Using Dominance Analysis to Identify the Most Important Dimensions of Safety Culture for Predicting Patient Safety

Abstract

Studies have demonstrated associations between safety culture and patient safety based on the perceptions of healthcare professionals, but limited attention has been given to the perceptions of nurses. Moreover, most studies have used regression modeling, an approach that limits researchers’ ability to identify the most important predictors of patient safety due to intercorrelations among predictors in the model. Therefore, the purpose of this study was to examine the effects of seven dimensions of safety culture on nurse-rated patient safety and identify the relative importance of these dimensions for predicting patient safety. This correlational study used data from the Agency for Healthcare Research and Quality’s 2018 Hospital Survey on Patient Safety Culture. Data from 13,031 nurses working in surgical areas of 443 hospitals in the United States were examined using logistic regression and dominance analysis. Staffing adequacy was the strongest predictor of patient safety, followed by hospital management support for patient safety and organizational learning/continuous improvement. However, dominance analysis showed that hospital management support for patient safety was the most important predictor rather than staffing adequacy. Nurse managers and hospital administrators should role model a culture of safety and demonstrate their valuing of patient safety by providing sufficient resources, listening to and valuing staff suggestions regarding patient safety, and providing feedback about organizational changes to improve patient safety.

Factors Affecting Patient Safety Culture from Nurses’ Perspectives for Sustainable Nursing Practice

“…This might be due to an unclear communication route, rigorous time pressure for staff and economic reasons such as the ineffective and inefficient utilization of resources such as time, budget, materials and supplies that leads to precarious situations for personnel and sub-optimal care, and staff nurses may be fearful about discussing and reporting problems that may occur at the hospital. These findings were consistent with and supported by the findings of Lee and Dahinten, (2021) [ 25 ], who discovered that the frequency of reported occurrences had a modest mean score and was seen as a potential area for development.…”

Patient Safety Culture and Its Associated Factors: A Situational Analysis among Nurses in Katsina Public Hospitals, Northwest Nigeria

“…The lower reliability of the survey tool can be attributed to differences in the respondents’ demographic characteristics and their levels of heterogeneity. In addition, the lack of modification and inconsistencies in the assessments of constructive validity were additional factors to explain the differences [ 37 , 38 , 39 , 40 ].…”

Analysis of Patient Safety Culture using Hospital Survey on Patient Safety Culture (HSOPSC) in Seven Countries

“…11 The many dimensions of several surveys are not the basis for survey selection, but most researchers prefer HSOPSC as their research instrument, especially from various countries, 26 making it easier for researchers to take research data as a reference.…”