Keeping patients safe in healthcare organizations: a structuration theory of safety culture

Groves, Patricia S.; Meisenbach, Rebecca J.; Scott-Cawiezell, Jill

doi:10.1111/j.1365-2648.2011.05619.x

Cited by 67 publications

(69 citation statements)

References 22 publications

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“…Therefore, the impact of the factors that favor patient safety is expected to be felt in the future, and the findings of this study may contribute to change the focus of the institution to the search for a safety culture (8) . The low scores of the domain perception of hospital and unit management suggest that the institution should focus on leadership skills training.…”

Section: Discussionmentioning

confidence: 99%

“…In this context, the environment of health organizations is a determining factor in the quality and safety of health care, and the nursing team provides a significant contribution to the creation of a safety environment for health. The major role played by the nursing team in this regard can also be explained by the fact that this team adds knowledge on the health environment due to the proximity of nurses to patients (8) .…”

Section: Introductionmentioning

confidence: 99%

“…Some studies recommend the assessment of the safety climate as an indirect measure of the culture, which can be measured by attitudes that favor patient safety (8)(9) . Job satisfaction, the way in which the institution deals with errors, and perception of the types of management by health workers are considered essential indicators of the presence of attitudes that favor a safety climate in health institutions (9)(10) .…”

Section: Introductionmentioning

confidence: 99%

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Ambiente de trabalho da enfermagem, segurança do paciente e qualidade do cuidado em hospital pediátrico

Alves

Guirardello

2016

Rev. Gaúcha Enferm.

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How to cite this article:Alves DFS, Guirardello EB. Nursing work environment, patient safety and quality of care in pediatric hospital. Rev Gaúcha Enferm. 2016 jun;37 (2) RESUMEN Objetivos:Describir las características del ambiente de trabajo, las actitudes hacia la seguridad, el cuidado de la calidad medida por el personal de enfermería de las unidades de pediatría, así como analizar la evolución de los indicadores de bienestar y desempeño de los hospitales. Métodos: Estudio descriptivo con 136 profesionales en un asilo de ancianos hospital pediátrico, realizado a través de la forma de caracterización personal y profesional, Enfermería Índice de Trabajo -Revisado, Actitudes Seguridad Cuestionario -Short Form 2006 y los indicadores de calidad. Resultados: Los profesionales perciben el ambiente tan favorable a la práctica profesional y de la buena calidad de la atención, una reducción de los eventos adversos y la estancia hospitalaria. Satisfacción en el trabajo se consideró favorable para la seguridad del paciente. Conclusiones: El ambiente de trabajo es propicio para la práctica de los profesionales de enfermería que aprueban la calidad de la atención y la reducción de puntos de indicadores de los eventos adversos y la estancia hospitalaria Palabras clave: Ambiente de instituciones de salud. Seguridad del paciente. Calidad de la atención de salud. Satisfacción en el trabajo. Evaluación del resultado de la atención al paciente.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Ambiente de trabalho da enfermagem, segurança do paciente e qualidade do cuidado em hospital pediátrico

Alves

Guirardello

2016

Rev. Gaúcha Enferm.

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“…Professional staff nurses are most likely involved in adverse events and an estimated 11 million nurses throughout the world have a critical impact on safety initiatives [9]. Several studies have indicated that long working hours have adverse effects on nurse performance.…”

Section: Introductionmentioning

confidence: 99%

The impact of nurse working hours on patient safety culture: a cross-national survey including Japan, the United States and Chinese Taiwan using the Hospital Survey on Patient Safety Culture

Fujita

Seto

et al. 2013

BMC Health Serv Res

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BackgroundA positive patient safety culture (PSC) is one of the most critical components to improve healthcare quality and safety. The Hospital Survey on Patient Safety Culture (HSOPS), developed by the US Agency for Healthcare Research and Quality, has been used to assess PSC in 31 countries. However, little is known about the impact of nurse working hours on PSC. We hypothesized that long nurse working hours would deteriorate PSC, and that the deterioration patterns would vary between countries. Moreover, the common trends observed in Japan, the US and Chinese Taiwan may be useful to improve PSC in other countries. The purpose of this study was to clarify the impact of long nurse working hours on PSC in Japan, the US, and Chinese Taiwan using HSOPS.MethodsThe HSOPS questionnaire measures 12 sub-dimensions of PSC, with higher scores indicating a more positive PSC. Odds ratios (ORs) were calculated using a generalized linear mixed model to evaluate the impact of working hours on PSC outcome measures (patient safety grade and number of events reported). Tukey’s test and Cohen’s d values were used to verify the relationships between nurse working hours and the 12 sub-dimensions of PSC.ResultsNurses working ≥60 h/week in Japan and the US had a significantly lower OR for patient safety grade than those working <40 h/week. In the three countries, nurses working ≥40 h/week had a significantly higher OR for the number of events reported. The mean score on ‘staffing’ was significantly lower in the ≥60-h group than in the <40-h group in all the three countries. The mean score for ‘teamwork within units’ was significantly lower in the ≥60-h group than in the <40-h group in Japan and Chinese Taiwan.ConclusionsPatient safety grade deteriorated and the number of events reported increased with long working hours. Among the 12 sub-dimensions of PSC, long working hours had an impact on ‘staffing’ and ‘teamwork within units’ in Japan, the US and Chinese Taiwan.

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“…From a benevolent orientation, the mitigation of adverse health events is optimized through vigilance and commitment to evidence informed practice. Patient safety is recognized as a transglobal mandate central to nursing care across all sectors and settings [3,4]. Beyond a mandate, the Canadian Nurses Association characterizes the commitment to patient safety as an ethical obligation.…”

Section: Introductionmentioning

confidence: 99%

Unsafe clinical practices as perceived by final year baccalaureate nursing students: Q methodology

et al. 2012

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BackgroundNursing education necessitates vigilance for clinical safety, a daunting challenge given the complex interchanges between students, patients and educators. As active learners, students offer a subjective understanding concerning safety in the practice milieu that merits further study. This study describes the viewpoints of senior undergraduate nursing students about compromised safety in the clinical learning environment.MethodsQ methodology was used to systematically elicit multiple viewpoints about unsafe clinical learning from the perspective of senior students enrolled in a baccalaureate nursing program offered at multiple sites in Ontario, Canada. Across two program sites, 59 fourth year students sorted 43 theoretical statement cards, descriptive of unsafe clinical practice. Q-analysis identified similarities and differences among participant viewpoints yielding discrete and consensus perspectives.ResultsA total of six discrete viewpoints and two consensus perspectives were identified. The discrete viewpoints at one site were Endorsement of Uncritical Knowledge Transfer, Non-student Centered Program and Overt Patterns of Unsatisfactory Clinical Performance. In addition, a consensus perspective, labelled Contravening Practices was identified as responsible for compromised clinical safety at this site. At the other site, the discrete viewpoints were Premature and Inappropriate Clinical Progression, Non-patient Centered Practice and Negating Purposeful Interactions for Experiential Learning. There was consensus that Eroding Conventions compromised clinical safety from the perspective of students at this second site.ConclusionsSenior nursing students perceive that deficits in knowledge, patient-centered practice, professional morality and authenticity threaten safety in the clinical learning environment. In an effort to eradicate compromised safety associated with learning in the clinical milieu, students and educators must embody the ontological, epistemological and praxis fundamentals of nursing.

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Keeping patients safe in healthcare organizations: a structuration theory of safety culture

Abstract: Applying structuration theory to the concept of safety culture reveals a dynamic system of individual action and organizational structure constraining and enabling safety practice. Nurses are central to the (re)production of this safety culture system.

Cited by 67 publications

References 22 publications

Ambiente de trabalho da enfermagem, segurança do paciente e qualidade do cuidado em hospital pediátrico

Ambiente de trabalho da enfermagem, segurança do paciente e qualidade do cuidado em hospital pediátrico

The impact of nurse working hours on patient safety culture: a cross-national survey including Japan, the United States and Chinese Taiwan using the Hospital Survey on Patient Safety Culture

Unsafe clinical practices as perceived by final year baccalaureate nursing students: Q methodology

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