Written reports of adverse events in acute care—A discourse analysis
Journal article, 2019

Adverse health care events are a global public health issue despite major efforts, and they have been acknowledged as a complex concern. The aim of this study was to explore the construction of unsafe care using accounts of adverse events concerning the patient, as reported by patients, relatives, and health care professionals. Twenty-nine adverse events reported in an acute care setting in a Swedish university hospital were analyzed through discourse analysis, where the construction of what was considered to be real and true in the descriptions of unsafe care was analyzed. In the written reports about unsafe events, the patient was spoken of in three different ways: (a) the patient as a presentation of physical signs, (b) the patient as suffering and vulnerable, and (c) the patient as unpredictable. When the patient's voice was subordinate to physical signs, this was described as being something that conflicted with patient safety. The conclusion was that the patient's voice might be the only sign available in the early stages of adverse events. Therefore, it is crucial for health care professionals to give importance to the patient's voice to prevent patients from harm and not unilaterally act only upon abnormal physical signs.

adverse health care event

discourse analysis

adverse event

patient safety

unsafe care


Anna Gyberg

University of Gothenburg

Sahlgrenska University Hospital

Ingela Henoch

University of Gothenburg

Angered Hospital

Margret Lepp

Östfold University College

Griffith University

University of Gothenburg

Helle Wijk

Sahlgrenska University Hospital

Chalmers, Architecture and Civil Engineering

University of Gothenburg

Kerstin Ulin

Sahlgrenska University Hospital

University of Gothenburg

Nursing Inquiry

1320-7881 (ISSN) 1440-1800 (eISSN)

Vol. 26 4 e12298

Subject Categories

Health Care Service and Management, Health Policy and Services and Health Economy


Social and Clinical Pharmacy





More information

Latest update

1/7/2021 8