Promoting a culture of safety as a patient safety strategy: a systematic review.
Ontology highlight
ABSTRACT:
SUBMITTER: Weaver SJ
PROVIDER: S-EPMC4710092 | biostudies-literature | 2013 Mar
REPOSITORIES: biostudies-literature
Publications
Promoting a culture of safety as a patient safety strategy: a systematic review.
Weaver Sallie J SJ Lubomksi Lisa H LH Wilson Renee F RF Pfoh Elizabeth R ER Martinez Kathryn A KA Dy Sydney M SM
Annals of internal medicine 20130301 5 Pt 2
Developing a culture of safety is a core element of many efforts to improve patient safety and care quality. This systematic review identifies and assesses interventions used to promote safety culture or climate in acute care settings. The authors searched MEDLINE, CINAHL, PsycINFO, Cochrane, and EMBASE to identify relevant English-language studies published from January 2000 to October 2012. They selected studies that targeted health care workers practicing in inpatient settings and included da ...[more]
Similar Datasets
Project description:BackgroundPatient safety in primary care is an emerging field of research with a growing evidence base in western countries but little has been explored in the Gulf Cooperation Council Countries (GCC) including the Sultanate of Oman. This study aimed to review the literature on the safety culture and patient safety measures used globally to inform the development of safety culture among health care workers in primary care with a particular focus on the Middle East.MethodsA systematic review of the literature. Searches were undertaken using Medline, EMBASE, CINAHL and Scopus from the year 2000 to 2014. Terms defining safety culture were combined with terms identifying patient safety and primary care.ResultsThe database searches identified 3072 papers that were screened for inclusion in the review. After the screening and verification, data were extracted from 28 papers that described safety culture in primary care. The global distribution of the articles is as follows: the Netherlands (7), the United States (5), Germany (4), the United Kingdom (1), Australia, Canada and Brazil (two for each country), and with one each from Turkey, Iran, Saudi Arabia and Kuwait. The characteristics of the included studies were grouped under the following themes: safety culture in primary care, incident reporting, safety climate and adverse events. The most common theme from 2011 onwards was the assessment of safety culture in primary care (13 studies, 46%). The most commonly used safety culture assessment tool is the Hospital survey on patient safety culture (HSOPSC) which has been used in developing countries in the Middle East.ConclusionsThis systematic review reveals that the most important first step is the assessment of safety culture in primary care which will provide a basic understanding to safety-related perceptions of health care providers. The HSOPSC has been commonly used in Kuwait, Turkey, and Iran.
| S-EPMC6026504 | biostudies-literature
Project description:BackgroundPatient safety, concerned with the prevention of harm to patients, has become a fundamental component of the global healthcare system. The evidence regarding the status of the patient safety culture in Arab countries in general shows that it is at a suboptimal level due to a punitive approach to errors and deficits in the openness of communications.ObjectivesTo identify factors contributing to the patient safety culture in Saudi Arabia.DesignSystematic review.MethodsA systematic search was carried out in May 2018 in five electronic databases and updated in July 2020-MEDLINE, CINAHL, Embase, PsycINFO and the Cochrane Database of Systematic Reviews. Relevant journals and reference lists of included studies were also hand-searched. Two independent reviewers verified that the studies met the inclusion criteria, assessed the quality of studies and extracted their relevant characteristics. The Yorkshire Contributory Factors Framework (YCFF) was used to categorise factors affecting safety culture in the included papers.Results14 papers were included and the majority of studies were appraised as being of good quality. Strength and weakness factors that contribute to patient safety culture were identified. Ineffective leadership, a blame culture, workload/inadequate staffing and poor communication are reported as the main factors hindering a positive patient safety culture in Saudi Arabia. Conversely, 'strength' factors contributing to a positive patient safety culture included supportive organisational attitudes to learning/continuous improvement, good teamwork within units and support from hospital management for patient safety. There is an absence of patient perspectives regarding patient safety culture in Saudi Arabia.ConclusionPolicymakers in the Saudi healthcare system should pay attention to the factors that may contribute to a positive patient safety culture, especially establishing a blame-free culture, improving communications and leadership capacity, learning from errors and involving patient perspectives in safety initiatives. Further research is required to understand in depth the barriers and facilitators to the implementation of a positive patient safety culture in Saudi Arabia.
| S-EPMC7559108 | biostudies-literature
Project description:BackgroundUnsafe health practices are one of the leading causes of disability and even death. Competent nurses are crucial to ensure safe and high-quality healthcare services. The patient safety culture is concerned with internalizing safety beliefs, values, and attitudes, translating them into healthcare practices, and committing to maintaining an error-free health environment. A high level of competence ensures the achievement and compliance with the safety culture goal. This systematic review aims to identify the relationship between the level of nursing competence and the safety culture score and perception among nurses at their workplace.MethodsFour international online databases were searched to find relevant studies published between 2018 and 2022. Peer-reviewed articles using quantitative methods, targeting nursing staff, and written in English were included. After reviewing 117 identified studies, 16 full-text studies were included. The PRISMA 2020 checklist for systematic reviews was used.ResultsEvaluation of the studies indicates safety culture, competency, and perception were assessed using various instruments. Safety culture was generally perceived as positive. No unique and standard tool has been developed to investigate the effect of safety competency on the perception of the safety culture in a standardized way.ConclusionsExisting research provides evidence of a positive correlation between nursing competence and patient safety score. Future research is recommended to investigate ways to measure the effect of nursing competency level on safety culture in healthcare institutions.
| S-EPMC10196295 | biostudies-literature
Project description:IntroductionAdverse events in hospitals are prevented through risk reduction and reliable processes. Highly reliable hospitals are grounded by a robust patient safety culture with effective communication, leadership, teamwork, error reporting, continuous improvement, and organizational learning. Although hospitals regularly measure their patient safety culture for strengths and weaknesses, there have been no systematic reviews with meta-analyses reported from Latin America.PurposeOur systematic review aims to produce evidence about the status of patient safety culture in Latin American hospitals from studies using the Hospital Survey on Patient Safety Culture (HSOPSC).MethodsThis systematic review was guided by the JBI guidelines for evidence synthesis. Four databases were systematically searched for studies from 2011 to 2021 originating in Latin America. Studies identified for inclusion were assessed for methodological quality and risk of bias. Descriptive and inferential statistics, including meta-analysis for professional subgroups and meta-regression for subgroup effect, were calculated.ResultsIn total, 30 studies from five countries-Argentina (1), Brazil (22), Colombia (3), Mexico (3), and Peru (1)-were included in the review, with 10,915 participants, consisting primarily of nursing staff (93%). The HSOPSC dimensions most positive for patient safety culture were "organizational learning: continuous improvement" and "teamwork within units", while the least positive were "nonpunitive response to error" and "staffing". Overall, there was a low positive perception (48%) of patient safety culture as a global measure (95% CI, 44.53-51.60), and a significant difference was observed for physicians who had a higher positive perception than nurses (59.84; 95% CI, 56.02-63.66).ConclusionsPatient safety culture is a relatively unknown or unmeasured concept in most Latin American countries. Health professional programs need to build patient safety content into curriculums with an emphasis on developing skills in communication, leadership, and teamwork. Despite international accreditation penetration in the region, there were surprisingly few studies from countries with accredited hospitals. Patient safety culture needs to be a priority for hospitals in Latin America through health policies requiring annual assessments to identify weaknesses for quality improvement initiatives.
| S-EPMC9658502 | biostudies-literature
Project description:Study objectivesTo assess the patient safety culture in Primary Health Care (PHC) setting after the transition to the Family Health Strategy (FHS) model in a Brazilian metropolitan area and compare the results between the categories of health care professionals.MethodsA cross-sectional study including 246 workers from primary health care services in Federal District, Brazil. Data collection took place from October to December 2019 through the Medical Office Survey on Patient Safety Culture (MOSPSC) application. Patient safety culture was considered positive when the score was above 60%. For comparisons between the categories of health care professionals', the ANOVA and Kruskal-Wallis test were used for composite percent positive scores, and Pearson's chi-square or Fishers exact test for frequency and percentage of positive responses.ResultsThe overall MOSPSC composite percent positive score was 49.9%. Among the 12 dimensions, only three showed a positive patient safety culture: Teamwork (73.1%), Organizational learning (62.9%), and Patient care tracking/follow-up (60.1%). The percentage of positive responses on overall quality assessment (78.1%) and overall patient safety assessment (78.0%) showed a positive evaluation. There was no significant difference in the composite percent positive score of overall MOSPSC (p = 0.135) and the percentage of positive responses on overall patient safety assessment (p = 0.156) between the categories of health care professionals. Overall quality assessment showed a significant difference between job roles (p < 0.001), in which nursing /health care technicians showed a significantly lower score than other job roles.ConclusionThe patient safety culture assessment showed a weakness in the patient safety in the PHC services. The MOSPSC and nine of its dimensions presented a negative safety culture assessment, regardless of the high scores in the overall patient safety and quality assessments.
| S-EPMC9321378 | biostudies-literature
Project description:BackgroundWork stress is one of the leading causes of physical and mental problems among nurses and can affect patient safety. Nurses experiencing stress are more prone to make errors, which has consequences for the safety culture. This study aimed to describe the findings of studies that examined the relationship between job stress and patient safety culture among nurses.MethodsA systematic review of published English-language articles from 2017 to 2021 was obtained through an electronic search of three large online databases (i.e., CINAHL through EBSCOhost, Medline through PubMed, and Embase). We used the Statement of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) to guide the undertaking of this review. In addition, data extraction and quality assessment were performed for the final seven quantitative articles.ResultsThis review showed a significant relationship between job-related stress in its different factors, patient safety culture, and patient safety. Three studies of the seven reviewed articles examined the relationship. The rest of the studies examined the relationship indirectly, discussing factors that impacted job stress and how they affected patient safety culture. However, differences in working conditions and study characteristics affected the results of these studies and the significance of this relationship.ConclusionsThis review suggests that nursing managers and administrators should consider actions to minimize nursing job stress to the minimum levels and improve their work environment to provide the best possible patient care. Future studies are needed to develop interventions to reduce workplace stress and improve nurses' safety. Furthermore, nurses' managers and educators should train nurses on resilience and how to work in trauma-informed care.
| S-EPMC9926568 | biostudies-literature
Project description:This review aims to provide an overview of empirical studies using the HSOPSC in Norway and to develop recommendations for further research on patient safety culture. Oria, an online catalogue of scientific databases, was searched for patient safety culture in February 2021. In addition, three articles were identified via Google Scholar searches. Out of 113 retrieved articles, a total of 20 articles were included in our review. These were divided into three categories: seven perception studies, six intervention studies, and seven reliability and validation studies. The first study conducted in Norway indicated a need to improve patient safety culture. Only one intervention study was able to substantially improve patient safety culture. The validity of HSOPSC is supported in most studies. However, one study indicated poor quality in relation to the testing of criteria related to validity. This review is limited to Norwegian healthcare but has several relevant implications across the research field, namely that intervention studies should (1) validate dimensions more carefully, (2) avoid pitfalls related to both factor analysis methods and criteria validity testing, (3) consider integrating structural models into multilevel improvement programs, and (4) benefit from applying different, new versions of HSOPSC developed in Norway.
| S-EPMC8296424 | biostudies-literature
Project description:OBJECTIVE:To carry out a systematic review of the psychometric properties of international studies that have used the Hospital Survey on Patient Safety Culture (HSPSC). DESIGN:Literature review and an analysis framework to review studies. SETTING:Hospitals and other healthcare settings in North and South America, Europe, the Near East, the Middle East and the Far East. DATA SOURCES:A total of 62 studies and 67 datasets made up of journal papers, book chapters and PhD theses were included in the review. PRIMARY AND SECONDARY OUTCOME MEASURES:Psychometric properties (eg, internal consistency) and sample characteristics (eg, country of use, participant job roles and changes made to the original version of the HSPSC). RESULTS:Just over half (52%) of the studies in our sample reported internal reliabilities lower than 0.7 for at least six HSPSC dimensions. The dimensions 'staffing', 'communication openness', 'non-punitive response to error', 'organisational learning' and 'overall perceptions of safety' resulted in low internal consistencies in a majority of studies. The outcomes from assessing construct validity were reported in 60% of the studies. Most studies took place in a hospital setting (84%); the majority of survey participants (62%) were drawn from nursing and technical staff. Forty-two per cent of the studies did not state what modifications, if any, were made to the original US version of the instrument. CONCLUSIONS:While there is evidence of a growing worldwide trend in the use of the HSPSC, particularly within Europe and the Near/Middle East, our review underlines the need for caution in using the instrument. Future use of the HSPSC needs to be sensitive to the demands of care settings, the target population and other aspects of the national and local healthcare contexts. There is a need to develop guidelines covering procedures for using, adapting and translating the HSPSC, as well as reporting findings based on its use.
| S-EPMC6731893 | biostudies-other
Project description:IntroductionHospitals commonly examine patient safety culture and other quality indicators to evaluate and improve performance in relation to quality and safety. A growing body of research has separately examined relationships between patient safety culture and patient experience on clinical outcomes and other quality indicators. However, there is a knowledge gap regarding the relationship between these two important domains. This article describes the protocol for a scoping review of published literature examining the relationship between patient safety culture and patient experience in hospital settings. The scoping review will provide an overview of research into the relationship between patient safety culture and patient experience in hospital contexts, map key concepts underpinning these domains and identify research gaps for further study.Methods and analysisThe scoping review will be conducted using the five stages of Arksey and O'Malley's framework: identify the research question; identify relevant studies; study selection; chart data; and collate, summarise and report the results. The inclusion criteria will be applied using the Population, Concept and Context Framework. Searches will be conducted in the CINAHL, Cochrane Library, ProQuest, MEDLINE, PsycINFO, Scopus and SciELO databases, without applying date range limits. Hand-searching of grey literature will also be performed to find relevant, non-indexed literature. Data will be extracted using a standardised data extraction form developed by the Joanna Briggs Institute. Both descriptive and thematic analyses will be undertaken to scope key concepts within the body of reviewed literature.Ethics and disseminationThis type of study does not require an ethics review. The results will be submitted for publication in a peer-reviewed journal and presented at conferences.
| S-EPMC8169466 | biostudies-literature
Project description:BackgroundThe study of safety culture and its relationship to patient care have been challenged by variation in definition, dimensionality and methods of assessment. This systematic review aimed to map methods to assess safety culture in hospitals, analyse the prevalence of these methods in the published research literature and examine the dimensions of safety culture captured through these processes.MethodsWe included studies reporting on quantitative, qualitative and mixed methods to assess safety culture in hospitals. The review was conducted using four academic databases (PubMed, CINAHL, Scopus and Web of Science) with studies from January 2008 to May 2020. A formal quality appraisal was not conducted. Study purpose, type of method and safety culture dimensions were extracted from all studies, coded thematically, and summarised narratively and using descriptive statistics where appropriate.ResultsA total of 694 studies were included. A third (n=244, 35.2%) had a descriptive or exploratory purpose, 225 (32.4%) tested relationships among variables, 129 (18.6%) evaluated an intervention, while 13.8% (n=96) had a methodological focus. Most studies exclusively used surveys (n=663; 95.5%), with 88 different surveys identified. Only 31 studies (4.5%) used qualitative or mixed methods. Thematic analysis identified 11 themes related to safety culture dimensions across the methods, with 'Leadership' being the most common. Qualitative and mixed methods approaches were more likely to identify additional dimensions of safety culture not covered by the 11 themes, including improvisation and contextual pressures.DiscussionWe assessed the extent to which safety culture dimensions mapped to specific quantitative and qualitative tools and methods of assessing safety culture. No single method or tool appeared to measure all 11 themes of safety culture. Risk of publication bias was high in this review. Future attempts to assess safety culture in hospitals should consider incorporating qualitative methods into survey studies to evaluate this multi-faceted construct.
| S-EPMC8317080 | biostudies-literature