Actions Promoting Patient Safety Research Articles

Assessment of patient safety culture in Moroccan primary health care: a multicentric study

BackgroundPromoting patient safety is a critical concern for developing-countries health systems like Morocco. There is an increasing acknowledgment of the need to create a patient-centered culture with the aim to decrease the number of adverse events related to care and improve health-care quality in Morocco.ObjectiveThe purpose of this study is to examine the perceptions of health professionals working in primary care level of care facilities in Morocco about the concept of patient safety culture.MethodsWe conducted a multicentric cross-sectional study of a quantitative nature in primary healthcare facilities in ten Moroccan cities, measuring ten patient safety culture dimensions, from February 2022 to June 2022. Data was collected using the French version of the HSOPSC questionnaire.ResultsThe most developed dimension of the culture of patient safety was found to be Teamwork within Units (69%), followed by Supervisor/Manager’s Expectations & Actions Promoting Patient Safety (59%). The least developed dimensions were Staffing (34%) and Nonpunitive Response to Errors (37%).ConclusionImproving patient safety culture should be a priority for primary healthcare facility administrators and all stakeholders, addressing, in particular, the shortage of human resources. In addition, health personnel should be encouraged to report errors without fear of punitive consequences.

Văn hoá an toàn người bệnh và một số yếu tố ảnh hưởng tại Bệnh viện Phạm Ngọc Thạch, Thành phố Hồ Chí Minh năm 2023

Objective: To measure patient safety culture and some factors influence in 12 areas relating to patient care in Pham Ngoc Thach Hospital. Methods: Cross-sectional research. The Hospital Survey on Patient Safety Culture (HSOPSC) questionnaire of the Agency of Healthcare Research and Quality (AHRQ) version Vietnamese was used in this survey. All medical staff working in the Pham Ngoc Thach Hospital were asked to complete the questionnaire. We employed the software Stata 16.0 and Microsoft Excel 2010 to perform the statistical analysis of the survey data. Average positive response rate in 12 patient safety culture dimensions in Pham Ngoc Thach Hospital was 75%, higher than in Taiwan (64%). Worthy of note were the high positive response rates observed in the following areas: Teamwork within units (94%), manager views and actions promoting patient safety (91%), management support for patient safety, learning-continuous improvement (89%), and feedback and communication about errors (85,6%). However, there were three areas that still received many negative responses and showed room for improvement such as handoff, transitions, staffing, and non-punitive response to errors. The survey in Pham Ngoc Thach Hospital which provides an overview of the patient safety culture in the hospital. Although most medical staff had positive responses regarding patient safety in many areas relating to patient care within their departments as well as in the whole hospital, but there were still areas that had a low positive response and needed to be improved.

Awareness of the culture of patient safety among medical staff in neurosurgery departments from Moldova

To improve outcomes for patients and prevent avoidable surgical errors, neurosurgeons must change the culture of patient safety. The purpose of the study was to explore the perception of Patient Safety Culture (PSC) and the factors influencing it among the staff in the neurosurgical departments from Republic of Moldova. Material and methods. A cross sectional study was conducted in neurosurgical departments using the Hospital Survey on Patient Safety Culture (HSOPSC). Descriptive statistics were carried out, comprised the Cronbach “α” coefficient, frequency of positive answers (PPRs), level of minimum and maximum of 95% confidential interval, F. Galton correlation coefficient, Kendall rank coefficient, Harrington scale. Results. Medical staff from neurosurgical departments from five hospitals voluntarily participated in the study n=345. Most of the respondents rated the patient’s safety grade as “excellent” and “very good”. The value of the frequency of positive responses to the dimensions of the survey varies between 37.3% (CI 95% [34.8-39.9]) (staffing) and 85.0% (CI.95% [83.1-86.9]) (teamwork within units). The dimensions with the highest score of the PPRs stand out: „teamwork within units”, „organizational learning- continuous improvement” and „supervisor/manager expectations and actions promoting patient safety”. Analyzing the effect of the influence of patient safety culture factors on the degree of patient safety appreciated by the staff, we notice that the dimensions with the greatest influence are “Feedback and Communication About Error”, “Teamwork Across Units”, “Management Support for Patient Safety”, “Handoffs and transitions”, “Communication openness”. We found significant correlations among patient safety culture composites with the degree of patient safety with differences in the strength of the correlation. Conclusions. The results reflected the positive attitude of the staff towards most composites of the patient safety culture. The study made it possible to highlight the strong and vulnerable points of the patient safety culture and the factors influencing the patient safety degree in neurosurgical departments from Moldova.

The challenges and opportunities of patient safety culture in neurosurgical departments from the Republic of Moldova

Neurosurgery is a high-risk speciality, so the Patient Safety Culture should become a priority to improve patient safety and the quality of medical care. The purpose of the study was to explore the perception of Patient Safety Culture (PSC) among the staff in the neurosurgical departments of the Republic of Moldova.
 A cross-sectional study was conducted in neurosurgical departments using the Hospital Survey on Patient Safety Culture (HSOPSC). Descriptive statistics were carried out, comprising the Cronbach "?" coefficient, frequency of positive answers (PPRs), and level of minimum and maximum of 95% confidential interval. PPRs by question and dimension were analysed overall and classified according to the Harrington scale.
 Medical staff from five hospitals voluntarily participated in the study. Most of the respondents rated the patient's safety grade as excellent and very good. The value of the frequency of positive responses to the dimensions of the survey varies between 37.3% (nonpunitive response to error) and 85.0% (teamwork within units). The dimensions with the highest score of the PPRs stand out: „teamwork within units”, „organizational learning- continuous improvement” and „supervisor/manager expectations and actions promoting patient safety”. The dimension with a high score of PPRs was „feedback and communication about error”. The dimensions with a satisfactory score of the PPRs were „handoffs and transitions”, „frequency of events reported”, „management support for patient safety”, „teamwork across units”, „communication openness”, „overall perceptions on patient safety”, „non-punitive response to errors” and „staffing”.
 For the first time in the Republic of Moldova, the perception of patient safety culture in neurosurgery departments was studied. The results reflect the positive attitude of the staff towards most dimensions of the patient safety culture. The study made it possible to highlight the strong and vulnerable points of the patient safety culture in neurosurgical departments from Moldova.

Patient safety culture in a COVID-19 ICU compared to a clinical-surgical ICU in the Brazilian Eastern Amazon: A cross-sectional study.

The COVID-19 pandemic highlighted the need for a new dynamic in the organization and practices of health services, as it required rapid restructuring to promote safe and harm-free assistance. To assess the dimensions of the patient safety culture (PSC) from the perspective of the health team professionals in clinical-surgical ICU (G1) compared to a COVID-19 ICU (G2). Cross-sectional, analytical, descriptive and inferential study, using the "Hospital Survey on Patient Safety Culture" questionnaire. The domain "Supervisor/Manager Expectations and Actions Promoting Patient Safety (PS)" was a potential weakness for G1 (p =0.003). G2 was most positive on improving PS, being informed about errors, considering PS as a top priority to management, and that the units work together to provide the best care (p >0.05). G1 was most negative about the work culture with staff from other units, exchange of information across units, and shift changes (p >0.05). The highest PS grade was related to greater communication, and a smaller frequency of events was reported only for G2 (p >0.05). There must be a balance in terms of attention focused on PS between different ICUs in times of crisis, especially regarding the supervisors/managers actions.

Nurses' perceptions about patient safety culture in public hospital in Vietnam

AimThis paper is aimed to assess nurses' perceptions of patient safety culture in four public general hospitals in Hanoi, Vietnam. BackgroundPatient safety culture is a vital component in ensuring high quality and safe patient care. Assessment of nurses' perceptions on existing hospital patient safety culture (PSC) is the first step to promote PSC. MethodsThe cross-sectional study surveyed 705 nurses utilizing the validated Hospital Survey on Patient Safety Culture (HSOPSC) in an online format. ResultsThe average positive response rate was high at 72.8 % and varied from 52.9 % to 93.4 %. The strongest areas are teamwork within units (93.7 %) and supervisor/manager expectations and actions promoting patient safety (85.0 %). The areas for improvement are staffing (52.9 %) and non-punitive response to error (57.6 %). The communication openness, staffing, frequency of events reported, lengths of services in hospital and unit are significant factors that predict the overall patient safety grade. ConclusionsInitiatives are necessary to improve response to errors, staffing, and error reporting. Nurse managers could develop and implement interventions and program to improve patient safety, including providing education related to patient safety culture, encouraging staff to notify incidents and avoiding punitive responses.

Factors affecting patient safety culture in a university hospital under the universal health insurance system: A cross-sectional study from Japan.

We conducted a cross-sectional study of patient safety culture aimed at examining the factors that influence patient safety culture in university hospitals under a universal health insurance system. The Hospital Survey on Patient Safety Culture developed by the Agency for Healthcare Research and Quality was used. The survey was distributed to 1066 hospital employees, and 864 responded. The confirmatory factor analysis showed a good fit of the results to the 12-composites model. The highest positive response rates were for "(1) Teamwork within units" (81%) and "(2) Supervisor/manager expectations and actions promoting patient safety" (80%), and the lowest was for "(10) Staffing" (36%). Hayashi's quantification theory type 2 revealed that working hours per week had the greatest negative impact on patient safety culture. Under a universal health insurance system, workload and human resources might have a significant impact on the patient safety culture.

The relationship between patient safety culture and patient safety competency with adverse events: a multicenter cross-sectional study

BackgroundPatient safety culture and patient safety competency could be associated with adverse events (AEs). This study aimed to investigate the associations between nurses’ perceptions of patient safety culture, patient safety competency, and AEs.MethodsA cross-sectional study was carried out among 338 nurses employed in three university hospitals in Qom, Iran between 17 August 2021 and 12 November 2021. Data were collected using three questionnaires: patient safety culture, patient safety competency, and AEs. Data were analyzed using SPSS-21 software. A multiple logistic regression model was used to analyze the data.ResultsThe results of this study showed that medication errors were significantly associated with “frequency of events reported” (OR = 0.706, P = 0.012), “supervisor/manager expectations and actions promoting patient safety” (OR = 0.733, P = 0.048), and “management support for patient safety” (OR = 0.755, P = 0.012). Pressure ulcers were significantly associated with “supervisor/manager expectations and actions promoting patient safety” (OR = 0.729, P = 0.039), “handoffs and transition” (OR = 0.707, P = 0.034), and “comfort speaking up about patient safety” (OR = 0.614, P = 0.016). Falls were significantly associated with “teamwork within units” (OR = 0.735, P = 0.031), “feedback and communication about error” (OR = 0.756, P = 0.046), and “handoffs and transition” (OR = 0.660, P = 0.012). The use of restraints for ≥8 hr. was significantly associated with “management support for patient safety” (OR = 0.701, P = 0.021).ConclusionsAccording to the results of this study, AEs are associated with some dimensions of patient safety culture and patient safety competency. Further research is needed to confirm these findings and identify interventions to reduce the occurrence of AEs.

Psychometric Properties of the Hospital Survey of Patient Safety Culture in Type A Hospitals in Kingston and St. Andrew, Jamaica

This study sought to examine the internal consistency reliability and underlying factor structure of the Agency of Health Research on Quality Hospital Survey on Patient Safety Culture (AHRQ HSOPSC) in two large acute care hospitals in a developing country setting (Jamaica). A cross-sectional study was done among 328 doctors and nurses. Reliability (internal consistency) analysis was done for each of the 12 composites and the Cronbach’s Alpha coefficients were reported. Principal axis factor analysis (PA) using Varimax rotation was done to identify the underlying factor structure. The Cronbach’s Alpha coefficient was ≥ 0.60 in ten composites. ‘Overall perception of patient safety’ and ‘staffing’ had Cronbach’s Alpha values of 0.585 and 0.553 respectively. A ten-factor solution (34 items) with factor loading of ≥ 0.40 is the best model fit, and composites are now named ‘handoff and transitions/information exchange,’ ‘communication/feedback,’ ‘frequency of events reported,’ ‘management support for patient safety,’ ‘teamwork in unit,’ ‘non-punitive response to errors,’ ‘overall perception of patient safety,’ ‘supervision/management expectations and actions promoting patient safety,’ ‘organizational learning - continuous improvement’ and ‘staffing’. The AHRQ HSOPSC is generally reliable in this developing country setting and the ten-factor structure is consistent with suggested modifications for the emergent AHRQ HSOPSC Version 2 tool.

Assessment of Patient Safety Culture in Primary Healthcare Services in Alexandria, Egypt

Background: Patient safety is a critical component of healthcare quality. This study aimed at assessing the perceptions of primary healthcare staff members about patient safety culture and explores the areas of deficiency and opportunities for improvement concerning this issue.
 Methods: This descriptive cross sectional study surveyed 328 staff members in 28 primary healthcare facilities in Alexandria using an anonymous direct structured interview format of a modified “Hospital Survey on Patient Safety Culture” adopted questionnaire. The total number of respondents was 250 participants (response rate = 76.2%). The main outcome measures include patient safety culture score including sub scores on 12 dimensions and 42 items; patient safety grade, number of events reported and factors contributing to the adverse events.
 Results: The overall median% score for perception of patient safety culture at the facility level was 68.6%. After controlling of the confounders; being female respondent, being physicians or nurses or midwives, having long experience in PHC service and receiving education and training about safety issues were positively associated with positive response on patient safety culture scale. The domains with the highest positive score and are thus considered areas of strength were teamwork within units (80.0%), management support for patient safety (80.0%), supervisor expectations and actions promoting patient safety (75.0%) and handoffs and transitions (75.0%). Dimensions scoring the lowest and as such can be considered areas requiring improvement were overall perceptions of patient safety, frequency of events reported and staffing (60% give positive response for each). More than two-fifths (43.6%) did not report any events in the 12 months preceding the survey. The difference between professions regarding the most common procedure that causes adverse event is statistically significant. Patients' related factors such as ignorance and socio cultural acceptance were reported to be the most common factors contributing to the adverse events (92.4% of the studied participants reported that).
 Conclusions: Improving patient safety culture should be a priority among health center administrators. Healthcare staff should be encouraged to report errors

Perceptions of patient safety culture among healthcare professionals in Ministry of Health hospitals in Eastern Province of Saudi Arabia

Healthcare Organizations (HCOs) give due importance to the quality and safety of their services by incorporating a strong Patient Safety Culture (PSC) among employees. Accordingly, this study adopted a cross-sectional study design to reveal the perception of HCPs towards PSC in the selected Ministry of Health (MOH) hospitals of Eastern Province, Saudi Arabia. The sample consisted of 781 HCPs, including 221 nurses, 216 doctors, 198 other clinical staff, and 146 administrative staff were administered with the Hospital Survey on Patient Safety Culture (HSOPSC) questionnaire. The data collected from the samples were subjected to suitable statistical analysis. The results showed that the overall composite positive score for all the 12 PSC dimensions was 67%. In addition, 79% of the HCPs graded the overall patient safety in MOH hospitals as “excellent” or “very good”. More nurses have graded the overall patient safety as “excellent” or “very good” than physicians, other clinical staff, and administrative staff. Among PSC dimensions, “Teamwork within units” was the strength of the selected MOH hospitals, though communication openness, handoffs and transitions, staffing, and non-punitive response to error were identified as weaknesses. There was a significant difference between the four job categories of HCPs' perception regarding the PSC dimensions, viz. Supervisor/Manager Expectations & Actions Promoting Patient Safety, Staffing, Communication Openness, and Overall Perception of Patient Safety (p < 0.05). This study uncovers the strengths and weaknesses of the selected MOH hospitals concerning their PSC from HCPs outlooks, thereby helping them take the necessary initiatives to improve and sustain patient safety.

Concern for Patient Safety Culture of ECMO Team in Emergency Department: A Cross-Sectional Survey.

To evaluate the patient safety culture status of the ECMO team in the emergency department of a tertiary care hospital. A cross-sectional survey was conducted in the emergency department of Xiangya Hospital from September 1st to 30th, 2021. The Chinese version of HSOPSC electronic questionnaire was administered to all staff involved in ECMO management and initiation. A total of 152 ECMO team members completed the survey. Among the 12 dimensions of patient safety culture, 4 dimensions recorded relatively high positive response rates (>50%): organizational learning-continuous improvement (87.1%), teamwork within units (86.8%), feedback and communication about errors (58.5%), and supervisor/manager expectations and actions promoting patient safety (55.6%). 8 dimensions recorded relatively low positive response rates (<50%): nonpunitive responses to errors (24.1%), hospital handoffs and transitions (27.1%), staffing (28.6%), the frequency of event reporting (32.4%), teamwork across units (33.2%), communication openness (39.7%), management support for patient safety (48.7%), and overall perceptions of patient safety (49.3%). The overall level of patient safety culture was measured at 47.6%. The ECMO team should immediately address issues of nonpunitive responses to errors, hospital handoffs and transitions, and staffing to improve the safety of ECMO. Going forward, the head of the ECMO team should regard patient safety culture as a top priority, improve staff satisfaction, standardize the transfer and handover process, and create a blame-free environment to facilitate event reporting.

Patient safety culture: a survey of private sector tertiary care hospital of Lahore, Pakistan

Patient safety is a critical component to improving healthcare quality. Due to the potential of growing recognition and importance of establishing a patient safety culture within healthcare organizations, assessing existing patient safety culture is a prerequisite. Despite a vital role in delivering quality care, little attention has been given to describe healthcare professionals' perceptions and expectations of the patient safety culture in Pakistan. Objective:The current study aimed to assess the patient safety culture at a private tertiary hospital in Lahore from the perspectives of doctors and nurses. Methods: This cross-sectional study collected data from 120 nurses and doctors of the private hospital using the Hospital Survey of Patient Safety Culture (HSOPSC).The respondent's demographic characteristics and study variables influencing patient safety culture were presented through descriptive statistics, and a chi-square test was applied to identify the variable influencing patient safety.Results: The current study outcomes revealed a positive score for different dimensions ranging from 32.1% to 86.5%. The dimension of organizational learning-continuous improvement (86.5%) and teamwork within units (81.7%) had the highest scores as compared to teamwork across units (74.7%), feedback and communication about the error (73.7%), management support for patient safety (71.6%), supervisor/ manager expectations and actions promoting patient safety (69.8%), communication openness (65.4%), overall perceptions of patient safety (62%), frequency of events reported (53.7%), handoffs and transitions (49.9%), staffing (33.3%) and non-punitive response to errors (32.1%).Conclusion: The current study's findings highlighted a less positive attitude of doctors and nurses towards patient safety culture within their organizations. The outcomes of the present study could be used for designing and establishing interventions to improve patient safety practices in similar tertiary care settings across Pakistan.

Perceptions of Staff Nurses about Patient Safety Culture at Minia General Hospital

Background: Since worries about not harming patients have gotten more attention in recent years, patient has become a key healthcare priority. Numerous studies have found that adverse outcomes are more likely to occur in general healthcare settings. Aim: the current aim is to assess perceptions of staff nurses about patient culture at Minia General Hospital. Research design: Descriptive cross-sectional research design. Setting: The study was conducted in Minia General Hospital, at Minia city, Egypt. Subjects: conveniencesampleincluded all available staff nurses during data collection in Minia General Hospital(no. =280). Tool of data collection: one tool was used Patient Safety Culture. Results: the study showed that the highest percentage of staff nurses have high total scores regarding patient culture for the dimensions feedback and communication about error, frequency of event reporting teamwork within units and organizational learning continuous improvement. Also, the study showed that the lowest dimensions from the staff nurses perception were for supervisor manager expectations and actions promoting patient safety; perceptions of patient safety staffing; and teamwork across hospital units. Conclusion: the results indicated that the overall perception of staff nurses regarding patient culture in the hospital were moderate. Recommendation: Nurses should be encouraged to participate and foster the patient activities and communication channels in order to maintain regulation

Rapid Response System Restructure: Focus on Prevention and Early Intervention.

This article describes the staged restructure of the rapid response program into a dedicated 24/7 proactive rapid response system in a quaternary academic medical center in the southern United States. Rapid response nurses (RRNs) completed clinical leadership training on artificial intelligence, electronic risk stratification alerts, expert nurse rounding, emergency response, teamwork, closed-loop communication, and outcome measurement. The program goal was to reduce preventable deaths and resuscitation events outside the intensive care unit (ICU). Program outcomes between 2017 and 2019 included a 65% decrease in cardiac arrests outside the ICU, a 27% decrease of cardiac arrests inside the ICU, a 4.7% decrease in patients admitted to the ICU from inpatient beds, and a 27% reduction in the risk-adjusted mortality index for patients with expert proactive rounding encounters. Hospital peer group ranking on the Hospital Survey of Patient Safety improved in the areas of events reported, actions promoting patient safety, and continuous improvement suggesting a positive cultural shift. Implementation of a dedicated 24/7 RRN model of care integrating proactive rounding, technology, and ART can improve outcomes for patients and staff.

Patient Safety Culture: From Perception to Assessment

<p style="text-align: justify;"><strong>Introduction:</strong> The patient safety culture constitutes the basis for the development of safe processes and better outcomes for the patients, as it favors the implementation of safe practices. <strong>Objectives: </strong>The present study aims to assess the patient safety culture in the perception of a multidisciplinary team. <strong>Methods:</strong> This was a quantitative and qualitative cross-sectional study with 284 professionals who answered the Hospital Survey on Patient Safety Culture questionnaire adapted to Brazil, which measures 12 safety culture dimensions. The reliability of the instrument was verified by the Cronbach&rsquo;s Alpha coefficient. The dependent variables were the percentages of positive answers to estimate strengths and weaknesses in each dimension. EpiData 3.1, the Stata 14.2 software and IRAMUTEQ 0.7.2.0 were used for data processing. <strong>Results: </strong>The dimensions best assessed were &ldquo;Supervisor/Manager expectations and actions promoting patient safety&rdquo; (68.0%) and &ldquo;Organizational learning and continuous improvement&rdquo; (67.0%). The aspects requiring improvements were &ldquo;Non-punitive response to error&rdquo; (20.0%) and &ldquo;Staffing&rdquo; (31.0%). Other organizational weaknesses were identified from the comments regarding infrastructure, work processes and management support, which can have repercussions in the adoption of the safe practices. In this study, Cronbach&rsquo;s Alpha presented a global value of 0.60. The &ldquo;time working in the profession&rdquo; variable (<em>p</em>-value = 0.033) presented an association with the &ldquo;overall patient safety grade&rdquo;; whereas &ldquo;age&rdquo; (<em>p</em> = 0.004) was associated with &ldquo;number of adverse events in the last year&rdquo;. <strong>Conclusion: </strong>The findings indicate the need for changes in the patient safety culture and in organizational management. <p style="text-align: justify;"><strong>Key words: </strong>Patient Safety, Organizational Culture, Attitudes and Practice in Health, Quality of Health Care, Hospital Services.

Assessment of Patient Safety Culture in a Pediatric Department.

BackgroundAn assessment of the prevalent culture needs to be the first step when building patient safety programs in healthcare organizations to achieve high-quality health care.ObjectiveTo conduct a baseline assessment of patient safety culture, to provide insight into the factors that contribute to patient safety, and to use the information to make improvements. MethodsThe Hospital Survey on Patient Safety Culture (PSC) questionnaire was conducted from October through December 2020 at the Brookdale Hospital Medical Center (BHMC) Pediatric departments (Pediatric Inpatient Unit, Neonatal Intensive Care Unit [NICU], Pediatric Intensive Care Unit [PICU], and Pediatric Emergency Department) and four community-based ambulatory pediatric practices (Brookdale Family Care Centers [BFCC]). The percentages of positive responses on the 12 patient-safety dimensions and the summation of PSC and two outcomes (overall patient safety grade and adverse events reported in the past year) were assessed. Factors associated with PSC aggregate score were analyzed.ResultsFrom the 385 emails that were sent, 136 surveys were considered for analysis. This gives us a response rate of 35.3%. Most of the participants were nurses (58%) with direct contact with patients (94.2%). Most respondents did not report any events (60.7%), whereas 30.3% reported 1-2 events in the past year. The patient safety composites with the highest positive scores were teamwork within units (78%), supervisor/manager expectations and actions promoting patient safety (71.2%), and organizational learning--continuous improvement (66.8%). The composites with the lowest scores were non-punitive response to error (35.9%) and staffing (38%).ConclusionsAll of our composite measures, with the exception of teamwork within units, appear to be low, which means that all the other composite measures require interventions for improvement of overall safety culture. In order for healthcare leaders and policymakers to establish a culture of safety and improvement, they must create a climate of open communication, continuous learning, and eliminate the fear of blame and punitive feedback.

Patient safety culture from the perspective of nursing technicians of an emergency sector

Objective: to characterize the culture of patient safety from the perspective of nursing technicians of an emergency sector. Methods: cross-sectional study, developed in the emergency sector of a state hospital with 175 nursing technicians, from a 12-dimensional instrument on safety culture. The analysis of the data made based on the percentages of positive, negative and neutral responses of each dimension. Results: the culture of patient safety was characterized positively from the dimension Expectations about its supervisor/head and actions promoting patient safety (56.6%); negatively in the sphere Adequacy of professionals (75.5%); and in a neutral way, in the scope of Organizational Learning - continuous improvement (61.1%). Conclusion: it was understood that nursing technicians characterize the culture of patient safety in the emergency sector as an important aspect of the work environment, but that it needs to be optimized.

Factors Influencing Patient Safety Culture in Saudi Arabia: A Systematic Review

ABSTRACT&#x0D; Context: Patient safety, which is concerned with preventing harm to patients, has already become a vital element of the global healthcare system. The evidence relating to the status of the patient safety culture in Arab countries suggests that it is at a sub-optimal level because of a punitive approach to errors and deficits in communications openness.&#x0D; Aim: The given review aimed to identify the relevant evidence related to factors influencing patient safety culture in Saudi Arabia hospitals from patients and health care provider perspectives.&#x0D; Methods: A systematic search was conducted in five electronic databases—MEDLINE, CINAHL, Embase, PsycINFO, and the Cochrane Database of Systematic Reviews. Related papers and reference lists of included studies were also hand-searched. One reviewer verified that the research met the inclusion criteria, assessed the research quality, and extracted their relevant features. The Yorkshire Contributory Factors Model (YCFF) was used to categorize factors influencing safety culture in the included documents.&#x0D; Results: 14 documents were included, and most research was appraised as being satisfactory to high quality. Strength and weakness factors that are influencing patient safety culture have been identified. In Saudi Arabia, ineffective leadership, a blame culture, workload/inadequate staffing, and poor communication are key factors hindering a positive patient safety culture. Conversely, 'strength' factors influencing a positive patient safety culture included good teamwork within units, realistic manager expectations and supportive actions promoting patient safety, and organizational attitudes to learning/continuous improvement. There is an absence of patient perspectives about patient safety culture in Saudi Arabian studies.&#x0D; Conclusion: In the Saudi healthcare system, policymakers should pay attention to factors that may influence a positive patient safety culture, particularly the development of a blame-free culture, improving communications and leadership ability, learning from mistakes, and involving patient perspectives in safety initiatives. Further study must understand the barriers and facilitators in Saudi Arabia Hospitals to implement a positive patient safety culture.

The association between self-reported workload and perceptions of patient safety culture: A study of intensive care unit nurses.

This study aimed to examine the association between workload and patient safety culture (PSC) among intensive care unit (ICU) nurses. ICU nurses play a vital role in promoting patient safety and are essential indicators in any healthcare system including ICUs. Research studies focusing on the relationship between nursing workload and PSC among ICU nurses are limited. Descriptive correlational design. The study participants involved 380 ICU nurses at two hospitals in Riyadh, Saudi Arabia. Data were collected between February 2019-April 2019 and were analysed using SPSS v.22 statistical software. This study was guided by the STROBE checklist. The results showed that ICU nurses have high positive perceptions in the following PSC subscales: teamwork within units, organisational learning-continuous improvement, frequency of events reported, feedback and communication about error, management support for patient safety, teamwork across units, supervisor/manager expectations and actions promoting patient safety, handoffs and transitions, nonpunitive response to errors, staffing and overall perceptions of patient safety. However, the participants collectively considered the overall grade on patient safety as poor. The participants had high mean scores in physical demand, effort, mental demand and overall workload. A statistically significant variability existed in the mean scores of the PSC subscales and workload of ICU nurses. The overall workload was significantly and negatively associated with the PSC perceptions of ICU nurses. The ICU nurses experienced high overall workload, physical demand, effort and mental demand which influenced the poor grade of their overall perceived PSC. Identifying differences and associations with the perceptions of ICU nurses regarding workload and PSC is important because such perceptions may affect their delivery of nursing care. Hospital and nursing administrators must use the study results to find strategies that address workload issues and enhance patient safety.