A Longitudinal Study of Assessing the Patient Safety Culture from Nurses’ Viewpoints Based on the Safety Attitudes Questionnaire in Taiwan

Abstract

This study uses internal survey data based on the Chinese version of safety attitudes questionnaire in 2011-2014 from a regional teaching hospital in Taichung City, Taiwan to assess nurses' perceptions toward the patient safety culture. In order to make a comparison among different years, analysis of variance with  = 0.05 is used, and Bonferroni method is chosen to perform post hoc analysis. The results show that teamwork climate has been improved since 2012. Safety climate, job satisfaction, stress recognition, and perception of management have not been improved or declined statistically in 2011-2014. In contrast, the hospital management needs to pay much attention to working condition because the performance perceived by nurses has been decreased and reached the lowest agreement value in 2014 among four years. Obviously, working condition should be improved in a top priority in order to improve the patient safety culture in this case hospital.

The Assessment of the Patient Safety Culture Based on the Safety Attitudes Questionnaire in a State-Owned Regional Hospital in Taiwan

“…There are six dimensions in the safety attitudes questionnaire including teamwork climate, safety climate, perceptions of management, job satisfaction, stress recognition, and working conditions [1], [10]. Besides, safety attitudes questionnaire has thirty questions as shown in Table 1, and each question uses a five-point Likert's scale ranging from strongly agree to strongly disagree [2]. Both physicians and nurses are required to fill out these thirty questions on a yearly basis [3].…”

“…A positive patient safety culture in healthcare organizations improves patient safety performance and safety outcomes [1], [4]. More importantly, it indicates that organizations strive to improve patient safety relentlessly and place the patient safety culture as one of their highest priorities [2]. Furthermore, Aghdash et al [5] summarized that patient safety, which is a critical element for healthcare organizations, should be assessed on a regular basis to improve patient safety.…”

“…Chen and Li [4] emphasized that the culture of healthcare organizations should be assessed in order to improve patient safety within the healthcare processes. Based on the assessment results, healthcare organizations can identify specific requirements to strengthen their patient safety culture and then make comparisons with other healthcare organizations [2]. Safety attitudes questionnaire (SAQ) originally developed by Sexton et al [7] has been widely used to assess the safety culture of healthcare organizations [8]- [10].…”

“…Lee et al [2] pointed out that nurses' attitudes toward the patient safety culture is critically important because they have contacts and close relationships with patients in healthcare organizations. Lee et al [12] stated that the core staffs in healthcare organizations are physicians and nurses and it would be of interest to observe how their attitudes toward the patient safety culture.…”

A Comparative Study of a State-Owned and A Private Regional Hospitals in Taiwan by Safety Attitudes Questionnaire from Viewpoints of Physicians and Nurses

“…Chi et al [2] pointed out that assessing the existing patient safety culture enables hospital management to have a clear vision of a healthcare organization to identify its strengths and weaknesses. Safety attitudes questionnaire developed by Sexton et al [3] possesses good psychometric properties and great internal consistency, has been validated in different languages, and is considered as an effective tool to assess the patient safety culture from employees' viewpoints in healthcare organizations [2], [4], [5].…”