Patient Safety Culture Research Articles

Patient safety culture can improve the quality of nursing care

Patient safety is an indispensable and vital component of healthcare systems, constituting a fundamental pillar of quality within healthcare organizations [1]. Currently, the focus on ensuring patient safety is a crucial aspect of delivering healthcare services in hospitals, as any deficiencies in this area may result in unfavorable outcomes. Indeed, the entitlement to be protected from harm while undergoing medical treatment is a fundamental human right. Ensuring patient safety is a critical measure of hospital management, and neglecting it may result in a rise in patient mortality [2]. Nursing errors and mistakes not only result in harm to patients but also give rise to various issues. These include ineffective and incomplete treatment, prolonged hospital stays, escalated expenses, erosion of patient confidence in the healthcare system, and the potential for legal complications for nurses [3].

Maximizing Patient Safety in Al-Diwaniya Private Pharmacies: An Exploratory Review of the Various Physiological Disorders Where Field Pharmacists are Central to Treatment and Management

The community pharmacist is unique among health care providers in that he or she interacts with a wide variety of people every day, giving them enough opportunities to raise patients' levels of self-awareness and provide guidance toward healthier lifestyle choices. This project detailed the duties of several authorized committees and administrations, some of which were excellent and others of which were subpar. There has to be more work done by community pharmacists to help improve health care, but integrated care where they provide clinical pharmacy services while dispensing may make a big difference. From December 2021 until the end of May 2022, online surveys were conducted. The pharmacists' understanding of patient safety culture was evaluated using a community pharmacy questionnaire. The results showed that of all the areas examined, patient counseling had the greatest level of positive awareness (23–59%), and yet only 18% of pharmacists regularly educate patients of important information about their new prescriptions, which is a very low response rate.

Investigating the Relationship between Communication Skills of Treatment Staff and Patient’s Safety Culture: A Cross-Sectional Study

Background: One of the most important effective factors in increasing patient satisfaction and improving health and treatment results is proper communication between physician and nurse, and the patient. The present study was conducted with the aim of determining the relationship between the communication skills of the medical staff and patient’s safety culture. Methods: This was an analytical study conducted among 277 working medical staff including nurses, paramedics, full-time geographical employment doctors and anesthesia, and operating room technicians in Shahid Sadoughi Hospital in Yazd by stratified random sampling in 2022. The instrument used was the safety culture standard questionnaire made by the health care quality and research agency and communication skills of Barton J. Data analysis was done with SPSS 25 software, Mann-Whitney, Kruskal-Wallis, and multiple linear regression tests. Results: The overall mean and standard deviation of patient safety culture was 3.04 ± 0.23, which indicates the average status of safety culture in the studied hospital, and the overall mean of communication skills among medical staff was 3.36 ± 0.40. Which reports a relatively strong level of this skill. The results of linear regression showed that 2 components of communication skills (listening and feedback) have a positive and significant effect on the improvement of patient safety culture, so that they are able to explain 33 percent of the variance of patient safety culture changes. Conclusion: Based on the findings of the research, the communication skills of the medical staff have a significant effect on patient's safety culture. Therefore, in order to improve the patient’s safety culture among them, special attention should be paid to communication skills because effective communication is considered a vital element in effective care, and in the medical system it has a significant effect on the quality of care and consequently increases the satisfaction of patients.

Determination of Patient Safety Culture Perception in Internal Medicine Clinic Nurses

Objectives: This study was conducted to determine patient safety cultural perception and the factors affecting this perception among internal medicine clinic nurses. Methods: It was conducted descriptively with 90 nurses working in Internal Clinics between January and March 2019. In the study, “Introductory Information Form” and ‘‘the Hospital Survey on Patient Safety Culture’’ were used for data collection. In the analysis of the data, t test, Mann Whitney U test, Kruskal Wallis H test, and Tamhane's Post Hoc test were used. Results: Mean overall scores of patients from Patient Safety Culture Survey were found to be (3.12±0.30). The highest mean score was found in “Teamwork in Units” sub-dimension (3.96±0.18), while the lowest mean score was found in “Hospital Interventions and Change” sub-dimension (2.20±0.32). Conclusions: It was found that nurses had moderate level of patient safety culture perceptions. With training programs on patient safety, nurses’ awareness can be increased and the perception of patient safety culture can be increased to high levels.

Emergency department nurses' reflective thinking and patient safety competency: The mediating effect of patient safety culture

AimThis study aimed to identify the mediating effect of patient safety culture on the relationship between reflective thinking and patient safety competency in emergency department nurses. BackgroundGiven the complexity and the need for timely assessments and interventions in the emergency department, the patient safety competency of nurses is crucial for preventing safety incidents. MethodsThis study utilized a cross-sectional descriptive correlational design with a convenience sample of 200 emergency department nurses. Participants completed a web-based, self-administered questionnaire that assessed reflective thinking, patient safety culture, and patient safety competency. The percentile bootstrap method for mediation analysis was performed to ascertain the mediating role of patient safety culture in the relationship between reflective thinking and patient safety competency. ResultsBoth reflective thinking and patient safety culture were significant predictors of patient safety competency. Furthermore, patient safety culture was found to mediate the relationship between reflective thinking and patient safety competency among emergency department nurses. ConclusionsThe findings suggest that emergency department nurses could benefit from a competency enhancement program or quality improvement projects that focus on reflective thinking and patient safety culture, which are significant predictors of patient safety competency.

A Study on Internet News for Patient Safety Campaigns: Focusing on Text Network Analysis and Topic Modeling.

Background/Objectives: This study aimed to identify the main issues related to public patient safety campaigns reflected in Korean online news. This study utilized a text-mining method to identify keywords and topics related to patient safety campaigns. Methods: The data collection period was from 1 January 2022 to 31 December 2023, and 4110 news articles were extracted. Through data preprocessing, 2661 duplicated news and 1213 unrelated news were removed, and 236 news were selected. Using the NetMiner program, keyword co-occurrence frequency calculation, keyword centrality analysis, and topic modeling analysis were performed. Results: The results showed that the most frequently mentioned keywords with high degree centrality, betweenness centrality, and closeness centrality in online news were "hospital", "medical", "medicine", "project", and "treatment". The topics of online news related to the patient safety campaign were "patient-centered care for medical safety", "health promotion projects at a regional institution", "hand hygiene education to prevent infection", "healthcare quality improvement through the Mint Festival", and "safe use of medicines". Conclusions: This study analyzed patient safety campaign news topics using text network analysis and topic modeling. It was confirmed that patient safety campaigns are essential for fostering a patient safety culture, improving medical quality, and encouraging patient participation in hospitals. Therefore, to build a safe medical environment, it is necessary to establish an effective patient safety campaign for not only medical staff providing medical care, but also patients and their caregivers, and for this, cooperation and participation from various professional occupations are necessary.

Patient Safety Culture in Hospital Settings Across Continents: A Systematic Review

Patient Safety Culture (PSC) is the cornerstone of quality healthcare. Prior research has highlighted the critical role of a safety culture in healthcare. The Institute of Medicine (IOM) has emphasized its effectiveness in reducing errors and improving patient care. This systematic review investigated variations in how staff at international hospitals perceive PSC. In addition to assessing the status of patient safety, this investigation offers a comprehensive synthesis of research from multiple countries to inform future research endeavors. It focused on studies published between 2010 and 2024 that used the standardized Hospital Survey on Patient Safety Culture (HSOPSC) tool, versions 1.0 and 2.0. By following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the review identified vital strengths and weaknesses in PSC globally. Despite these variations, two key strengths emerged consistently across studies, particularly in Asia: teamwork within units and a focus on continuous learning. However, healthcare professionals also raised concerns about a punitive environment that discourages error reporting and inadequate staffing levels. Interestingly, nurses held less positive views on some PSC aspects compared to mixed staff. Several PSC areas of concern raised in previous studies have continued to appear in recent studies. These findings highlight the need for a holistic approach to strengthen PSC globally. This includes fostering a just culture that encourages error reporting, addressing staffing shortages, and promoting open communication among all healthcare professionals. Additionally, tailoring interventions to address regional variations is crucial for creating a safer and more supportive environment for patients worldwide.

Lessons learnt from a 2017 Irish national clinical claims review: a retrospective observational study

ObjectiveLearning from adverse outcomes in health and social care is critical to advancing a culture of patient safety and reducing the likelihood of future preventable harm to service users. This...

Effect of Feedback Provision on Improving Patient Safety Indices Based on Hospital Accreditation Model: A Study in Shahid Rahnemoon Hospital, Yazd

Background: Accreditation means systematic evaluation of health service centers with specific standards. One of the most important goals of the accreditation process is to improve patient safety. Patient safety visits are one of the most important standards for improving safety. One of the ways to increase the effectiveness of visits is holding feedback sessions. Objectives: The present study was conducted with the aim of assessing the effect of feedback provision on improving patient safety indices based on the hospital accreditation model in Shahid Rahnemoon Hospital, Yazd. Methods: The present study is a semi-experimental study with a before-and-after design that was conducted in Shahid Rahnemoon Hospital, Yazd, from September to December 2021 and January to August 2022. After each visit, formal feedback sessions were held with the attendance of patient safety team members and officials of the visited wards/units. Evaluation indicators included patient safety indicators in accreditation standards, such as error reporting, rate of unwanted events, and patient safety culture score. These were measured before and after feedback. The tools used were the patient safety standards evaluation checklist based on the accreditation model, the patient safety culture questionnaire, and other indicators extracted using documentation. The Patient Safety Culture Evaluation Questionnaire was completed by 360 nurses working in the hospital in the form of a census. Analysis was done using descriptive statistical tests and paired t-tests with STATA 14.2 software. Results: Based on the results of the study, safety feedback was provided to increase patient safety indicators in different departments and units of hospitals [t = - 4.8652, w/df = 10, P = 0.0007, (P = 0.05)]. A significant difference was observed in the amount of error reporting (P = 0.031) and patient safety (P < 0.001) before and after the intervention. The degree of compliance with the dimensions of the patient safety culture had a statistically significant difference before and after the intervention (P < 0.001). Conclusions: Providing a safety feedback program had a significant positive effect on the consumption and consequences of the patient’s safety culture. Therefore, conducting regular safety visits and setting up a direct feedback program to each department/unit after the visit, and the follow-up of corrective measures, will lead to an increase in patient safety standards.

Patient Safety Culture in a Tertiary Referral Hospital: Evidence from a Main Criterion in Accreditation

Objectives: In Iran’s accreditation program, the patient safety dimension is one of the main dimensions, holding the highest weight among the accreditation criteria. The purpose of this study was to identify the patient safety culture (PSC) in a tertiary referral hospital. Methods: The current study was conducted between March and April 2021 in a tertiary hospital in Iran. The sample size was 628 participants, selected through simple random sampling. The hospital survey on patient safety culture (HSOPSC) was used to assess provider and staff perceptions about patient safety issues, medical errors, and event reporting. The survey included 32 items that measure 10 dimensions of PSC. Normality tests, along with non-parametric Mann-Whitney and Kruskal-Wallis tests, were used to examine the relationship between PSC and demographic variables using SPSS 22 software. Results: Based on current findings, among the 10 dimensions of PSC, teamwork and organizational learning-continuous improvement received the highest scores (83% positive response), which were higher than these variables in the Agency for Healthcare Research and Quality (AHRQ) data. Conversely, staffing and work pace, as well as hospital management support for patient safety, received the lowest positive scores (43% and 55% positive response, respectively), which were lower than these variables in the AHRQ data. There was a significant positive relationship between dimensions of PSC and older age, female gender, staff with longer working experience, and longer work hours per week (P < 0.05). Conclusions: The majority of our participants felt that patient safety needs to be enhanced. Based on the findings of this study, it is recommended to emphasize the dimensions of “staffing and work pace” and “hospital management support for patient safety” more in the accreditation criteria to strengthen these dimensions in hospitals. Additionally, we have introduced a comprehensive guide for using an international tool to measure PSC, which hospitals can use to succeed in annual accreditation.

Relationship among Nursing Work Environment, Professional Competencies, Patient Safety Culture, and Attitude toward Incident Report

Relationship among Nursing Work Environment, Professional Competencies, Patient Safety Culture, and Attitude toward Incident Report

Determination of Medical Faculty Clinical Students' Attitudes Towards Patient Safety: A Mixed Design Study

BackgroundThe study was planned to determine the attitudes of medical faculty students in clinics toward patient safety. MethodsIt is a mixed-design study using quantitative and qualitative methods. The “student information form” and the “Attitudes toward Patient Safety Culture Questionnaire (APSQ)” created using “Google Forms” were e-mailed to clinical students of the medical faculty. Quantitative data were collected from 125 students. Then, semi-structured focus group interviews were conducted with six students from each class. The data were obtained through video and audio recordings of the 45-minute interviews through the Zoom program. ResultsAccording to the results, 86% of the 125 students did not receive any training on patient safety. The total score of the students on the APSQ was 94.87 ± 14.32. Six main themes and twenty sub-themes emerged from the qualitative data. The main themes are students' awareness of patient safety, students' misconceptions about “patient safety,” students' knowledge about the scope of patient safety, students' experiences with medical errors, deficiencies in educational processes on patient safety, and suggestions for educational approaches to patient safety. ConclusionsAfter completing undergraduate medical education, physicians typically assume roles as general practitioners in various healthcare settings, such as hospital’s emergency departments, home care, or community health centers. The lack of awareness among medical students about patient safety is a significant concern that needs to be addressed. As stakeholders in their education, students recognize the importance of being well-prepared to provide safe and effective patient care in their future roles as physicians.

Patient Safety Culture Scale in Medication Administration: A Scale Development Study

Patient Safety Culture Scale in Medication Administration: A Scale Development Study

Assessing Patient Safety Culture: Insights from a Neurological Institute.

A cross-sectional descriptive study was conducted among healthcare workers exercising at a neurological institution using a validated Hospital Survey of Patient Safety Culture questionnaire containing ten safety care dimensions. A total of 123 responses to the questionnaire were analyzed, accounting for 34.5% of the total (Cronbach's alpha=0.677). Among the participants, 61.8% considered the level of awareness regarding patient safety to be acceptable. The dimensions considered as strengths were "Organizational learning and continuous improvement" with the highest positive response (60.3%) "Relationship patient-staff member" (58.9%) and "Teamwork within units" (58.9%). However, the dimensions considered as weaknesses were "Management support for patient safety" with 28.5% of positive responses and "Communication openness and non-punitive response to error" (40%). Patient safety culture among healthcare professionals is at an average with "Organizational learning and continuous improvement" being a positive aspect. However, improvements should be made in all dimensions to enhance and promote patient safety within the institution.

Exploring the relationship between patient safety culture and the full-range leadership theory in primary care settings: a conceptual analysis

PurposeThis study aims to investigate the conceptual relationship between full-range leadership theory (FRLT) and patient safety culture in primary care settings, aiming to understand how leadership styles influence the development and sustainability of a culture prioritizing patient safety.Design/methodology/approachUsing a conceptual analysis approach, the study builds a theoretical framework that integrates FRLT – which includes transformational, transactional and laissez-faire leadership styles – with the elements of patient safety culture. This framework serves as the basis for a comprehensive literature review, allowing for the formulation of hypotheses regarding the impact of each leadership style on patient safety culture.FindingsThe analysis demonstrates that transformational leadership bolsters patient safety culture by fostering open communication, encouraging error reporting and facilitating continuous improvement. Transactional leadership yields mixed effects, effectively supporting compliance and operational outcomes but showing limitations in promoting a proactive safety culture. Conversely, laissez-faire leadership is associated with negative outcomes for patient safety culture, mainly due to its passive and detached approach.Originality/valueThe originality of this study is rooted in its focused examination of FRLT’s impact on patient safety culture within primary care settings, the development of a unique conceptual framework and its contribution of actionable insights for health-care leadership. These elements collectively advance the understanding of how leadership can enhance patient safety culture, providing a solid foundation for future research and practical application in primary care environments.

Patient safety initiatives and practices in Nigerian healthcare settings: A comprehensive analysis of current knowledge, challenges, and barriers

The imperative of patient safety in healthcare takes a central stage, more so in the context of Nigeria. This review aims to provide a comprehensive understanding of the patient safety landscape in Nigeria, drawing on 12 empirical studies. This study aims to elucidate the multifarious challenges and barriers health-care professionals encounter in Nigeria concerning patient safety. Concurrently, it delves into the prevailing patient safety culture and the factors shaping it. This study used secondary data to conduct a systematic review of existing literature; 12 studies, spanning from 2015 to 2022, were meticulously examined. These explorations cover a broad spectrum of patient safety aspects in Nigeria, focusing particularly on the insights of nurses and doctors. Through the use of thematic analysis, the studies’ synthesis illuminates a significant gap between the envisioned safety protocols and their on-ground realization. Exacerbating this challenge is the acute lack of resources, which invariably hampers the quality of care. In addition, barriers to effective communication and inadequate reporting mechanisms emerge as significant obstacles. The deficiencies in consistent training and education are also prominent, which stand as potential vulnerabilities in the system. The palpable need for heightened awareness, emphasis on recurrent training initiatives, and strict adherence to established safety guidelines are amplifying these concerns. It was, thus, concluded that the healthcare trajectory in Nigeria, as informed by this review, underscores a pressing need for systemic interventions to elevate patient safety standards. Such a transformative journey demands the concerted efforts of all stakeholders, fostering an environment that prioritizes patient safety and enhances the overall trust in Nigeria’s healthcare system.

Associations of perceptions of patient safety culture, job crafting, and perceptions of patient rounding with patient safety management activities among tertiary hospital nurses

Associations of perceptions of patient safety culture, job crafting, and perceptions of patient rounding with patient safety management activities among tertiary hospital nurses

Nurses' burnout and patient safety culture: The moderating effect of structural empowerment.

To identify correlations among job burnout, structural empowerment, and patient safety culture (PSC), and to explore the potential moderating effect of structural empowerment on the associations between burnout and PSC. The study used a cross-sectional survey design. Convenient sampling was employed. We conducted an anonymous online survey in January 2024 among nurses employed at hospitals in three regions of China. Job burnout, structural empowerment, and perceptions of PSC were assessed. A total of 1026 useable surveys were included in the analyses. Descriptive statistics were performed using SPSS software. A latent structural equation modeling approach using Mplus software was used to analyze the moderating effect. The proposed hypothetical model was supported. Job burnout had a strong direct negative effect on structural empowerment and PSC. Structural empowerment had a significant moderating effect on the relationship between job burnout and PSC. The empirically validated moderation model and study results suggest that managers of healthcare organisations can improve patient safety and care quality by fostering empowerment and providing sufficient support to clinical nurses. The findings of this study suggest that providing more support, resources, and information is likely to be effective in weakening the detrimental impact of job burnout on PSC. This study provides insights into the possible approaches that may improve patient safety. To control the impact of nurses' burnout on care quality, nurse managers should increase empowerment as well as staff nurse engagement. We have adhered to relevant EQUATOR guidelines and conducted an observational study, following the STROBE checklist. During the data collection phase of this study, clinical caregivers participated in completing the online survey.

The Veterinary Student Survey on Patient Safety Culture (VSSPSC): A Quantitative and Qualitative Exploration of American Veterinary Students' Perceptions of Patient Safety Culture.

Patient safety culture (PSC) is a multidimensional construct that reflects the way healthcare organizations promote safe patient care. Veterinary students are explicitly and implicitly indoctrinated into organizational cultures and will carry these attitudes and behaviors into their future work. In this study, we evaluated the psychometric properties of a PSC survey among veterinary students in the United States and investigated their attitudes toward PSC. Exploratory factor analysis identified factors that explained portions of the variance in responses. Importantly, the measures derived from those factors predicted the likelihood of a student mentioning a negative experience/opinion regarding error reporting. Most students reported receiving explicit training in communication, but coursework in other areas, such as human factors and safety culture, was uncommon. Veterinary students generally reported high levels of agreement with the tenets of patient safety science, though some items demonstrated wide variation in responses, underscoring the need for more uniform incorporation of education in veterinary PSC.

Perceptions of hospital electronic health record (EHR) training, support, and patient safety by staff position and tenure

BackgroundHospitals rely on their electronic health record (EHR) systems to assist with the provision of safe, high quality, and efficient health care. However, EHR systems have been found to disrupt clinical workflows and may lead to unintended consequences associated with patient safety and health care professionals’ perceptions of and burden with EHR usability and interoperability. This study sought to explore the differences in staff perceptions of the usability and safety of their hospital EHR system by staff position and tenure.MethodsWe used data from the AHRQ Surveys on Patient Safety Culture® (SOPS®) Hospital Survey Version 1.0 Database and the SOPS Health Information Technology Patient Safety Supplemental Items (“Health IT item set”) collected from 44 hospitals and 8,880 staff in 2017. We used regression modeling to examine perceptions of EHR system training, EHR support & communication, EHR-related workflow, satisfaction with the EHR system, and the frequency of EHR-related patient safety and quality issues by staff position and tenure, while controlling for hospital ownership type and bed-size.ResultsIn comparison to RNs, pharmacists had significantly lower (unfavorable) scores for EHR system training (regression coefficient = -0.07; p = 0.047), and physicians, hospital management, and the IT staff were significantly more likely to report high frequency of inaccurate EHR information (ORs = 2.03, 1.34, 1.72, respectively). Compared to staff with 11 or more years of hospital tenure, new staff (less than 1 year at the hospital) had significantly lower scores for EHR system training, but higher scores for EHR support & communication (p < 0.0001). Dissatisfaction of the EHR system was highest among physicians and among staff with 11 or more years tenure at the hospital.ConclusionsThere were significant differences in the Health IT item set’s results across staff positions and hospital tenure. Hospitals can implement the SOPS Health IT Patient Safety Supplemental Items as a valuable tool for identifying incongruity in the perceptions of EHR usability and satisfaction across staff groups to inform targeted investment in EHR system training and support.