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Perceived barriers to whistle blowing in healthcare amongst healthcare professionals: An integrative review

Mandu Stephene Ekpenyong (Department of Nursing, Manchester Metropolitan University, Manchester, UK)
Mathew Nyashanu (Department of Health and Allied Professions, Nottingham Trent University - City Campus, Nottingham, UK)
Amina Ibrahim (Good Hope Hospital, Birmingham, UK)
Laura Serrant (Department of Nursing, Manchester Metropolitan University, Manchester, UK)

International Journal of Human Rights in Healthcare

ISSN: 2056-4902

Article publication date: 4 November 2020

Issue publication date: 6 February 2021




Whistleblowing is a procedure where an existing or past participant of an establishment reveals actions and practices believed to be illegal, immoral or corrupt, by individuals who can influence change. Whistleblowing is an important means of recognising quality and safety matters in the health-care system. The aim of this study is to undergo a literature review exploring perceived barriers of whistleblowing in health care among health-care professionals of all grades and the possible influences on the whistleblower.


An integrative review of both quantitative and qualitative studies published between 2000 and 2020 was undertaken using the following databases: CINAHL Plus, Embase, Google Scholar, Medline and Scopus. The primary search terms were “whistleblowing” and “barriers to whistleblowing”. The quality of the included studies was appraised using the Critical Appraisal Skills Programme criteria. The authors followed preferred reporting items for systematic review and meta-analysis (Prisma) in designing the research and also reporting.


A total of 11 peer-reviewed articles were included. Included papers were analysed using constant comparative analysis. The review identified three broad themes (cultural, organisational and individual) factors as having a significant influence on whistleblowing reporting among health-care professionals.


This study points out that fear is predominantly an existing barrier causing individuals to hesitate to report wrongdoing in care and further highlights the significance of increasing an ethos of trust and honesty within health care.



Further readingThe authors wish to thank the University of Wolverhampton library staff for their assistance with the literature searches.Conflict of Interest: The authors have no conflict of interest.Funding Statements: This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.Author Contributions: Conceptualizaion: EME &IA, Study Design: EMS & IA, Data Extraction and Analysis: EMS, IA, Manuscript preparation: EMS, SL, NM, Language Editing: SL, NM & IA.


Ekpenyong, M.S., Nyashanu, M., Ibrahim, A. and Serrant, L. (2021), "Perceived barriers to whistle blowing in healthcare amongst healthcare professionals: An integrative review", International Journal of Human Rights in Healthcare, Vol. 14 No. 1, pp. 10-27.



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