Hospital Safety Culture Research Articles

NURSES’ PERCEPTION ON PATIENT SAFETY CULTURE IN CRITICAL CARE AREA AT A TERTIARY HOSPITAL IN PAHANG, MALAYSIA

Patient safety culture is important in measuring the quality of health care. There is a need for the establishment of patient safety culture in hospitals as it is one of the global issues that requires attention. Issues such as medication errors are the third leading cause of death in the US and approximately one in ten patients have been reported being harmed while receiving hospital treatment. Adverse events such as bed falls, adverse drug effects, infections, work overload and absenteeism have become the matters of risk for the patient’s safety. Nevertheless, research that is related to patient safety were less studied in the healthcare area especially dealing with ill patients in the Intensive Care Unit (ICU).

Relationship between Patient Safety Culture and Adverse Events in Hospital: A case study

Introduction: Patient safety culture is an important factor in reducing hospital's adverse event and improving patient safety. The aim of this study was to evaluate the relationship between patient safety culture and adverse events in hospitals of Hamadan city. Methods: The present study was a descriptive-analytical study which was performed in hospitals of Hamadan in 2018. The study population consisted of nurses working in hospitals. The patient safety culture questionnaire and adverse event checklist were used for data collection. Questionnaires were completed by 650 nurses. Multiple logistic regression was used to examine the relationship between the variables. Results: The highest mean score of patient safety culture was related to the dimension of organizational learning, and the lowest score was for exchange and transfer of information. 35.4 percent of nurses said they had seen at least one patient fall in the past year (the least adverse event). Moreover, 51.9 percent of nurses stated that at least one pressure ulcer, or a complaint by a patient or his/her family had happened at their workplace in the past year (the most adverse event). Finally, the mean score of the patient safety culture had a significant relationship with the incidence of adverse events. Conclusion: This study confirms the patient safety culture as a predictor of adverse events. Hence, health officials and hospital administrators should provide prerequisites for promoting patient safety culture and reducing adverse events through different strategies, such as encouraging adverse events reporting as well as holding nurse training courses. © 2020. All Rights Reserved.

Psychometric properties of the Georgian version of the Safety Attitudes Questionnaire: a cross-sectional study

ObjectiveTo study the psychometric properties of the Georgian version of the Safety Attitudes Questionnaire short version.DesignCross-sectional study.SettingThree Georgian hospitals.ParticipantsPersonnel of participating hospitals (n=305 responses, estimated response rate 30%).InterventionsNone.Primary and secondary...

Assessment of patient safety culture in benghazi children's hospital from the viewpoint of nursing staff

Assessment of patient safety culture in benghazi children's hospital from the viewpoint of nursing staff

Practice gaps and challenges to effective patient safety culture in a tertiary hospital in Nigeria

Background: Knowledge and experiences of inefficiencies, odds and difficulties in patient safety culture (PSC) maintenance in health-care systems can facilitate the development and implementation of better strategies. Objective: The aim is to determine the practice gaps and challenges to effective PSC in Nnamdi Azikiwe University Teaching Hospital, (NAUTH) Nnewi, Nigeria. Materials and Methods: This was a cross-sectional survey conducted from June to November 2016 in NAUTH Nnewi, Nigeria. Data were collected through mixed methods:-self-administered structured questionnaire survey (QS), focus group discussions (FGD) and key informant interviews (KII). Stratified sampling technique was used for the QS, while the convenience sampling technique. was employed in the FGD and KII. Data were analysed using the Statistical Package for the Social Sciences version 22. Results: Challenges to the effective promotion of PSC each relate to gaps in either poor staff strength or punitive response to the error report. The challenges reported from the FGD are lack of training and re-training programmes (61%), poor team spirit and low staff capacity (56%). From the KII >80% reported non-availability of PSC unit, patient safety committee, patient safety guideline/policy, nor standard operation procedure while (61%) reported that management effort to provide enabling patient safety environment was adequate. Conclusions: This study found challenges to effective PSCsuch as poor training, staff strength, team spirit cum communication, excessive work hours and fear of punitive response to the error report. This buttresses the need for urgent attention to these areas of weakness through awareness and educational programmes on PSC, adequate staffing and prompt information dissemination.

Patient safety culture in university hospital's emergency departments: A case study.

Improving patient safety culture in healthcare organization is the first step in reducing medical errors and improving patient safety. The aim of the study was to determine and to compare patient safety culture dimensions in emergency departments of selected educational hospitals of Kerman University of Medical Sciences. This descriptive-analytical study was conducted in 2018 in the emergency departments Shahid Bahonar, Afzalipour, Shahid Beheshti, and Shafa hospitals. Data collection was carried using the Hospital Survey of Patient Safety Culture questionnaire which includes 42 questions and 12 dimensions. Data were analyzed using descriptive and analytical statistics. The highest and lowest mean related to the organizational learning (3.96 ± 0.34) and handoffs and transitions (2.27 ± 0.55). According to independent t test, there was a significant relationship between nurse's gender and patient safety culture. Also, according to analysis of variance test, there was a significant relationship between work experience and patient safety culture. The situation of patient safety culture was average at a moderate level. Development of reporting system and encouraging staff to report errors and adjusting nursing number and workload is suggested.

Analysis of affecting factors on patient safety culture in public and private hospitals in Iran

BackgroundPatient safety culture is one of the main components of the quality of health services and is one of the main priorities of health studies. Accordingly, this study aimed to determine and compare the views of healthcare staff on the patient safety culture and the impact of effective factors on patient safety culture in public and private hospitals in Tehran, Iran.MethodsThis cross-sectional study was carried out on a sample of 1203 health care workers employed in three public and three private hospitals in Tehran, Iran. Stratified random sampling was used in this study. Data were collected using the Maslach burnout inventory and patient safety culture questionnaire (HSOPSC). IBM SPSS v22 and Amos v23 were used to perform path analysis.ResultsEight hundred sixty-seven (72.57%) females and 747 (27.43%) males with a mean age of 33.88 ± 7.66 were included. The average percentage of positive responses to the safety culture questionnaire in public and private hospitals was 65.5 and 58.3%, respectively. The strengths of patient safety culture in public hospitals were in three dimensions including non-punitive response to errors (80%), organizational learning—continuous improvement (79.77%), and overall perceptions of patient safety (75.16%), and in private hospitals, were three dimensions including non-punitive responses to errors (71.41%), organizational learning & continuous improvement (69.24%), and teamwork within units (62.35%). The type of hospital and work-shift hours influenced the burnout and patient safety questionnaire scores (P-value < 0.05). The path analysis results indicate the fitness of the proposed model (RMSEA = 0.024). The results showed a negative impact of a work shift (β = − 0.791), occupational burnout (β = − 0.554) and hospital type (β = − 0.147) on the observance of patient safety culture.ConclusionProviding feedback on errors and requirements for the frequent incident reporting, and patient information exchange seem necessary to promote the patient safety culture. Also, considering the negative impact of the shift work and burnout on patient safety culture, by planning and managing these factors appropriately, correct actions could be designed to improve the safety culture.

The Relationship between Professional Commitment and Patient Safety Culture in Educational Hospitals of Shahrekord University of Medical Sciences

The Relationship between Professional Commitment and Patient Safety Culture in Educational Hospitals of Shahrekord University of Medical Sciences

Patient safety culture in Peking University Cancer Hospital in China: baseline assessment and comparative analysis for quality improvement

BackgroundLimited information is available regarding the patient safety culture in Chinese hospitals. This study aims to assess the patient safety culture in Peking University Cancer Hospital and to identify opportunities for improving the organization’s safety culture.MethodsA cross-sectional study was conducted in April 2018 and 2019, respectively. Data on patient safety culture were collected from clinical and administrative staffs using the Hospital Survey on Patient Safety Culture (HSOPSC).ResultsTwelve composite dimension variables were hierarchically clustered. Three highest positive response dimensions include ‘Organizational Learning and continuous improvement’ (92.9%), ‘Teamwork within units’ (89.7%), and ‘Hospital management support for patient safety’ (83.7%), while 3 lowest positive response dimensions included ‘Frequency of events reported’ (43.9%), ‘Non-punitive response to error’ (51.1%), ‘Communication openness’ (52.2%), and ‘Staffing’ (53.7%). Compared to the average scores of the United States, the scores of the Peking University Cancer Hospital was significantly lower on ‘Communication openness’ and ‘Frequency of events reported’. After targeted continuous improvement based on results in 2018, all 12 dimensions surprisingly increased in the safety culture conducted in 2019.ConclusionInadequate feedback and communications about error and lack of communication openness are key challenges for patient safety in the delivery of care in this hospital. Results of this baseline survey indicate the need for a modified approach and attention to context when designing interventions aimed at improving the safety culture in this organization.

&gt;Metodologias ativas para a cultura de segurança

Introduction: The promotion of the patient safety culture makes part of the strategies proposed in the National Patient Safety Program. Objective: This paper presented the experience of the Patient Safety Nucleus during 2018 in promoting the patient safety culture. Method: The use of active learning methodologies in a medium-sized public hospital in Minas Gerais, that belongs to the Sentinel Network of Anvisa. Results: The “10 Goals – Patient Safety” campaign originated after the identification and prioritization of the macroproblems related to patient safety in the institution. The 10 goals defined were: 1) Effective communication; 2) Fall prevention; 3) Safe surgery; 4) Prevention of pressure injury; 5) Safe use of probes and catheters; 6) Safe identification; 7) Drug safety; 8) Clean and safe care; 9) Patient involved; and 10) Safe and rational use of blood. The structuring of educational strategies was based on active learning and problematization methodologies. Conclusions: It was observed that the use of active methodologies can stimulate and induce employees and users to discuss and know the meaning of the hospital safety culture.

Development of the Austrian version of the Hospital Survey on Patient Safety Culture

Abstract Background Patient safety culture in hospitals (PSC), as well as its measurement and development, have received plenty of attention in Europe in recent years. Several instruments have been developed for its measurement in European countries. As Austria does not have empirically reviewed questionnaires to measure PSC jet, the research question of this study was: Is the globally admitted American questionnaire “Hospital Survey on Patient Safety Culture (HSOPSC)” (Sorra &amp; Nieva, 2004) suitable for the healthcare system in Austria? Methods The HSOPSC contains 42 questions, which constituted twelve factors altogether. The pre-test was done with 101 health professionals. The online survey was conducted in ten public hospitals in 2017. Overall 1525 health professionals participated, which corresponded to a response rate of 23%. A new instrument, namely “Hospital Survey on Patient Safety Culture in Austria (HSPSC-AUT)”, was developed using the Exploratory Factor Analysis (EFA) and the Confirmatory Analysis (CFA). Results The factor structure of HSOPSC was not identical to the factor structure of HSPSC-AUT, developed in our study. The study showcased a new tool, HSPSC-AUT, with 30 items altogether, consisting of seven departmental factors, two hospital factors and one outcome factor. This new tool (HSPSC-AUT) showed pleasant results on the model, indicator, and construct level. The results of CFA for HSPSC-AUT (χ2 [360] = 1408.245, p = 0.0001) showed a better model compared to HSOPSC. The absolute and relative fit-indices showed excellent model adjustment (RMSEA = 0.049, SRMR = 0.041, GFI = 0.927, CFI = 0.941, TLI = 0.929). Conclusions The study presents a new instrument, HSPSC-AUT, for the measurement of PSC. According to the results, HSPSC-AUT (10-factor structure) has a better model fit than the original HSOPSC. This was confirmed by chi-square test, absolute and relative fit-indices, informational criteria, reliability, and construct validity. Key messages The development of an instrument for measuring safety culture is the first step leading to a better PSC. For this reason, HSPSC-AUT is recommended as an instrument to measure the PSC in Austria. Finally, it can be said that the development of a new questionnaire as well as the related measurements of validity and reliability have added value to science and practice.

Patient safety culture in Austrian hospitals – A qualitative study

Abstract Background Adverse events in the healthcare system often have severe consequences for the patient and healthcare institutions. Thus, various risk management tools have been recently introduced to 11 Austrian hospitals to increase patient safety. The goal of our study was to test whether the introduced risk management tools actually improved patient safety culture (PSC). Methods An exploratory research approach was used to examine the current status of five aspects from PSC in hospitals. Semi-structured expert interviews with health professionals were conducted (N = 32). The inductive content analysis and technique of content structuring were used to analyze and systemize extensive qualitative data material. Intercoder reliability (κ = .605) shows satisfactory results. Results The results of the first aspect, Critical Incident Reporting System (CIRS), show that hospitals still have potential for improvement in terms of education of employees, coordination, and communication. The data of the second issue, surgical checklist, shows that the education was insufficient and that these checklists are not handled properly and used only fragmentarily. Concerning the third aspect “transfer/report”, it can be stated that systematic transfer/reports are widely unknown. Furthermore, the fourth aspect, hand hygiene, lacks a systematic training concept and control of compliance. The fifth aspect, education of risk manager, has brought a number of general benefits (e.g. methodical knowledge) to risk managers. Conclusions The results provide valuable insights into strengths and weaknesses of the implementation of risk management tools and thus highlight opportunities on how to influence PSC through organizational development and change management. Furthermore, this study has taken the first essential step towards the understanding of the effective and efficient development of PSC by providing valuable insights into the underlying mechanisms of non-functioning PSC. Key messages The study showed where the weakness points in processes of implementing risk management tools are and offered a theoretical solution for the development of a patient safety culture. Risk management tools were not equally effective in every controlled aspect. The effective implementation of these tools requires change management as a foundation to develop PSC.

Developing strategies for patient safety implementation: a national study in Iran.

Today, healthcare organizations focus mainly on development and implementation of patient safety strategic plan to improve quality and ensure safety of provided services. The purpose of this paper is to recommend potential strategies for successful implementation of patient safety program in Iranian hospitals based on a strengths, weaknesses, opportunities, threats (SWOT) analysis. In this qualitative study, key informant interviews and documentation review were done to identify strength and weakness points of Iranian hospitals in addition to opportunities and threats facing them in successful implementation of a patient safety program. Accordingly, the research team formulated main patient safety strategies and consequently prioritized them based on Quantitative Strategic Planning Matrix (QSPM) matrix. The study recommended some of the potential patient safety strategies including provision of education for employees, promoting a safety culture in hospitals, managerial support and accountability, creating a safe and high-quality delivery environment, developing national legislations for hospital staff to comply with patient safety standards and developing a continuous monitoring system for quality improvement and patient safety activities to ensure the achievement of predetermined goals. Developing a comprehensive and integrated strategic plan for patient safety based on accurate information about the health system's weaknesses, strengths, opportunities and threats and trying to implement the plan in accordance with patient safety principles can help hospitals achieve great success. Ministry of Health and Medical Education (MOHME) conducted a national study to recommend potential strategies for successful implementation of patient safety in Iranian hospitals based on a SWOT analysis and QSPM matrix.

Changes in Hospital Safety Culture after Implementation of Comprehensive Learning Collaborative Strategies in Statewide Collaborative

Changes in Hospital Safety Culture after Implementation of Comprehensive Learning Collaborative Strategies in Statewide Collaborative

The Hospital Patient Safety Culture Survey: Reform of Analysis and Visualization Methods.

Understanding the topography of hospital safety culture is vital for developing, implementing, and monitoring the effectiveness of tailored safety programs. Since 2009, the Chinese version of the Safety Attitudes Questionnaire (SAQ-C) has been introduced and administered to providers in many Taiwanese hospitals. The percentage of SAQ respondents who demonstrate attitudinal agreement within each of the SAQ domains, the percent agreement (PA) score, is used worldwide as the main parameter of safety culture surveys. However, several limitations within PA scoring have been identified. Our study sought to improve scoring methodology and develop a new graph layout for cultural topography presentation. A total of 37,163 responses to a national SAQ-C administration involving 200 Taiwan hospitals were retrospectively analyzed. To understand the central tendency and spread of safety culture scores across all participating hospitals, the median and interquartile range (IQR) of individual respondent’s SAQ-C scores by its domain were calculated, plotted, and named “Jeong & Lee plot”. Because of space limitation, we showed teamwork domain only. Study results denote limitations in the current PA scoring scheme, suggest SAQ analysis modification, and introduce a visualization graph layout that can provide richer information about safety culture dissemination than that available from currently utilized tools.

Clinical practitioners' perception of the dimensions of patient safety culture in a government hospital: A one‐sample correlational survey

To assess the perceptions of clinical practitioners regarding the different dimensions of patient safety culture in their hospital and examine the work-related predictors of patient safety culture perceptions. Patient safetyis seen as a progressively critical focus in healthcare areas worldwide. Saudi Arabia aims to improve healthcare quality by providing access to healthcare for its increasing population. Hence, constantly assessing the patient safety culture of healthcare facilities in the country is imperative. One-sample correlational survey design. The Hospital Survey of Patients' Safety Culture was used to survey the total population sample of 181 healthcare practitioners in a Saudi hospital from December 2018-January 2019. Strengths and weaknesses on PS culture were identified as perceived by the clinical practitioners. Regression analysis was performed to identify the work-related predictors of patient safety culture perceptions. The study followed the STROBE guideline. Nine of the 12 dimensions measured were identified as patient safety culture weaknesses, including 'management support for patient safety' (49.2%), 'teamwork across unit' (44.2%), 'frequency of events reporting' (43.1%), 'communication openness' (41.3%), 'overall perception of patient safety' (38.7%), 'supervisor/manager expectations and actions promoting patient safety' (32.9%), 'staffing' (23.7%), 'hospital handoffs and transitions' (19.6%) and 'non-punitive response to errors' (15.8%). None of the dimensions were identified as strengths by the respondents. Working hours per week and staff position were identified as significant predictors. The study underscores the urgent need to improve the patient safety culture of the hospital. Hospital administrators should highlight initiatives on positive patient safety impact plan for clinical practitioners and patients, such as monitoring, reporting and strictly adhering to hospital activities that reduce the risks associated with exposure to medical care.

An exploration of patient safety culture in Kuwait hospitals: a qualitative study of healthcare professionals' perspectives.

Patient safety culture (PSC) represents a key component of the quality of care offered by healthcare professionals. Therefore, it is crucial to understand the factors that influence the implementation of a safe culture. This study explored the knowledge and attitudes of healthcare professionals in Kuwait towards the factors that might affect the PSC. A qualitative study using semi-structured interviews with healthcare professionals was conducted between February and June 2018 at two major hospitals in Kuwait. Both hospitals had been accredited and have been applying the safety programmes recommended by the Kuwaiti Ministry of Health. Participants were purposively selected where 20 healthcare professionals were interviewed. The interviewees comprised of six physicians, six clinical pharmacists, six nurses and two members of the patient safety committee. Inclusion criteria involved healthcare professionals who had more than 1-year clinical experience, have interest in patient safety and had a good level of English. Interviews were audio-recorded and transcribed verbatim. Thematic analysis of the interview transcripts was conducted to identify the emergent themes. Thematic analysis of the interviews yielded three major themes related to 'management', 'regulations and policies' and 'healthcare professionals'. Management issues included managerial support, resources, safety environment and staff training. Regulations and policies highlighted issues related to policies and procedures and incident reporting system. Healthcare professionals' theme covered factors related to knowledge, communication and teamwork among healthcare professionals. This study gave insight into how healthcare professionals perceive the current PSC in Kuwait. Despite their positive attitudes and knowledge towards patient safety, various barriers were reported that hinder optimal PSC. These barriers were related to support, staffing, resources and response to error.

Factors that influence the implementation of patient's safety culture by ward nurses in district general hospital

This study aims to determine the influencing factors of patient safety culture implementation by ward nurses in the hospital. This research used descriptive correlation with cross-sectional approach. The study population was 205 respondents. Data obtained by distributing valid and reliable questionnaires. Univariate and bivariate data were analyzed using chi-square test. The results showed that 60.5% of nurses had good patient safety knowledge. A total of 57.5% of nurses had high motivation and stated that leader behaviors supported patient safety implementation (54.6%). In another hand, 51.2% of nurses said they had implemented patient safety culture. In the next analysis, there was a significant relationship between nurses' knowledge, the motivation of patient safety, and the behavior leaders with its implementation of patient safety culture (p<0.05). This study shows the individual factors influence the implementation of patient's safety culture in hospital.

Comparing patient safety culture in Bulgarian, Croatian and American hospitals - preliminary results.

Background and aimsPatient safety culture (PSC) is an essential component of the quality of healthcare. Improving PSC is considered a priority in many developed countries. A specialized software platform for registration and evaluation of hospital patient safety culture has been developed with the support of the Medical University Plovdiv Project №11/2017.The aim of the study is to assess the status of PSC in Bulgarian hospitals and to compare it to that in USA and Croatian hospitals.MethodsThe study was conducted from June 01 to July 31, 2018 using the web-based Bulgarian Version of the Hospital Survey on Patient Safety Culture Questionnaire (B-HSOPSC). Two hundred and forty-eight medical professionals from different hospitals in Bulgaria participated in the study. In order to quantify the differences of positive scores distributions for each of the 42 HSOPSC items between Bulgarian, Croatian and USA samples, the χ2-test was applied. The research hypothesis assumed that there were no significant differences between the Bulgarian, Croatian and US PSCs.ResultsThe results revealed 14 significant differences in the positive scores between the Bulgarian and Croatian PSCs and 15 between the Bulgarian and the USA PSC, respectively. Bulgarian medical professionals provided less positive responses to 12 items compared with Croatian and USA respondents. The Bulgarian respondents were more positive compared to Croatians on the feedback and communication of medical errors (Items - C1, C4, C5) as well as on the employment of locum staff (A7) and the frequency of reported mistakes (D1). Bulgarian medical professionals were more positive compared with their USA colleagues on the communication of information at shift handover and across hospital units (F5, F7). The distribution of positive scores on items: “Staff worry that their mistakes are kept in their personnel file” (RA16), “Things ‘fall between the cracks’ when transferring patients from one unit to another” (RF3) and “Shift handovers are problematic for patients in this hospital” (RF11) were significantly higher among Bulgarian respondents compared with Croatian and US respondents.ConclusionsSignificant differences of positive scores distribution were found between Bulgarian and USA PSC on one hand and between Bulgarian and Croatian on the other. The study reveals that distribution of positive responses could be explained by the cultural, organizational and healthcare system differences.

요양병원 인증제 시행이 환자안전 관리활동에 미치는 영향: 손위생을 중심으로

The purpose of the study is to examine healthcare workers’ hand hygiene perception, knowledge, and self-reported compliance in accreditated long-term care hospitals in Korea. Perceptions on hand hygiene before and after the national accreditation are compared. We further investigated factors associated with perception, knowledge, and compliance. The introduction of national mandatory accreditation on long-term care hospitals since 2013 resulted in improved hand hygiene compliance and perception among hospital workers. Self-reported hand hygiene compliance rate was 89.7%. Perception is strongly in favor of hand hygiene compliance. Additionally, education level, profession department, and hand hygiene education exposure increased the likelihood of self-reported hand hygiene compliance. Results have implications for efforts to increase hand hygiene compliance rate and improve patient safety culture in long-term care hospitals.