Azeze Gedion Asnake, Haile Kirubel Eshetu, Gebrekidan Amanuel Yosef, Kassie Gizachew Ambaw, Negash Berhan Tsegaye, Asgedom Yordanos Sisay
Department of Midwifery, College of Medicine and Health Science, Hawassa University, Sidama region, Ethiopia.
School of Nursing, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia.
PLoS One. 2025 Jun 4;20(6):e0325723. doi: 10.1371/journal.pone.0325723. eCollection 2025.
Patient safety is a major health care challenge and is an issue of global concern. Poor healthcare system in Ethiopia, alongside increasing concerns for safety and patient safety culture, prompted to this systematic review and meta-analysis. Our systematic review and meta-analysis aims to determine the pooled prevalence of patient safety culture among healthcare providers in Ethiopia from studies that administered Hospital Survey on Patient Safety Culture (HSOPSC) tool.
This study employed a systematic review and meta-analysis and followed the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines. We carried out a comprehensive search for studies in Science Direct, Medline, African Journals Online (AJOL), Excerpta Medical Database (EMBASE), Scopus and Google Scholar to identify relevant observational studies published in the English language. Data sources were searched on the 10th of October 2024 and updated the search on the 29th of March 2025. All selected articles met the inclusion criteria according to the Participants, Intervention, Comparison and Outcome (PICOS) criteria.. Random effects model meta-analysis using STATA version 15 statistical software was conducted to estimate the pooled prevalence with 95% confidence intervals (CI). Funnel plot and I2 test were used to check publication bias and heterogeneity between studies, respectively. Subgroup analysis and leave-out-one sensitivity analysis was done.
Searches retrieved a total of 667. After removing duplicates, 610 remained. 138 studies were reviewed in full, but only 14, which included 5,901 health care providers, were considered in the final meta-analysis. The pooled prevalence of patient safety culture among health care providers in public hospitals of Ethiopia was 45.52% (95% CI: 41.27, 49.76; I2 = 91.3; p-value<0.001).
Patient safety culture among health care providers in Ethiopia remained poor. These findings underscore the need for increased focus on education and training, development of guidelines and policies for patient safety to integrate a patient safety culture into the existing health system. Additionally, integrating patient safety education and training topics early in pre-service curricula is crucial.
Registered in PROSPERO database with registration number of CRD42023407601.
患者安全是医疗保健领域的一项重大挑战，也是全球关注的问题。埃塞俄比亚医疗体系薄弱，同时人们对安全和患者安全文化的担忧与日俱增，促使我们开展这项系统评价和荟萃分析。我们的系统评价和荟萃分析旨在通过使用患者安全文化医院调查（HSOPSC）工具的研究，确定埃塞俄比亚医疗服务提供者中患者安全文化的合并患病率。
本研究采用系统评价和荟萃分析，并遵循系统评价和荟萃分析的首选报告项目（PRISMA）指南。我们在科学Direct、Medline、非洲期刊在线（AJOL）、医学文摘数据库（EMBASE）、Scopus和谷歌学术上全面检索研究，以识别以英文发表的相关观察性研究。于2024年10月10日检索数据源，并于2025年3月29日更新检索。所有选定的文章均根据参与者、干预措施、对照和结局（PICOS）标准符合纳入标准。使用STATA 15版统计软件进行随机效应模型荟萃分析，以估计合并患病率及95%置信区间（CI）。漏斗图和I²检验分别用于检查发表偏倚和研究间的异质性。进行了亚组分析和逐一剔除敏感性分析。
检索共获得667项研究。去除重复项后，剩余610项。对138项研究进行了全文审查，但最终的荟萃分析仅纳入了14项研究，其中包括5901名医疗服务提供者。埃塞俄比亚公立医院医疗服务提供者中患者安全文化的合并患病率为45.52%（95%CI：41.27，49.76；I² = 91.3；p值<0.001）。
埃塞俄比亚医疗服务提供者中的患者安全文化仍然较差。这些发现强调需要更加关注教育和培训，制定患者安全指南和政策，以便将患者安全文化融入现有的医疗体系。此外，在入职前课程中尽早纳入患者安全教育和培训主题至关重要。
已在PROSPERO数据库注册，注册号为CRD42023407601。
