A Comparative Study on Effective Factors in Patient Safety Culture from the Nursing Staff Points of View

Document Type : Articles



Introduction: Patient safety and its requirements fulfillment are today one of the useful valuation indicators in healthcare organizations. Thus, patient safety culture and its promotion are referred to as one of the most important issues raised in the country. The present study aims to examine the effective factors (personal and organizational) in patient safety culture from the point of view of nursing staff in Bahman and Parsian private hospitals.Method: The study has an analytical cross-sectional design and is an applied research. HSOPSC (with Cronbach’s alpha coefficient was 0.82) and researcher-devised questionnaires (with Cronbach’s Alpha equal to 0.912) were the only data collection tools. Statistical population includes nursing staff of Bahman and Parsian private hospitals in north-west Tehran. A sample consisting of 150 nurseshift supervisors and head nurses was selected from the population. Necessary data for completing questionnaires were collected by interview. Data were analyzed using SPSS16 software. Given the levels of measurement for the variables, valid measures of central tendency (mean, standard deviation), correlation tests, Chi-square, t- test, and ANOVA were used.Results: The findings showed us that such factors as organizational commitment, error reporting system, management support, reward system, and employee empowerment equipment distribution have important roles in patient safety. Their P-values are reported <0.001 for all of them. Patient safety was not significantly associated with age (P=0.964), educational level (P=0.154), and work experience (P=0.888) There is no low awareness about safety culture in any hospital and their mean awareness about patient safety culture was equal to 3.13 ±0.478 and 3.68 ±0.587 in Parsian and Bahman hospitals, respectively (P<0.001).Conclusion: Error reporting system and organizational commitment respectively have the most and the least effect on promoting  patient safety culture. Empowerment heightens the awareness of employees, enhances their performance and productivity, reduces errors caused by lack of awareness, and improves patient safety. Reward system and organizational commitment had the least effect.Keywords: Patient, Safety culture, Hospital, Nurse

  1. Williams S, Osborn S. National Patient Safety Agency: an introduction. Clinical Governance: An International Journal. 2004;9(2):130-1.
  2. van Duong D. Measuring client-perceived quality of maternity services in rural Vietnam. International Journal for Quality in Health Care. 2004;16(6):447-52.
  3. Smits M, Christiaans-Dingelhoff I, Wagner C, van der Wal G, Groenewegen PP. The psychometric properties of the ‘Hospital Survey on Patient Safety Culture’ in Dutch hospitals. BMC Health Services Research. 2008;8(1).
  4. Alahmadi HA. Assessment of patient safety culture in Saudi Arabian hospitals. BMJ Quality & Safety. 2010;19(5):e17-e.
  5. Peters G, Peters B. Medical error and patient safety: Human factors in medicine. CRC Press; 2007.
  6. Kohn LT, Corrigan JM, Donaldson MS. To err is human: building a safer health system. National Academies Press; 2000.
  7. Ravaghi H, Barati Marnani A, Hosseini AF, Takbiri A. The Relationship between Health Care Providers’ Perceptions of Patient Safety Culture and Patients’ Perceptions of Medical Errors in Teaching Hospitals in Tehran: 2011. Journal of Health Administration. 2012;15(48):57-68.
  8. Nakhaei M, Faragzadeh Z, Tabiei S, Saadatjoo S, Rad GM, Hoseini M. Evaluation of ergonomic position during work in nurses of medical and surgical wards in Birjand University of Medical Sciences hospitals. Journal of Birjand University of Medical Sciences. 2006;13(2):9-15.
  9. Agharahimi Z, Mostofi M, Jafari M, Raesi Ahmad A. Evaluation of staff attitudes about patients’ safety culture in Noor & Ali Asghar hospitals in Isfahan-2011. Journal of Hospital. 2012;11(3):17-26.
  10. WHO. Call for more research on patient safety 2007. Geneva: World Health Organization; 2015 [updated 2015; cited]; Available from.
  11. Stavropoulou C, Doherty C, Tosey P. How Effective Are Incident-Reporting Systems for Improving Patient Safety? A Systematic Literature Review. The Milbank Quarterly. 2015;93(4):826-66.
  12. Tabibi J, Nasiripour A, Maleki M, Raessi P, Mahmmoudi M, Azimi L. Survey of employees’ safety attitude in a teaching hospital Tehran 2010. Iran Occupational Health. 2011;7(4):5-0.
  13. Moghri J, Akbari Sari A, Yousefi M, Zahmatkesh H, Ranjbar Ezzatabadi M, Hamouzadeh P, et al. Is Scores Derived from the Most Internationally Applied Patient Safety Culture Assessment Tool Correct? Iran J Public Health. 2013;42(9):1058-66.
  14. Moghri J, Arab M, Saari AA, Nateqi E, Forooshani AR,Ghiasvand H, et al. The Psychometric Properties of the Farsi Version of “Hospital Survey on Patient Safety Culture” In Iran’s Hospitals. Iran J Public Health. 2012;41(4):80-6.
  15. Bodur S, Filiz E. Validity and reliability of Turkish version of “Hospital Survey on Patient Safety Culture” and perception of patient safety in public hospitals in Turkey. BMC Health Services Research. 2010;10(1).
  16. Chen IC, Li H-H. Measuring patient safety culture in Taiwan using the Hospital Survey on Patient Safety Culture (HSOPSC). BMC Health Services Research. 2010;10(1).
  17. Davoodi R, Mohammadzadeh Shabestari M, Takbiri A, Soltanifar A, Sabouri G, Rahmani S, et al. Patient Safety Culture Based on Medical Staff Attitudes in Khorasan Razavi Hospitals, Northeastern Iran. Iran J Public Health. 2013;42(11):1292-8.
  18. El-Jardali F, Jaafar M, Dimassi H, Jamal D, Hamdan R. The current state of patient safety culture in Lebanese hospitals: a study at baseline. Journal for Quality in Health Care. 2010;22(5):386-95.
  19. Hellings J, Schrooten W, Klazinga N, Vleugels A. Challenging patient safety culture: survey results. International Journal of Health Care Quality Assurance. 2007;20(7):620-32.
  20. Rockville M. Hospital Survey on Patient Safety Culture. Content last reviewed May 2016.: Agency for Healthcare Research and Quality (AHRQ); [cited]; Available from: http://www.ahrq. gov/professionals/quality-patient-afety/patientsafetyculture/hospital/index.html.
  21. Saturno PJ, Da Silva Gama ZA, De Oliveira-Sousa SL, Fonseca YA, De Souza-Oliveira AC. Analisis de la cultura sobre seguridad del paciente en los hospitales del Sistema Nacional de Salud español. Medicina Clinica. 2008;131:18-25.
  22. Sorra JS, Dyer N. Multilevel psychometric properties of the AHRQ hospital survey on patient safety culture. BMC Health Services Research. 2010;10(1).
  23. Moghri J, Ghanbarnezhad A, Moghri M, Rahimi Forooshani A, Akbari Sari A, Arab M. Validation of Farsi version of hospital survey on patient Safety culture questionnaire, using confirmatory factor analysis method. Journal of Hospital.2012;11(2):19-30.
  24. Baghaei R, Nourani D, Khalkhali H, Pirnejad H. Evaluating Patient Safety Culture in Personnel of Academic Hospitals in Urmia University of Medical Sciences in 2011. Journal of Urmia Nursing & Midwifery Faculty. 2012;10(2).
  25. Izadi AR, Drikvand J, Ebrazeh A. The patient safety culture in Fatemeh Zahra hospital of Najafabad, Iran. Director General. 2013;9(6).
  26. Kusano AS, Nyflot MJ, Zeng J, Sponseller PA, Ermoian R, Jordan L, et al. Measurable improvement in patient safety culture: A departmental experience with incident learning. Practical Radiation Oncology. 2015;5(3):e229-e37.