all nurses working in selected educational and medical centers of Iran University of Medical Sciences (Rasoul Akram, Shahid Motahari, Shahid Hasheminejad, Shafa Yahyaian, and Firoozgar Hospitals). The study was performed on 315 nurses. Inclusion criteria having at least 6 months of experience in the clinic as a nurse, and exclusion criteria also included those who had completed the questionnaire incompletely. 
The sampling method in this stratified study was proportional to the allocation in such a way that first, a list of educational and medical centers of Iran University of Medical Sciences and the number of qualified nurses to enter the study was prepared, and then according to the number of samples required for hospital incidents Another was selected and qualified nurses were studied (each hospital was considered as a class). The tools used in this study consist of two parts: Demographic information form, including questions about age, gender, marital status, education, employment status, work experience, work experience in other centers, wards, shift work, and average overtime in Is the moon. 
Nurses' perceptions of the disclosure of patient safety incidents were measured using the Lee and Kim questionnaire. This questionnaire was translated and used for the first time in Iran. The translation of this questionnaire was done according to the protocol of the World Health Organization (WHO) in such a way that first the permission to use and translate the questionnaire was obtained from the original designers by email, then the English version questionnaire by two people who are fluent in English and with specialized terms in the questionnaire. They were familiar. It was translated into Persian. These translations were combined to obtain a single translation in the next step. Then, the final version translated by two other people was translated from Persian into English. 
To determine the validity of the questionnaire, the content validity method was used so that the questionnaires were reviewed using the scientific opinions of three faculty members of the School of Nursing and Midwifery of Iran University of Medical Sciences and were finalized after the required corrections. 
To determine the reliability of this questionnaire, the internal correlation of questions Cronbach's alpha and reproducibility were tested by test on 20 nurses at one-week intervals, where Cronbach's alpha of the whole instrument was 0.885, and its intra-cluster correlation coefficient was 0.793. Analyzes were performed using SPSS software v. 22 using descriptive statistics (Mean±SD) and inferential statistics (independent t-test and ANOVA). Finally, a significant level was considered less than 0.05 in the analyzes.
3. Results
The analysis results showed the general perception of nurses about the disclosure of patient safety incidents with a Mean±SD of 55.66±13.20 (based on 0-100). The Mean±SD score (based on 0-100) was highest in the dimension of "nurses' perception of facilitators of open disclosure" with an average of 71.49, and in the measurement of "nurses' perception of the negative consequences of open disclosure" was the lowest with an average of 35.23. Nurses' perception of the disclosure of patient safety incidents had a statistically significant relationship only with the type of employment (P=0.04). Pairwise comparison showed that the average score of nurses with contract employment was significantly lower than formal (P=0.033) and contract (P=0.008). Also, the average score obtained by corporate nurses was significantly lower. It was less than conventional (P=0.029), and this difference was not significant at other levels.
4. Conclusion
Based on the findings of the present study that nurses' perception of the disclosure of patient safety incidents was positive, it is suggested that to improve patient safety incidents disclosure; hospitals should create a positive culture in which explicit the disclosure of patient safety incidents is first and foremost an opportunity be considered to improve hospital safety actively. The people and the media must also create an atmosphere that reflects the trust and support of health care providers and institutions in exposing patient safety incidents. This allows healthcare providers to have positive perceptions of the disclosure of patient safety incidents.

Ethical Considerations
Compliance with ethical guidelines
Ethical Code was obtained from the Research Ethics Committee of Iran University of Medical Sciences (IR.IUMS.REC.1399.454). Ethical principles are fully observed in this article. Participants were allowed to leave the study whenever they wished. Also, all participants were aware of the research process. Their information was kept confidential.

Funding
This study is taken from the dissertation of the responsible author in the School of Nursing and Midwifery, Iran University of Medical Sciences.

Authors' contributions
Conceptualization: Alice Khachian, Mahnaz Seyed Al-Shohadaei, Milad Ghanbari; Research: Alice Khachian, Mahnaz Seyed Al-Shohadaei, Milad Ghanbari, Shima Haghani; Editing and finalizing: Alice Khachian, Mahnaz Seyed Al-Shohadaei, Milad Ghanbari.

Conflict of interest
The authors declared no conflict of interest.

Acknowledgments
The financial support of Iran University of Medical Sciences and the officials of the School of Nursing and Midwifery is appreciated. All nurses who assisted the researcher in completing the questionnaire are also appreciated.


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