Table 3 Themes generated from data analysis

Organisational barriers

Reporting system [31,32,33,34, 36, 38, 39]

No proper reporting system, consumed time, long forms for reporting, heavy workload

Definition of ME [28,29,30,31, 37, 39]

Unclear definition, no standard definition

Management behaviour [13, 28,29,30,31,32, 34,35,36,37,38,39]

Punitive actions, negative response, no feedback after reporting, targeting the individual than the system, blame culture, lack of confidentiality

Professional and behavioural barriers

Personal reasons/ lawsuit [27, 29, 30, 32, 33, 35, 36, 39]

Fear of reporting, being stigmatized, fear of legal action, forgetfulness, fear of being called incompetent or inadequate

Knowledge of error [31, 33, 35, 38, 39]

 Inadequate knowledge on what constitutes error, unable to recognize an error, unaware of error occurrence