Improve Patient Safety Culture Research Articles

Association between the nationality of nurses and safety culture in maternity units of Oman.

Patient safety culture/climate in maternity units has been linked to better safety outcomes. Nurses have a crucial role in patient safety and represent the majority of staff in maternity units. In many countries, nurses are recruited from abroad, bringing their own perceptions of patient safety culture. Nonetheless, little is known about the relationship between perceptions of patient safety culture and nurses' nationality. Understanding this relationship will assist stakeholders in designing a responsive programme to improve patient safety culture. To investigate the association between nurses' nationality and their perceptions about patient safety culture in maternity units in Ministry of Health hospitals in Oman. In 2017, the Safety Attitude Questionnaire (SAQ) was distributed to all staff (892 distributed, 735 returned) in 10 maternity units. About three-quarters (74%, 541/735) of the returned SAQs were completed by nurses, of whom 34% were non-Omani, 21.8% were Omani and 44.7% did not report their nationality (missing). Overall, the mean safety score for non-Omani nurses was significantly higher than for the Omani nurses: 3.9 (SD 1.3) vs 3.6 (SD 1.2) (P < 0.001). The mean safety score for stress recognition was significantly lower for non-Omani nurses: 2.8 (SD 1.5) vs 3.2 (SD 1.3) (P < 0.001). Non-Omani nurses have a more positive perception of patient safety culture than Omani nurses except in respect of stress recognition. Decision-makers, directors, and clinicians should consider these differences when designing interventions to improve patient safety culture.

Association between organizational citizenship behavior and patient safety culture from nurses\u2019 perspectives: a descriptive correlational study

BackgroundNurses play a key role in providing patient safety. It is known that patient safety requires the improvement of patient safety culture, which can be a difficult process. One of the current challenges of hospitals is to explore the ways to improve patient safety culture. Organizational citizenship behaviors are one of the factors, which can develop organizational culture including safety culture; however, its role is not well established.MethodsIn this cross-sectional study, a stratified random sample of 214 nurses was selected from a largest teaching hospital in west of Iran. The institutional research board approved the study protocol. Data were collected using three self-report questionnaires: demographic information; hospital survey on patient safety culture (HSPSC); and organizational citizenship behaviors questionnaire. Data were analyzed using Spearman’s correlation coefficient test in SPSS (α < 0.05).ResultsOrganizational citizenship behaviors were found to be at an intermediate level (56.84 ± 16.22). However, some of its dimensions, including sportsmanship, civic virtue, and courtesy, were at weak levels (< 50%). The mean percentage of positive responses to the patient safety culture was 49.00 ± 14.01. The patient safety culture had significant positive correlations with organizational citizenship behaviors (r = 0.349, P = 0.001) and dimensions of altruism (r = 0.255, P = 0.001), civic virtue (r = 0.434, P = 0.001), and courtesy (r = 0.214, P = 0.001).ConclusionOur findings proposed the hypothesis that OCB has a statistical significant impact on PSC. Low levels of civic virtue, sportsmanship and courtesy behaviors may be indicative low nurses’ interest in participating in organizational affairs and nurses’ low attention to measures that prevent harm to their organization. It is recommended that nursing managers focus more on these dimensions, identifying influintioal factors and taking appropriate management measures to promote these behaviors. If our findings are confirmed in future studies, nursing managers can consider the development of organizational citizenship behaviors as one of the managerial approaches for promoting a patient safety culture.

Barriers and Strategies in Promoting and Improving Patient Safety Culture Among Indonesian Nurses: A Systematic Review

Introduction: Patient Safety Culture (PSC) is one of the indicators in the quality of care and services. The nurse has an important role to promoteand improve PSC in the hospital. As a developing country, Indonesia still struggles to improve quality health care by increasing PSC among healthprofessional including nurses. This systematic review aims to identify Indonesian nurses’ barriers and strategies to promote and improve PSC inhospitals.Method: This systematic review study used the PRISMA protocol to select appropriate resources. Nine journal databases of CINAHL, DOAJ,GARUDA, Google Scholar, MDPI, Medline, Proquest, PUBMED, and Science Direct were searched in this regard.Results: The barriers that nurses faced in PSC promotion and improvement in the Indonesian hospital settings were nursing capabilities, regulation,organizational culture, equality, equally and supports, and natural resources. While the strategies are incorporating patient safety topics into thenursing curriculum, leaders’ supervision, integrative team, and regular training and workshop.Conclusion: This review finding both the barriers and strategies in PSC promotion and improvement differ among Indonesian nurses. The majorbarrier was predominantly related to nurses’ capabilities and competences. Hence, the strategies were related to improving nurses’ capabilitiesand competences in patient safety both through improvement nursing curriculum, and continuing nursing education programs.

Evaluation of the Relationship Between the Patient Safety Culture and Medical Error Attitudes of the Pediatric Nurses

Objectives: This study was conducted descriptively so as to determine the relationship between the patient security culture and medical error attitudes of the nurses. Methods: The population of the study was conducted between the dates that the data were collected in the hospitals in the eastern Turkey of 82 nurses working in children's services. The sampling selection method was not used in this study, but 68 nurses that were accessed between the dates and that accepted to participate in the study voluntarily were included in the sampling of the study. “Descriptive Information Form”, “Patient Security Culture Scale” (PSCS) and “Medical Error Attitude Scale” (MEAS), in which the socio-demographic information of the nurses is assessed, were used as data collection tools in the study. Results: Nurses received an average score of 3.71±0.27 from PSCS, and an average score of 3.02±0.44 from MEAS. A significant relationship was determined between the education status of the nurses and their PSCS total score (p&amp;lt;0.05). As a result of the correlation analysis it was determined that there was a positively significant relationship between the PSCS score and MEAS scores of the nurses, and as their PSCS scores increased, their MEAS scored increased as well. Conclusion:Evaluation of the current status by conducting regular measurements in regard to patient security in institutions and should be make improvements accordingly. Also, nurses should take responsibility in patient safety and improvement of patient safety culture should be the main priority of the institutions.

Shift schedule realignment and patient safety culture.

The purpose of this paper is to assess the association between shift schedule realignment and patient safety culture. Using difference in differences model, BIMC Hospitals and Siloam Hospital Bali were compared before and after shift schedule realignment to test the association between shift schedule realignment and patient safety culture. Shift schedule realignment was associated with a significant improvement in staffing (coefficient 1.272; 95% CI 0.842 - 1.702; p<0.001), teamwork within units (coefficient 1.689; 95% CI 1.206 - 2.171; p<0.001), teamwork across units (coefficient 1.862; 95% CI 1.415 - 2.308; p<0.001), handoffs and transitions (coefficient 0.999; 95% CI 0.616 - 1.382; p<0.001), frequency of error reported (coefficient 1.037; 95% CI 0.581 - 1.493; p<0.001), feedback and communication about error (coefficient 1.412; 95% CI 0.982 - 1.841; p<0.001) and communication openness (coefficient 1.393; 95% CI 0.968 - 1.818; p<0.001). With positive impact on patient safety culture, shift schedule realignment should be considered as quality improvement initiative. It stretches the compressed workload suffered by staff while maintaining 40 h per week in accordance with applicable laws and regulations. Shift schedule realignment, designed to improve patient safety culture, has never been implemented in any Indonesian private hospital. Other hospital managers might also appreciate knowing about the shift schedule realignment to improve the patient safety culture.

Improvements in patient safety culture: a national Taiwanese survey, 2009-16.

To assess national trends in patient safety culture in Taiwan. A safety attitudes questionnaire (SAQ) was distributed to 144 hospitals from 2009 to 2016 (n=392341). Taiwan's medical centers, regional hospitals and community hospitals. Hospital staff in Taiwan. None. 5-point Likert scale to assess changes in patient safety culture dimensions (teamwork, safety climate, job satisfaction, stress recognition, management and working conditions) converted to positive response rate (percentage of respondents who answered slightly agree or strongly agree on Likert scale). Dimensions for patient safety culture significantly increased in Taiwan over a period of 8years, with an all-composite improvement in positive response rate of 4.6% (P<0.001). Regional hospitals and community hospitals registered an all-composite improvement of 6.7 and 7.0%, respectively, while medical centers improved by 4.0%. Improvements for regional and community hospitals primarily occurred in teamwork (regional hospitals, 10.4% [95% confidence interval [CI], 10.2-10.6]; community hospitals, 8.5% [95% CI, 8.0-9.0]) and safety climate (regional hospitals, 11.1% [95% [CI], 10.9-11.4]; community hospitals, 11.3% [95% CI, 10.7-11.8]) (P<0.001, all differences). Compared with nurses (5.1%) and pharmaceutical staff (10.6%), physicians improved the least (2.0%). Improvements for nurses and pharmacists were driven by increases in perceptions of teamwork (nurses, 9.8% [95% CI, 9.7-10.0]; pharmaceutical staff, 14.2% [95% CI, 13.4-14.9]) and safety climate (nurses, 9.0% [95% CI, 8.8-9.1]; pharmaceutical staff, 16.4% [95% CI, 15.7-17.2]) (P<0.001, all differences). At study end, medical centers (55.1%) had greater all-composite measurements of safety culture than regional hospitals (52.4%) and community hospitals (52.2%) while physicians (63.7%) maintained greater measurements of safety culture than nurses (52.1%) and pharmaceutical staff (56.6%). These results suggest patient safety culture improved in Taiwan from 2009 to 2016.

The Role Of Teamwork In Improving Patient Safety Culture

Since the declaration of patient safety culture in the hospital X in 2015, there were 171 cases of patient safety incident until December 2018, with Near Injury Incidence (KNC) dominated at 56%. Of all the patient safety incidents, about 60% occurred in the treatment facility. Poor coordination among nurses has led to the absence of the same perception on the filling of incident reporting formats, the choice of incidents that had not been so precise, and a feeling of fear of being blamed when reporting an incident. The purpose of this research is to analyze the influence of leadership styles, teamwork, and knowledge of the safety culture of patients at X Hospital, Bekasi. The study aims to analyse the influence of leadership style, teamwork, and knowledge on patient safety culture at X Hospital, Bekasi. This research method uses the analytical causality approach, conducted by a survey method and its correlation technique with the time dimension of one short study. The sample in this study were nurses in the inpatient installation. Sampling size determined using the Purposive Sampling technique resulting in 98 samples. Data analysis uses multiple regression test. The result showed that leadership style, teamwork, and knowledge influence either partially or simultaneously to patient safety culture at X Bekasi Hospital. The dominant of independent variables is teamwork. Finding: In-hospital services, the role of teamwork is significant in creating the patient safety culture. Implications: Hospital management must involve the active role of each team member in improving patient safety culture .

Trends in the Staff's Perception of Patient Safety Culture in Romanian Hospitals.

Introduction. The IRIS-2 project (2019) expanded the application of the HSOPSC in Romanian hospitals, yet applied, for the first time in the country, in 2014 (IRIS-1). The aim is an update on patient safety culture for staff, by geographic region and overall, by year of survey. Materials and methods. A cross-sectional study was carried out in voluntary staff in four hospitals in four regions (n. 1,121 staff) and compared with a previous study based on six hospitals in four regions (n. 969 staff). The instrument was the Romanian version of the HSOPSC with 31 items and 9 dimensions. Statistics to analyze trend were computed using “R”. Results No significant differences between the proportion of positive response (PPRs) by dimension were observed in IRIS-2 with respect to IRIS-1, with two exceptions: significantly lower PPR for “teamwork across hospital units“ (65% versus 73%) and significantly higher PPR for “frequency of events reporting” (65% versus 59%). Four dimensions were well developed and five dimensions needed to be improved. The poorest PPRs were for the “teamwork across hospital units”, the “frequency of event reporting” and the “non punitive response to error” dimensions. Besides, one outcome indicator changed through time: the proportion of the staff who did not report any event was significantly lower (64% versus 73%) and the proportion of the staff who reported “1-2 events” was significantly higher (21% versus 15%). Conclusion. Despite some small progress related to the frequency of events reporting, there is room for further patient safety culture improvement.

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.

Patient safety management systems, activities and work environments related to hospital-level patient safety culture: A cross-sectional study.

Improvement in patient safety culture requires constant attention. This study aimed to identify hospital-level elements related to patient safety culture, such as patient safety management systems, activities and work environments.Two questionnaire surveys were administered to hospitals in Japan in 2015 and 2016. The first survey aimed to determine which hospitals would allow their staff to respond to a questionnaire survey. The second survey aimed to measure the patient safety culture in those hospitals. Patient safety culture was assessed using the Hospital Survey on Patient Safety Culture (HSOPS). The relationship of hospital-level patient safety culture with the aforementioned elements in each hospital was analyzed.The response rate to the first survey was 22% (721/3270), and 40 eligible hospitals were selected from the respondents. The second survey was administered to healthcare workers in those 40 hospitals, and the response rate was 94% (3768/4000). The proportion of respondents who had 7 or more days off each month was related to the scores of 7 composites and the Patient Safety Grade of HSOPS. Both the presence of a mission statement describing patient safety and the proportion of respondents who participated in in-house patient safety workshops at least twice annually were related to the scores of 5 composites and the Patient Safety Grade of HSOPS.Our study suggests that the number of days off each month, the presence of a hospital patient safety mission statement, and the participation rate in in-house patient safety workshops might be key factors in creating a good patient safety culture within each hospital.

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.

From organisational support to second victim-related distress: Role of patient safety culture.

This cross-sectional correlation study aimed to explore the associations among patient safety culture, organisational support, second victim-related distress, absenteeism and turnover intentions in the registered nurses (RNs) by using structural equation modelling. Medical errors could cause RNs' second victim-related distress, which may either positively or negatively impact patient safety culture. The Hospital Survey on Patient Safety Culture (HSOPSC) and Second Victim Experience and Support Tool (SVEST) were used to investigate 267 RNs who were involved in direct patient care and medical errors within the previous year in China. About half (45.3%) of nurses experienced psychological distress, and 26.6% of the nurses intended to leave. The model showed that 6 dimensions of patient safety culture have contributed to decreasing absenteeism and turnover intention via increased organisational supports and decreased second victim-related distress. The second victim-related distress may be relieved, and organisational support may be enhanced through improvements in patient safety culture. Strategies are needed to establish an environment where cooperation/cooperative relationships between the supervisor and the staff nurse can be ensured.

Prevalence of medical errors in Iran: a systematic review and meta-analysis

BackgroundMedical errors are considered as a major threat to patient safety. To clarify medical errors’ status in Iran, a review was conducted to estimate the accurate prevalence of medical errors.MethodsA comprehensive search was conducted in international databases (MEDLINE, Scopus and the Web of Science), national databases (SID, Magiran, and Barakat) and Google Scholar search engine. The search was performed without time limitation up to January 2017 using the MeSH terms of Medical “error(s)” and “Iran” in Endnote X5. Article in English and Persian which estimated the prevalence of medical errors in Iran were eligible to be included in this review. The JBI appraisal instrument was used to assess the quality of included studies, by two independent reviewers. The prevalence of medical errors was calculating using random effect model. Stata software was used for data analysis.ResultsIn 40 included studies, the most frequent occupational group observed were nursing staff and nursing students (21 studies; 52% of studies). The most reported type of error was medication error (25 studies; 62% of studies, with prevalence ranged from 10 to 80%). University or teaching hospitals (30 studies; 75% of studies) as well as, internal/intensive care wards (10 studies; 25% of studies) were the most frequent hospitals and wards detected. Based on the result of the random effect model, the overall estimated prevalence of medical errors was 50% (95% confidence interval: 0.426, 0.574).ConclusionResult of the comprehensive literature review of the current studies, found a wide variation in the prevalence of medical errors based on the occupational group, type of error, and health care setting. In this regards, providing enough education to nurses, improvement of patient safety culture and quality of services and attention to special wards, especially in teaching hospitals are suggested.

Exploring the Relationship Between Contact Frequency, Leader-Member Relationships, and Patient Safety Culture.

This study uses Leader-Member Exchange theory to explore the associations between contact frequency (CF) of nurse leaders and their team members, leader-member relationship, and patient safety culture. Leader-member relationships are an important part of patient safety culture development. The behaviors of leaders to achieve these relationships are unknown. This study explores CF as a leader behavior to improve patient safety culture. Cross-sectional survey of bedside nurses (N = 746) from an 8-hospital system. A significant association was found between relationship strength and patient safety culture; CF's effect on relationship and patient safety culture was demonstrated. Contact frequency may support relationships between leaders and members and improve patient safety culture on nursing units. Future studies should explore factors that could be enhancing and limiting CF.

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.

Staff perceptions of patient safety culture in general surgery departments in Turkey.

The first step towards establishing and improving patient safety culture in hospitals is measuring patient safety culture perceptions of staff. Few studies have examined the perception of patient safety culture in general surgery departments. The objective of this study was to evaluate patient safety culture and patient safety grade in general surgery departments and to examine the relation between the patient safety culture and the patient safety grade. This study examined patient safety culture and patient safety grades of 124 staff in seven surgery departments of a hospital in Turkey. The staff completed the hospital survey on patient safety culture and answered questions about their professional characteristics. One-way ANOVA, Independent-samples t test, corrected chi-square test, multiple correspondence analysis and Eta co-efficient were used in statistical analyses. The patient safety dimension of "teamwork within units" had the highest mean and percentage of positive responses. The "frequency of events reported" and "non-punitive response to errors" had the lowest means and percentages of positive responses. Participants with resident or nurse positions, < age 31 years, with < 6 years of professional experience, and 60 or more work hours/week, had significantly more negative perceptions of patient safety culture than other participants. Patient safety grades and the dimensions of "management support for patient safety" and "overall perceptions of patient safety" had significantly high Eta coefficients. Frequency of events reported and non-punitive responses to errors should be improved, and participants' characteristics should be considered at improvement efforts in general surgery departments. The dimesions with low means suggest opportunities for improvement.

Impacts of job-related stress and patient safety culture on patient safety outcomes among nurses in Taiwan

ABSTRACT Background: Patient safety is critical in healthcare. Studies have documented high level of stress among nurses that may adversely affect quality of patient care and patient safety. Methods: This study measured job-related stress, patient safety culture and patient safety outcomes among nurses in Taiwan. A total of 1562 respondents completed the survey. Partial Least Square-Structural Equation Modelling (PLS-SEM) was applied to explore the relationship between job-related stress, patient safety culture, and patient safety outcomes. Result: Job-related stress was found to have varying influence on the perception of patient safety culture. Specifically, stress related to interpersonal relationship and work environment is negatively related to patient safety culture, whereas nurse–patient relationship stress is positively related to patient safety culture. Meanwhile, patient safety culture was found to have positive influence on patient safety outcomes and fully mediates the relationship between job-related stress and patient safety outcomes. Conclusion: This study points to job-related stress as a challenge and hindrance to improve patient safety culture, necessitating implementation of appropriate strategies for managing stress among nurses. Patient safety culture is vital for healthcare organizations to promote patient safety and to enhance quality of care.

Improving Hospital Safety Culture for Falls Prevention Through Interdisciplinary Health Education.

Falls are a serious public health problem, with an estimated 37.3 million falls a year requiring medical assistance. Improving hospital culture to address safety and falls prevention is a major organizational challenge that requires interdisciplinary teams and evidence-based education to change individual behaviors and improve outcomes. We collaborated with an interdisciplinary team of health practitioners at a critical access hospital to develop a health education program tailored to their internal assessment of falls and safety issues. The resulting program used the Five As behavior change model and evidence-based health education. Education session activities and posttests were used to measure participant outcomes, and the Agency for Healthcare Research and Quality (AHRQ) Hospital Survey on Patient Safety Culture was distributed hospital-wide to measure patient safety culture pre- and postintervention. Participants reported increased knowledge, attitudes, and motivations with attendance at education sessions. The AHRQ Hospital Survey showed positive improvements in 10 of the 11 composite categories, 4 of which were statistically significant. The use of the Five As, along with an interdisciplinary health education approach, can improve individual hospital employee falls prevention knowledge, attitudes, and motivations. That individual-level change can improve patient safety culture at the organizational level.

Cross-Sectional Study on Patient Safety Culture, Patient Safety Competency, and Adverse Events.

This study aims to examine the associations between nurses' perceptions of patient safety culture, patient safety competency, and adverse events. Using convenience sampling, we conducted a cross-sectional study from February to May 2018 in two university hospitals. Furthermore, we performed multiple logistic regression to examine associations between patient safety culture, patient safety competency, and adverse events. Higher mean scores for "communication openness" in patient safety culture were significantly correlated with lower rates for pressure ulcers and falls; furthermore, higher mean scores for "working in teams with other health professionals" in patient safety competency were significantly correlated with reductions in ventilator-associated pneumonia. We recommend that a well-structured hospital culture emphasizing patient safety and continuation of in-service education programs for nurses to provide high-quality, clinically safe care is required. Moreover, further research is required to identify interventions to improve patient safety culture and competency and reduce the occurrence of adverse events.

A cross-sectional survey on patient safety culture in secondary hospitals of Northeast China.

ObjectivesThis study aims to investigate patient safety culture in secondary hospitals of Heilongjiang, Northeast China, and explore the implications of patient safety culture and practices through the perspectives of various healthcare workers.MethodsA cross-sectional survey using the Safety Attitude Questionnaire (SAQ) was conducted to ascertain the status of patient safety culture in nine secondary hospitals across the six dimensions of the SAQ. Among the 900 staff members who were invited to participate, 665 completed the questionnaire. Descriptive statistics were used to calculate the general means and standard deviations of the patient safety culture dimensions and other numerical variables, and F-test and a multivariate regression analysis were used to statistically analyze the differences in perceptions of safety culture considering the differences in demographic characteristics. All statistical analyses were performed using SPSS v. 22.0.ResultsThe respondents rated job satisfaction as the highest among all six dimensions of the SAQ, followed in order by teamwork climate, working conditions, and stress recognition (the lowest). There were significant differences among the dimensions of patient safety culture and other factors, such as gender, age, job position, and education. Compared with previous studies, teamwork climate and working conditions scores were quite high, while stress recognition score was very low. We also found differences in patient safety culture by demographic characteristics.ConclusionsThe findings revealed the patient safety culture attitudes of healthcare workers in secondary hospitals of Heilongjiang, and provided baseline data for related future research. This evidence may also help government health policymakers and hospital administrators understand related challenges and develop strategies to improve patient safety culture in secondary hospitals of China and perhaps also in other developing countries.