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

Tlili, Mohamed Ayoub; Aouicha, Wiem; Sahli, Jihène; Zedini, Chekib; Dhiab, Mohamed Ben; Chelbi, Souad; Mtiraoui, Ali; Latiri, H Said; Ajmi, Thouraya; Rejeb, M Ben; Mallouli, Manel

doi:10.1016/j.aucc.2020.09.004

Cited by 18 publications

(25 citation statements)

References 37 publications

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“…The second high dimension was teamwork within units of 86% score, which was similar to the results from previous studies [19][20][21][22][23][24]. Nurses in this hospital believe that good teamwork is crucial for improving patient safety culture.…”

Section: Discussionsupporting

confidence: 85%

Patient safety culture in Palestine: university hospital nurses’ perspectives

2022

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Background Understanding the perspectives of healthcare workers toward patient safety-related activities is critical in maintaining a healthy safety climate. The objectives of this research are 1) to examine the perception of Patient Safety Culture (PSC) at a university hospital in Palestine, and to highlight areas in need of improvement, and 2) to assess the relationship between the outcome dimensions (frequency of events reported, and overall perceptions of safety) and the other dimensions of PSC, and 3) to determine the relationship among selected demographic variables (gender, age, hospital tenure, work tenure, profession tenure, and hours worked per week) and nurses’ perceptions of PSC. Methods A cross-sectional study design was used with a convenience sample of 107 nurses. Nurses were asked by email to complete the Arabic version of the Hospital Survey of Patients’ Safety Culture (HSOPSC) using the SurveyMonkey® online account form within two weeks. The survey data were analyzed using descriptive and inferential statistics. Univariate and multiple regression were used to examine the relationships. Results The dimensions of patient safety with the highest positive response were organizational learning and continuous improvement (87%) and teamwork within units (86%). The dimension with the lowest positive score was the nonpunitive response to error (22%). Multiple regression revealed that the dimension of communication openness was a predictor of the overall perceptions of safety (β = 0.257, p = 0.019). In addition, the dimension of feedback and communication about error was a predictor of the frequency of the reported events (β = 0.334, p = 0.005). Furthermore, age was found to be a predictor of PSC (p < 0.05). Conclusions This study provides a general assessment of perceived safety among nurses in a hospital. However, we found that nurses negatively perceive a nonpunitive response to error. Therefore, strenuous efforts are required by hospital management to improve the culture of incident reporting.

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Section: Discussionsupporting

confidence: 85%

Patient safety culture in Palestine: university hospital nurses’ perspectives

2022

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“…Staffing (D8) was also revealed to be a concerning dimension; it had a score of 27.2% with responses to statements highlighting staff shortage, high level of workload and emphasized therefore the deplorable working conditions within the included ICUs. A study exploring patient safety culture in ICUs in 10 hospitals also revealed that the PSC was substantially less developed when the workload was higher, which can have negative consequences for both the staff and the patient [27].…”

Section: Discussionmentioning

confidence: 99%

Assessing patient safety culture in 15 intensive care units: a mixed-methods study

Tlili

Aouicha

Sahli

et al. 2022

BMC Health Serv Res

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Background Within hospitals, intensive care units (ICUs) are particularly high-risk areas for medical errors and adverse events that could occur due to the complexity of care and the patients’ fragile medical conditions. Assessing patient safety culture (PSC) is essential to have a broad view on patient safety issues, to orientate future improvement actions and optimize quality of care and patient safety outcomes. This study aimed at assessing PSC in 15 Tunisian ICUs using mixed methods approach. Methods A cross-sectional mixed methods approach using a sequential explanatory design was conducted from December 2019 to January 2020. The first quantitative stage was conducted in 15 ICUs belonging to the two university hospitals in the region of Sousse (Tunisia). All the 344 healthcare professionals (clinical staff) working for more than 1 month in these ICUs were contacted in order to take part in the study. In the second qualitative stage 12 participants were interviewed based on purposive sampling. Results All of the PSC dimensions had a score of less than 50%. The developed dimension was ‘teamwork within units’ (48.8%). The less developed dimensions were ‘frequency of event reporting’ (20.8%), ‘communication openness’ (22.2%) and ‘non-punitive response to error’ (19.7%). Interviews’ thematic analysis revealed four main themes including “Hospital management/system failure”, “Teamwork and communication”, “Error management” and “Working conditions”. Conclusion This research revealed that PSC is still in need of improvement and provided a clearer picture of the patient safety issues that require specific attention. Improving PSC through the use of quality management and error reporting systems may help to improve patient safety outcomes.

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“…Nursing activities in ICUs are dynamic and variable over the 24‐h period 3 and the management of nursing workload is becoming a challenge 1,4–9 . In fact, increased nursing workload is associated with increased incidence of adverse events 10,11 that could compromise the patient safety culture 12–14 and the quality of care 6,15,16 …”

Section: Introductionmentioning

confidence: 99%

“…1,2 Nursing activities in ICUs are dynamic and variable over the 24-h period 3 and the management of nursing workload is becoming a challenge. 1,[4][5][6][7][8][9] In fact, increased nursing workload is associated with increased incidence of adverse events 10,11 that could compromise the patient safety culture [12][13][14] and the quality of care. 6,15,16 According to a recent Systematic Review, 4 Health care Systems should invest in appropriate nurse staffing models to enhance patient health.…”

Section: Introductionmentioning

confidence: 99%

Nursing workload assessment in an intensive care unit: A retrospective observational study using the Nursing Activities Score

Sardo

Macedo

Alvarelhão

et al. 2022

Nursing in Critical Care

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Background: Nursing Activities Score (NAS) is a promising tool for calculating the nursing workload in intensive care units (ICU). However, data on intensive care nursing activities in Portugal are practically non-existent.Aim: To assess the nursing workload in a Portuguese ICU using the NAS.Study Design: Retrospective cohort study developed throughout the analysis of the electronic health record database from 56 adult patients admitted to a six-bed Portuguese ICU between 1 June-31 August 2020. The nursing workload was assessed by the Portuguese version of the NAS. The study was approved by the Hospital Council Board and Ethics Committee. The study report followed the STROBE guidelines. Results:The average occupancy rate was 73.55% (±16.60%). The average nursing workload per participant was 67.52 (±10.91) points. There was a correlation between the occupancy rate and the nursing workload. In 35.78% of the days, the nursing workload was higher than the available human resources, overloading nurse staffing/team.

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

Cited by 18 publications

References 37 publications

Patient safety culture in Palestine: university hospital nurses’ perspectives

Patient safety culture in Palestine: university hospital nurses’ perspectives

Assessing patient safety culture in 15 intensive care units: a mixed-methods study

Nursing workload assessment in an intensive care unit: A retrospective observational study using the Nursing Activities Score

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