Incident reporting is considered an important source of risk management data for identifying and addressing the causes of errors that occur in health-care organizations. However, the effectiveness of incident reporting in accurately identifying risk may be influenced by variables in the structure and design of incident reporting systems. Several variables, including data bias, system usability, non-standardized terminology and coding, and deficiencies in combined data analysis can reduce risk data accuracy. Until incident reporting systems are enhanced and an environment of safety is promoted, incident reports can provide only a glimmer of insight into organizational risk and quality improvement. Practice environments that support shared decision-making and collaborative care teams and provide stimulating learning opportunities can enhance professional nursing practice and inspire a culture of patient safety.