Care Hospital Setting Research Articles

(Re)conceptualising Good Care in Hospital Settings From the Perspectives of Older Persons: A Concept Analysis Using Pragmatic Utility.

To understand good care from the perspective of hospitalised older persons. Older persons are the largest group of hospital users, and numbers will increase in the next decades. Hospital organisations are attempting to transform traditional care models to meet the specialised needs of hospitalised older persons. To achieve this, healthcare providers including nurses and administrators need to understand the perspectives of hospitalised older persons on what constitutes good care. This knowledge is critical to nursing to ensure that care aligns with the perceived needs of hospitalised older persons. However, good care from the viewpoints of hospitalised older persons remains ambiguous and poorly delineated in the literature. We conducted a concept analysis using the pragmatic utility method. To identify peer-reviewed articles, we searched CINAHL, MedLine, PsycINFO, Scopus and Embase databases for related literature using the keywords and related terms to 'good care', 'hospital or acute care' and 'older persons'. Twenty-two peer-reviewed articles out of 2144 search results were included. The heterogeneity of older persons' perspectives and limitations in the literature on good care led to a tentative understanding. Good care, a partially mature concept, is the provision of person-centred, culturally sensitive, holistic and integrated care that fosters autonomy, control and participation, resulting in a sense of belonging, smooth transitions, optimal management of clinical conditions, satisfaction in care and informed older persons and family caregivers. Older persons are a heterogeneous group with diverse perceptions of good care. Instead of seeking a common understanding of good care, efforts should be focused on identifying individual preferences, values and goals of hospitalised older persons. The components of good care are important for many hospitalised older persons and can serve as a starting point for improvements in practice settings. However, this understanding is tentative and may overlook critical aspects of care at an individual level. Hospital organisations, healthcare providers and nurses should be cognizant of this limitation and cultivate adaptability for an individualised approach to care.

The identification, referral and management of patients with cardiac-related distress: a new model to support psychological recovery after a cardiac event

Abstract Background Identification, referral and management of patients with psychological distress is an important component of cardiac rehabilitation (CR). We developed a protocol to identify patients in hospital, CR and primary care settings, and refer them to a specialist psychocardiology clinic. Using the newly developed Cardiac Distress Inventory (CDI), we demonstrated that counselling resulted in reduced rates of cardiac-related distress. This study demonstrates the importance of having a clear pathway from screening to referral to intervention to support cardiac patients in their recovery. Purpose The team identified a dearth of high-quality research on distress in cardiac patients, including a lack of data on the resolution of cardiac-related distress after psychotherapeutic intervention. This was due to the lack of appropriate measurement of cardiac distress, and the absence of clear pathways for identification, referral and management of cardiac distress. Methods The Cardiac Emotions Study is a multi-site, multi-component study of cardiac-related distress. The team first developed the 55-item Cardiac Distress Inventory (CDI), a comprehensive clinical assessment tool. A brief screening version, the 12-item Cardiac Distress Inventory Short Form (CDI-SF), was then developed. Patients referred to the specialist psychocardiology clinic over a 6-month period (N=113) were administered the CDI-SF, together with the Generalised Anxiety Disorder 7 (GAD7) and the Patient Health Questionnaire (PHQ9), with all measures re-administered at discharge. Results More than half the clients presented to the Clinic within the first 3 months post-event (58%), while 84% presented within the first year. At presentation, over half the clients were anxious (GAD7>10; 53%), depressed (PHQ9>10; 57%), or distressed (CDI-SF>13; 56.4%). Levels of particular aspects of cardiac distress are shown in the Figure. On completion of counselling, distress had resolved for the majority of clients, with the distress rate of 18.6% at discharge equivalent to that seen in a normative sample of cardiac patients. Rates of anxiety and depression also significantly decreased after counselling. Conclusion This study demonstrated that distressed cardiac patients could be appropriately identified in settings such as hospital, CR and primary care and referred for counselling, and that counselling resulted in significant reductions in rates of cardiac distress, anxiety and depression. Undergoing counselling through a specialist psychocardiology clinic assisted clients in obtaining normative rates of post-cardiac event distress. The analysis showed the necessity of having a clear clinical pathway from screening to psychological treatment, and the utility of having a validated measure of cardiac distress that is sensitive to change after intervention.

Symptom- and function-based trajectories of patients with dementia in hospital and community palliative care settings in the last two weeks of life: a retrospective cohort study

BackgroundThe prevalence of dementia is increasing worldwide and many people with the condition require some level of palliative care. However, the trajectories of function and symptom burden in palliative care services at the end of life remain unclear. This study aimed to describe and compare the longitudinal trajectories of function and symptom burden among patients with dementia between hospital versus palliative community care services in the last two weeks of life.MethodsA retrospective cohort study used data from the Australian Palliative Care Outcomes Collaboration. Patients with dementia who died between 1 January 2013 and 31 December 2020 from the Australian Palliative Care Outcomes Collaboration. Four validated clinical instruments were used to collect outcomes on each individual’s function and symptom distress and severity. Multilevel models were used to estimate the differences in clinical trajectories between hospital and community-based palliative care in the last two weeks of life.ResultsPatients with dementia tended to have low levels of distress for most symptoms but increasing levels of functional impairment. There were no or only marginally significant differences in the symptom trajectories between the community and hospital groups (OR ranged from 0.57 to 1.97). Although clinical trajectories of function were relatively similar between two groups, statistically higher functional indicators were observed for people when admitted to community palliative care services (OR = 0.42 and 2.27, respectively).ConclusionsOur findings suggest that community-based palliative care services can be as effective as hospital-based care for many patients with dementia nearing the end of life. With appropriate support for families, community-based care could serve as a viable alternative to hospital-based care for some patients in the final stages of dementia.

Implementation of Regulations and Policies for Nursing Care Quality in Hospitals Worldwide

This systematic review examines the global implementation of regulations and policies aimed at enhancing the quality of nursing care in hospital settings. Through a comprehensive literature search, 20 studies were identified and analyzed. The review focuses on various regulatory frameworks, accreditation standards, and governmental policies that influence nursing care quality. The findings reveal that while regulations generally improve patient outcomes and care standards, challenges such as resource limitations, enforcement variability, and cultural resistance persist. The review concludes with recommendations for future research and policy development to address these challenges and improve nursing care quality globally.

Effects of States' Methods for Estimating Nonfatal Overdose, United States, 2021.

Previous nonfatal overdose is a key risk factor for drug overdose death; however, current nonfatal overdose surveillance is limited to people who receive medical attention. We identified states that tracked nonfatal overdoses treated in prehospital and hospital care settings, assessed the effects of different surveillance methods on the magnitude of nonfatal overdose estimates, and estimated states' nonfatal-to-fatal overdose ratio. Two analysts independently reviewed state websites to characterize states' methods of capturing nonfatal overdose events from December 2022 through February 2023. We collected information on surveillance methods in 5 states that met the inclusion criteria, including data source, measure specification, drug(s) involved, and whether states performed deduplication or published mutually exclusive measure specifications to capture unique events across care settings. We calculated nonfatal-to-fatal overdose ratios to assess the effects of different data sources on estimates of nonfatal overdoses. Illinois, Maine, North Carolina, and West Virginia used syndromic surveillance data and New Jersey used hospital discharge data to track nonfatal overdose-related emergency department visits. Illinois and West Virginia tracked nonfatal overdose-related encounters with emergency medical services. Other states tracked opioid overdoses reversed following naloxone administration by emergency medical services, law enforcement, and community members. Maine, New Jersey, and West Virginia published nonfatal overdose information by using mutually exclusive measure specifications; the number of nonfatal overdoses per fatal overdose in these states ranged from approximately 5:1 to 14:1. Establishing a standard framework to combine data from existing national surveillance systems in prehospital and hospital care settings can improve nonfatal overdose estimates and enable comparisons between jurisdictions to help decision makers identify areas most in need of essential services.

Why Do Physicians Prescribe Antibiotics? A Systematic Review of the Psycho-Socio-Organisational Factors Related to Potentially Inappropriate Prescribing of Antimicrobials in Europe.

Purpose: Effective antimicrobial use enhances care quality and combats antibiotic resistance. Yet, non-guideline factors influence potentially inappropriate prescribing. This study explores psycho-socio-organisational factors in antimicrobial prescribing as perceived by physicians across primary, secondary, and tertiary care. Methods: Adhering to PRISMA guidelines, a systematic review was conducted using PubMed and Scopus databases from 1 January 2000, to 8 March 2023, with an update search until 30 January 2024. Inclusion criteria focused on studies in Europe exploring psycho-socio-organisational factors for antibiotic prescribing from physicians' perspectives in hospital, inpatient, or primary care settings. Exclusion criteria targeted out-of-office prescriptions or low-quality studies. To evaluate the latter, several quality and risk-of-bias checklists were used. Data were extracted on study characteristics, study design, and methods and identified determinants of antibiotic prescribing. Data was analysed using a narrative synthesis method. Results: Among 8370 articles, 58 met inclusion criteria, yielding 35 articles from 23 countries. Three main themes emerged: personal, psychological, and organisational factors, encompassing seven determinants including work experience, knowledge, guideline adherence, uncertainty management, perceived pressure, time constraints, and diagnostic resource availability. Uncertainty management was key, with work experience and knowledge mitigating it. No additional factors emerged in the updated search. Conclusion: Enhanced uncertainty management decreases perceived patient and/or parental pressure to prescribe antibiotics, contributing to reducing potentially inappropriate prescribing (PIP). Therefore, it is imperative to educate physicians on effectively managing uncertainty. Interventions to improve antibiotic prescribing should be tailored to the specific needs and preferences of the different prescribing physicians.

Care settings of transient ischemic attack in the United States: A cohort study from the TriNetX health research network

BackgroundEvaluation and hospitalization rates after a transient ischemic attack (TIA)-like presentation vary widely in clinical practice. This study aimed to examine variations in care settings at initial TIA diagnosis in the United States. MethodsWe retrospectively analyzed an adult cohort with a first TIA principal diagnosis between January 1, 2015, and December 31, 2019, from TriNetX Diamond Network. Care settings at TIA diagnosis were defined as hospital care (including inpatient services and observation unit care without admission) and outpatient care (including any outpatient or emergency department visits). We estimated the distribution of care settings at TIA diagnosis and examined the associations of the hospital care setting with baseline age, sex, race, ethnicity, region, and stroke history. ResultsAmong the 554,315 included patients, 38.8% received hospital care at their initial TIA diagnosis. A higher percentage of hospital care was observed in the age group of 50-64 years (40.3%), Black (46.0%), Hispanic (41.2%), South (40.9%), and Midwest (43.0%) Regions, and with a history of stroke (39.6%). Multivariable logistic regression consistently showed patients who were aged 50-64 years (Odds Ratio=1.09, 95% CI: [1.07, 1.11]), Black (1.28, [1.24, 1.32]), Hispanic (1.13, [1.09, 1.18]), from South (1.20, [1.18, 1.22]) and Midwest Region (1.33, [1.30, 1.35]), and had a history of stroke (1.02, [1.00, 1.04]) to more likely receive hospital care. ConclusionsAlthough there are TIA care disparities based on demographics, most patients with initial TIA received acute care in outpatient settings. It is imperative to ensure primary providers can risk-stratify TIA patients and provide rapid and proper management.

Including 'Work as a Treatment Goal' in the Care for Patients with Chronic Diseases : The Development of a Generic Care Model-A Descriptive Study.

The Netherlands faces 60% prevalence of chronic conditions by 2040, impacting societal participation and quality of life. Current clinical care inadequately addresses these consequences, and most hospitals do not integrate occupational health in their care. To develop a generic person- and work-oriented medical care model (WMCM) based on real life experiences with work-oriented care and supporting the chronically ill in active societal participation. A qualitative research project with a participative approach in one hospital (November 2019 until March 2020). In an expert meeting, a schematic representation of a work-oriented care model was developed. Subsequent discussion rounds, with professionals from different patient groups, iteratively refined the model to a WMCM. Consensus was reached after seven rounds of discussion, defining the model's core elements (1) a combination of biomedical and biopsychosocial approaches, (2) involvement of a clinical occupational physician in the treatment team, (3) a coordinating role for nursing specialists, and (4) incorporation of a work-oriented intervention plan (WoIP) into the treatment plan. Advocating early attention to societal participation, the model emphasises the WoIP and consensus on monitoring indicators. The final goal is a sustainable return to societal participation, considering both quality of life and work. It is feasible to develop a generic person- and work-oriented care model for patients with chronic illness within a hospital care setting. Collaboration between healthcare professionals and a specialised occupational physician, with a central role for nurses, is deemed crucial.

Effectiveness of nirsevimab immunoprophylaxis against respiratory syncytial virus-related outcomes in hospital and primary care settings: a retrospective cohort study in infants in Catalonia (Spain)

BackgroundIn Catalonia, infants under 6 months old were eligible to receive nirsevimab, a novel monoclonal antibody against respiratory syncytial virus (RSV). We aimed to analyse nirsevimab’s effectiveness across primary and...

HIV and vicarious stigma in a cohort of people living with HIV in Italy: What happens when the stigma is fueled by healthcare providers?

ABSTRACT Vicarious stigma shows how indirect stigmatizing experiences can lead people living with HIV (PLWH) to feel discriminated against. We enrolled 350 PLWH, who were administered a 17-item questionnaire to investigate a subjective experience of stigma experienced in the hospital care setting. We found that at least once 215 PLWH (61.4%) did not want the HIV exemption indicated on the prescription for a specialist medical visit, 232 PLWH (66.3%) never used their HIV-related exemption to make a specialist medical visit, 230 PLWH (65.7%) avoided undergoing a medical assessment outside the infectious disease clinics and 241 patients (68.9%) felt unwelcome during a specialist medical visit. Moreover, 241 patients (61.1%) had heard at least once stories of health workers who did not want to touch PLWH, 213 patients (60.9%) had heard stories at least once of PLWH who had been mistreated by hospital staff, 180 patients (51.4%) had at least once heard stories about PLWH being refused treatment and services and 257 patients (73.4%) had at least once heard stories about health workers talking publicly about PLWH. This is a little explored area, especially regarding the vicarious stigma faced by PLWH. Our findings indicate the importance of combating HIV-related stigma for the wellbeing of PLWH.

Understanding moral distress among healthcare personnel in end-of-life care hospital settings

Understanding moral distress among healthcare personnel in end-of-life care hospital settings

Self-Efficacy with Anxiety Levels of Diabetes Mellitus Patients in Hospital Care Settings

Self-Efficacy with Anxiety Levels of Diabetes Mellitus Patients in Hospital Care Settings

HOSPITAL MANAGEMENT SYSTEM BASED ON WEB

Hospital Management Systems (HMS) represent a key advancement in healthcare technology designed to revolutionize operational efficiency, raise standards of patient care and ensure compliance with regulatory protocols. This paper explores the multifaceted functions of HMS, highlighting its role in automating administrative tasks, supporting real-time access to patient data, and facilitating seamless communication between healthcare professionals. Drawing on current research and practical implementations, we delve into the transformative potential of HMS, particularly in the context of recent innovations in telemedicine, data analytics, and remote monitoring systems. In our research, we present SIMRS, a robust hospital management information system developed using the waterfall method, strategically focused on the systematic improvement of hospital operations. By automating key processes such as patient registration, appointment scheduling, payment and inventory management, SIMRS optimizes hospital workflows and ultimately improves patient care delivery. In addition, we examine the empirical evidence that shows the significant impact of management systems and leadership traits on the quality of care in hospital settings, and highlight the indispensable role of effective leadership and management frameworks. Next, we discuss the technical foundations of HMS and highlight the integration of various programming languages and database management systems such as HTML, CSS, JavaScript, PHP, MySQL, and MongoDB. This cross-disciplinary approach underscores the synergy between technological innovation and healthcare management, paving the way for a more efficient patient- centered healthcare ecosystem. In summary, this research illuminates the transformative potential of HMS to revolutionize healthcare operations, improve patient outcomes and optimize resource allocation, advocating for its widespread adoption to shape the future of healthcare delivery. Key Words: JavaScript, MySql, HMS, Electronic Health Records, Telehealth

Environmental Health Practice and Quality of Nursing Care: A Protocol for Systematic Review

Objectives: To systematically synthesize studies that analyze the relationship between a healthy practice environment and quality of nursing care in hospital settings; to identify the most commonly used instruments to assess nurses’ perceptions of a healthy practice environment; to identify the most commonly used instruments to assess nurses’ perceptions of quality of nursing care. Method: A systematic literature review will be conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The literature search will be conducted in the principal databases. Review of international scientific articles published in the last ten years, accessed through the database of the Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, on nurses’ perceptions of the influence of the environment on healthy nursing practice and quality of care. Inclusion: Articles published after 2012 in Portuguese, Spanish, and English. The identified, selected, and included studies will be highlighted for the selection process using the Preferred Reporting Items for Systematic Review and Meta-Analyses Protocols (PRISMA-P). If possible, quantitative data will be pooled into a meta-analysis using the Joanna Briggs Institute (JBI) Meta-Analysis of Statistics Assessment and Review Instrument (MASTARI).

Multicomponent processes to identify and prioritise low-value care in hospital settings: a scoping review

ObjectivesThis scoping review mapped and synthesised original research that identified low-value care in hospital settings as part of multicomponent processes.DesignScoping review.Data sourcesElectronic databases (EMBASE, PubMed, CINAHL, PsycINFO and Cochrane CENTRAL)...

Venous Thromboembolism Risk and Prophylaxis in the Acute Hospital Care Settings in Oman: A National Multicenter Cross-sectional Study.

To evaluate the prevalence of risk for venous thromboembolism (VTE) and the proportion of at-risk patients who receive appropriate thromboprophylaxis among inpatients in acute hospital care settings in Oman. A related objective was to evaluate the type and time of initiation of VTE prophylaxis. This multicenter, cross-sectional study was conducted in three tertiary hospitals in Oman. The study included acutely ill medical and surgical inpatients admitted from August to September 2022. VTE risk assessment and prophylaxis were assessed based on the 2012 recommendations of the American College of Chest Physicians (ACCP). A total of 384 patients were enrolled, 240 were medical patients and 144 were surgical patients. As per the ACCP criteria, 179 (74.6%) of medical and 92 (63.9%) of surgical patients were at risk for VTE and required prophylaxis. Appropriate prophylaxis was received by 142 (79.3%) at-risk medical and 70 (76.1%) at-risk surgical patients. In cases where pharmacological prophylaxis was contraindicated, mechanical prophylaxis was markedly underused. For medical patients, the median day of initiating VTE prophylaxis was day one of admission. For surgical patients, the median day of initiating VTE prophylaxis was postoperative day one. The majority of hospitalized patients in Oman are at risk of VTE. However, a significant minority of patients do not receive the required pharmacological or mechanical prophylaxis. We recommend the development of a national VTE risk assessment and guiding tool with a facility for monitoring compliance.

Co-located Heroin Assisted Treatment within primary care: A preliminary analysis of the implications for healthcare access, cost, and treatment delivery in the UK

BackgroundThe UK is experiencing its highest rate of drug related deaths in 25 years. Poor and inconsistent access to healthcare negatively impacts health outcomes for people who use drugs. Innovation in models of care which promote access and availability of physical treatment is fundamental. Heroin Assisted Treatment (HAT) is a treatment modality targeted at the most marginalised people who use drugs, at high risk of mortality and morbidity. The first service-provider initiated HAT service in the UK ran between October 2019 and November 2022 in Middlesbrough, England. The service was co-located within a specialist primary care facility offering acute healthcare treatment alongside injectable diamorphine. MethodsAnalysis of anonymised health records for healthcare costs (not including drug treatment) took place using descriptive statistics prior and during engagement with HAT, at both three (n=15) and six (n=12) months. Primary outcome measures were incidents of wound care, skin and soft tissue infections (SSTIs), overdose (OD) events, unplanned overnight stays in hospital, treatment engagement (general and within hospital care settings) and ambulance incidents. Secondary outcome measures were costs associated with these events. ResultsA shift in healthcare access for participants during HAT engagement was observed. HAT service attendance appeared to support health promoting preventative care, and reduce reactive reliance on emergency healthcare systems. At three and six months, engagement for preventative wound care and treatment for SSTIs increased at the practice. Unplanned emergency healthcare interactions for ODs, overnight hospital stays, serious SSTIs, and ambulance incidents reduced, and there was an increase in treatment engagement (i.e. a reduction in appointments which were not engaged with). There was a decrease in treatment engagement in hospital settings. Changes in healthcare utilisation during HAT translated to a reduction in healthcare costs of 58% within six months compared to the same timeframe from the period directly prior to commencing HAT. ConclusionThis exploratory study highlights the potential for innovative harm reduction interventions such as HAT, co-located with primary care services, to improve healthcare access and engagement for a high-risk population. Increased uptake of primary healthcare services translated to reductions in emergency healthcare use and associated costs. Although costs of HAT provision are substantial, the notable cost-savings in health care should be an important consideration in service implementation planning.

Improving Best Practices in Assessing the Usage Conditions of Hospital and Long-Term Care Mattresses

Background: Inadequate mattresses can pose risks to users, and the routine inspection of mattresses often falls short in various healthcare settings. Objectives: To evaluate the physical condition of mattresses in hospitals and long-term care facilities and to explore the association with management practices regarding procurement, handling, and maintenance. Methods: This analytical descriptive cross-sectional study was conducted in 13 hospitals and 5 long-term care facilities, examining a total of 278 mattresses through proportional stratified sampling. The Mann-Whitney U test, Kruskal-Wallis test, and Multiple Regression Analysis were utilized for data analysis. Results: A mere 9.9% of the mattresses met the physical evaluation criteria, revealing a significant gap in mattress management standardization. The highest compliance was noted in the utilization of waterproof coverings, whereas the lowest was in mattress labeling. Factors significantly influencing the scores included the involvement of nurses in the evaluation process, periodic replacement of coverings, type of administration, assessment of mattress and covering integrity during bed making, and the nature of the institution. Conclusions: Due to inadequate physical conditions in both hospital and long-term care settings, the low approval rate of mattresses underscores the urgent need for standardized mattress management practices. Descriptors: Beds, Hospital Infection, Disinfection, Long-Term Care Facilities for the Elderly, Patient Safety.

Parental Satisfaction with Health Care During Child Hospitalization at Tertiary Care Hospital Karachi

Pediatric care in hospital settings necessitates a comprehensive approach that considers not only the medical needs of the child but also the satisfaction and involvement of their parents or guardians. Parental satisfaction with healthcare services during their child's hospitalization is crucial for shaping their overall experience and ensuring quality care. Objective: To assess the level of satisfaction among parents of pediatric patients receiving care at a tertiary care hospital in Karachi, Pakistan. Methods: A cross-sectional study was conducted at the National Institute of Child Health Hospital in Karachi from October to December 2023. A total of 50 parents or blood-related guardians actively caring for pediatric patients were included in the study. Data were collected using a structured questionnaire comprising socio-demographic information and a 20-item Likert scale to measure parental satisfaction. Statistical analysis was performed using SPSS version 26.0. Results: The statistical results indicate that 26% had low satisfaction 28% moderate and 46% had high parental satisfaction with health care during child hospitalization at a tertiary care hospital in Karachi. Conclusions: The stats show mixed feelings among parents about the healthcare during their child's hospital stay in a Karachi tertiary care hospital. While 46% were happy with the services, indicating a good experience, 26% weren't satisfied. Another 28% felt okay. This means improvements are needed to address the concerns of the dissatisfied group and enhance overall satisfaction levels.

Intern nursing students' perceptions of patient safety culture and their experiences with factors affecting the safety of care in hospital settings: A mixed method study

BackgroundPatient safety culture is a globally studied subject as it plays a significant role in preventing and reducing errors. There is limited mixed-method research into the in-depth investigation of intern nurses' views on patient safety in hospital settings and the factors affecting it. ObjectiveThis study was conducted to determine intern nursing students' perceptions of patient safety culture and their experiences with exploring factors affecting the safety of care in hospital settings. Design and methodsA convergent mixed-method design was used. The study group was selected using the purposive sampling method. STROBE and COREQ checklists were followed. The quantitative phase was descriptive and correlational, and the qualitative phase was phenomenological. Quantitative data were collected using a “Personal Information Form” and “Patient Safety Culture Scale” and qualitative data using a “Semi-Structured Interview Form.” Mean ± standard deviation, median (min-max), frequency, percentage values, Shapiro-Wilk, and Mann-Whitney U tests were employed to evaluate quantitative data. The inductive content analysis method was used to analyze qualitative data. Setting and participantsThe study consisted of intern nursing students from a university in the 2020–2021 academic year. The quantitative phase of the research was conducted with 38 and the qualitative phase with nine intern nursing students. In the qualitative phase, the saturation point was taken as a basis. ResultsIn the study, nursing students' perceptions of patient safety culture were high (3.24 ± 0.49; min = 1.88 and max = 4). The results of the qualitative data analysis indicated that the factors affecting patient safety in hospital settings consisted of three themes, namely “health professionals, care environment, and patients and caregivers” and nine subthemes. ConclusionsIntern nursing students had high perceptions of patient safety culture and had highly significant experiences with the factors affecting safe care in hospital settings.