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Thu NTH, Anh BTM, Ha NTT, Tien DNT, Giang PH, Nga TT, Nam NH, Hung PT. Health staff perceptions of patient safety and associated factors in hospitals in Vietnam. Front Public Health 2023; 11:1149667. [PMID: 37965513 PMCID: PMC10641002 DOI: 10.3389/fpubh.2023.1149667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 10/12/2023] [Indexed: 11/16/2023] Open
Abstract
Introduction Patient safety is a global challenge of preventing and mitigating medical errors which might harm patients during their course of treatment and care. This study was employed to contribute to the existing literature aimed to assess patient safety culture among health staff and to determine predictors of health staff perceptions of patient safety in hospitals in Vietnam. Methods A cross-sectional study was conducted in three hospitals of Vietnam with a total of 763 participants. This study used the Hospital Patient Safety Scale developed by the American Health and Quality Research Organization. Results In general, 8 of 12 patient safety dimensions in two hospital; and 10 of 12 dimensions in a third hospital had average scores of 60% and above positive responses. The communication openness and organizational learning dimensions were found to be significant different when comparing hospitals. Regarding sample characteristics, department (subclinical department) and health staff positions (nurses/technicians, pharmacists) were significant predictors in the total model including three hospitals (R2 = 0.07). Conclusion This study reported that communication openness and organization learning are two aspects that need to be improved they are strongly related to patient safety culture and to knowledge exchange among health staff. It has been suggested that hospitals should deliver patient safety training courses and establish a supportive learning environment to improve these challenges.
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Affiliation(s)
- Nguyen Thi Hoai Thu
- Department of Health Management and Organization, School of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Bui Thi My Anh
- Department of Health Management and Organization, School of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Nguyen Thi Thu Ha
- Department of Health Management and Organization, School of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Doan Ngoc Thuy Tien
- Department of Health Economics, School of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Pham Huong Giang
- Institute of Development Policy, University of Antwerp, Antwerp, Belgium
| | - Tran Thi Nga
- Department of Health Management and Organization, School of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Nguyen Hoang Nam
- Department of International Economics, Foreign Trade University, Hanoi, Vietnam
| | - Phung Thanh Hung
- Department of Health Management and Organization, School of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
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Babaie M, Nourian M, Atashzadeh-Shoorideh F, Manoochehri H, Nasiri M. Psychometric evaluation of the Persian version of the Hospital Survey on Patient Safety Culture Questionnaire (HSOPSC) in neonatal intensive care units: a methodological study. BMC Nurs 2023; 22:279. [PMID: 37612742 PMCID: PMC10463421 DOI: 10.1186/s12912-023-01435-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 08/07/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND A valid and reliable tool compatible with the culture is needed to evaluate the safety culture as one of the vital and promotional components in improving the quality of safety and health care. This study aimed to investigate the psychometric properties of the Persian version of the "Hospital Survey on Patient Safety Culture (HSOPSC)" in physicians and nurses working in Neonatal Intensive Care Units. METHODS In this methodological research, the qualitative face, content validity, and construct validity were performed by Confirmatory Factor Analysis to the psychometric evaluation of the HSOPSC questionnaire. Based on convenience sampling and the inclusion criteria, 360 individuals completed the questionnaire. Internal consistency and stability were measured. Data analysis was performed using SPSS 21 and LISREL. RESULTS In examining the construct validity, fit indices were not appropriate for the 12-dimension model of the Persian version. According to T-value, six heterogeneous items and a dimension were omitted. The 11-dimension model with 36 items showed an appropriate fit with the data. Cronbach's alpha was evaluated at 0.79, and the stability was 0.82 (p˂0.001). CONCLUSION The Persian version of HSOPSC with 11 dimensions and 36 items has favorable validity and reliability and can be used in NICUs.
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Affiliation(s)
- Mohadese Babaie
- Student Research Committee, Department of Pediatric and Neonatal Intensive Care Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Anesthesiology, School of Allied Medical Sciences, Alborz University of Medical Sciences, Karaj, Iran
| | - Manijeh Nourian
- Department of Pediatric and Neonatal Intensive Care Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Foroozan Atashzadeh-Shoorideh
- Department of Psychiatric Nursing and Management, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Houman Manoochehri
- Department of Basic Sciences, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Malihe Nasiri
- Department of Biostatistics, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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De Miguel MS, de Elguea JO, Gómez-Gastiasoro A, Urcola F, Cid-Expósito MG, Torres-Enamorado D, Orkaizagirre-Gomara A. Patient safety and its relationship with specific self-efficacy, competence, and resilience among nursing students: A quantitative study. NURSE EDUCATION TODAY 2023; 121:105701. [PMID: 36563588 DOI: 10.1016/j.nedt.2022.105701] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 12/01/2022] [Accepted: 12/13/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Patient safety is a relevant subject in the nursing curriculum. Each university programs patient safety teaching and practical training differently. However, few studies have sought to explore the relationship between patient safety as perceived by nursing students and other important psychosocial competencies in the nursing curriculum, such as self-efficacy, competence, and resilience. OBJECTIVES To analyze differential patient safety integration into three nursing education programs, and to assess agreement levels regarding patient safety climate, students' knowledge of patient safety and correlations with specific self-efficacy, competence and resilience. METHODS Participants were 647 undergraduate students from three universities. Patient safety climate and knowledge of patient safety (good praxis) were measured using the Hospital Survey on Patient Safety Culture for nursing students, and other psychosocial variables were also analyzed using other instruments: specific self-efficacy, perceived competence and resilience. Nursing education programs and patient safety climate were analyzed using the Rwg(j) and ICC measures of inter-rater agreement across different academic levels. RESULTS The ICC and Rwg indexes revealed high inter-rate agreement in all three universities. Differences were observed between Univ-2 and Univ-3 in patient safety climate scores and agreement values between academic levels. Differences in good praxis were found when academic levels were compared in Univ1-and Univ-2. Patient safety climate was found to correlate significantly with the psychosocial variables studied, but only in Univ-1. CONCLUSIONS Perceived patient safety climate differs between universities and academic levels. This competency is related to self-efficacy, competence and resilience, which endorses the assessment of patient safety integration from a broader perspective.
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Affiliation(s)
- Manuel Sánchez De Miguel
- Faculty of Psychology, University of the Basque Country UPV/EHU, San Sebastián, Gipuzkoa, Spain; Biodonostia Health Research Institute, San Sebastián, Gipuzkoa, Spain.
| | - Javier Ortiz de Elguea
- Faculty of Medicine and Nursing, University of the Basque Country UPV/EHU, San Sebastián, Gipuzkoa, Spain; Donostia University Hospital (Osakidetza, Basque Health Service), San Sebastián, Gipuzkoa, Spain
| | | | - Fernando Urcola
- Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
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Camacho-Rodríguez DE, Carrasquilla-Baza DA, Dominguez-Cancino KA, Palmieri PA. Patient Safety Culture in Latin American Hospitals: A Systematic Review with Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14380. [PMID: 36361273 PMCID: PMC9658502 DOI: 10.3390/ijerph192114380] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 10/24/2022] [Accepted: 10/27/2022] [Indexed: 06/16/2023]
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.
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Affiliation(s)
- Doriam E. Camacho-Rodríguez
- Facultad de Enfermería, Universidad Cooperativa de Colombia, Santa Marta 470002, Colombia
- EBHC South America: A JBI Affiliated Group, Calle Cartavio 406, Lima 15023, Peru
| | - Deibys A. Carrasquilla-Baza
- Facultad de Enfermería, Universidad Cooperativa de Colombia, Santa Marta 470002, Colombia
- EBHC South America: A JBI Affiliated Group, Calle Cartavio 406, Lima 15023, Peru
| | - Karen A. Dominguez-Cancino
- EBHC South America: A JBI Affiliated Group, Calle Cartavio 406, Lima 15023, Peru
- Addiction Study Program, Université de Sherbrooke, 150, Place Charles-Le Moyne, Bureau 200, Longueuil, QC J4K 0A8, Canada
- Escuela de Salud Pública, Universidad de Chile, Av. Independencia 939, Independencia, Santiago de Chile 8380453, Chile
| | - Patrick A. Palmieri
- EBHC South America: A JBI Affiliated Group, Calle Cartavio 406, Lima 15023, Peru
- South American Center for Qualitative Research, Universidad Norbert Wiener, Av. Arequipa 444, Lima 15046, Peru
- College of Graduate Health Studies, A.T. Still University, 800 West Jefferson Street, Kirksville, MO 63501, USA
- Center for Global Nursing, Texas Woman’s University, 6700 Fannin St, Houston, TX 77030, USA
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Draganović Š, Offermanns G. Development of the German version of the patient safety climate inventory to the Austrian context. BMJ Open 2022; 12:e049270. [PMID: 35172993 PMCID: PMC8852657 DOI: 10.1136/bmjopen-2021-049270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES In recent years, patient safety culture (PSC) in hospitals, including its development and measurement, has increasingly received attention in Europe. Even though several instruments have been developed for PSC measurement in European countries, there is, to date, no validated measure to assess PSC in Austria. The study at hand addresses this gap in the evidence base by psychometrically assessing the German 'Patient Safety Climate Inventory' (PaSKI) in terms of its potential suitability for the Austrian healthcare system. The goal is to theoretically develop and empirically verify a separate instrument for PSC measurement in Austria. SETTING Ten hospitals. PARTICIPANTS Healthcare professionals (n=1202); doctors (n=142), nurse (n=645), other health workers (n=51), medical technology professions (n=170), management/administration (n=76), other (n=20), no response (n=98). PRIMARY AND SECONDARY OUTCOME MEASURES The pretest was conducted with 101 health professionals. Psychometric evaluations, including exploratory factor analysis and confirmatory factor analysis, were performed with both an original version of the PaSKI and an adapted one. The original PaSKI and the newly adapted 'Austrian Patient Safety Climate Inventory' (A-PaSKI) were then compared. RESULTS The A-PaSKI's factor structure developed in our study differs from the original 14-factor structure (49 items) of the PaSKI. The new instrument consists of 10 factors (30 items), comprising seven departmental factors, two hospital factors, and one outcome factor. The new instrument A-PaSKI revealed satisfactory results on the model-level and internal consistency. The confirmatory factor analysis for the A-PaSKI (χ2 (360)=1408.245, p=0.0001) showed a good model fit, and the absolute and relative fit indices showed an excellent model adjustment. The construct validity was acceptable for nine and unacceptable for one factor. CONCLUSIONS This is the first validation study of a standardised safety culture measure in Austrian hospitals. The Austrian version of PaSKI demonstrated good psychometric properties, with acceptable to good internal consistency and construct validity for use in Austrian hospitals.
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Affiliation(s)
- Šehad Draganović
- Department of Organization, Human Resources, and Service Management, University of Klagenfurt, Klagenfurt, Austria
| | - Guido Offermanns
- Department of Organization, Human Resources, and Service Management, University of Klagenfurt, Klagenfurt, Austria
- Institute for Hospital Organization, Karl Landsteiner Society, Vienna, Austria
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The COVID-19 Pandemic Crisis and Patient Safety Culture: A Mixed-Method Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042237. [PMID: 35206429 PMCID: PMC8872302 DOI: 10.3390/ijerph19042237] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 02/05/2022] [Accepted: 02/12/2022] [Indexed: 01/27/2023]
Abstract
The COVID-19 pandemic has put inordinate pressure on frontline healthcare workers (HCWs) and hospitals. HCWs are under chronic emotional stress, affected by burnout, moral distress and interpersonal issues with peers or supervisors during the pandemic. All of these can lead to lower levels of patient safety. The goal of this study was to examine patient safety culture values in a COVID-19 frontline hospital. Patient safety represents action, while patient safety culture represents the beliefs, values and norms of an organization that support and promote patient safety. Patient safety culture is a prerequisite for patient safety. A cross-sectional study on healthcare workers (228, response rate of 81.43%) at a COVID-19 frontline hospital was conducted using the Hospital Survey on Patient Safety Culture (HOSPSC), which had PSC dimensions, single question dimensions and comments. Our research revealed that, during the COVID-19 pandemic, a number of patient safety issues have been identified: low communication openness and current punitive response to errors, which might have incapacitated HCWs in the reporting of adverse events. Although participants expressed high supervisor/management expectations, actual support from the supervisor/management tier was low. Poor teamwork across units was identified as another issue, as well as low staffing. The infrastructure was identified as a potential new PSC dimension. There was a lack of support from supervisors/managers, while HCWs need their supervisors to be available; to be visible on the front line and to create an environment of trust, psychological safety and empowerment.
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Patient Safety Culture in European Hospitals: A Comparative Mixed Methods Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020939. [PMID: 35055760 PMCID: PMC8776090 DOI: 10.3390/ijerph19020939] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 12/27/2021] [Accepted: 12/31/2021] [Indexed: 12/10/2022]
Abstract
BACKGROUND Poorly organized health systems with inadequate leadership limit the development of the robust safety cultures capable of preventing consequential adverse events. Although safety culture has been studied in hospitals worldwide, the relationship between clinician perceptions about patient safety and their actual clinical practices has received little attention. Despite the need for mixed methods studies to achieve a deeper understanding of safety culture, there are few studies providing comparisons of hospitals in different countries. PURPOSE This study compared the safety culture of hospitals from the perspective of nurses in four European countries, including Croatia, Hungary, Spain, and Sweden. DESIGN A comparative mixed methods study with a convergent parallel design. METHODS Data collection included a survey, participant interviews, and workplace observations. The sample was nurses working in the internal medicine, surgical, and emergency departments of two public hospitals from each country. Survey data (n = 538) was collected with the Hospital Survey on Patient Safety Culture (HSOPSC) and qualitative date was collected through 24 in-depth interviews and 147 h of non-participant observation. Survey data was analyzed descriptively and inferentially, and content analysis was used to analyze the qualitative data. RESULTS The overall perception of safety culture for most dimensions was 'adequate' in Sweden and 'adequate' to 'poor' in the other countries with inconsistencies identified between survey and qualitative data. Although teamwork within units was the most positive dimension across countries, the qualitative data did not consistently demonstrate support, respect, and teamwork as normative attributes in Croatia and Hungary. Staffing and workload were identified as major areas for improvement across countries, although the nurse-to-patient ratios were the highest in Sweden, followed by Spain, Hungary, and Croatia. CONCLUSIONS Despite all countries being part of the European Union, most safety culture dimensions require improvement, with few measured as good, and most deemed to be adequate to poor. Dimension level perceptions were at times incongruent across countries, as observed patient safety practices or interview perspectives were inconsistent with a positive safety culture. Differences between countries may be related to national culture or variability in health system structures permitted by the prevailing European Union health policy.
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Lee SE, Havaei F, Astivia OLO, Shin JA. Psychometric Evaluation of the Korean Version of Hospital Survey on Patient Safety Culture. J Patient Saf 2022; 18:26-32. [PMID: 33044256 DOI: 10.1097/pts.0000000000000792] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES This study evaluated the psychometric properties of the Korean-language version of the Hospital Survey on Patient Safety Culture (HSOPSC) among Korean nurses. METHODS We analyzed secondary data from 801 direct care nurses working at a tertiary, private, nonprofit, teaching hospital in South Korea. Descriptive statistics, internal consistency coefficients, and intercorrelations were calculated. The latent factor structure of the HSOPSC was examined using exploratory structural equation modeling techniques, which account for the noncontinuous nature of ordinal data. RESULTS Although a majority of subscales showed acceptable to good internal consistency, 4 dimensions (staffing, overall perceptions of patient safety, organizational learning-continuous improvement, and nonpunitive response to errors) had reliability levels less than 0.6. The HSOPSC items loaded somewhat diffusely on 3 subscales: staffing, teamwork across units, and organizational learning-continuous improvement. Correlations between the 12 HSOPSC factors indicated discriminant validity. Convergent validity was supported by correlations between the 12 subscales and a single-item outcome variable, namely, patient safety grade. Several items did not load well on their respective subscales, but most items fit the underlying theoretical model implied by the HSOPSC, resulting in an acceptable model fit (confirmatory fit index = 0.985, root mean square error of approximation = 0.034, weighted root mean square residual = 0.54). CONCLUSIONS Despite the acceptable model fit of the Korean version of HSOPSC, the psychometric properties of this instrument require further investigation to ensure it is an effective tool to measure patient safety culture and identify areas for improvement in the Korean health care system.
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Affiliation(s)
- Seung Eun Lee
- From the Mo-Im KIM Nursing Research Institute, College of Nursing, Yonsei University, Seoul, South Korea
| | - Farinaz Havaei
- School of Nursing, University of British Columbia, Vancouver, Canada
| | | | - Jeong Ae Shin
- Division of Quality Improvement, Inha University Hospital, Incheon, South Korea
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Calvache JA, Benavides E, Echeverry S, Agredo F, Stolker RJ, Klimek M. Psychometric Properties of the Latin American Spanish Version of the Hospital Survey on Patient Safety Culture Questionnaire in the Surgical Setting. J Patient Saf 2021; 17:e1806-e1813. [PMID: 32011426 PMCID: PMC8612909 DOI: 10.1097/pts.0000000000000644] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The Hospital Survey on Patient Safety Culture (HSPSC) was designed to assess staff views on patient safety and has been translated and validated into several languages and settings. This study developed a Latin American Spanish version of the HSPSC for use in perioperative settings and examines its psychometric properties. METHODS After translation and adjustments, a web-based questionnaire was administered to all health care personnel at operating room in a public university-affiliated hospital in Popayán, Colombia. Descriptive statistics, internal reliability, confirmatory and exploratory factor analysis, and intercorrelations among survey composites were calculated. RESULTS Confirmatory factor analysis showed inadequate model fit for the original 12-factor structure of the HSPSC. Rather, a 9-factor, 36-item instrument showed acceptable factor loadings, internal consistency, and psychometric properties. Five factors were formed with minor changes. Adjusted factors emerged, like "staffing and work pressure" and "supervisor/manager expectations and actions promoting patient safety," "organizational learning-continuous improvement," and "hospital management support for safety," as well as "repeated errors and perception of safety." Internal consistency for each remaining composite met or exceeded a Cronbach α value of 0.60. CONCLUSIONS Psychometric analyses provided overall support for 9 of the 12 initial factors of patient safety culture. Our findings suggest that more validation studies need to be conducted before applying safety dimensions from the original HSPSC to perioperative settings only. By providing this initial tool, we hope to stimulate further studies and the patient safety research agenda in this part of the world.
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Affiliation(s)
- Jose Andres Calvache
- From the Anesthesiology Department, Erasmus University Medical Center, Rotterdam, the Netherlands
- Departamento de Anestesiología, Universidad del Cauca, Popayán, Colombia
| | - Edison Benavides
- Departamento de Anestesiología, Universidad del Cauca, Popayán, Colombia
| | | | - Francisco Agredo
- Departamento de Anestesiología, Universidad del Cauca, Popayán, Colombia
| | - Robert Jan Stolker
- From the Anesthesiology Department, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Markus Klimek
- From the Anesthesiology Department, Erasmus University Medical Center, Rotterdam, the Netherlands
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Draganović Š, Offermanns G, Davis RE. Adaptation of the Agency for Healthcare Research and Quality's 'Hospital Survey on Patient Safety Culture' to the Bosnia and Herzegovina context. BMJ Open 2021; 11:e045377. [PMID: 34385231 PMCID: PMC8362708 DOI: 10.1136/bmjopen-2020-045377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Measuring staff perspectives on patient safety culture (PSC) can identify areas of concern that, if addressed, could lead to improvements in healthcare. To date, there is no validated measure to assess PSC that has been tested and adapted for use in Bosnia and Herzegovina (BiH). This research addresses the gap in the evidence through the psychometric assessment of the Agency for Healthcare Research and Quality's: 'Hospital Survey on Patient Safety Culture' (HSOPSC), to determine its suitability for the health system in BiH. SETTING Nine hospitals. PARTICIPANTS Healthcare professionals (n=1429); nurse (n=823), doctors (n=328), other clinical personnel (n=111), non-clinical personnel (n=60), other (n=64), no response (n=43). PRIMARY AND SECONDARY OUTCOME MEASURES A translated version of HSOPSC was used to conduct psychometric evaluation including exploratory factor analysis and confirmatory factor analysis (CFA). Comparison between the original HSOPSC and the newly adapted 'Hospital Survey on Patient Safety Culture for Bosnia and Herzegovina' (HSOPSC-BiH) was carried out. RESULTS Compared with the original survey, which has 12 factors (42 items), the adapted survey consisted of 9 factors (29 items). The following factors from the original survey were not included in their original form: Communication Openness, Feedback and Communications about error, Overall Perceptions of Patient Safety and Organisational learning-Continuous Improvement. The results of the CFA for HSOPSC-BiH showed a better model fit compared with the original HSOPSC. The absolute and relative fit indices showed excellent model adjustment. CONCLUSIONS The BiH version of Hospital Survey on Patient Safety Culture demonstrated satisfactory psychometric properties, with acceptable to good internal consistency and construct validity. Therefore, we recommend the HSOPSC-BiH as a basis for assessing PSC in BiH. This survey could provide insight into patient safety concerns in BiH so that strategies to overcome these issues could be formulated and implemented.
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Affiliation(s)
- Šehad Draganović
- Faculty of Management and Economics, Department of Human Resource Management, Leadership and Organizational Behavior, University of Klagenfurt, Klagenfurt, Austria
| | - Guido Offermanns
- Faculty of Management and Economics, Department of Human Resource Management, Leadership and Organizational Behavior, University of Klagenfurt, Klagenfurt, Austria
- Karl Landsteiner Society, Institute for Hospital Organization, Vienna, Austria
| | - Rachel E Davis
- Centre for Implementation Science, Health Service and Population Research Department, King's College London Institute of Psychiatry Psychology and Neuroscience, London, UK
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Kalánková D, Bartoníčková D, Gurková E, Žiaková K, Kurucová R. A validation study of the Slovak version of the Hospital Survey on Patient Safety Culture (with Slovak nurses). CENTRAL EUROPEAN JOURNAL OF NURSING AND MIDWIFERY 2021. [DOI: 10.15452/cejnm.2021.12.0010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Perception of Patient Safety Culture among Hospital Staff. Zdr Varst 2021; 60:97-104. [PMID: 33822831 PMCID: PMC8015657 DOI: 10.2478/sjph-2021-0015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 02/01/2021] [Indexed: 11/30/2022] Open
Abstract
Introduction A patient safety culture (PSC) is a complex phenomenon, representing an essential part of the organizational culture and refers to the shared values, conceptions and beliefs which contribute to the formation and encouragement of safe behavioural models in a health organization. With this study, the authors wanted to delineate the attitude of hospital staff in Bulgaria regarding PSC and to document to whether attitudes differ between physicians and other healthcare professionals (HCPs). Methods A national cross-sectional survey among 384 HCPs was conducted using an online version of the Bulgarian version of Hospital Survey on Patient Safety Culture (B-HSOPSC). The data was analysed with descriptive statistics, non-parametric Mann-Whitney U and x 2 tests. Results The physicians represented 37.50% (144) of the sample and other HCPs 62.50% (240). Respondents from governmental/municipal hospitals prevailed (53.6%). The dimensions “Staffing” and “Non-punitive response to error” were most problematic, as their percentage of positive response rates (PRRs) were lowest. However, “Handoffs and transitions” and “Supervisor/manager expectations and actions promoting safety“ showed the highest mean values in both physicians and other HCPs. From all participants, 76.0% have never reported an adverse event or error. Conclusion The results of the study show that all respondents demonstrate a positive attitude regarding PSC. A comparison of the mean values and that of PRRs in the dimensions did not show any group differences, according to the type of staff position, i.e. physicians or other HCPs.
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Azyabi A, Karwowski W, Davahli MR. Assessing Patient Safety Culture in Hospital Settings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2466. [PMID: 33802265 PMCID: PMC7967599 DOI: 10.3390/ijerph18052466] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 02/23/2021] [Accepted: 03/01/2021] [Indexed: 12/02/2022]
Abstract
The current knowledge about patient safety culture (PSC) in the healthcare industry, as well as the research tools that have been used to evaluate PSC in hospitals, is limited. Such a limitation may hamper current efforts to improve patient safety worldwide. This study provides a systematic review of published research on the perception of PSC in hospitals. The research methods used to survey and evaluate PSC in healthcare settings are also explored. A list of academic databases was searched from 2006 to 2020 to form a comprehensive view of PSC's current applications. The following research instruments have been applied in the past to assess PSC: the Hospital Survey on Patient Safety Culture (HSPSC), the Safety Attitudes Questionnaire (SAQ), the Patient Safety Climate in Health Care Organizations (PSCHO), the Modified Stanford Instrument (MSI-2006), and the Scottish Hospital Safety Questionnaire (SHSQ). Some of the most critical factors that impact the PSC are teamwork and organizational and behavioral learning. Reporting errors and safety awareness, gender and demographics, work experience, and staffing levels have also been identified as essential factors. Therefore, these factors will need to be considered in future work to improve PSC. Finally, the results reveal strong evidence of growing interest among individuals in the healthcare industry to assess hospitals' general patient safety culture.
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Affiliation(s)
- Abdulmajeed Azyabi
- Department of Industrial Engineering and Management Systems, University of Central Florida, Orlando, FL 32816, USA;
| | | | - Mohammad Reza Davahli
- Department of Industrial Engineering and Management Systems, University of Central Florida, Orlando, FL 32816, USA;
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Gurková E, Kalánková D, Kurucová R, Žiaková K. Assessment of patient safety climate by nurses in Slovak Public and private hospitals. J Nurs Manag 2020; 28:1644-1652. [PMID: 32757476 DOI: 10.1111/jonm.13120] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 07/21/2020] [Accepted: 07/31/2020] [Indexed: 11/29/2022]
Abstract
AIM To examine variations in the safety climate reported by nurses in Slovak hospitals and to analyse the association between dimensions of the patient safety climate and demographic and organisational factors. BACKGROUND A deeper understanding of how safety climate varies across hospitals can be useful in determining areas with a potential for improvement. Staffing and non-punitive response to errors were identified in recent research syntheses as the weakest dimensions of safety climate that require strengthening. METHODS The sample consisted of 1,429 nurses working in public and private hospitals in Slovakia. The Hospital Survey on Patient Safety Culture questionnaire was used for data collection, and descriptive analysis was carried out to examine relationships between variables. RESULTS Nurses working in general private hospitals with a bed capacity of less than 500 beds were more positive about their hospital safety climate than other nurses working in differently organised hospitals. The lowest number of positive responses was scored in the domain of 'Non-Punitive Response to Error'. This result came from a blame-free error-reporting atmosphere. CONCLUSIONS Nurses perceived a higher level of patient safety when they had experienced better sharing of information on event reporting and had better learning opportunities. IMPLICATIONS FOR NURSING MANAGEMENT The results revealed strengths and weaknesses of the patient safety climate in the network of Slovak hospitals from the perspective of nurses working in these hospitals. This knowledge can enable nurse managers to instigate supportive strategies for just reporting, and learning from events, within an enhanced safety culture.
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Affiliation(s)
- Elena Gurková
- Department of Nursing, Faculty of Health Sciences, Palacký University in Olomouc, Czech Republic
| | - Dominika Kalánková
- Department of Nursing, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Bratislava, Slovak Republic
| | - Radka Kurucová
- Department of Nursing, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Bratislava, Slovak Republic
| | - Katarína Žiaková
- Department of Nursing, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Bratislava, Slovak Republic
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Granel N, Manresa-Domínguez JM, Watson CE, Gómez-Ibáñez R, Bernabeu-Tamayo MD. Nurses' perceptions of patient safety culture: a mixed-methods study. BMC Health Serv Res 2020; 20:584. [PMID: 32590990 PMCID: PMC7318509 DOI: 10.1186/s12913-020-05441-w] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 06/18/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There are relatively few qualitative studies concerning patient safety culture. METHODS We aimed to explore patient safety culture as perceived by the nursing staff in two public hospitals in Catalonia, Spain. A mixed-methods design was employed using a questionnaire, in-depth interviews, and non-participant observations. RESULTS Sixty-two percent of the nursing staff rated patient safety as "Acceptable" but was not higher because of work pressure and lack of resources as perceived by staff. "Teamwork within units" had the highest rate of positive responses, and "Staffing" had the lowest rate. Emergency units showed more negative results than the other two units. CONCLUSIONS Safety incidents are not always reported due to fear of punishment, reflecting a lack of positive safety culture. It is necessary to design and implement strategies that promote a positive culture to avoid punitive responses and apply and evaluate these changes.
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Affiliation(s)
- Nina Granel
- Nursing Department, Medicine Faculty, Universitat Autònoma de Barcelona, Av. de Can Domènech, 737, 08193 Bellaterra, Barcelona, Spain.
| | - Josep Maria Manresa-Domínguez
- Nursing Department, Medicine Faculty, Universitat Autònoma de Barcelona, Av. de Can Domènech, 737, 08193 Bellaterra, Barcelona, Spain
| | - Carolina Eva Watson
- Nursing Department, Medicine Faculty, Universitat Autònoma de Barcelona, Av. de Can Domènech, 737, 08193 Bellaterra, Barcelona, Spain
| | - Rebeca Gómez-Ibáñez
- Nursing Department, Medicine Faculty, Universitat Autònoma de Barcelona, Av. de Can Domènech, 737, 08193 Bellaterra, Barcelona, Spain
| | - Maria Dolors Bernabeu-Tamayo
- Nursing Department, Medicine Faculty, Universitat Autònoma de Barcelona, Av. de Can Domènech, 737, 08193 Bellaterra, Barcelona, Spain
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Aletras VΗ, Klinis S, Mavrodi AG, Kakalou D, Ntantana A, Mallidou AA, Niakas DA. A cross-sectional study of patient safety culture in acute-care hospitals in Greece. JOURNAL OF PATIENT SAFETY AND RISK MANAGEMENT 2020. [DOI: 10.1177/2516043520924192] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Background The development of a culture of safety can bring about an improvement in patient safety and quality of care. We aimed to investigate patient safety culture within an acute-care hospital setting in Greece. Methods A cross-sectional quantitative study was conducted using the Hospital Survey on Patient Safety Culture (HSOPSC) questionnaire in two large acute-care hospitals in Greece. We examined questionnaire’s factorial structure using confirmatory and exploratory factor analysis. We assessed scales’ internal consistency, test–retest reliability and construct validity. To assess changes in patient safety culture, we conducted surveys at two points in time (2009 and 2014). Regression analysis examined whether any changes in scale scores could have been due to quality programs implementation or participants’ professional characteristics. Results Six scales with satisfactory psychometric properties emerged, namely ‘Teamwork Across Hospital Units’, ‘Teamwork Within Hospital Units’, ‘Feedback and Communication About Error’, ‘Frequency of Event Reporting’, ‘Supervisor/Manager Expectations and ‘Actions Promoting Safety’, ‘Hospital Management Support for Patient Safety’. Overall ratings of patient safety did not change over time. However, one of the two institutions experienced an increase in reported events. Conclusions The HSOPSC is a valuable tool for assessing patient safety culture in Greece. Moreover, despite the radical reduction in the financing of the Greek National Health System reported between 2009 and 2014, patient safety culture did not deteriorate. A worldwide trend towards increasing patient safety awareness, along with the increasing effort of hospitals’ administration to support patient safety might explain this lack of differences between the two points in time.
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Affiliation(s)
- Vassilis Η Aletras
- Department of Business Administration, University of Macedonia, Thessaloniki, Greece
| | - Spyridon Klinis
- School of Social Sciences, Hellenic Open University, Patras, Greece
| | - Afentoula G Mavrodi
- Department of Business Administration, University of Macedonia, Thessaloniki, Greece
| | - Despina Kakalou
- School of Social Sciences, Hellenic Open University, Patras, Greece
| | - Asimenia Ntantana
- Department of Business Administration, University of Macedonia, Thessaloniki, Greece
| | | | - Dimitris A Niakas
- School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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Granel N, Manresa-Domínguez JM, Barth A, Papp K, Bernabeu-Tamayo MD. Patient safety culture in Hungarian hospitals. Int J Health Care Qual Assur 2019; 32:412-424. [PMID: 31017066 DOI: 10.1108/ijhcqa-02-2018-0048] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The Hospital Survey on Patient Safety Culture (HSOPSC) is a rigorously designed tool for measuring inpatient safety culture. The purpose of this paper is to develop a cross-cultural HSOPSC for Hungary and determine its strengths and weaknesses. DESIGN/METHODOLOGY/APPROACH The original US version was translated and adapted using existing guidelines. Healthcare workers (n=371) including nurses, physicians and other healthcare staff from six Hungarian hospitals participated. Answers were analyzed using exploratory factor analyses and reliability tests. FINDINGS Positive responses in all dimensions were lower in Hungary than in the USA. Half the participants considered their work area "acceptable" regarding patient safety. Healthcare staff worked in "crisis mode," trying to accomplish too much and too quickly. The authors note that a "blame culture" does not facilitate patient safety improvements in Hungary. PRACTICAL IMPLICATIONS The results provide valuable information for promoting a more positive patient safety culture in Hungary and for evaluating future strategies to improve patient safety. ORIGINALITY/VALUE Introducing a validated scale to measure patient safety culture in Hungary improves healthcare quality.
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Affiliation(s)
- Nina Granel
- Department of Nursing, Universitat Autònoma de Barcelona , Barcelona, Spain
| | - Josep Maria Manresa-Domínguez
- Department of Nursing, Universitat Autònoma de Barcelona , Barcelona, Spain.,Institut de Recerca en Atencio Primaria Jordi Gol, Universitat Autònoma de Barcelona , Barcelona, Spain
| | - Anita Barth
- Department of Health Methodology and Public Health, Institute of Health Sciences, University of Debrecen , Debrecen, Hungary
| | - Katalin Papp
- Department of Nursing, Institute of Health Sciences, University of Debrecen , Debrecen, Hungary
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Brborović O, Brborović H, Nola IA, Milošević M. Culture of Blame-An Ongoing Burden for Doctors and Patient Safety. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16234826. [PMID: 31805629 PMCID: PMC6926580 DOI: 10.3390/ijerph16234826] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 11/20/2019] [Accepted: 11/29/2019] [Indexed: 11/16/2022]
Abstract
Introduction: Every procedure in healthcare carries a certain degree of inherent unsafety resulting from problems in practice, which might lead to a healthcare adverse event (HAE). It is very important, and even mandatory, to report HAE. The point of HAE reporting is not to blame the person, but to learn from the HAE in order to prevent future HAEs. Study question: Our aim was to examine the prevalence and the impact of culture of blame on health workers’ health. Methods: A cross-sectional study on healthcare workers at two Croatian hospitals was conducted using the Hospital Survey on Patient Safety Culture (PSC). Results: The majority of PSC dimensions in both hospitals were high. Among the dimensions, Hospital Handoffs and Transitions and Overall Perceptions of Safety had the highest values. The Nonpunitive Response to Error dimension had low values, indicating the ongoing culture of blame. The Staffing dimension had low values, indicating the ongoing shortage of doctors and nurses. Discussion: We found inconsistencies between a single-item measure and PSC dimensions. It was expected that Frequency of Events Reported (PSC dimension) relates to Number of Events Reported (single-item measure). However, in our study, the relations between these pairs of measures were different between hospitals. Our results indicate the ongoing culture of blame. Healthcare workers do not report HAE because they fear they will be punished by management or by law.
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Affiliation(s)
- Ognjen Brborović
- University of Zagreb, School of Medicine, Andrija Štampar School of Public Health, Department of Social Medicine and Organization of Health Care, Zagreb 10 000, Croatia;
| | - Hana Brborović
- University of Zagreb, School of Medicine, Andrija Štampar School of Public Health, Department of Environmental and Occupational Health and Sports Medicine, WHO CC for Occupational Health, Zagreb 10 000, Croatia; (I.A.N.); (M.M.)
- Correspondence: ; Tel.: +385-1459-0179
| | - Iskra Alexandra Nola
- University of Zagreb, School of Medicine, Andrija Štampar School of Public Health, Department of Environmental and Occupational Health and Sports Medicine, WHO CC for Occupational Health, Zagreb 10 000, Croatia; (I.A.N.); (M.M.)
| | - Milan Milošević
- University of Zagreb, School of Medicine, Andrija Štampar School of Public Health, Department of Environmental and Occupational Health and Sports Medicine, WHO CC for Occupational Health, Zagreb 10 000, Croatia; (I.A.N.); (M.M.)
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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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Al Salem G, Bowie P, Morrison J. Hospital Survey on Patient Safety Culture: psychometric evaluation in Kuwaiti public healthcare settings. BMJ Open 2019; 9:e028666. [PMID: 31152040 PMCID: PMC6549604 DOI: 10.1136/bmjopen-2018-028666] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE As healthcare organisations endeavour to improve the quality and safety of their services, there is increasing recognition of the importance of building a culture of safety to promote patient safety and improve the outcomes of patient care. Surveys of safety culture/climate have not knowingly been conducted in Kuwait public hospitals, nor are valid or reliable survey instruments available for this context. This study aims to investigate the psychometric properties of the HSOPSC (Hospital Survey on Patient Safety Culture) tool in Kuwaiti public hospitals in addition to constructing an optimal model to assess the level of safety climate in this setting. DESIGN Cross-sectional study. SETTING Three public hospitals in Kuwait. PARTICIPANTS About 1317 healthcare professionals. MAIN OUTCOME MEASURE An adapted and contextualised version of HSOPSC was used to conduct psychometric evaluation including exploratory factor analysis, confirmatory factor analysis reliability and correlation analysis. RESULTS 1317 questionnaires (87%) were returned. Psychometric evaluation, showed an optimal model of eight factors and 22 safety climate items. All items have strong factor loadings (0.42-0.86) and are theoretically related. Reliability analysis showed satisfactory results (α >0.60). CONCLUSIONS This is the first validation study of a standardised safety climate measure in a Kuwaiti healthcare setting. An optimal model for assessing patient safety climate was produced that mirrors other international studies and which can be used for measuring the prevailing safety climate. More importance should be attached to the psychometric fidelity of safety climate questionnaires before extending their use in other healthcare culture and contexts internationally.
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Affiliation(s)
- Gheed Al Salem
- Institute of Health and Well-being, University of Glasgow, Glasgow, UK
- Quality and Accreditation Directorate, Ministry of health, Kuwait City, Kuwait
| | - Paul Bowie
- Safety & Improvement, NHS Education for Scotland, Glasgow, Scotland, UK
| | - Jill Morrison
- General Practice and Primary Care, University of Glasgow, Glasgow, UK
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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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Stoyanova R, Dimova R, Tarnovska M, Boeva T. Linguistic Validation and Cultural Adaptation of Bulgarian Version of Hospital Survey on Patient Safety Culture (HSOPSC). Open Access Maced J Med Sci 2018; 6:925-930. [PMID: 29875873 PMCID: PMC5985869 DOI: 10.3889/oamjms.2018.222] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 04/24/2018] [Accepted: 04/30/2018] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND: Patient safety (PS) is one of the essential elements of health care quality and a priority of healthcare systems in most countries. Thus the creation of validated instruments and the implementation of systems that measure patient safety are considered to be of great importance worldwide. AIM: The present paper aims to illustrate the process of linguistic validation, cross-cultural verification and adaptation of the Bulgarian version of the Hospital Survey on Patient Safety Culture (B-HSOPSC) and its test-retest reliability. METHODS: The study design is cross-sectional. The HSOPSC questionnaire consists of 42 questions, grouped in 12 different subscales that measure patient safety culture. Internal consistency was assessed using Cronbach’s alpha. The Wilcoxon signed-rank test and the split-half method were used; the Spearman-Brown coefficient was calculated. RESULTS: The overall Cronbach’s alpha for B-HSOPSC is 0.918. Subscales 7 Staffing and 12 Overall perceptions of safety had the lowest coefficients. The high reliability of the instrument was confirmed by the Split-half method (0.97) and ICC-coefficient (0.95). The lowest values of Spearmen-Broun coefficients were found in items A13 and A14. CONCLUSION: The study offers an analysis of the results of the linguistic validation of the B-HSOPSC and its test-retest reliability. The psychometric characteristics of the questions revealed good validity and reliability, except two questions. In the future, the instrument will be administered to the target population in the main study so that the psychometric properties of the instrument can be verified.
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Affiliation(s)
- Rumyana Stoyanova
- Department of Health Management and Health Economics, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Rositsa Dimova
- Department of Health Management and Health Economics, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Miglena Tarnovska
- Department of Healthcare Management, Section of Medical Ethics and Law, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Tatyana Boeva
- Department of Educational and Scientific Documentation, Medical University of Plovdiv, Plovdiv, Bulgaria
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Tereanu C, Sampietro G, Sarnataro F, Siscanu D, Palaria R, Savin V, Cliscovscaia T, Pislaru V, Oglinda V, Capmare L, Ghelase MS, Turcanu T. Survey on patient safety culture in the Republic of Moldova: a baseline study in three healthcare settings. CLUJUL MEDICAL (1957) 2018; 91:65-74. [PMID: 29456450 PMCID: PMC5808270 DOI: 10.15386/cjmed-869] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 10/20/2017] [Accepted: 11/06/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND AIMS The Republic of Moldova is a small ex-soviet country in the Central Eastern European group of states, whose official language is Romanian. In countries with limited resources, quality improvement in healthcare and patient safety are very challenging. This study aims to identify which areas of the patient safety culture (PSC) need prompt intervention. METHODS A cross-sectional study was conducted in three Moldovan healthcare settings, using the Romanian translation of the US Hospital Survey on Patient Safety Culture HSOPSC. Descriptive statistics were carried out, based on the responses from n. 929 staff. Percentages of positive responses (PPRs) by item (41 items) and composite (12 PSC areas) were computed. RESULTS Most respondents were nurses (53%), followed by doctors (35%). The main work areas were: primary care (27%), medical specialties (20%), gynecology and obstetrics (16%), and general surgery (11%). The highest composite PPRs were for: teamwork within units (80%), feedback & communication about error, organizational learning-continuous improvement and supervisor/manager expectations & actions promoting patient safety (78%), and management support for patient safety (75%). The lowest composites were for: frequency of events reported (57%), non-punitive response to errors (53%), communication openness (51%) and staffing (37%). CONCLUSION Our results suggest that staffing issues should be tackled to provide safe care. Staff avoid to openly report adverse events and/or discuss errors, likely because a poor understanding of the potential of these events for learning and because of fear of blame or punitive actions. Future research should check psychometrics of the Romanian version of the HSOPSC applied to Moldovan staff.
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Affiliation(s)
- Carmen Tereanu
- Department of Hygiene and Prevention, Agenzia di Tutela della Salute, Bergamo, Italy
| | | | - Francesco Sarnataro
- Department of Hygiene and Prevention, Agenzia di Tutela della Salute, Bergamo, Italy
| | - Dumitru Siscanu
- Consultative Unit of the Perinatology Center, Municipal Clinical Hospital 1, Chisinau, Republic of Moldova
| | - Rodica Palaria
- Quality Management, Municipal Clinical Hospital 1, Chisinau, Republic of Moldova
| | - Victor Savin
- Municipal Clinical Hospital 1, Chisinau, Republic of Moldova
| | | | | | | | | | - Mugurel Stefan Ghelase
- Department of Public Health and Healthcare Management, University of Medicine and Pharmacy of Craiova, Romania
| | - Tamara Turcanu
- Department of Pediatrics, Nicolae Testemitanu University of Medicine and Pharmacy of Chisinau, Republic of Moldova
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Patient safety culture shapes presenteeism and absenteeism: a cross-sectional study among Croatian healthcare workers. Arh Hig Rada Toksikol 2017; 68:185-189. [DOI: 10.1515/aiht-2017-68-2957] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 09/01/2017] [Indexed: 11/15/2022] Open
Abstract
Abstract
Healthcare workers have high rates of injuries and illnesses at the workplace, and both their absence from work due to illness (absenteeism) or working ill (presenteeism) can compromise patient safety and the quality of health care delivered. Following this premise, we wanted to determine whether presenteeism and absenteeism were associated with patient safety culture (PSC) and in what way. Our sample consisted of 595 Croatian healthcare workers (150 physicians and 445 nurses) who answered the short-form WHO Health and Work Performance Questionnaire and the Hospital Survey on Patient Safety Culture. The results have confirmed the association with both presenteeism and absenteeism in several PSC dimensions, but not as we expected based on the premise from which we started. Opposite to our expectations, lower job performance (as a measure of presenteeism) was associated with higher PSC instead of lower PSC. Absenteeism, in turn, was associated with lower PSC, just as we expected. These findings suggest that it is the PSC that shapes presenteeist and absenteeist behaviour and not the other way around. High PSC leads to presenteeism, and low PSC to absenteeism. We also believe that the presenteeism questionnaires should be adjusted to health care and better define what lower performance means both quantitatively and qualitatively in a hospital setting
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Aboneh EA, Look KA, Stone JA, Lester CA, Chui MA. Psychometric properties of the AHRQ Community Pharmacy Survey on Patient Safety Culture: a factor analysis. BMJ Qual Saf 2015. [PMID: 26208535 DOI: 10.1136/bmjqs-2015-004001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND The U.S. Agency for Healthcare Research and Quality (AHRQ) developed a hospital patient safety culture survey in 2004 and has adapted this survey to other healthcare settings, such as nursing homes and medical offices, and most recently, community pharmacies. However, it is unknown whether safety culture dimensions developed for hospitals can be transferred to community pharmacies. The aim of this study was to assess the psychometric properties of the Community Pharmacy Survey on Patient Safety Culture. METHOD The survey was administered to 543 community pharmacists in Wisconsin, USA. Confirmatory factor analysis was used to assess the fit of our data with the proposed AHRQ model. Exploratory factor analysis was used to determine the underlying factor structure. Internal consistency reliabilities were calculated. RESULTS A total of 433 usable surveys were returned (response rate 80%). Results from the confirmatory factor analysis showed inadequate model fit for the original 36 item, 11-factor structure. Exploratory factor analysis showed that a modified 27-item, four-factor structure better reflected the underlying safety culture dimensions in community pharmacies. The communication openness factor, with three items, dropped in its entirety while six items dropped from multiple factors. The remaining 27 items redistributed to form the four-factor structure: safety-related communication, staff training and work environment, organisational response to safety events, and staffing, work pressure and pace. Cronbach's α of 0.95 suggested good internal consistency. CONCLUSIONS Our findings suggest that validation studies need to be conducted before applying safety dimensions from other healthcare settings into community pharmacies.
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Affiliation(s)
- Ephrem A Aboneh
- Social & Administrative Sciences Division, School of Pharmacy, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Kevin A Look
- Social & Administrative Sciences Division, School of Pharmacy, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Jamie A Stone
- Social & Administrative Sciences Division, School of Pharmacy, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Corey A Lester
- Social & Administrative Sciences Division, School of Pharmacy, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Michelle A Chui
- Social & Administrative Sciences Division, School of Pharmacy, University of Wisconsin-Madison, Madison, Wisconsin, USA
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Farup PG. Are measurements of patient safety culture and adverse events valid and reliable? Results from a cross sectional study. BMC Health Serv Res 2015; 15:186. [PMID: 25934272 PMCID: PMC4424527 DOI: 10.1186/s12913-015-0852-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2014] [Accepted: 04/25/2015] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The association between measurements of the patient safety culture and the "true" patient safety has been insufficiently documented, and the validity of the tools used for the measurements has been questioned. This study explored associations between the patient safety culture and adverse events, and evaluated the validity of the tools. METHODS In 2008/2009, a survey on patient safety culture was performed with Hospital Survey on Patient Safety Culture (HSOPSC) in two medical departments in two geographically separated hospitals of Innlandet Hospital Trust. Later, a retrospective analysis of adverse events during the same period was performed with the Global Trigger Tool (GTT). The safety culture and adverse events were compared between the departments. RESULTS 185 employees participated in the study, and 272 patient records were analysed. The HSOPSC scores were lower and adverse events less prevalent in department 1 than in department 2. In departments 1 and 2 the mean HSOPSC scores (SD) were at the unit level 3.62 (0.42) and 3.90 (0.37) (p < 0.001), and at the hospital level 3.35 (1.53) and 3.67 (0.53) (ns, p = 0.19) respectively. The proportion of records with adverse events were 10/135 (7%) and 28/137 (20%) (p = 0.003) respectively. CONCLUSIONS There was an inverse association between the patient safety culture and adverse events. Until the criterion validity of the tools for measuring patient safety culture and tracking of adverse events have been further evaluated, measurement of patient safety culture could not be used as a proxy for the "true" safety.
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Affiliation(s)
- Per G Farup
- Department of Research, Innlandet Hospital Trust, N-2819, Gjøvik, Norway.
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