Patient safety culture has been identified as one of the important factors in reducing hospital adverse events and improving patient safety. The present study was conducted to investigate the relationship between patient safety culture and adverse events among nurses of selected teaching hospitals in Tehran.


 

This cross-sectional study was performed in 2019 on 260 nurses in 7 hospitals affiliated to Tehran University of Medical Sciences. Data was collected using the patient safety culture questionnaire and the frequency of adverse events. Multiple logistic regression was used to investigate the relationship between patient safety culture and adverse events in SPSS 22 (SPSS Inc., Chicago, Ill., USA).

The overall score of patient safety culture in the present study was moderate. In line with the findings of this study, the study of Mostafaei et al. in Tehran hospitals showed that patient safety culture in the studied hospitals with an average of 60% compared to other countries is at an average level and among the various dimensions of safety culture, the highest score Positive was the dimension of teamwork within hospital units and the frequency of reporting adverse events (25).
In the present study, among the dimensions of patient safety culture, the highest means were related to the dimension of organizational learning, the dimension of communication and providing feedback on errors, and the dimension of teamwork between organizational units. In studies conducted in other countries, the dimension of teamwork within hospital units and organizational learning were identified as the strength of patient safety culture, which were consistent with the findings of the present study [26-32].
In addition to some of the mentioned strengths, in the present study, the dimensions of exchanges and information transfer, management support for patient safety and open communication channel in the hospital were the weak points of patient safety culture from the nurses' point of view. In a study conducted in Sweden, management support for patient safety was also identified as a weakness of patient safety culture (32).
Regarding the prevalence of adverse events, the results of the present study showed that the prevalence of these accidents was high among nurses. The majority (35.4% to 51.9%) of nurses estimated that an unintended accident happened to them once a year. The rate of reporting unintended accidents in a study in Iran was between 57.7% and 76.1%, which for blood infection, bed sores, falls and nosocomial infections, this rate was 76.1%, 66.2%, 59% and 57.7%, respectively (8).
In relation to the association between the dimensions of patient safety culture and adverse events and based on the findings of the present study, general understanding of patient safety culture, teamwork within organizational units, communication and feedback on errors, staff and exchange issues and information transfer were the significant predictors of unintended incidents.

 

The results of the present study confirmed the hypothesis that improving the patient safety culture leads to decrease in the incidence of adverse events among nurses, therefore promoting the safety culture in hospitals of country should be considered as one of the main priorities of management programs.

 

This article was the result of a research project approved by Tehran University of Medical Sciences and Health Services in 2017 with the approved project number 36848-61-01-97 and ethics code IR.TUMS.VCR.REC.1397.293. The authors would like to thank the Vice Chancellor for Research and Technology of Tehran University of Medical Sciences and Health Services for their financial support and all the officials of the university hospitals for their cooperation in conducting the research.

 

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.