Nurses’ perception of patient safety culture and its relationship with adverse events: a national questionnaire survey in Iran

Abstract

Background Patient safety culture is an important factor in determining hospitals’ ability to address and reduce the occurrence of adverse events (AEs). However, few studies have reported on the impact of nurses’ perceptions of patient safety culture on the occurrence of AEs. Our study aimed to assess the association between nurses’ perception of patient safety culture and their perceived proportion of adverse events. Methods A cross-sectional survey was carried out among 2295 nurses employed in thirty-two teaching hospitals in Iran. Nurses completed the Persian version of the hospital survey of patients’ safety culture between October 2018 and September 2019. Results Positive Response Rates of overall patient safety culture was 34.1% and dimensions of patient safety culture varied from 20.9 to 43.8%. Also, nurses estimated that the occurrence of six adverse events varied from 51.2–63.0% in the past year. The higher nurses’ perceptions of “Staffing”, “Hospital handoffs and transitions”, “Frequency of event reporting”, “Non-punitive response to error”, “Supervisor expectation and actions promoting safety”, “Communication openness”, “Organizational learning continuous improvement”, “Teamwork within units”, and “Hospital management support patient safety” were significantly related to lower the perceived occurrence at least two out of six AEs (OR = 0.69 to 1.46). Conclusions Our findings demonstrated that nurses’ perception regarding patient safety culture was low and the perceived occurrence of adverse events was high. The research has also shown that the higher level of nurses’ perception of patient safety culture was associated with lowered occurrence of AEs. Hence, managers could provide prerequisites to improve patient safety culture and reduce adverse events through different strategies, such as encouraging adverse events’ reporting and holding training courses for nurses. However, further research is needed to assess how interventions addressing patient safety culture might reduce the occurrence of adverse events.

Patient safety culture in Palestine: university hospital nurses’ perspectives

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“…The prevalence of adverse events in ED is higher and varied from 4 to 68% [ 3 ]. According to a study by Kakemam et al, the prevalence of adverse events in Iran is between 7 and 40% [ 4 ]. Lower adverse events and better patient care safety are usually the outcomes of perceived teamwork [ 5 ].…”

The impact of nurses' perceptions of systems thinking on occurrence and reporting of adverse events: A cross‐sectional study

“…But it was lower than another conducted study in Iran, which showed that the experience of occurrence of AEs by nurses in the past 6 months was 48% (Kakemam, Hajizadeh, et al, 2021). Evidence has demonstrated that many factors can be attributed to the AEs occurrence, such as heavy workload, inappropriate shifting, less unsuccessful cognition, long working hours, job stress, weak teamwork and poor patient safety (Kakemam et al, 2019; Kakemam, Gharaee, et al, 2021; Kakemam, Hajizadeh, et al, 2021).…”

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