Development and validation of questionnaire assessing the perception of hospital patient safety practices in public health facilities of India

Abstract

Background In ‘‘To Err is Human’’ released by the Institute of Medicine Committee on Quality of Health Care, it was emphasized that it is important to establish a safety culture in the hospitals and ensure that the patients are not inadvertently harmed by the errors. Hence, we developed and validated a questionnaire for assessing the perception of patient safety practices across the secondary and tertiary care facilities in India. Methods The scale was developed based on literature review and expert opinion. It consisted of 10 questions and response to these items were based on a 5-point Likert scale ranging from “strongly agree” to “strongly disagree”. All the analysis was performed using STATA version 14.2 software. Exploratory factor analysis (EFA) was run using principal components analysis with oblique Promax rotation, and confirmatory factor analysis (CFA) using structural equation modelling with maximum likelihood estimation. Results The entire dataset was split into testing set to run EFA (with 692 participants) and validation set to run CFA (with 645 participants). In EFA, two factors were retained as they had eigenvalue more than one (4.76, 1.09) and the scree plot also showed that the slope flattens off after two factors. Factor loadings were generated using oblique promax rotation. Factor 1 consisted of seven items (Item 1, Item 2, Item 3, Item 4, Item 5, Item 6, Item 7 – questions related to patient-doctor communication, hospital environment and procedures) accounting for 47.6% of variance, and Factor 2 had three items (Item 8, Item 9, Item 10 – infection prevention and control practices in hospital) explaining 10.9% of the variance. Thus, together the two factors explained 58.5% of the variance. CFA revealed good confirmatory fit indices of 0.85, standardized root mean square residual of 0.07 and acceptable Tucker-Lewis Index of 0.80. The reliability coefficient was 0.88 indicating very good internal consistency. Conclusion This study develops and validates a scale that can be used universally for assessing the patients’ perception on hospital safety practices across secondary and tertiary care facilities in India.

Nurses’ perspectives on nurses’ work methods

“…Since the end of the last century, with the publication of the “To Err is Human” report ( 1 ) , the importance of establishing a culture of safety in hospitals and ensuring that patients are not harmed by adverse events has been highlighted. The advancement of health technology and patients’ demands regarding health care have brought forth concepts related to the quality of care and patient safety as essential principles and key components of care delivery ( 2 ) .…”

“…Desde o final do século passado, pela divulgação do Relatório “ To Err is Human ”, realçou-se a importância de estabelecer uma cultura de segurança nos hospitais e garantir que os pacientes não fossem prejudicados por eventos adversos ( 1 ) . O avanço da tecnologia em saúde e as exigências dos pacientes no tocante à assistência em saúde fazem emergir conceitos relacionados com a qualidade dos cuidados e a segurança do paciente, como sendo princípios essenciais e componentes-chave da prestação de cuidados ( 2 ) .…”