Volume 28, Issue 4 (Fall 2020)                   Avicenna J Nurs Midwifery Care 2020, 28(4): 74-83 | Back to browse issues page


XML Persian Abstract Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Mohammadi Z. Relationship Between Nursing Communication Characteristics and Patient Safety Culture at Educational Hospitals in Sanandaj City. Avicenna J Nurs Midwifery Care 2020; 28 (4) :74-83
URL: http://nmj.umsha.ac.ir/article-1-2213-en.html
Faculty of Nursing and Midwifery, Medical Sciences University of Kurdistan. Sanandaj, Iran , zahra.mohammadi1116@gmail.com
Persian Full-Text [PDF 441 kb]   (1141 Downloads)     |   Abstract (HTML)  (3358 Views)

✅ Based on the results of the research, the status of the patient safety culture and communication skills was moderate. To improve the patient's safety status, nurses’ communication skills should be improved. This is possible during the nurse’s formal education or in-service training.


Extended Abstract:   (987 Views)
Introduction

Hospitals are one of the most important institutions providing health services that should provide a safe environment for their patients and prevent accidents for them [1]. The first goal in a medical center is to prevent harm to the patient and endanger his safety and provide health services. Studies show that one-fifth of the population is exposed to medical errors and mistakes, and as a result, millions of people may die or avoid unavoidable medical injuries as a result of these errors. Therefore, improving patient safety is a common international priority [2]. Patient safety is one of the vital components and quality indicators of health-related care [3].
Patient safety means preventing the damage caused by errors while performing the task due to negligence or those actions that reduce the risk of adverse events related to medical error [9, 8]. The current study investigated the relationship between nurses' communication features and patient safety culture in educational hospitals in Sanandaj city, Iran.



 

Materials and Methods


This correlational study was performed on 278 nurses working in educational hospitals in Sanandaj, Iran. The standard safety culture questionnaire made by Barton J.'s quality and health care research and communication skills agency was used. The standard questionnaire used was in two sections. Data analysis was conducted using SPSS 19. In the descriptive statistics section, mean and standard deviation, and in the inferential statistics, correlation tests, Mann-Whitney, Kruskal-Wallis, and linear regression were used.

 

Results

The mean of total positive responses to 12 dimensions of patient safety culture was 59.11%. The negative response was 22.07% and the neutral responses were 17.94%. These results indicated an acceptable status of safety culture in the studied hospitals. The average of communication skills among nurses in Sanandaj was 66.98±9.57 (maximum score is 90). The inferential analysis showed that there is a significant relationship between variables such as age, work experience, marital status, educational level, and type of employment with two main variables (communication skills and patient safety culture). The results of linear regression showed that the components of communication skills (verbal, listening, and feedback) have a positive and significant effect on improving the patient's safety culture. These components may explain 55.2% of the variation of the dependent variable (the patient's safety culture).
Table 1. Frequency distribution of study participants
Variable Category N %
Gender
 
Man 98 35.25
Female 180 64.75
Marital status
 
Single 101 36.33
Married 177 63.67
Age
 
30 ˂ 83 29.85
4030 152 54.67
40 ˃ 43 15.48
Work experience 8 ˂ 159 57.19
8-18 years 78 28.05
18˃ 41 14.76
Level of Education
 
Bachelor 218 78.41
Master and higher 60 21.59
Employment relationship Official 38 13.66
Trial 48 17.26
Project 68 24.46
Contractual 29 10.43
Company 53 19.06
Design 42 15.13
 
Table 2. Mean and standard deviation of patient safety culture and communication skills of nurses
Variables Aspects M SD
Safety culture Frequency of incident reporting 2.87 0.68
General understanding of patient safety 3.46 0.71
Actions of the head of the unit in the direction of patient safety 3.82 0.61
Organizational learning and continuous improvement 3.98 0.72
Teamwork within the unit 3.85 0.62
Open communication channel 3.68 0.71
Communication and providing feedback on errors 4.01 0.49
Non-punitive responses to errors 3.12 0.52
Employee issues 2.25 0.61
Support your manager 3.88 0.72
Teamwork among hospital units 4.01 0.59
Exchange of information 2.85 0.53
Patient safety culture 3.48 0.62
Communication skills Verbal 23.59 2.87
Heard 21.17 3.28
Feedback 22.22 3.42
 
Table 3. Relationship between demographic variables with the two main research variables (communication skills and patient safety culture)
Demographic variables
 
Categories Frequency Type of test The dependent variable
Communication skills Safety culture
Age
 
30 ˂ 83 Spearman correlation r=0.28 r=0.37
4030 152
40 ˃ 43 P=0.015 P=0.015
Work experience
 
8 ˂ 159 Spearman correlation r=0.28 r=0.37
8-18 years 78 P=0.015 P=0.015
18˃ 41
Gender
 
Male 98 Mann–Whitney 2.01± 25.88 2.28± 19.16
Female 180 1.25± 26.14 2.25± 18.15
P=0.213 P=0.315
Marital status
 
Single 101 Mann–Whitney 1.25± 25.75 2.11± 18.24
Married 177 1.36± 28.13 1.24± 19.52
P=0.001 P=0.213
Level of Education
 
Bachelor 218 Mann–Whitney 2.11± 24.27 2.18± 18.25
Master and higher 60 2.52± 27.85 1.87± 21.17
P=0.010 P=0.001
Type of employment Official 38 Kruskal-Wallis 1.25± 23.14 2.58± 28.14
Trial 48 2.42± 22.14 2.04± 26.41
Project 68 2.21± 21.12 2.52± 27.65
Contractual 29 2.12± 19.14 2.01± 24.25
Company 53 2.12± 18.52 2.42± 22.14
Design 42 2.14± 17.15 2.24± 19.52
P=0.001 P=0.001
 
Table 4. The effect of communication skills component on patient safety culture
Predictive variables B Std. Error Beta t Sig. R R2 R2Ad
- Verbal skills 2.82 0.505 0.261 **5.592 0.001      
- Listening skills 3.74 0.604 0.301 **6.203 0.001 0.772 0.552 0.559
- Feedback skills 2.435 0.580 0.216 **4.197 0.001      
F: 24.107Sig: 0.000Constant: 15.949
 
 
 


 
Discussion


Initially, patient safety culture status (HSOPSC), which is one of the common tools for examining patient safety culture in hospitals, was used. The overall mean of patient safety culture was (3.48 ± 0.62) which indicates the average of patient safety culture. The results of this section are consistent with the studies of Rezapoor et al. [34] and Mahfoozpour et al. [35] who in their research estimated the status of patient safety culture in teaching hospitals of Tehran University of Medical Sciences and Shahid Beheshti at a moderate level. This finding indicates that due to the sensitivity of the issue, there is an urgent need to improve the patient's safety culture in the hospital. Therefore, in order to strengthen the patient's safety culture, the three factors of blame, fear and silence that are destructive to any organization must be eradicated from the workplace. Errors should not be hidden but should be learned and used as a first step to eliminate the damage caused by them and improve patient safety [36].
Also, in examining the dimensions of 12 patient safety cultures, the most positive response of organizational learning and continuous improvement (84.82%) of the results of this part of the study with the findings of Sharifi et al. in Mazandaran hospitals [37] and non-punitive responses to errors ( 19/14) received the lowest positive response is consistent with the findings of Yaghoubi et al. in Sabzevar hospitals [38].
In addition, the results of inferential analysis showed that the variable of communication skills with their demographic characteristics, ie age, marital status, work experience, education level and type of employment has a positive and significant relationship with the study of Wang et al. in China [29] and Mirhaghjou et al. in Kerman Province, Iran [43], and contradicted Rezaei's studies on the lack of association between age groups and work experience with the status of safety culture [33].
Also, in examining the relationship between demographic characteristics and culture, it was shown that there is a positive and significant relationship with the variables of age, marital status, work experience, level of education and type of employment. The results of this section are consistent with studies by Sorra and Nieva at the International Agency for Research and Health Quality [30]. In analyzing this finding, it can be said that, considering the importance of the patient's safety culture, the role of demographic factors should be considered in order to have a significant effect on its improvement.


 

Conclusion

Based on the results of the research, the status of the patient safety culture and communication skills was moderate. To improve the patient's safety status, nurses’ communication skills should be improved. This is possible during the nurse’s formal education or in-service training.

 

Acknowledgments

The support of Kurdistan University of Medical Sciences in conducting this research is hereby thanked and appreciated. This article is an excerpt from a research project with ethics code IR.MUK.REC.1398.199.

 

Conflicts of Interest

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

 

Type of Study: Original Research | Subject: Nursing
Received: 2020/07/20 | Accepted: 2020/10/11 | Published: 2020/11/23

References
1. Nieva VF, Sorra J. Safety culture assessment: a tool for improving patient safety in healthcare organizations. Qual Saf Health Care. 2003; 12(2):17-23. [DOI:10.1136/qhc.12.suppl_2.ii17] [PMID] [PMCID]
2. Milligan F. Establishing a culture for patient safety - The role of education. Nurse Edu Today: 2007; 27:95102. [DOI:10.1016/j.nedt.2006.03.003] [PMID]
3. Smits M, Christiaans-Dingelhoff I, Wagner C, WalG, Groenewegen PP. The psychometric properties of the 'Hospital Survey on Patient Safety Culture' in Dutch hospitals. Health Serv Res. 2008; 8:230-237. [DOI:10.1186/1472-6963-8-230] [PMID] [PMCID]
4. Gupta B, Guleria K, Arora R. Patient safety in obstetrics and gynecology departments of two teaching hospitals in Delhi. India J Comm Med: Off Pub India Assoc Prev Soc Med. 2016; 41(3):235. [DOI:10.4103/0970-0218.183592] [PMID] [PMCID]
5. Bavil DA, Dolatian M, Mahmoodi Z, Baghban AA. Comparison of lifestyles of young women with and without primary dysmenorrhea. Elec Phys. 2016; 8(3):2107. [DOI:10.19082/2107] [PMID] [PMCID]
6. Hwang JI. What are hospital nurses' strengths and weaknesses in patient safety competence? Findings from three Korean hospitals. Int J Qual Health Care. 2015; 27(3):232-8. [DOI:10.1093/intqhc/mzv027] [PMID]
7. Johnstone MJ. Patient safety ethics and human error management in ED contexts: Part I: Development of the global patient safety movement. Aust Emerg Nurs J. 2007; 10(1):13-20. [DOI:10.1016/j.aenj.2006.09.002]
8. Bodur S, Filiz E. A survey on patient safety culture in primary healthcare services in Turkey. Int J Qual Health Care. 2009; 21(5):348-55. [DOI:10.1093/intqhc/mzp035] [PMID]
9. Ilan R, Fowler R. Brief history of patient safety culture and science. J Crit Care. 2005; 20(1):2-5. [DOI:10.1016/j.jcrc.2005.02.003] [PMID]
10. McGlynn EA. The quality of health care delivered to adults in the United Stated. N Engl J Med. 2003; 348:2681-3. [DOI:10.1056/NEJMsa022615] [PMID]
11. Adams RE, Boscarino JA. A community survey of medical errors in New York. Int J Qual Health Care. 2004; 16(5):353-62. [DOI:10.1093/intqhc/mzh063] [PMID]
12. Vifladt A, Simonsenc BO, Lydersend S, Farup PG. Changes in patient safety culture afterrestructuring of intensive care units: Two cross-sectional studies. Inten Crit Care Nurs. 2016; 32:58-65. [DOI:10.1016/j.iccn.2015.06.004] [PMID]
13. Verklan MT, Walden M. Core Curriculum for Neonatal Intensive Care Nursing [Book on CD‑ROM]. Avaivable on: https://www.amazon.com/CurriculumNeonatal-Intensive-NursingAWHONN/dp/032322590X.
14. Chen IC, Li HH. Measuring patient safety culture in Taiwan using the Hospital Survey on Patient Safety Culture (HSOPSC). BMC Health Serv Res. 2010; 10(1):152. [DOI:10.1186/1472-6963-10-152] [PMID] [PMCID]
15. Zendegani N, Zare zadeh N, Montaseri AM, Rabei S. Evaluating patient's safety from the perspective of health-care officials in hospitals affiliating with Jahrom University of Medical Sciences in 2014. J Edu Ethic Nurs. 2015; 3(4): 49-55.
16. James JT. A new, evidence-based estimate of patient harms associated with hospital care. J Patient Safety. 2013; 9(3):122-8. [DOI:10.1097/PTS.0b013e3182948a69] [PMID]
17. Abdi ZH, Maleki MR, Khosravi A. Extracting staff from patient safety culture in selected hospitals of Tehran University of Medical Sciences. Payesh. 2011; 10(4):411-9.
18. Fakhr-Movahedi A, Salsali M, Negarandeh R, Rahnavard Z. Exploring contextual factors of the nurse-patient relationship: A qualitative study. Koomesh. 2011; 13(1):23-34.
19. Melissa DZ, McCarroll ML, Mendise TM, Ferris EF, Roulette GD, Zolton J, et al. Safety Culture in the Gynecology Robotics Operating Room. J Min Inv Gynecol. 2014; 21(5): 893-900. [DOI:10.1016/j.jmig.2014.03.027] [PMID]
20. Rabiei N, Gholami Fesharaki M, Maleki S, Mohamadian M. Relationship between burnout, job satisfaction and demographic factors with the level of patient safety culture in military healthcare staff. J Mil Med. 2018; 19(6):571-8.
21. Davati A, Vatankhah S, Sharifi K. Assessment of patient safety culture at Shahid Mostafa Khomeini Hospital: nurses' perspective. J Health Admin (JHA). 2018; 20(70):10-21.
22. Hosseini M, Sedghi Goyaghaj N, Alamadarloo A, Farzadmehr M, Mousavi A. The relationship between job burnout and job performance of clinical nurses in Shiraz Shahid Rajaei hospital (thruma) in 2016. J Clin Nurs Midwifery. 2017; 6(2):59-68
23. Ammouri AA, Tailakh AK, Muliira JK, Geethakrishnan R, Al Kindi SN. Patient safety culture among nurses. Int Nurs Rev. 2015; 62(1):102-10. [DOI:10.1111/inr.12159] [PMID]
24. Qin CH, Xie J, Jiang J, Zhen F, Ding S. Reporting Among Nurses and Its Correlation with Hospital Safety Culture. J Nurs Care Qual. 2015; 30(1): 77-83. [DOI:10.1097/NCQ.0000000000000068] [PMID]
25. Vifladt A, Simonsenc BO, Lydersend S, Farup PG. Changes in patient safety culture after restructuring of intensive care units: Two cross-sectional studies. Inten Critic Care Nurs. 2016; 32, 58-65.
26. Wigham C, Chanier T. A study of verbal and nonverbal communication in Second Life-the ARCHI21 experience. ReCALL. 2013; 25(01):6384. [DOI:10.1017/S0958344012000250]
27. Wloszczak-Szubzda A, Jarosz MJ. Professional communication competences of nurses -- a review of current practice and educational problems. Ann Agric Environ Med. 2013; 20(1):183-8.
28. Barnard A, Ganca L. Using communication skills for difficult conversations in palliative care:'Suffering is not a question which demands an answer, It is not a problem which demands a solution, It is a mystery which demands a "Presence".'(Anonymous). Cont Med Educ. 2011;29(7).
29. Wang W, Liang Z, Blazeck A, Greene B. Improving Chinese nursing students' communication skills by utilizing video-stimulated recall and role-play case scenarios to introduce them to the SBAR technique. Nurse Edu Today. 2015; 35(7):881-7. DOI: 10.1016/j.nedt.2015.02.010 PMID: 25753352. [DOI:10.1016/j.nedt.2015.02.010] [PMID]
30. Sorra J, Nieva VF. Hospital survey on patient safety culture. Maryland: Agency for Healthcare Research and Quality; 2004.
31. Bognár A, Barach P, Johnson JK, Duncan RC, Birnbach D, Woods D, Holl JL, Bacha EA. Errors and the burden of errors: attitudes, perceptions, and the culture of safety in pediatric cardiac surgical teams. Ann Thor Surgery. 2008; 85(4):1374-81. [DOI:10.1016/j.athoracsur.2007.11.024] [PMID]
32. Moghimi M. [Sazman va Modiriat: Rooykardi Pajooheshi]. 8th ed. Tehran: Termeh; 2011.
33. Rezaei Baghebidi MH, Halvani G, Ghiyasi S, Dehghani Tafti A. Assessing Safety Culture and its Influencing Factors in a Steel-Manufacturing Plant. Tolooe Behdasht. 2017; 16(4):37-48.
34. Rezapoor A, Tanoomand Khoushehmehr A, Bayat R, Arabloo J, Rezapoor Z. Study of patients' safety culture in Selected Training hospitals affiliated with Tehran university of medical sciences. Hospital. 2012; 11(2): 55-64.
35. Mahfoozpour S, Eini E, Moasheri F, Faramarzi A. Study of patient safety culture in teaching hospitals affiliated to Shahid Beheshti University of Medical Sciences in 2012. Pajoohande. 2012; 17(3):134-41.
36. Pour RM, Fatemi, MA. Evaluation of Patient Safety Culture Based on the Viewpoint of Nurses and Physicians Employed in a Military Hospital. J Milit Care Sci. 2018; 5(1):26-33. [DOI:10.29252/mcs.5.1.26]
37. Sharifi S, Izadi-Tame A, Hatamipour K, Sadeghigooghary N, Safabakhsh L. Patient Safety Culture from Mazandaran Clinical Nurses' Perspective. Iran J Nurs. 2014; 27(88):77-87. [DOI:10.29252/ijn.27.88.77]
38. Yaghobi Far MA, Takbiri A, Haghgoshaye E, Tabarraye Y. The survey of patient safety culture and recognizing its Weaknesses and strengths in Sabzevar hospitals. J Sabzevar Univ Med Sci. 2011; 20(2):154-64.
39. Keshtkaran A, Heidari A, Bastani P. Study of managers' communication skills based on the staff's view in Shiraz University of Medical Sciences. J Payavard Salamat. 2012; 5(4):41-8.
40. Kashani F, Kashani P, Moghimian M, Shakour M. Effect of stress inoculation training on the levels ofstress, anxiety, and depression in cancer patients. Iran J Nurs Midwifery Res. 2015; 20(3):359-64.
41. Pakgohar M, Rahimikian F, Mehran A, Mohammadi T. Quality assessment of family planning counseling in health and treatment centers, affiliated to Tehran University of Medical Sciences. Hayat. 2002; 8(2):62-71.
42. Barati M, Afsar A, Ahmadpanah M. Assessment of communication skills level among healthcare practitioners. Avicenna J Clin Med. 2013; 19(1):62-9.
43. Mirhaghjou S, Nayebi N, Majd Teymouri R, Kazemnejadleily E. Communication skills and related factors within patient by nursing student. J Nurs Midwifery Fac. 2013; 25(76):93-101.
44. Burke ME, LeBlanc RG, Henneman EA. ABCDs of professional introductions: teaching nursing students the most fundamental of all communication skills. Nurse Edu. 2016; 41(3):115-6. [DOI:10.1097/NNE.0000000000000216] [PMID]

Add your comments about this article : Your username or Email:
CAPTCHA

Send email to the article author


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

© 2024 CC BY-NC 4.0 | Avicenna Journal of Nursing and Midwifery Care

Designed & Developed by : Yektaweb