Abstract
BackgroundThe Nursing Act 33 of 2005 holds nurse practitioners responsible for all acts and omissions in the delivery of quality patient care. But quality patient care is influenced by a number of factors beyond the control of nurse practitioners. Patient safety culture is one such factor and is seldom explored in hospitals in developing countries. This article describes the patient safety culture of a district hospital in South Africa.ObjectivesThe study identified and analysed the factors that influence the patient safety culture by using the Manchester Patient Safety Framework at the National District Hospital, Bloemfontein, Free State Province.MethodA descriptive cross-sectional study was conducted and included the total population of permanent staff; community service health professionals; temporarily employed health professionals and volunteers. The standard Manchester Patient Safety Framework questionnaire was distributed with a response rate of 61%.ResultsLess than half of the respondents (42.4%; n = 61) graded their units as acceptable. Several quality dimensions were statistically significant for the employment profile: overall commitment to quality (p = 0.001); investigating patient incidents (p = 0.031); organisational learning following incidents (p < 0.001); communication around safety issues (p = 0.001); and team working around safety issues (p = 0.005). These same quality dimensions were also statistically significant for the professional profiles. Medical doctors had negative perceptions of all the safety dimensions.ConclusionThe research measured and described patient safety culture (PSC) amongst the staff at the National District Hospital (NDH). This research has identified the perceived inadequacies with PSC and gives nurse managers a clear mandate to implement change to ensure a PSC that fosters quality patient care.
Highlights
Patient safety is at the forefront of service delivery in South Africa (SA), as the health system is struggling to cope with the collision of four excessive health burdens, namely communicable diseases; non-communicable diseases; maternal, neonatal and child deaths; and deaths from injury and violence (Coovadia et al 2009:817–843)
SA experiences acute shortages of health professionals in the publicly funded sector. This combination of increasing numbers of patients and a shortage of professionals is a real concern for nurse managers, as nurse practitioners are responsible for all acts and omissions in the delivery of quality patient care (Eygelaar & Stellenberg 2012:1) and patients have little guarantee that they are receiving safe health care
The results indicated that of the 15 548 records reviewed 8.2% showed at least one adverse event, with a range of 2.5% to 18.4% per country. 83% of those adverse events were preventable and 30% were associated with the death of the patients (Wilson et al 2012:4.)
Summary
Patient safety is at the forefront of service delivery in South Africa (SA), as the health system is struggling to cope with the collision of four excessive health burdens, namely communicable diseases (especially HIV/AIDS); non-communicable diseases; maternal, neonatal and child deaths; and deaths from injury and violence (Coovadia et al 2009:817–843). SA experiences acute shortages of health professionals in the publicly funded sector. This combination of increasing numbers of patients and a shortage of professionals is a real concern for nurse managers, as nurse practitioners are responsible for all acts and omissions in the delivery of quality patient care (Eygelaar & Stellenberg 2012:1) and patients have little guarantee that they are receiving safe health care. One of the key priorities of this plan is the improvement in the quality of healthcare services (National Department of Health 2010:6). Patient safety culture is one such factor and is seldom explored in hospitals in developing countries. This article describes the patient safety culture of a district hospital in South Africa
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