Comparison of Perception Differences among Nurses based on Harm Assessment Education in the Patient Safety Classification System

Kwangmi Lee1, Eunhee Shin2, *
1 Department of Public Health Service Team, National Cancer Center, Goyang-si, South Korea
2 Department of Nursing Science, Sangji University, Wonju-si, Gangwon-do, South Korea

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Creative Commons License
© 2023 Lee and Shin

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Nursing Science, Sangji University, Wonju-si, Gangwon-do, South Korea; E-mail:



Accurate harm assessment is critical in the patient safety event management system, but few studies have been published to support the need for training in harm assessment of patient safety events for nurses.


The purpose of this study was to see if there was a difference in the degree of agreement between before and after nurses received training on a patient safety event harm assessment guideline.


After participating in online harm assessment education, 65 subjects completed the self-report questionnaire. Data for the general characteristics of the study subjects and the frequency of respondents for each scenario were analyzed using descriptive statistics. Fleiss' kappa was calculated by estimating the inter-rater agreement among respondents for each scenario.


The agreement value of subjects by Fleiss' Kappa value improved from k = 0.23 before education to k = 0.31 after education, according to the harm assessment. There was no change at k = 0.30 before and after education for the harm period.

Implication for Nursing & Conclusion:

This study’s findings suggest that harm assessment agreement among nurses could be increased through harm assessment education. As a result, case-based education on harm assessment must be expanded, as well as related programs for practical education via patient safety event casebooks.

Keywords: Nurses, Patient safety classification system, Harm assessment, Agreement value, Harm assessment guideline, Harm duration.