Baseline assessment of patient safety culture in primary care centres in Kuwait: a national cross-sectional study

Assessment of a patient safety culture: a nationwide cross-sectional study comparing public and private hospitals in Kuwait

BACKGROUND

Several international health bodies advocate measuring patient safety culture within an organisation as an effective strategy for sustainably improving safety. This study aims to assess and compare patient safety culture across public and private hospitals in Kuwait.

METHODS

A cross-sectional study was conducted utilising the Hospital Survey of Patient Safety Culture. The questionnaire was distributed among clinical staff in public general and private hospitals. Data analysis using Microsoft Excel and SPSS 23 (α level = 0.05) provided an overview of participant characteristics and patient safety culture scores. A model for predicting the determinants of patient safety culture score was constructed from a regression analysis.

RESULTS

A total of 890 questionnaires were distributed equally between the public and private sectors. The overall response rate was 94.9%. Assessment of the positive percentage of patient safety culture showed that nationally, five composites were areas of strength: "Teamwork within Units" (87.2%), "Organizational Learning-Continuous Improvement" (87.5%), "Management Support for Patient Safety" (77.8%), "Feedback & Communication about Error" (75.8%) and "Teamwork across Units" (75.0%). Private hospitals showed these same areas of strength, whereas public hospitals had fewer. Private hospitals scored statistically significant higher positive percentages than public hospitals in most of the composites. Benchmarking against a 2015 study in Kuwait indicates that the positive percentages of six composites increased at the national level, whereas four remained the same. "Staffing" and "Non-punitive response to errors" were strikingly low.

CONCLUSION

In this first national study to assess patient safety culture in public and private hospitals in Kuwait, many areas of safety culture had improved. However, some areas require special attention, although causality cannot be inferred, which is a limitation of the study's design. A comparison between the two sectors revealed differences in the patient safety culture, which might be relevant to the guidelines governing them. Policymakers should set unified guidelines governing staffing in both sectors and devise intervention strategies to develop a culture that establishes learning from adverse events and supports patient safety, incorporating a just culture and whistle-blower protection. In academia, Kuwait University should incorporate patient safety and quality-of-care topics into its curricula.

Assessment of patient safety culture in Moroccan primary health care: a multicentric study

BACKGROUND

Promoting patient safety is a critical concern for developing-countries health systems like Morocco. There is an increasing acknowledgment of the need to create a patient-centered culture with the aim to decrease the number of adverse events related to care and improve health-care quality in Morocco.

OBJECTIVE

The purpose of this study is to examine the perceptions of health professionals working in primary care level of care facilities in Morocco about the concept of patient safety culture.

METHODS

We conducted a multicentric cross-sectional study of a quantitative nature in primary healthcare facilities in ten Moroccan cities, measuring ten patient safety culture dimensions, from February 2022 to June 2022. Data was collected using the French version of the HSOPSC questionnaire.

RESULTS

The most developed dimension of the culture of patient safety was found to be Teamwork within Units (69%), followed by Supervisor/Manager's Expectations & Actions Promoting Patient Safety (59%). The least developed dimensions were Staffing (34%) and Nonpunitive Response to Errors (37%).

CONCLUSION

Improving patient safety culture should be a priority for primary healthcare facility administrators and all stakeholders, addressing, in particular, the shortage of human resources. In addition, health personnel should be encouraged to report errors without fear of punitive consequences.

Knowledge, attitudes, and practices toward Patient Safety among nurses in health centers

OBJECTIVE

To assess knowledge, attitudes, and practices (KAPs) toward patient safety among nurses working at primary and comprehensive health care centers in Jordan; to identify factors that predict KAPs among nurses.

METHODS

A descriptive cross-sectional design was conducted using a convenience sample of 307 primary health care nurses in Jordan. A self-reported questionnaire (KAPs) toward patient safety was distributed to the nurses between August 2022 and October 2022.

RESULTS

The results revealed that the mean score of knowledge was 9.51 out of 11 (SD = 1.35), the mean score of attitudes was 57.66 out of 75 (SD = 9.17), and the mean score of practices was 5.64 out of 8 (SD = 1.72). Where 59% of participants reported good knowledge about patient safety. 61% of participants reported positive attitudes toward patient safety. A significant regression equation was found (R² = 0.073, F= (2.94), p = 0 0.003). Age and having information on patient safety during continuing education were significant predictors of the attitude score (p ≤ 0.05).

CONCLUSION

It is necessary to implement patient safety education programs and training.

Professional burnout and patient safety culture in Primary Health Care

OBJECTIVES

to analyze the association between the risk of occupational exhaustion (burnout) and safety culture in Primary Health Care.

METHODS

ross-sectional study conducted in 18 Primary Health Care Units in the Northeast of Brazil. Three questionnaires were used: sociodemographic, Maslach Burnout Inventory, and the Medical Office Survey on Patient Safety Culture. The study was approved by the Research Ethics Committee.

RESULTS

seventy-eight healthcare workers participated, of which 64.1% presented a reduced risk of burnout; and 11.5%, a high risk (p=0.000). The following were identified as weakened dimensions of safety culture: Work pressure and pace; Owner, managing partners, leadership support; Overall ratings on quality; and Overall rating on patient safety.

CONCLUSIONS

an association was found between low risk of developing burnout syndrome and positive evaluation of safety culture.

Patient safety culture as a space of social struggle: understanding infection prevention practice and patient safety culture within hospital isolation settings - a qualitative study

BACKGROUND

In recent times, infection prevention and patient safety have become a global health policy priority with thought being given to understanding organisational culture within healthcare, and of its significance in initiating sustained quality improvement within infection prevention and patient safety. This paper seeks to explore the ways in which engagement of healthcare workers with infection prevention principles and practices, shape and inform patient safety culture within the context of hospital isolation settings; and vice-versa.

RESEARCH METHODS

In this paper, we utilise focus group interviews at two hospital sites within one health board in order to engage healthcare staff in elaborating on their understandings of infection prevention practices and patient safety culture within isolation settings in their organisation. Focus group transcripts were analysed inductively using thematic analysis in order to identify and develop emerging empirical themes.

RESULTS

Positioned against a background of healthcare restructuring and ever-increasing uncertainty, our study found two very different hospitals in regard to patient safety culture and infection prevention practice. While one hospital site embodies a mixed picture in regard to patient safety culture, the second hospital is best characterised as being highly fragmented. The utilisation of focus group interviews revealed themes that capture the ways in which interviewees position and understand the work they perform within the broader structural, political and cultural context, and what that means for infection prevention practice and patient safety culture.

CONCLUSION

Drawing on the insights of Bourdieu, this paper theorises the field of patient safety as a space of social struggle. Patient safety is thus positioned within its structural, cultural and political context, rather than as merely an epidemiological dilemma.