Kakemam Edris, Gharaee Hojatolah, Rajabi Mohamad Reza, Nadernejad Milad, Khakdel Zahra, Raeissi Pouran, Kalhor Rohollah
Department of Health Services Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.
District Health Center of Hamadan City, Hamadan University of Medical Sciences, Hamadan, Iran.
BMC Nurs. 2021 Apr 12;20(1):60. doi: 10.1186/s12912-021-00571-w.
Patient safety culture is an important factor in determining hospitals' ability to address and reduce the occurrence of adverse events (AEs). However, few studies have reported on the impact of nurses' perceptions of patient safety culture on the occurrence of AEs. Our study aimed to assess the association between nurses' perception of patient safety culture and their perceived proportion of adverse events.
A cross-sectional survey was carried out among 2295 nurses employed in thirty-two teaching hospitals in Iran. Nurses completed the Persian version of the hospital survey of patients' safety culture between October 2018 and September 2019.
Positive Response Rates of overall patient safety culture was 34.1% and dimensions of patient safety culture varied from 20.9 to 43.8%. Also, nurses estimated that the occurrence of six adverse events varied from 51.2-63.0% in the past year. The higher nurses' perceptions of "Staffing", "Hospital handoffs and transitions", "Frequency of event reporting", "Non-punitive response to error", "Supervisor expectation and actions promoting safety", "Communication openness", "Organizational learning continuous improvement", "Teamwork within units", and "Hospital management support patient safety" were significantly related to lower the perceived occurrence at least two out of six AEs (OR = 0.69 to 1.46).
Our findings demonstrated that nurses' perception regarding patient safety culture was low and the perceived occurrence of adverse events was high. The research has also shown that the higher level of nurses' perception of patient safety culture was associated with lowered occurrence of AEs. Hence, managers could provide prerequisites to improve patient safety culture and reduce adverse events through different strategies, such as encouraging adverse events' reporting and holding training courses for nurses. However, further research is needed to assess how interventions addressing patient safety culture might reduce the occurrence of adverse events.
患者安全文化是决定医院处理和减少不良事件（AE）发生率能力的一个重要因素。然而，很少有研究报告护士对患者安全文化的认知对不良事件发生率的影响。我们的研究旨在评估护士对患者安全文化的认知与他们所感知的不良事件比例之间的关联。
对伊朗32家教学医院的2295名护士进行了横断面调查。护士们在2018年10月至2019年9月期间完成了波斯语版的医院患者安全文化调查。
整体患者安全文化的积极回应率为34.1%，患者安全文化各维度的回应率在20.9%至43.8%之间。此外，护士估计在过去一年中六种不良事件的发生率在51.2%至63.0%之间。护士对“人员配备”“医院交接与过渡”“事件报告频率”“对错误的非惩罚性回应”“主管期望与促进安全的行动”“沟通开放性”“组织学习与持续改进”“科室内部团队合作”以及“医院管理支持患者安全”的认知越高，与六种不良事件中至少两种的感知发生率较低显著相关（比值比=0.69至1.46）。
我们的研究结果表明，护士对患者安全文化的认知较低，不良事件的感知发生率较高。研究还表明，护士对患者安全文化的认知水平越高，不良事件的发生率越低。因此，管理人员可以通过不同策略提供改善患者安全文化和减少不良事件的先决条件，如鼓励报告不良事件并为护士举办培训课程。然而，需要进一步研究来评估针对患者安全文化的干预措施如何减少不良事件的发生。
