Nurse perceptions of organizational culture and its association with the culture of error reporting: a case of public sector hospitals in Pakistan.

Sara Rizvi Jafree,Muhammad Zakria Zakar,Florian Fischer,Rubeena Zakar

doi:10.1186/s12913-015-1252-y

Sara Rizvi Jafree, Muhammad Zakria Zakar + Show 2 more

Open Access

https://doi.org/10.1186/s12913-015-1252-y

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Abstract

BackgroundThere is an absence of formal error tracking systems in public sector hospitals of Pakistan and also a lack of literature concerning error reporting culture in the health care sector. Nurse practitioners have front-line knowledge and rich exposure about both the organizational culture and error sharing in hospital settings. The aim of this paper was to investigate the association between organizational culture and the culture of error reporting, as perceived by nurses.MethodsThe authors used the “Practice Environment Scale-Nurse Work Index Revised” to measure the six dimensions of organizational culture. Seven questions were used from the “Survey to Solicit Information about the Culture of Reporting” to measure error reporting culture in the region. Overall, 309 nurses participated in the survey, including female nurses from all designations such as supervisors, instructors, ward-heads, staff nurses and student nurses. We used SPSS 17.0 to perform a factor analysis. Furthermore, descriptive statistics, mean scores and multivariable logistic regression were used for the analysis.ResultsThree areas were ranked unfavorably by nurse respondents, including: (i) the error reporting culture, (ii) staffing and resource adequacy, and (iii) nurse foundations for quality of care. Multivariable regression results revealed that all six categories of organizational culture, including: (1) nurse manager ability, leadership and support, (2) nurse participation in hospital affairs, (3) nurse participation in governance, (4) nurse foundations of quality care, (5) nurse-coworkers relations, and (6) nurse staffing and resource adequacy, were positively associated with higher odds of error reporting culture. In addition, it was found that married nurses and nurses on permanent contract were more likely to report errors at the workplace.ConclusionPublic healthcare services of Pakistan can be improved through the promotion of an error reporting culture, reducing staffing and resource shortages and the development of nursing care plans.

Highlights

There is an absence of formal error tracking systems in public sector hospitals of Pakistan and a lack of literature concerning error reporting culture in the health care sector
Six factors were extracted by Principal component analysis (PCA), including all the six subscales for organizational culture represented in the PES-NWI
A head nurse/supervisor who backs up the nursing staff in decision making, even if the conflict is with a physician Q40

Summary

Introduction

There is an absence of formal error tracking systems in public sector hospitals of Pakistan and a lack of literature concerning error reporting culture in the health care sector. Nurse practitioners have front-line knowledge and rich exposure about both the organizational culture and error sharing in hospital settings. When nurses and other medical practitioners are facilitated with a positive organizational culture, their commitment to a culture of error reporting and error sharing increases, improving patient safety and reducing mortality rates [8, 9]. WHO indicates that the organizational culture of a hospital influences health practitioner job satisfaction, role delivery and quality of patient care [10]. The status of error reporting from the perspective of public sector nurses in Pakistan has not yet been addressed by research

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