Volume 28, Issue 4 (Fall 2020)                   Avicenna J Nurs Midwifery Care 2020, 28(4): 20-31 | Back to browse issues page

XML Persian Abstract Print

1- PhD Student in Health Services Management, Department of Services Management, School of Health Management and Information Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
2- PhD Student in Health Economics, Department of Health Economics, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran , urmialord@gmail.com
Abstract:   (4392 Views)

Introduction: 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.
Methods: 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.
Results: Among the dimensions of patient safety culture, the highest mean score was related to the dimension of "organizational learning" and the lowest score was in the area of "information exchange and transmission". Between 35.4% and 51.9% of nurses estimated that they had experienced one of six adverse events in the past year. Logistic regression results indicated that dimensions of management support for patient safety, general understanding of patient safety culture, teamwork within organizational units, communication and feedback about errors, staffing issues and information exchange and transmission were significant predictors for adverse events (P<0/05).
Conclusion: 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.

Persian Full-Text [PDF 498 kb]   (1423 Downloads) |   |   Extended Abstract (HTML)  (725 Views)  

✅ 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.

Type of Study: Original Research | Subject: Nursing
Received: 2020/04/25 | Accepted: 2020/07/15 | Published: 2020/10/1

1. Najjar S, Nafouri N, Vanhaecht K, Euwema M. The relationship between patient safety culture and adverse events: a study in Palestinian hospitals. Safety in Health. 2015;1(1):16. [DOI:10.1186/s40886-015-0008-z]
2. Makary MA, Daniel M. Medical error-the third leading cause of death in the US. Bmj. 2016;353:i2139. [DOI:10.1136/bmj.i2139] [PMID]
3. Farup PG. Are measurements of patient safety culture and adverse events valid and reliable? Results from a cross sectional study. BMC health services research. 2015;15(1):186. [DOI:10.1186/s12913-015-0852-x] [PMID] [PMCID]
4. Zegers M, De Bruijne M, Wagner C, Hoonhout L, Waaijman R, Smits M, et al. Adverse events and potentially preventable deaths in Dutch hospitals: results of a retrospective patient record review study. Quality and safety in health care. 2009;18(4):297-302. [DOI:10.1136/qshc.2007.025924] [PMID]
5. Baker GR, Norton PG, Flintoft V, Blais R, Brown A, Cox J, et al. The Canadian Adverse Events Study: the incidence of adverse events among hospital patients in Canada. Canadian medical association journal. 2004;170(11):1678-86. [DOI:10.1503/cmaj.1040498] [PMID] [PMCID]
6. Wang Y, Eldridge N, Metersky ML, Verzier NR, Meehan TP, Pandolfi MM, et al. National trends in patient safety for four common conditions, 2005-2011. New England Journal of Medicine. 2014;370(4):341-51. [DOI:10.1056/NEJMsa1300991] [PMID] [PMCID]
7. Soop M, Fryksmark U, Köster M, Haglund B. The incidence of adverse events in Swedish hospitals: a retrospective medical record review study. International journal for quality in health care. 2009;21(4):285-91. [DOI:10.1093/intqhc/mzp025] [PMID] [PMCID]
8. Abadi MBH, Akbari H, Akbari H, Gholami-Fesharaki M, Ghasemi M. The Association of Nursing Workloads, Organizational, and Individual Factors with Adverse Patient Outcome. Iranian Red Crescent Medical Journal. 2016;19(4). [DOI:10.5812/ircmj.43444]
9. Hogan H, Healey F, Neale G, Thomson R, Vincent C, Black N. Preventable deaths due to problems in care in English acute hospitals: a retrospective case record review study. BMJ Qual Saf. 2012:bmjqs-2012-001159. [DOI:10.1136/bmjqs-2011-001159] [PMID] [PMCID]
10. James JT. A new, evidence-based estimate of patient harms associated with hospital care. Journal of patient safety. 2013;9(3):122-8. [DOI:10.1097/PTS.0b013e3182948a69] [PMID]
11. Levinson DR, General I. Adverse events in hospitals: national incidence among Medicare beneficiaries. Department of Health and Human Services Office of the Inspector General. 2010.
12. Hoonhout LH, de Bruijne MC, Wagner C, Zegers M, Waaijman R, Spreeuwenberg P, et al. Direct medical costs of adverse events in Dutch hospitals. BMC health services research. 2009;9(1):27. [DOI:10.1186/1472-6963-9-27] [PMID] [PMCID]
13. Stefl M. To Err is Human: Building a Safer Health System in 1999. Frontiers of health services management. 2001;18(1):1. [DOI:10.1097/01974520-200107000-00001] [PMID]
14. Reason J. Human error: models and management. BMJ: British Medical Journal. 2000;320(7237):768. [DOI:10.1136/bmj.320.7237.768] [PMID] [PMCID]
15. Woodward HI, Mytton OT, Lemer C, Yardley IE, Ellis BM, Rutter PD, et al. What have we learned about interventions to reduce medical errors? Annual review of public health. 2010;31:479-97. [DOI:10.1146/annurev.publhealth.012809.103544] [PMID]
16. Singer S, Lin S, Falwell A, Gaba D, Baker L. Relationship of safety climate and safety performance in hospitals. Health services research. 2009;44(2p1):399-421. [DOI:10.1111/j.1475-6773.2008.00918.x] [PMID] [PMCID]
17. Wang X, Liu K, You L-m, Xiang J-g, Hu H-g, Zhang L-f, et al. The relationship between patient safety culture and adverse events: A questionnaire survey. International journal of nursing studies. 2014;51(8):1114-22. [DOI:10.1016/j.ijnurstu.2013.12.007] [PMID]
18. Mardon RE, Khanna K, Sorra J, Dyer N, Famolaro T. Exploring relationships between hospital patient safety culture and adverse events. Journal of patient safety. 2010;6(4):226-32. [DOI:10.1097/PTS.0b013e3181fd1a00] [PMID]
19. Ebadi fard azar F, Rezapoor A, Tanoomand Khoushehmehr A, Bayat R, Arabloo J, Rezapoor Z. Study of patients' safety culture in Selected Training hospitals affiliated whith Tehran university of medical sciences. Journal of Hospital. 2012;11(2):55-64.
20. Hatam N, Keshtkar V, Forouzan F, Bastani P. Patient safety culture status in teaching hospitals: a case of Shiraz University of Medical Sciences. Middle-East Journal of Scientific Research. 2012;12(7):970-5.
21. Abdi Z, Delgoshaei B, Ravaghi H, Abbasi M, Heyrani A. The culture of patient safety in an Iranian intensive care unit. Journal of nursing management. 2015;23(3):333-45. [DOI:10.1111/jonm.12135] [PMID]
22. Rezaean M, Aqaie Borz Abad P, Yazdanpanah A, Zinat Motlagh S. Patient Safety Culture Status From The Perspective Medical Staff Of Yasuj Hospitals In 2015. Armaghane danesh. 2016;20(10):935-46.
23. Almasi A, Pourmirza KR, Ahmadi JT, Godarzi A, Ahmadi A. Evaluation of patient safety culture in personnel of hospitals in Kermanshah, 2013. J Clin Res Paramed Sci. 2015;4(1):14-23.
24. Goodman R. Psychometric properties of the strengths and difficulties questionnaire. J Am Acad Child Adolesc. Psychiatry. 2001;40(11):1337-45. [DOI:10.1097/00004583-200111000-00015] [PMID]
25. Mostafaei D, Aryankhesal A, Dastoorpoor M, Rahimikhalifekandi Z, Estebsari F. Patient Safety Culture Assessment of Clinical and Paraclinical Staff Perspective in Selected University of Medical Sciences Hospitals in Tehran. Iranian Journal of Health Education and Health Promotion. 2018;6(3):293-301. [DOI:10.30699/acadpub.ijhehp.6.3.293]
26. Alquwez N, Cruz JP, Almoghairi AM, Al‐otaibi RS, Almutairi KO, Alicante JG, et al. Nurses' perceptions of patient safety culture in three hospitals in Saudi Arabia. Journal of Nursing Scholarship. 2018;50(4):422-31. [DOI:10.1111/jnu.12394] [PMID]
27. El-Jardali F, Sheikh F, Garcia NA, Jamal D, Abdo A. Patient safety culture in a large teaching hospital in Riyadh: baseline assessment, comparative analysis and opportunities for improvement. BMC health services research. 2014;14(1):122. [DOI:10.1186/1472-6963-14-122] [PMID] [PMCID]
28. Güneş ÜY, Gürlek Ö, Sönmez M. A survey of the patient safety culture of hospital nurses in Turkey. Collegian. 2016;23(2):225-32. [DOI:10.1016/j.colegn.2015.02.005]
29. Chen I-C, 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):152. [DOI:10.1186/1472-6963-10-152] [PMID] [PMCID]
30. Hamdan M, Saleem AAo. Assessment of patient safety culture in Palestinian public hospitals. International journal for quality in health care. 2013;25(2):167-75. [DOI:10.1093/intqhc/mzt007] [PMID]
31. Wagner C, Smits M, Sorra J, Huang C. Assessing patient safety culture in hospitals across countries. International Journal for Quality in Health Care. 2013;25(3):213-21. [DOI:10.1093/intqhc/mzt024] [PMID] [PMCID]
32. Danielsson M, Nilsen P, Rutberg H, Årestedt K. A National Study of Patient Safety Culture in Hospitals in Sweden. Journal of patient safety. 2017.
33. Alahmadi H. Assessment of patient safety culture in Saudi Arabian hospitals. Qual Saf Health Care. 2010;19(5):e17-e. [DOI:10.1136/qshc.2009.033258] [PMID]
34. Elmontsri M, Almashrafi A, Banarsee R, Majeed A. Status of patient safety culture in Arab countries: a systematic review. BMJ open. 2017;7(2):e013487. [DOI:10.1136/bmjopen-2016-013487] [PMID] [PMCID]
35. 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. International Journal for Quality in Health Care. 2010;22(5):386-95. [DOI:10.1093/intqhc/mzq047] [PMID]
36. Aiken LH, Clarke SP, Sloane DM, Sochalski JA, Busse R, Clarke H, et al. Nurses' reports on hospital care in five countries. Health affairs. 2001;20(3):43-53. [DOI:10.1377/hlthaff.20.3.43] [PMID]
37. Ljunggren G, Phillips CD, Sgadari A. Comparisons of restraint use in nursing homes in eight countries. Age and ageing. 1997;26(suppl_2):43-7. [DOI:10.1093/ageing/26.suppl_2.43] [PMID]
38. Kakemam E, Kalhor R, Khakdel Z, Khezri A, West S, Visentin D, et al. Occupational stress and cognitive failure of nurses and associations with on self‐reported adverse events: a national cross‐sectional survey. Journal of advanced nursing. 2019. [DOI:10.1111/jan.14201] [PMID]
39. Chang Y, Mark B. Effects of learning climate and registered nurse staffing on medication errors. Nursing research. 2011;60(1):32-9. [DOI:10.1097/NNR.0b013e3181ff73cc] [PMID] [PMCID]
40. Kantelhardt P, Müller M, Giese A, Rohde V, Kantelhardt S. Implementation of a critical incident reporting system in a neurosurgical department. Central European Neurosurgery-Zentralblatt für Neurochirurgie. 2011;72(01):15-21. [DOI:10.1055/s-0029-1243199] [PMID]
41. 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):230. [DOI:10.1186/1472-6963-8-230] [PMID] [PMCID]
42. Welp A, Meier LL, Manser T. The interplay between teamwork, clinicians' emotional exhaustion, and clinician-rated patient safety: a longitudinal study. Critical Care. 2016;20(1):110. [DOI:10.1186/s13054-016-1282-9] [PMID] [PMCID]
43. Nordin A, Theander K, Wilde-Larsson B, Nordström G. Health care staffs' perception of patient safety culture in hospital settings and factors of importance for this. 2013. [DOI:10.4236/ojn.2013.38A005]
44. Okuyama A, Wagner C, Bijnen B. Speaking up for patient safety by hospital-based health care professionals: a literature review. BMC health services research. 2014;14(1):61. [DOI:10.1186/1472-6963-14-61] [PMID] [PMCID]

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.