Patient Safety Culture Questionnaire Research Articles

ANALYSIS OF MANAGEMENT EFFORTS IN SHAPING SAFETY CULTURE IN X HOSPITAL SEMARANG

Patient safety is the essence of health service quality. Hospitals are a combination of several elements that together produce a high-risk situation. Safety culture should be the core in hospital organization. From the data obtained there are still incidents of safety of patients in hospital X Semarang and there has been no trend decrease in the incidence of meaningful incidents over time. This research aims to determine the cultural overview of safety and how the management efforts influence in shaping the safety culture of hospital X Semarang. This type of research is quantitative analytic with survey method that analyzes management efforts in shaping safety culture in hospital X Semarang. Research conducted in January-March 2020. Data collection techniques using a questionnaire adapted from the American College of Healthcare Executives in 2017 and a description of safety culture were acquired by collecting data from a Patient safety culture questionnaire adopted from the Hospital Survey on Patient Safety Culture questionnaire published by The Agency for Healthcare Research and Quality (AHRQ) in 2004. Number of respondents as many as 220 people selected in proportionate stratified random sampling. The results showed that the safety culture at hospital X showed a positive response in the organizational learning dimension and continuous improvement (90.15%), the dimension of cooperation in units (81.82%) and dimension of management support to patient safety efforts (80.45%). The other dimension of safety culture has a negative response (< 75%). Management efforts that include the determination of vision, trust values, respect and inclusion, selection, development and management engagement, leadership development that prioritizes safety, just culture, expectations of organizational behaviour as well as assumptions, values and artifacts related to safety culture have an influence in the establishment of safety culture in hospital X Semarang. Keyword: Safety Culture, management efforts

Assessment of nurses' patient safety culture in 30 primary health-care centres in Tunisia.

Ensuring patient safety and health-care quality remain priorities and challenges worldwide and the role of nurses is essential to meet these challenges. Developing patient safety culture is a key component to improve patient safety and health-care quality. To assess nurses' patient safety culture in primary health-care centres in Tunisia and to determine its associated factors. This was a multicentre, cross-sectional descriptive study conducted across 30 primary health-care centres in Tunisia, using the French validated version of the Hospital Survey on Patient Safety Culture questionnaire. All the nurses working in these centres were invited to participate in the study (n = 158). The response rate for participation in the study was 87.3%. The dimension of "teamwork within units" had the highest score (70.6%). Three safety dimensions had low scores: "frequency of event reporting" (27.6%), "staffing" (34.76%) and "nonpunitive response to errors" (36.5%). Two factors were associated with patient safety culture: participation in risk management committees, and district of the primary care centre. The level of nurses' patient safety culture needs to be improved in primary health-care centres in Tunisia. Strategies to nurture patient safety culture should focus upon building leadership capacity that supports open communication, blame-free environment, teamwork and continuous organizational learning.

A baseline assessment of patient safety culture and its associated factors from the perspective of critical care nurses: Results from 10 hospitals

IntroductionCritical care nurses are considered the key to patient safety improvement and play a vital role in enhancing quality of care in intensive care units (ICUs) where adverse events are frequent and have severe consequences. Moreover, there is recognition of the importance of the assessment and the development of patient safety culture (PSC) as a strategic focus for the improvement of patient safety and healthcare quality, notably in critical care settings. ObjectivesThis study aimed to assess critical care nurses' perception of PSC and to determine its associated factors. MethodsThis cross-sectional study was conducted among nurses working in the ICUs of the Tunisian centre (six Tunisian governorates). The study instrument was the French validated version of the Hospital Survey on Patient Safety Culture questionnaire, comprising 10 dimensions and a total of 50 items. ResultsA total of 249 nurses from 18 ICUs participated in the study, with a participation rate of 87.36%. The dimensions scores ranged between 17.2% for the dimension “frequency of events reported” and 50.1% for the dimension “teamwork within units”. Multivariable logistic regression indicated that respondents who worked in private hospitals were five times more likely to have a developed PSC (adjusted odds ratio [AOR]: 5.34; 95% confidence interval [CI], [2.28, 12.51]; p < 10–3). Similarly, participants who worked in a certified hospital were two times more likely to have a more developed PSC than respondents who work in noncertified hospitals (AOR: 2.51; 95% CI, [.92–6.82]; p = 0.041). In addition, an increased nurse-per-patient ratio (i.e., reduced workload) increased PSC (AOR: 1.10; 95% CI, [1.02–1.12]; p = 0.018). ConclusionThis study has shown that the state of critical care nurses' PSC is critically low and these baseline results can help to form a plan of actions for improvements.

Effect of Applying A training Program about International Patient Safety Goals on Patient’s Safety Culture

Abstracts Background: The goal of head nurses is to achieve patient safety, which is considered a critical component of quality health care. Aim: To assess the effect of applying a training program about international patient safety goals on patient’s safety culture at Rajhy Liver Hospital, Assiut University. Subject and method: A quasi-experimental design used to conduct this study. The study subjects included all head nurses (n=29) from different health care units. The data collection tool included three tools: I. Personal data questionnaire, II. Head nurses management regarding patient's safety questionnaire, and III. Hospital survey on patient's safety culture questionnaire. Results: there was a highly statistically significant difference with a strong positive correlation impact between head nurses' management regarding applying international patient safety goals using the PDCA model and patient’s safety culture. Conclusion: The implementation of a training program is successful and effective in improving head nurses' management regarding applying international patient safety goals using the PDCA model after implementing the training program. Recommendations: The continuous training program and development activities about international patient safety goals should be applied to all head and staff nurses in the study setting, and extended to other similar settings.

Dimensions analysis of the Hospital Survey on Patient Safety Culture questionnaire in Iran: Psychometric properties.

The present study aimed to investigate the possible alternative factorial structure of the patient safety culture model in Iran. This study was performed based on data collected by Hospital Survey on Patient Safety Culture (HSOPSC) questionnaire from 420 staff in four hospitals. Internal consistency reliability and construct validity were evaluated by Cronbach's alpha and correlation analysis. Exploratory factor analysis (EFA), confirmatory factor analysis (CFA) and structural equation modeling (SEM) were used to investigate the possible alternative factorial structure, examine and confirm the obtained structure, alternatively. Kaiser-Meyer-Olkin measure and Bartlett test were calculated to determine the factor ability of sample and fit of the factor analysis, alternatively. SPSS and AMOS version 25 were used. EFA identified 12 dimensions which one dimension has been also created from a new question. Distribution of items in all dimensions differed from the original HSOPSC questionnaire except two dimensions. The obtained structure was a proportional model. The calculation of Cronbach's alpha (∝ = .8) showed that, the internal consistency reliability was appropriate for all items in the questionnaire. Also, construct validity was acceptable for all factors. The structure of the dimensions obtained in this study was not consistent with the structure of the original HSOPSC model. Provide a model for assessing patient safety culture with relative stability with respect to the native culture of the region. Good content and construct validity. Differences in the distribution of items in dimensions. Formation of new dimensions. Performing a psychometric analysis of the instrument using EFA, CFA and SEM to examine the disagreement on the validity, reliability and dimensions of patient safety culture in previous studies in Iran. Numerous discrepancies in item wording comply with the approach advocated by the translation guideline for AHRQ survey on patient safety.

Assessing patient safety culture and its associated factors in Tunisian primary healthcare centers

Abstract Background Primary healthcare centers provide the first contact for patients and it goes without saying that quality and patient safety in these facilities are vital goals and challenges. In fact, it has been identified that a significant proportion of safety incidents caught in hospitals had originated in the earlier levels of care, and some studies have found that errors in primary care can result in severe consequences. Hence why, a developed Patient Safety Culture is a component key to improve patient safety and healthcare quality in these settings. Thus, this study aimed to assess patient safety culture in Tunisian primary healthcare centers and to explore its associated factors. Methods It is a cross-sectional descriptive multicenter study, conducted from January to April 2016 in all the 30 primary healthcare settings of the Tunisian center, partners of the Faculty of Medicine of Sousse. The measurement instrument used was the validated French version of the Hospital Survey on Patient Safety Culture Questionnaire. The data analysis was conducted using the Statistical Package for Social Sciences (SPSS 20.0) and Epi info 6.04d for windows. Results A total of 214 professionals participated in the study, corresponding to a response rate of 85%. The “Teamwork within units” dimension had the highest score (71.5%). The lowest scores were for the dimensions related to “Frequency of events reported” and the “Non-punitive response to errors” (31.4% and 35.4% respectively). Additionally, the “Frequency of reported events” dimension was significantly higher among professionals involved in risk management committees (p = 0.01). Conclusions This study demonstrates that the level of patient safety culture needs to be improved in primary healthcare centers in Tunisia. Strategies to nurture patient safety culture should focus upon building leadership capacity that supports open communication, blame-free environment, teamwork and continuous organizational learning. Key messages Patient safety culture in primary healthcare settings is not as strong to ensure the provision of safe care. A well-designed patient safety initiatives, with organizational policies, must be integrated in order to enhance patient safety and quality of care.

Assessment of patient safety culture in intensive care units and factors affecting it

Abstract Background The intensive care units are a high-risk environments for the occurrence of adverse events with serious consequences. The development of patient safety culture is a strategic focus to prevent these adverse events and improve patient safety and healthcare quality. This study aimed to assess patient safety culture in Tunisian intensive care units and to determine its associated factors. Methods It is a multicenter, descriptive cross-sectional study, among healthcare professionals of the intensive care units in the Tunisian center. The data collection was spread over a period of 2 months (October-November 2017). The measuring instrument used is the validated French version of the Hospital Survey On Patient Safety Culture questionnaire. Data entry and analysis was carried out by the Statistical Package for Social Sciences (SPSS 20.0) and Epi Info 6.04. Chi-square test was used to explore factors associated with patient safety culture. Results A total of 404 professionals participated in the study with a participation rate of 81.94%, spread over 10 hospitals and 18 units. All dimensions were to be improved. The overall perception of safety was 32.35%. The most developed dimension was teamwork within units with a score of 47.87% and the least developed dimension was the non-punitive response to error (18.6%). The patient safety culture was significantly more developed in private hospitals in seven of the 10 dimensions. Participants working in small units had a significantly higher patient safety culture. It has been shown that when workload is reduced the patient safety culture was significantly increased. Conclusions This study has shown that the patient safety culture still needs to be improved and allowed a clearer view of the safety aspects requiring special attention. Thus, improving patient safety culture. by implementing the quality management and error reporting systems could contribute to enhance the quality of healthcare provided to patients. Key messages The culture of culpability is the main weakness in the study. Encouraging event reporting and learning from errors s should be priorities in hospitals to enhance patient safety and healthcare quality.

Assessing patient safety culture and its associated factors in 12 emergencies across Tunisia

Abstract Background Although the emergency departments (EDs) are the front line of the public health system, they are considered high-risk environments because of the shocking frequency of adverse events, within. Developing safety culture among EDs professionals, as a strategic focus, remains a priority. The purpose of this study is to measure safety culture in EDs and to determine its associated factors. Methods This is a cross-sectional and multicenter study, conducted among professionals from all the EDs of public and private healthcare institutions in central Tunisia. It was conducted from June to September 2017. The instrument tool used was the self-administered Hospital Survey On Patient Safety Culture questionnaire translated and validated by the CCECQA. Data entry and analysis were performed using SPSS 20.0 and Epi info 6. Also, ethical considerations were taken into account. Results In total, the study included 442 participants from 12 ED, with a participation rate of 80.35%. All the ten dimensions of safety culture were all to be improved. As for 'teamwork within units', it scored the highest with 46%, however, the lowest scores were attributed to 'the frequency of reported adverse events' (19.6%) followed by 'the non-punitive response to error' (19.8%). Private EDs have shown significantly higher scores regarding nine safety culture dimensions. Also, the size of the hospital was significantly associated with all dimensions of the safety culture. Conclusions This study has shown that the level of safety culture needs to be improved in public and private EDs and also underlines the importance of developing the safety culture and the implementation of safety and quality management systems. Key messages Patient safety culture is to be improved in Tunisian emergencies, although it is significantly more developed in private settings. A punitive culture still reigns in Tunisian healthcare context.

Assessment of patient safety climate by nurses in Slovak Public and private hospitals.

To examine variations in the safety climate reported by nurses in Slovak hospitals and to analyse the association between dimensions of the patient safety climate and demographic and organisational factors. A deeper understanding of how safety climate varies across hospitals can be useful in determining areas with a potential for improvement. Staffing and non-punitive response to errors were identified in recent research syntheses as the weakest dimensions of safety climate that require strengthening. The sample consisted of 1,429 nurses working in public and private hospitals in Slovakia. The Hospital Survey on Patient Safety Culture questionnaire was used for data collection, and descriptive analysis was carried out to examine relationships between variables. Nurses working in general private hospitals with abed capacity of less than 500 beds were more positive about their hospital safety climate than other nurses working in differently organised hospitals. The lowest number of positive responses was scored in the domain of 'Non-Punitive Response to Error'. This result came from a blame-free error-reporting atmosphere. Nurses perceived a higher level of patient safety when they had experienced better sharing of information on event reporting and had better learning opportunities. The results revealed strengths and weaknesses of the patient safety climate in the network of Slovak hospitals from the perspective of nurses working in these hospitals. This knowledge can enable nurse managers to instigate supportive strategies for just reporting, and learning from events, within an enhanced safety culture.

Cultura de seguridad del paciente en un hospital de alta especialidad

Introducción. La cultura de seguridad del paciente permite trabajar de manera multidisciplinaria, identificar vulnerabilidades y modificar áreas de oportunidad para disminuir riesgos que pudieran propiciar un error que cause daño al paciente. Objetivo. Describir el grado de cultura de seguridad del paciente en un hospital de alta especialidad. Métodos. Estudio cuantitativo, descriptivo y transversal, con técnica de muestreo aleatorio simple. Se aplicó el cuestionario Hospital Survey on Patient Safety Culture, de la Agency for Healthcare Research and Quality. Bajo las pautas SQUIRE para mejorar la atención médica. Resultados. El porcentaje general del grado de cultura de seguridad del paciente fue 45.1%, la percepción del personal sobre el grado de seguridad global del paciente 8.1/ 10. La fortaleza principal: Trabajo en equipo con 75.3%. Variables críticas: Personal, dotación, suficiencia y gestión (28.8%), Problemas en cambios de turno (34.8%) y Respuesta no punitiva a errores (21.5%). Conclusiones. Toda institución debe identificar las fortalezas y áreas de oportunidad, con el objetivo de vigilar los procesos que conllevan a mejorar la seguridad en atención y disminuir los sesgos que propician el error.

Front-line staff's perspective on patient safety culture in Iranian medical centers: A systematic review and meta-analysis.

The prerequisite for promoting safety culture is to assess the existing safety culture level of institutes, because safety precautions without appropriate evaluation increase costs and unforeseen risks. This study aimed to systematically review the status of patient safety culture from the perspective of clinical personnel at Iranian hospitals through a meta-analysis of studies using the Hospital Survey on Patient Safety Culture (HSOPSC) questionnaire. The present systematic review and meta-analysis was conducted in 2018. Data were gathered by searching Google Scholar, Scopus, PubMed, and Web of Science databases up to November 2018. Search keywords were "patient", "safety", "culture", "healthcare", "hospital", "medical center", "HSOPSC tool", and "Iran". The search protocol was limited to 10 years. To estimate the PSC score, computer software CMA:2 (Comprehensive Meta-Analysis) was used. The presence of heterogeneity across the studies was assessed with the I2 statistic. A forest plot was used to report the results. Publication bias was assessed through a funnel plot. The meta-analysis of studies showed that the PSC score based on the random effect model was 52.7% (95% CI: 50.2%-55.2%), (Q = 522.3, df = 54, P < 0.05, I2 = 89.6). A mean of 12 dimensions of HSOPSC showed that the "Teamwork within units" dimension had the highest PSC score (67.2%) and "Non-punitive response to error" had the lowest score (40.4%). Managers and policymakers should be directed towards non-punitive responses to errors and persuade staff to report errors and execute the approach to learn from mistakes. Also, a periodic government evaluation of the patient safety culture will help further its sustainable development.

A cross-sectional study of patient safety culture in acute-care hospitals in Greece

Background The development of a culture of safety can bring about an improvement in patient safety and quality of care. We aimed to investigate patient safety culture within an acute-care hospital setting in Greece. Methods A cross-sectional quantitative study was conducted using the Hospital Survey on Patient Safety Culture (HSOPSC) questionnaire in two large acute-care hospitals in Greece. We examined questionnaire’s factorial structure using confirmatory and exploratory factor analysis. We assessed scales’ internal consistency, test–retest reliability and construct validity. To assess changes in patient safety culture, we conducted surveys at two points in time (2009 and 2014). Regression analysis examined whether any changes in scale scores could have been due to quality programs implementation or participants’ professional characteristics. Results Six scales with satisfactory psychometric properties emerged, namely ‘Teamwork Across Hospital Units’, ‘Teamwork Within Hospital Units’, ‘Feedback and Communication About Error’, ‘Frequency of Event Reporting’, ‘Supervisor/Manager Expectations and ‘Actions Promoting Safety’, ‘Hospital Management Support for Patient Safety’. Overall ratings of patient safety did not change over time. However, one of the two institutions experienced an increase in reported events. Conclusions The HSOPSC is a valuable tool for assessing patient safety culture in Greece. Moreover, despite the radical reduction in the financing of the Greek National Health System reported between 2009 and 2014, patient safety culture did not deteriorate. A worldwide trend towards increasing patient safety awareness, along with the increasing effort of hospitals’ administration to support patient safety might explain this lack of differences between the two points in time.

A cultura de segurança do paciente na perspectiva multiprofissional

Objetivo: analisar as dimensões da cultura de segurança do paciente na perspectiva multiprofissional. Método: estudo exploratório-descritivo, com abordagem quantitativa realizado em duas instituições hospitalares do Sul do Brasil. Participaram do estudo 108 trabalhadores da equipe multiprofissional da saúde. A coleta de dados foi realizada entre agosto a dezembro de 2017 tendo como instrumento a aplicação do questionário Hospital Survey on Patient Safety Culture. A análise dos dados se deu por estatística descritiva e analítica. Resultados: as crenças, atitudes e percepções dos profissionais de saúde em relação à segurança do paciente ainda apresentam importantes fragilidades nos hospitais avaliados. Mesmo tendo considerado a percepção geral da cultura de segurança como adequada, destacam-se as fragilidades quanto ao dimensionamento de pessoal, respostas não punitivas aos erros e trabalho em equipe entre as unidades. Conclusão: a consolidação da segurança do paciente se configura como estratégia para melhoria da qualidade e remodelamento dos processos, possibilitando que práticas seguras qualifiquem o trabalho multiprofissional e ao mesmo tempo garantam a qualidade da assistência, a qual é um direito do paciente.

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 Latin American Spanish Version of the Hospital Survey on Patient Safety Culture Questionnaire in the Surgical Setting.

The Hospital Survey on Patient Safety Culture (HSPSC) was designed to assess staff views on patient safety and has been translated and validated into several languages and settings. This study developed a Latin American Spanish version of the HSPSC for use in perioperative settings and examines its psychometric properties. After translation and adjustments, a web-based questionnaire was administered to all health care personnel at operating room in a public university-affiliated hospital in Popayán, Colombia. Descriptive statistics, internal reliability, confirmatory and exploratory factor analysis, and intercorrelations among survey composites were calculated. Confirmatory factor analysis showed inadequate model fit for the original 12-factor structure of the HSPSC. Rather, a 9-factor, 36-item instrument showed acceptable factor loadings, internal consistency, and psychometric properties. Five factors were formed with minor changes. Adjusted factors emerged, like "staffing and work pressure" and "supervisor/manager expectations and actions promoting patient safety," "organizational learning-continuous improvement," and "hospital management support for safety," as well as "repeated errors and perception of safety." Internal consistency for each remaining composite met or exceeded a Cronbach α value of 0.60. Psychometric analyses provided overall support for 9 of the 12 initial factors of patient safety culture. Our findings suggest that more validation studies need to be conducted before applying safety dimensions from the original HSPSC to perioperative settings only. By providing this initial tool, we hope to stimulate further studies and the patient safety research agenda in this part of the world.

A comparative study on patient safety culture among emergency nurses in the public and private hospitals of Tabriz, Iran.

AimTo appraise patient safety culture in emergency departments of Iranian public and private hospitals.DesignA comparative cross‐sectional survey design was used.MethodsThis cross‐sectional study was conducted from January–March 2019. For data collection, the Hospital Patient Safety Culture (HSOPSC) questionnaire was employed. The study sample comprised 256 participants. Independent t test and analysis of variance were performed to report the mean differences in total patient safety culture perception according to the participants' characteristics and according to hospital ownership.ResultsThere was no significant difference in overall perceptions of patient safety culture in public and private sectors (2.94 vs. 2.84, p > .05). There are no solid areas regarding patient safety found neither in public nor in private sectors. Out of 12 dimensions of patient safety culture, different perceptions of nurses working in public and private hospitals belonged to “Organizational learning” (t = 2.13, p = .034) and “Handoffs and transitions” (t = 2.91, p = .004). Regarding the participants' characteristics, no significant difference was observed as to the perspectives of nurses on patient safety culture. However, there was a meaningful difference in the attitudes of nurses working in public hospitals according to their employment status (t = 2.07, p = .039).

WOMEN'S SAFETY CULTURE IN CHILDBIRTH AND RELATED INSTITUTIONAL FACTORS

ABSTRACT Objective: to analyze the safety culture of women in childbirth and related institutional factors based on the perceptions of nursing and medical professionals. Methods: a mixed, sequential explanatory study, conducted with nursing technicians, nurses and physicians of the obstetric center of a public maternity hospital in the city of Rio de Janeiro. Data collection took place from May to July 2018. The Hospital Survey on Patient Safety Culture questionnaire and descriptive statistical treatment were applied. Then, 12 semistructured interviews and thematic content analysis were applied and, finally, this data set was integrated. Results: most of the dimensions of the safety culture are weakened, especially in the areas of institutional organization, and the team lacks knowledge about the actions of the Patient Safety Center in the institution, the uniformity of care is deficient and the number of personnel for care is limited. The safety management process and work organization need adaptations. Conclusion: the safety culture of women requires improvements in team training, skilled care, work organization, and commitment of local management to qualified and safe care in hospital births.

Arabic version of pharmacy survey on patient safety culture: Hospital pharmacy settings.

Objective:The objective was to assess the validity and reliability of a translated Arabic language version of the pharmacy survey on patient safety culture released by the United States Agency for Healthcare Research and Quality in 2012 and to utilize this to assess staff attitudes and perceptions of the patient safety culture in hospital pharmacies of Kuwait.Methods:This study used a cross-sectional timeframe. Data were gained from three of the largest public hospital pharmacies and three of the largest private hospital pharmacies in Kuwait. The primary and secondary outcome measures were descriptive statistics, internal consistency, construct validity, model fit, and calculation of the positive response rate for all composites and items.Results:The results demonstrated that 9 of the 11 composites had a Cronbach’s alpha (α) of >0.7, and all composites had factor loadings above 0.6. The standardized root mean residual score appropriately fitted the data with a value of 0.072. The intercorrelations among the patient safety composites ranged from 0.29 to 0.83. The proportion of pharmacy staff who categorized the grade of patient safety as “Good,” Very good,” or “Excellent” was 93%.Conclusion:The Arabic version of the pharmacy survey on patient safety culture questionnaire indicated suitable levels of reliability and validity. Also, the results demonstrated that the pharmacy staff surveyed in Kuwait have a positive perception of patient safety culture in their organizations.

Patient safety culture: perception of nursing professionals in high complexity institutions.

to analyze the perception of nursing professionals about patient safety culture in three highly complex hospital institutions. descriptive and quantitative study with professionals working in care. The Hospital Survey on Patient Safety Culture questionnaire was applied, classifying its dimensions according to the percentage of positive responses (strengthened: ≥75.0%; potential for improvement: <75.0% to> 50.0%; weakened: ≤50.0%). four hundred sixty-seven professionals (79.6%), mostly women (88.4%), nursing technicians/assistants (57.2%), 20 to 39 years (60.8%), less than five years in the institution (57.8%) and exclusive bond (79.2%) participated in the study. Safety culture was considered fragile, seven dimensions assessed as such, highlighting "Openness to communication" and "Non-punitive responses to errors" with <30.0% positive responses. evidence of the need for discussion of the subject and strategies for change that promote quality and safety of care.

EFFECT OF THE ADMINISTRATIVE TRANSITION OF HOSPITAL MANAGEMENT ON THE SAFETY CULTURE IN SURGICAL UNITS

ABSTRACT Objective: to analyze the safety culture in surgical units of a teaching hospital in different periods of hospital management. Method: this is a descriptive and analytical study developed with health professionals working at a surgical center and at five surgical inpatient units in two different periods of hospital management in southern Brazil. The Hospital Survey on Patient Safety Culture questionnaire was answered by 73 professionals in period I (2014/2015) and by 158 professionals in period II (2017). The analysis was based on descriptive statistics and on inferential analysis and reliability analysis using Cronbach's alpha coefficient; the dimensions were considered strong when the percentage of positive answers was ≥75%. Results: the administrative transition had a positive influence on the “Staffing” and “Handoffs and transitions” dimensions and a negative influence on “Teamwork within units” (p&lt;0.001), with no difference in the remaining nine dimensions. In both periods, no dimension was considered strong; there were no changes with regard to the notification of adverse events and to the overall safety assessment; and the overall reliability of the instrument was satisfactory (0.89). Conclusion: the administrative transition of hospital management had little impact on the dimensions of the organizational safety culture, and there are still challenges in the progressive development of this predictor of patient safety.