Patient safety culture in African health facilities: a systematic review and meta-analysis

Abstract

Background The risk of a patient being harmed in a hospital is high in low- and middle-income countries (LMICs), with the risk of health care-associated infection being up to 20 times higher than in developed countries. The purpose of this review was to assess the current patient safety culture and provide insight into areas of strength and areas for improvement in terms of patient safety culture. Method Data sources: English language articles were selected by consulting PubMed databases, African journals online, and Google scholar data sources from 2012-2022, . Medcalc software was used for all calculations. The random effects model was used. The presence of heterogeneity and Publication bias were assessed. Result The systematic review and meta-analysis result showed that the overall pooled result of patient safety culture status was 51.6% with 95% CI (43.364 to 59.773). The results of Cochran’s Q test and I2 statistics showed substantial heterogeneity among the included studies (Q=119.1617, df = 16, P < 0.0001 and I2=86.57%), and thus random effects model was used for meta-analysis. Non-punitive response to errors and staffing were the dimensions with the lowest positive response rate. Whereas, Team-work within units and supervisor expectation were the areas with good positive response rate. Conclusion The studies indicated a predominance of hospital organizational cultures that were immature or weak in terms of patient safety. For them to be effective, safety culture evaluation should be linked to hospital-wide safety culture development strategies.