A near miss occurs but the patient is unharmed. What should the nurse do?

Report it, because near misses help prevent future harm

Do nothing, as no harm was done

Which of these is an example of a never event?

Surgery performed on the wrong site

A patient feeling anxious before surgery

What is the main purpose of an incident reporting system?

To learn from incidents and improve safety

To defend the organisation only

A nurse hesitates to report an error for fear of being blamed. What does a just culture encourage?

Open reporting, treating most errors as system issues to learn from

Staying silent to protect yourself

Only reporting if someone else noticed

Blaming whoever was closest to the error

Part B6 of 8 Improving Safety and Quality of Care Chapter 61 of 75

Incident Reporting and Never Events Questions

NMC CBT incident reporting practice: reporting to learn, near misses, never events, a just culture, and worked scenario answers.

Start reading ← Bank contents ~5 min read

By JobLabs Editorial · UK healthcare reference editorial team

· July 16, 2026 · Updated Jul 17, 2026 · 2 min read

A safe organisation is not one where nothing goes wrong; it is one that finds out when things go wrong and learns from it. Incident reporting is how that happens, and the CBT tests whether you understand its purpose.

Report to learn, not to blame

The single most important idea is that reporting exists to learn and improve safety, not to punish individuals. Most errors have their roots in the system, in how work is designed, staffed and organised, and blaming the person closest to the error hides those causes and stops people reporting. This is the just culture the exam keeps returning to. A nurse who hesitates to report for fear of blame is describing exactly the problem a just culture is meant to solve.

Near misses count

You report incidents that reached a patient and near misses that did not. A near miss is a free lesson: it reveals a weakness in the system before anyone is harmed. So a near miss with no harm is still reported, because the value is in the learning, not the outcome. Options that say “no harm, no need to report” are wrong.

Never events

A never event is a serious, largely preventable patient safety incident that should not happen when the right safeguards are followed. The classic examples are surgery on the wrong site, giving a medicine by the wrong route, and a retained instrument after surgery. Never events are always reported and investigated. Recognising which scenario is a never event, and which is just a normal part of care like a patient declining medication, is a common exam task.

Prompt and factual

Incidents are reported promptly, with an accurate and factual account, so the organisation can respond while the details are fresh. Delaying until later, waiting for a complaint, or quietly not reporting all deprive the system of the chance to improve, and can leave the next patient exposed to the same risk. Reporting openly, early and honestly is the safe answer every time. Next: medication error scenarios. Five incident reporting scenarios first.

Sources & further reading

Key takeaway from Incident Reporting and Never Events Questions

Frequently asked questions

Should near misses be reported even if no harm occurred?

Yes. A near miss is a chance to prevent future harm, so it is reported like any incident. Reporting near misses is a sign of a healthy safety culture, because it reveals weaknesses in the system before they reach a patient.

What is a never event?

A serious, largely preventable patient safety incident that should not happen if the right measures are in place, such as surgery on the wrong site, the wrong route for a medicine, or a retained instrument. Never events are always reported and investigated.

Will I be punished for reporting my own mistake?

A just culture treats most errors as system problems to learn from, not reasons to punish honest staff. Reporting openly is expected and protected. Fear of blame is what stops reporting, which is exactly what makes care less safe.

Check your understanding

Quick quiz: Incident Reporting and Never Events Questions

5questions. Click an answer to see the explanation. Your score is saved on this device only.

1
A near miss occurs but the patient is unharmed. What should the nurse do?
Near misses are reported precisely because catching them prevents future harm. A no-harm outcome does not remove the value of the learning. Reporting near misses is a hallmark of a strong safety culture, not an optional extra.
2
Which of these is an example of a never event?
Wrong-site surgery is a classic never event: a serious, largely preventable incident that should not occur when the right safeguards are followed. A patient declining medication, a minor delay, or normal anxiety are not never events.
3
What is the main purpose of an incident reporting system?
Incident reporting exists to identify what went wrong and why, so care can be made safer. Treating it as a way to punish individuals discourages reporting and hides risks. A learning, just culture is what keeps patients safe.
4
A nurse hesitates to report an error for fear of being blamed. What does a just culture encourage?
A just culture encourages open, honest reporting and treats most errors as system problems rather than individual failings. Silence and blame both make care less safe by hiding the real causes. Honest reporting is expected and supported.
5
When should a patient safety incident be reported?
Incidents are reported promptly and factually, so the organisation can respond and learn while the details are fresh. Delaying, waiting for a complaint, or not reporting at all all prevent the system from improving and can leave others at risk.