Patient Safety Culture in Latin American Hospitals: A Systematic Review with Meta-Analysis

Abstract

Introduction: Adverse events in hospitals are prevented through risk reduction and reliable processes. Highly reliable hospitals are grounded by a robust patient safety culture with effective communication, leadership, teamwork, error reporting, continuous improvement, and organizational learning. Although hospitals regularly measure their patient safety culture for strengths and weaknesses, there have been no systematic reviews with meta-analyses reported from Latin America. Purpose: Our systematic review aims to produce evidence about the status of patient safety culture in Latin American hospitals from studies using the Hospital Survey on Patient Safety Culture (HSOPSC). Methods: This systematic review was guided by the JBI guidelines for evidence synthesis. Four databases were systematically searched for studies from 2011 to 2021 originating in Latin America. Studies identified for inclusion were assessed for methodological quality and risk of bias. Descriptive and inferential statistics, including meta-analysis for professional subgroups and meta-regression for subgroup effect, were calculated. Results: In total, 30 studies from five countries—Argentina (1), Brazil (22), Colombia (3), Mexico (3), and Peru (1)—were included in the review, with 10,915 participants, consisting primarily of nursing staff (93%). The HSOPSC dimensions most positive for patient safety culture were “organizational learning: continuous improvement” and “teamwork within units”, while the least positive were “nonpunitive response to error” and “staffing”. Overall, there was a low positive perception (48%) of patient safety culture as a global measure (95% CI, 44.53–51.60), and a significant difference was observed for physicians who had a higher positive perception than nurses (59.84; 95% CI, 56.02–63.66). Conclusions: Patient safety culture is a relatively unknown or unmeasured concept in most Latin American countries. Health professional programs need to build patient safety content into curriculums with an emphasis on developing skills in communication, leadership, and teamwork. Despite international accreditation penetration in the region, there were surprisingly few studies from countries with accredited hospitals. Patient safety culture needs to be a priority for hospitals in Latin America through health policies requiring annual assessments to identify weaknesses for quality improvement initiatives.

Patient Safety Culture in a Tertiary Hospital: A Cross-Sectional Study

“…In general, the PS rating valued by professionals was high. This result is consistent with those carried out in other countries such as Ghana [32], and contrary to other studies where the perception is lower, such as those carried out in Latin American countries [37], southwestern Ethiopia [33], Malaysia [38], Iran [39] and national studies [17,28]. The qualification had a significantly higher percentage of positive responses in professionals with time worked in the hospital between 1 and 5 years.…”

“…Some investigations show that a lack of knowledge of the registration system may be the main cause of underreporting of incidents [34]. The results of this study add to the already existing knowledge that teamwork and the support of those responsible for units found results in an increase in the notification of incidents and improvement of PS [32,[35][36][37]. In the same way, the number of incidents reported in this hospital is far from the data of national studies, where the majority of respondents did not report any event related to PS in the last year [17,28].…”

Patient safety culture in South America: a cross-sectional study

“…A recent systematic review by Camacho-Rodriguez et al , 9 confirmed the global concern about the PSC in Latin America, revealing that only 30 studies, limited only to five countries (none from Central America), reported a PSC evaluation. Most of these studies are from Brazil (22 studies), 17–38 and only three and one from Colombia 39–41 and Argentina, 42 respectively.…”

The effect of electronic error-reporting forms on nurse’s stress and the rate of error-reporting

“…4 The patient safety culture includes risk assessment, preventive and corrective measures, and ongoing development of activities. 5 According to studies, Empowering nurses and supervisors, 6 developing skills in communication, leadership, and teamwork, 7 health policies and their annual assessments, and Staff Well-Being 8 will improve patient safety culture. One of the factors that threaten patient safety is medical errors.…”