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Cullati S, Semmer NK, Tschan F, Choupay G, Chopard P, Courvoisier DS. When Illegitimate Tasks Threaten Patient Safety Culture: A Cross-Sectional Survey in a Tertiary Hospital. Int J Public Health 2023; 68:1606078. [PMID: 37744414 PMCID: PMC10511767 DOI: 10.3389/ijph.2023.1606078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 08/18/2023] [Indexed: 09/26/2023] Open
Abstract
Objectives: The current study investigates the prevalence of illegitimate tasks in a hospital setting and their association with patient safety culture outcomes, which has not been previously investigated. Methods: We conducted a cross-sectional survey in a tertiary referral hospital. Patient safety culture outcomes were measured using the Hospital Survey on Patient Safety Culture questionnaire; the primary outcome measures were a low safety rating for the respondent's unit and whether the respondent had completed one or more safety event reports in the last 12 months. Analyses were adjusted for hospital department and staff member characteristics relating to work and health. Results: A total of 2,276 respondents answered the survey (participation rate: 35.0%). Overall, 26.2% of respondents perceived illegitimate tasks to occur frequently, 8.1% reported a low level of safety in their unit, and 60.3% reported having completed one or more safety event reports. In multivariable analyses, perception of a higher frequency of illegitimate tasks was associated with a higher risk of reporting a low safety rating and with a higher chance of having completed event reports. Conclusion: The prevalence of perceived illegitimate tasks was rather high. A programme aiming to reduce illegitimate tasks could provide support for a causal effect of these tasks on safety culture outcomes.
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Affiliation(s)
- Stéphane Cullati
- Quality of Care Service, University Hospitals of Geneva, Geneva, Switzerland
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
| | - Norbert K. Semmer
- Department of Psychology, University of Bern, Bern, Switzerland
- National Center for Competence in Research on Affective Sciences, Geneva, Switzerland
- Biological Work and Health Psychology, University of Konstanz, Konstanz, Germany
| | - Franziska Tschan
- National Center for Competence in Research on Affective Sciences, Geneva, Switzerland
- Institute for Work and Organizational Psychology, University of Neuchâtel, Neuchâtel, Switzerland
| | - Gaëlle Choupay
- Quality of Care Service, University Hospitals of Geneva, Geneva, Switzerland
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Pierre Chopard
- Quality of Care Service, University Hospitals of Geneva, Geneva, Switzerland
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Delphine S. Courvoisier
- Quality of Care Service, University Hospitals of Geneva, Geneva, Switzerland
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Bethune RM, Ball S, Doran N, Harris M, Medina-Lara A, Fornasiero M, Hill M, Lang I, McGregor-Harper J, Sheaff R. How Safety Culture Surveys Influence the Quality and Safety of Healthcare Organisations. Cureus 2023; 15:e44603. [PMID: 37795070 PMCID: PMC10546949 DOI: 10.7759/cureus.44603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2023] [Indexed: 10/06/2023] Open
Abstract
Objectives Safety culture surveys have been widely used in healthcare for more than two decades predominantly as a tool for measuring the level of safety culture (as defined as the beliefs and attitudes that staff express about how their organisation ought to work and how it does in fact work). However, there is the potential for the survey process itself to influence the safety culture and working practices in departments and organisations. The objective of this study was to identify the mechanism by which these changes might occur. Design, setting and participants Mixed methods combining qualitative semi-structured interviews and quantitative scores from patient safety surveys. This evaluation was conducted across general practice, community and acute hospitals in two NHS regions in England; South West and Greater Manchester. The study was undertaken between 2015 and 2018 during the implementation of a series of Patient Safety Collaboratives. Safety, Communication, Operational Reliability, and Engagement (SCORE) surveys were administered in 15 units, followed by a staff debriefing and a second SCORE survey. Semi-structured interviews were conducted with clinicians (n=61). Results from the first and second surveys were compared in order to test for differences in responses. Sixty-one semi-structured interviews were conducted across participating units and thematically analysed. Analysis and results Results from the first and second surveys were compared using chi-squared and Fisher's exact tests. Sixty-one semi-structured interviews were conducted across participating units and thematically analysed. There was little change in responses between the first and second SCORE surveys. Within general practice there was some improvement in responses in three survey domains; however, these differences were not conclusive. The qualitative interview data demonstrated a beneficial effect on safety culture. Staff stated that the survey debriefings created a new safe space where problems could be discussed and improvement plans created. Conclusions Safety culture surveys can improve safety culture within departments if they are followed by a process that includes debriefing the staff and working with them to develop improvement plans.
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Affiliation(s)
- Rob M Bethune
- Colorectal Surgery, Royal Exeter University Healthcare NHS Foundation Trust, Exeter, GBR
- National Institute for Health and Care Research (NIHR) Applied Research Collaboration, South West Peninsula (PenARC), University of Exeter Medical School, Exeter, GBR
| | - Sue Ball
- National Institute for Health and Care Research (NIHR) Applied Research Collaboration, South West Peninsula (PenARC), University of Exeter Medical School, Exeter, GBR
| | - Natasha Doran
- National Institute for Health and Care Research (NIHR) Applied Research Collaboration, South West Peninsula (PenARC), University of Exeter Medical School, Exeter, GBR
| | - Michael Harris
- College of Medicine and Health, University of Exeter Medical School, Exeter, GBR
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, CHE
| | - Antionieta Medina-Lara
- Department of Public Health and Sports Science, Public Health Economics Group, University of Exeter Medical School, Exeter, GBR
| | - Mauro Fornasiero
- School of Law and Criminology, University of Plymouth, Plymouth, GBR
| | - Matt Hill
- Anaesthesia, University Hospital Plymouth NHS Trust, Plymouth, GBR
| | - Iain Lang
- National Institute for Health and Care Research (NIHR) Applied Research Collaboration, South West Peninsula (PenARC), University of Exeter Medical School, Exeter, GBR
- Department of Health and Community Sciences, University of Exeter Medical School, Exeter, GBR
| | | | - Rod Sheaff
- Faculty of Medicine and Dentistry, University of Plymouth, Plymouth, GBR
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Lopes MCC, Oliva CCC, Bezerra NMS, Silva MT, Galvão TF. Relationship between depressive symptoms, burnout, job satisfaction and patient safety culture among workers at a university hospital in the Brazilian Amazon region: cross-sectional study with structural equation modeling. SAO PAULO MED J 2022; 140:412-421. [PMID: 35508009 PMCID: PMC9671242 DOI: 10.1590/1516-3180.2021.0614.15092021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 09/15/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Workplaces can be sources of mental distress. In healthcare services, this can also affect patients. OBJECTIVE To assess the prevalence of and factors associated with depressive symptoms, burnout, job satisfaction and patient safety culture and the relationships between these constructs, among healthcare workers. DESIGN AND SETTING Cross-sectional study in a university hospital in Manaus, Brazil. METHODS Randomly selected workers were interviewed based on Brazilian-validated tools. We calculated the prevalence ratio (PR) and 95% confidence interval (CI) of depressive symptoms and burnout using Poisson regression with robust variance; and the β-coefficient of safety culture and job satisfaction using linear regression. Outcome relationships were assessed using partial least-squares structural equation modeling. RESULTS 300 professionals were included; 67.3% were women. The prevalence of depressive symptom was 19.0% (95% CI: 14.5; 23.5%) and burnout, 8.7% (95% CI: 5.2; 12.3%). Lack of work stability increased depression (PR = 1.88; 95% CI: 1.17; 3.01) and burnout (PR = 2.17; 95% CI: 1.03; 4.57); and reduced job satisfaction (β = -11.93; 95% CI: -18.79; -5.07). Depressive symptoms and burnout were positively correlated, as also were job satisfaction and safety culture (P < 0.001); job satisfaction was negatively correlated with burnout (P < 0.001) and depression (P = 0.035). CONCLUSION Impermanent employment contracts increased depression and burnout and reduced job satisfaction. Job satisfaction reduced poor mental health outcomes and increased safety culture. Job satisfaction and safety culture were directly proportional (one construct increased the other and vice versa), as also were depression and burnout. Better working conditions can provide a virtuous cycle of patient safety and occupational health.
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Affiliation(s)
- Marcélia Célia Couteiro Lopes
- MSc. Pharmacist, Postgraduate Pharmaceutical Sciences Program, Universidade Federal do Amazonas (UFAM), Manaus (AM), Brazil.
| | - Carmen Conceição Carrilho Oliva
- MSc. Pharmacist, Postgraduate Pharmaceutical Sciences Program, Universidade Federal do Amazonas (UFAM), Manaus (AM), Brazil.
| | - Nádia Maria Soares Bezerra
- MBA. Health Inspector, Department of Health Surveillance, Municipal Health Department of Manaus, Manaus (AM), Brazil.
| | - Marcus Tolentino Silva
- MSc, PhD. Professor, Postgraduate Pharmaceutical Sciences Program, Universidade de Sorocaba (UNISO), Sorocaba (SP), Brazil.
| | - Tais Freire Galvão
- MSc, PhD. Professor, School of Pharmaceutical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil.
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Abstract
OBJECTIVES Patient safety climate is associated with patient outcomes in hospitals around the world. A better understanding of how safety climate varies within and across hospitals will help identify improvement opportunities. We examined variations in safety climate by work area and job category in Chinese hospitals. METHODS We administered the Chinese Hospital Survey on Patient Safety Climate in 2011 to workers in 6 hospitals in China, with completed surveys from 1464 (86% response). We calculated the percent positive response for survey items and dimensions among hospitals and compared this across work areas and job categories using general linear models. RESULTS Overall, 68% of responses suggested the presence of a positive safety climate. The percent positive responses were highest for organizational learning (86.1%) and unit management support for safety (84.5%) and lowest for staffing (30.6%) and error reporting (44.5%). Workers in surgical units, intensive care units, operating rooms, and emergency departments were slightly more negative regarding overall safety climate than those in medical and ancillary units. Physicians reported worse perceptions than nurses or other hospital workers on all dimensions except for unit management support for safety and communication and peer support. CONCLUSIONS The perceived problem with staffing in Chinese hospitals was consistent with other studies. The lack of positive responses for error reporting may indicate a lack of awareness of the importance of learning from and reporting minor events and near misses. Variations within and across hospitals in safety climate suggest that improvement interventions should be tailored to individual units and professional groups.
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Affiliation(s)
- Junya Zhu
- From the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Liping Li
- School of Nursing, Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
| | - Zehui Zhou
- Columbian College of Arts & Sciences, The George Washington University, Washington, DC
| | - Qingqing Lou
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, People's Republic of China
| | - Albert W Wu
- From the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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Tlili MA, Aouicha W, Sahli J, Zedini C, Ben Dhiab M, Chelbi S, Mtiraoui A, Said Latiri H, Ajmi T, Ben Rejeb M, Mallouli M. A baseline assessment of patient safety culture and its associated factors from the perspective of critical care nurses: Results from 10 hospitals. Aust Crit Care 2020; 34:363-369. [PMID: 33121872 DOI: 10.1016/j.aucc.2020.09.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 09/01/2020] [Accepted: 09/07/2020] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Critical care nurses are considered the key to patient safety improvement and play a vital role in enhancing quality of care in intensive care units (ICUs) where adverse events are frequent and have severe consequences. Moreover, there is recognition of the importance of the assessment and the development of patient safety culture (PSC) as a strategic focus for the improvement of patient safety and healthcare quality, notably in critical care settings. OBJECTIVES This study aimed to assess critical care nurses' perception of PSC and to determine its associated factors. METHODS This cross-sectional study was conducted among nurses working in the ICUs of the Tunisian centre (six Tunisian governorates). The study instrument was the French validated version of the Hospital Survey on Patient Safety Culture questionnaire, comprising 10 dimensions and a total of 50 items. RESULTS A total of 249 nurses from 18 ICUs participated in the study, with a participation rate of 87.36%. The dimensions scores ranged between 17.2% for the dimension "frequency of events reported" and 50.1% for the dimension "teamwork within units". Multivariable logistic regression indicated that respondents who worked in private hospitals were five times more likely to have a developed PSC (adjusted odds ratio [AOR]: 5.34; 95% confidence interval [CI], [2.28, 12.51]; p < 10-3). Similarly, participants who worked in a certified hospital were two times more likely to have a more developed PSC than respondents who work in noncertified hospitals (AOR: 2.51; 95% CI, [.92-6.82]; p = 0.041). In addition, an increased nurse-per-patient ratio (i.e., reduced workload) increased PSC (AOR: 1.10; 95% CI, [1.02-1.12]; p = 0.018). CONCLUSION This study has shown that the state of critical care nurses' PSC is critically low and these baseline results can help to form a plan of actions for improvements.
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Affiliation(s)
- Mohamed Ayoub Tlili
- University of Sousse, Faculty of Medicine of Sousse (Tunisia), Laboratory of Research LR12ES03 «Qualité des soins et management des services de santé maternelle» - University of Sousse, Higher School of Health Sciences and Techniques of Sousse, Tunisia.
| | - Wiem Aouicha
- University of Sousse, Faculty of Medicine of Sousse (Tunisia), Laboratory of Research LR12ES03 «Qualité des soins et management des services de santé maternelle» - University of Sousse, Higher School of Health Sciences and Techniques of Sousse, Tunisia
| | - Jihene Sahli
- University of Sousse, Faculty of Medicine of Sousse (Tunisia), Department of Community and Family Health, Laboratory of Research LR12ES03 «Qualité des soins et management des services de santé maternelle», Tunisia
| | - Chekib Zedini
- University of Sousse, Faculty of Medicine of Sousse (Tunisia), Department of Community and Family Health, Laboratory of Research LR12ES03 «Qualité des soins et management des services de santé maternelle», Tunisia
| | | | - Souad Chelbi
- University of Sousse, Faculty of Medicine of Sousse (Tunisia) - University of Sousse, Higher School of Health Sciences and Techniques of Sousse, Tunisia
| | - Ali Mtiraoui
- University of Sousse, Faculty of Medicine of Sousse (Tunisia), Department of Community and Family Health, Laboratory of Research LR12ES03 «Qualité des soins et management des services de santé maternelle», Tunisia
| | - Houyem Said Latiri
- University of Sousse, Faculty of Medicine of Sousse (Tunisia)- University Hospital Sahloul (Sousse,Tunisia), Department of Prevention and Safety Care, Tunisia
| | - Thouraya Ajmi
- University of Sousse, Faculty of Medicine of Sousse (Tunisia), Department of Community and Family Health, Laboratory of Research LR12ES03 «Qualité des soins et management des services de santé maternelle», Tunisia
| | - Mohamed Ben Rejeb
- University of Sousse, Faculty of Medicine of Sousse (Tunisia)- University Hospital Sahloul (Sousse,Tunisia), Department of Prevention and Safety Care, Tunisia
| | - Manel Mallouli
- University of Sousse, Faculty of Medicine of Sousse (Tunisia), Department of Community and Family Health, Laboratory of Research LR12ES03 «Qualité des soins et management des services de santé maternelle», Tunisia
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Patient Safety Attitude of Nurses Working in Surgical Units: A Cross-Sectional Study in Turkey. J Perianesth Nurs 2020; 35:671-675. [PMID: 32682667 DOI: 10.1016/j.jopan.2020.03.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Revised: 03/14/2020] [Accepted: 03/14/2020] [Indexed: 11/22/2022]
Abstract
PURPOSE To determine the attitudes of nurses working in surgical units toward patient safety. DESIGN A descriptive and cross-sectional study. METHODS The sample in this study was 207 nurses (92% of all the nurses) working in surgical units in a training and research hospital in Turkey, all of whom agreed to participate in this study between April 30 and June 25, 2019. Study data were collected using a demographic characteristics form and the Patient Safety Attitude Questionnaire. Number, mean, SD, percentage calculations, Kruskal-Wallis test, Mann-Whitney U test, and the Spearman correlation test were used to analyze the study data. FINDINGS The mean total attitude score of the nurses was 176.30 ± 26.92. Nurses who previously received training on patient safety had statistically higher attitude scores than those who did not (U = 3883.000; P = .01). CONCLUSIONS Nurses working in surgical units had a positive attitude toward patient safety, and previous training on patient safety significantly improved their attitude scores. A recommendation is to conduct effective in-service training programs for patient safety in hospitals and to encourage participation by nurses in training programs such as courses and conferences that will result in attitude improvement.
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Salazar Maya AM, Restrepo Marín DM. Cultura de la seguridad del paciente en seis centros quirúrgicos de Antioquia. REVISTA CUIDARTE 2020. [DOI: 10.15649/cuidarte.1040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introducción: Colombia, como otros países promueve políticas de seguridad al paciente con el fin de evitar situaciones que afecten su bienestar y su salud, asimismo, reducir y, de ser posible, eliminar la ocurrencia de eventos adversos. Objetivo: Caracterizar la cultura de seguridad del paciente referido por el personal de seis centros quirúrgicos de Antioquia. Materiales y métodos: Estudio multicéntrico transversal descriptivo. Se aplicó el instrumento Hospital Survey on Patient Safety Culture propuesto por la Agency for Healthcare Research and Quality (AHRQ) a 514 trabajadores del área de la salud. Por recomendación de AHRQ, se recodificó la escala de Likert de la encuesta. Resultados: En una escala de cero a diez, el promedio del clima de seguridad en los servicios de cirugía es 8. El 62% de las respuestas sobre la percepción de la cultura de la seguridad fue positiva en aprendizaje organizacional/mejora continua en 81.70% de los trabajadores; en el trabajo en equipo en el servicio, 81.54%. Se encontraron oportunidades de mejora en dotación de personal (49.98%); respuesta no punitiva a errores (45.98%); y franqueza en comunicación (44.28%). Discusión: las dimensiones que son fortalezas y debilidades reportadas en la investigación son comparables con las reportadas en otros estudios y requiere atención del sistema de salud y de las direcciones de las instituciones. Conclusión: Se detectaron fortalezas y debilidades en la cultura de seguridad de los pacientes. En cuanto a las Fortalezas: el Aprendizaje organizacional/mejora continua y el Trabajo en equipo en la Unidad/Servicio; el resto son oportunidades de mejora.
Como citar este artículo: Salazar Maya Ángela María, Restrepo Marín Diana Marcela. Cultura de la seguridad del paciente en seis centros quirúrgicos de Antioquia. Revista Cuidarte. 2020; 11(2): e1040. http://dx.doi.org/10.15649/cuidarte.1040
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Waterson P, Carman EM, Manser T, Hammer A. Hospital Survey on Patient Safety Culture (HSPSC): a systematic review of the psychometric properties of 62 international studies. BMJ Open 2019; 9:e026896. [PMID: 31488465 PMCID: PMC6731893 DOI: 10.1136/bmjopen-2018-026896] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 05/10/2019] [Accepted: 07/22/2019] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE To carry out a systematic review of the psychometric properties of international studies that have used the Hospital Survey on Patient Safety Culture (HSPSC). DESIGN Literature review and an analysis framework to review studies. SETTING Hospitals and other healthcare settings in North and South America, Europe, the Near East, the Middle East and the Far East. DATA SOURCES A total of 62 studies and 67 datasets made up of journal papers, book chapters and PhD theses were included in the review. PRIMARY AND SECONDARY OUTCOME MEASURES Psychometric properties (eg, internal consistency) and sample characteristics (eg, country of use, participant job roles and changes made to the original version of the HSPSC). RESULTS Just over half (52%) of the studies in our sample reported internal reliabilities lower than 0.7 for at least six HSPSC dimensions. The dimensions 'staffing', 'communication openness', 'non-punitive response to error', 'organisational learning' and 'overall perceptions of safety' resulted in low internal consistencies in a majority of studies. The outcomes from assessing construct validity were reported in 60% of the studies. Most studies took place in a hospital setting (84%); the majority of survey participants (62%) were drawn from nursing and technical staff. Forty-two per cent of the studies did not state what modifications, if any, were made to the original US version of the instrument. CONCLUSIONS While there is evidence of a growing worldwide trend in the use of the HSPSC, particularly within Europe and the Near/Middle East, our review underlines the need for caution in using the instrument. Future use of the HSPSC needs to be sensitive to the demands of care settings, the target population and other aspects of the national and local healthcare contexts. There is a need to develop guidelines covering procedures for using, adapting and translating the HSPSC, as well as reporting findings based on its use.
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Affiliation(s)
- Patrick Waterson
- Human Factors and Complex Systems Group, Design School, Loughborough University, Loughborough, UK
| | - Eva-Maria Carman
- Trent Simulation and Clinical Skills Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Tanja Manser
- University of Applied Sciences and Arts Northwestern, Olten, Switzerland
| | - Antje Hammer
- Institute for Patient Safety, University Hospital Bonn, Bonn, Germany
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Abstract
BACKGROUND The first step towards establishing and improving patient safety culture in hospitals is measuring patient safety culture perceptions of staff. Few studies have examined the perception of patient safety culture in general surgery departments. OBJECTIVES The objective of this study was to evaluate patient safety culture and patient safety grade in general surgery departments and to examine the relation between the patient safety culture and the patient safety grade. METHODS This study examined patient safety culture and patient safety grades of 124 staff in seven surgery departments of a hospital in Turkey. The staff completed the hospital survey on patient safety culture and answered questions about their professional characteristics. One-way ANOVA, Independent-samples t test, corrected chi-square test, multiple correspondence analysis and Eta co-efficient were used in statistical analyses. RESULTS The patient safety dimension of "teamwork within units" had the highest mean and percentage of positive responses. The "frequency of events reported" and "non-punitive response to errors" had the lowest means and percentages of positive responses. Participants with resident or nurse positions, < age 31 years, with < 6 years of professional experience, and 60 or more work hours/week, had significantly more negative perceptions of patient safety culture than other participants. Patient safety grades and the dimensions of "management support for patient safety" and "overall perceptions of patient safety" had significantly high Eta coefficients. CONCLUSION Frequency of events reported and non-punitive responses to errors should be improved, and participants' characteristics should be considered at improvement efforts in general surgery departments. The dimesions with low means suggest opportunities for improvement.
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Affiliation(s)
- Mesut Teleş
- Department of Health Care Management, Faculty of Economics and Administrative Sciences, Hacettepe University
| | - Sıdıka Kaya
- Department of Health Care Management, Faculty of Economics and Administrative Sciences, Hacettepe University
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Healthcare Professional's Perception of Patient Safety Measured by the Hospital Survey on Patient Safety Culture: A Systematic Review and Meta-Analysis. ScientificWorldJournal 2018; 2018:9156301. [PMID: 30104917 PMCID: PMC6076892 DOI: 10.1155/2018/9156301] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 05/27/2018] [Accepted: 06/12/2018] [Indexed: 12/20/2022] Open
Abstract
Objective To assess the culture of patient safety in studies that employed the hospital survey on patient safety culture (HSOPS) in hospitals around the world. Method We searched MEDLINE, EMBASE, SCOPUS, CINAHL, and SciELO. Two researchers selected studies and extracted the following data: year of publication, country, percentage of physicians and nurses, sample size, and results for the 12 HSOPS dimensions. For each dimension, a random effects meta-analysis with double-arcsine transformation was performed, as well as meta-regressions to investigate heterogeneity, and tests for publication bias. Results 59 studies with 755,415 practitioners surveyed were included in the review. 29 studies were conducted in the Asian continent and 11 in the United States. On average studies scored 9 out of 10 methodological quality score. Of the 12 HSOPS dimensions, six scored under 50% of positivity, with “nonpunitive response to errors” the lowest one. In the meta-regression, three dimensions were shown to be influenced by the proportion of physicians and five by the continent where survey was held. Conclusions The HSOPS is widely used in several countries to assess the culture of patient safety in hospital settings. The culture of culpability is the main weakness across studies. Encouraging event reporting and learning from errors should be priorities in hospitals worldwide.
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Validation of a questionnaire measuring transitional patient safety climate indicated differences in transitional patient safety climate between primary and secondary care. J Clin Epidemiol 2018; 94:114-121. [DOI: 10.1016/j.jclinepi.2017.09.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 08/17/2017] [Accepted: 09/20/2017] [Indexed: 11/23/2022]
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Measuring Patient Safety Culture in Romania Using the Hospital Survey on Patient Safety Culture (HSOPSC). CURRENT HEALTH SCIENCES JOURNAL 2017; 43:31-40. [PMID: 30595852 PMCID: PMC6286728 DOI: 10.12865/chsj.43.01.05] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Accepted: 03/18/2017] [Indexed: 11/18/2022]
Abstract
Purpose To explore patient safety culture among Romanian staff, using the U.S. Hospital Survey on Patient Safety Culture (HSOPSC). MATERIAL AND METHODS A cross-sectional study was carried out in six hospitals, located in four Romanian regions (Craiova, Cluj-Napoca, Bucharest and Brasov), based on staff census in the Units/hospitals which volunteered to participate in the study (N=1,184). The response rate was 84%. The original questionnaire designed by the American Agency for Healthcare Research and Quality was translated into Romanian (with back translation), pre-tested before application and psychometrically checked. It consists of 42 questions grouped in 12categories, covering multiple aspects of patient safety culture (dimensions). Percentages of positive responses (PPRs) by question and category were analyzed overall and by staff profession. RESULTS Most respondents were nurses (69%). The main work areas were surgery (24%) and medicine (22%). The highest PPRs were for Supervisor/Manager Expectations & Actions Promoting Safety (88%), Teamwork Within Units (86%), Handoffs and Transitions (84%), Organizational Learning-Continuous Improvement (81%), Overall Perceptions of Safety (80%), Feedback & Communication About Error (75%). The lowest PPRs were for: Staffing (39%), Frequency of Events Reported (59%) and Non-punitive Response to Errors (61%). Nurses exhibited significantly higher PPRs than doctors. CONCLUSIONS This small-scale study of staff's attitude towards patient safety in Romanian hospitals suggests that there is room for future improvement, especially within the doctor category. Further research should assess the relationship between patient safety culture and frequency of adverse events.
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How Does Patient Safety Culture in the Surgical Departments Compare to the Rest of the County Hospitals in Xiaogan City of China? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14101123. [PMID: 28954427 PMCID: PMC5664624 DOI: 10.3390/ijerph14101123] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 09/16/2017] [Accepted: 09/22/2017] [Indexed: 11/17/2022]
Abstract
Objectives: Patient safety culture affects patient safety and the performance of hospitals. The Hospital Survey on Patient Safety Culture (HSOPSC) is generally used to assess the safety culture in hospitals and unit levels. However, only a few studies in China have measured surgical settings compared with other units in county hospitals using the HSOPSC. This study aims to assess the strengths and weaknesses of surgical departments compared with all other departments in county hospitals in China with HSOPSC. Design: This research is a cross-sectional study. Methods: In 2015, a Chinese translation of HSOPSC was administered to 1379 staff from sampled departments from 19 county hospitals in Xiaogan City (Hubei Province, China) using a simple random and cluster sampling method. Outcome Measures: The HSOPSC was completed by 1379 participants. The percent positive ratings (PPRs) of 12 dimensions (i.e., teamwork within units, organizational learning and continuous improvement, staffing, non-punitive response to errors, supervisor/ manager expectations and actions promoting patient safety, feedback and communication about errors, communication openness, hospital handoffs and transitions, teamwork across hospital units, hospital management support for patient safety, overall perception of safety, as well as frequency of events reported) and the positive proportion of outcome variables (patient safety grade and number of events reported) between surgical departments and other departments were compared with t-tests and X2 tests, respectively. A multiple regression analysis was conducted, with the outcome dimensions serving as dependent variables and basic characteristics and other dimensions serving as independent variables. Similarly, ordinal logistic regression was used to explore the influencing factors of two categorical outcomes. Results: A total of 56.49% of respondents were from surgical departments. The PPRs for “teamwork within units” and “organizational learning and continuous improvement” were ≥75%, which denoted strengths, and the PPRs for “staffing” and “non-punitive response to errors” were ≤50%, which denoted weaknesses in surgical units and other units. Three dimensions for surgical departments were weaker than those for other departments (p < 0.05). The staff from surgical units reported more events compared with the other units, but only a few respondents in surgical settings evaluated patient safety grade as good/excellent. Four dimensions influenced patient safety grade, and three dimensions influenced event reporting in surgical units. Conclusions: Strategies including recruiting workers, using the reporting system, and building a non-punitive culture should be adopted in the surgical units of county hospitals in China to improve safety culture. Supervisors should also prioritise patient safety.
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