Assessing Patient Safety Culture: Application of the Safety Attitudes Questionnaire in a Kenyan Setting

Abstract

Background: Patient safety has recently been declared a global health priority. Achievement and sustenance of a culture of patient safety require a regular and timely assessment of the organization. The Safety Attitudes Questionnaire is a patient safety culture assessment tool whose usefulness has been established in countries, but a few studies have been published from Africa, more so, in Kenyan settings. Objective: To evaluate the reliability of the Safety Attitudes Questionnaire in assessing the patient safety culture in a Kenyan setting and to assess healthcare workers' perceptions of patient safety culture. Methods: A descriptive quantitative approach was utilized whereby the Safety Attitudes Questionnaire was administered to 241 healthcare workers in two public hospitals. The Cronbach’s α was calculated to determine the internal consistency of the SAQ. Descriptive and inferential statistics were used to analyze and describe the data on patient safety culture. Results: The total scale Cronbach’s alpha of the SAQ was 0.86, while that of the six dimensions was 0.65 to 0.90. The overall mean score of the total SAQ was 65.8 (9.9). Participants had the highest positive perception for Job Satisfaction with a mean score of 78.3 (16.1) while the lowest was evaluated for Stress Recognition with a mean score of 53.8 (28.6). Conclusion: The SAQ demonstrated satisfactory internal consistency and is suitable for use in the Kenyan context. The perception of patient safety culture in the Kenyan hospital is below international recommendations. There is a need for implementation of strategies for the improvement of the organization culture in Kenyan hospitals.

Nurses and physicians attitudes towards factors related to hospitalized patient safety

“…Our study also showed that 87% of nurses (530/606) and almost 80% of physicians (421/527) gave low ratings to work conditions (WC) on patient safety. Similarly, low ratings of working conditions on patients’ safety was also observed in other countries [ 9 , 11 , 12 , 14 , 16 , 17 , 31 , 32 ] ( Table 4 ). The results of our study within the subscale WC were lower than the data obtained from nurses employed in Norway, Sweden or Brazil [ 33 , 34 ].…”

“…When comparing the findings internationally, the analyses showed that Polish nurses received lower mean results in the SR subscale than nurses working in Australia [ 9 ] or in Norway [ 10 ], but higher than nurses working in Sweden or Albania [ 11 , 12 ]. Polish nurses also obtained higher results than nurses working in Asian countries (China, Turkey, Saudi Arabia, Iran) [ 13 – 16 ], African (Kenya) [ 17 ] or in Americas (Brazil and Pittsburgh) [ 18 , 19 ] ( Table 4 ).…”

“…[ 14 ]. These results, however, were much lower compared to European countries such as Norway and Sweden [ 10 , 11 ], Asia nations (China, Saudi Arabia, Iran) [ 13 , 15 , 16 ], countries in the Americas (Brazil, and US-PA, Pittsburgh) [ 18 , 19 ], Australia [ 9 ] or Sub-Saharan Africa (Kenya) [ 17 ]. Polish physicians scored higher mean values in the area of team work (TC) than physicians from Albania [ 12 ], while lower than physicians working in Sweden, China, Kenya, America and Australia [ 9 , 11 , 13 , 17 ].…”

“…[ 12 ] and Turkey (46.44 pts.) [ 14 ], but definitely lower mean values than nurses working in Norway or Sweden [ 10 , 11 ], as well as in the area of Asia (China, Saudi Arabia, Iran) [ 13 , 15 , 16 ], Americas (Brazil, and the state of Pennsylvania US-Pittsburgh) [ 18 , 19 ], Australia (Australia) [ 9 ] or Africa (Kenya) [ 17 ]. Within the safety climate (SC) subscale, Polish physicians obtained higher mean results compared with the physicians from Sweden and Albania [ 11 , 12 ], ( Table 4 ).…”

Patient safety attitude among healthcare workers at different levels of healthcare in Sharqia Governorate, Egypt

“… 8 Patient safety in Kenya remains a challenge, with an increasing number of medical errors being reported in the media. 9 South Africa is among the developing countries that has a higher percentage of PS incidents. 10 Moreover, Eastern Mediterranean and African Study found that unsafe care affects around 10% of patients, most of those incidents were preventable.…”