Aim To evaluate how a 3‐year patient safety intervention, more specifically, the implementation of a patient safety incident reporting system, influences patient safety culture. Background Positive patient safety culture improves both the quality of health care and patient safety. Nevertheless, nursing managers need tools that can help them develop and evaluate patient safety culture. Methods The Hospital Survey on Patient Safety Culture was used to evaluate patient safety culture at two Finnish forensic psychiatric hospitals (study and control) over two periods, baseline and follow‐up. Data were analysed using Z‐score and T test statistics. Results The follow‐up results from the study hospital showed that five patient safety culture dimensions exhibited a significantly (p < 0.05) positive change in positive response rates over the 3‐year period. Furthermore, nine out of twelve patient safety culture dimensions at the study hospital showed a significant improvement in mean score. At the control hospital, only the dimension of frequency of reporting events showed a significantly positive change (p < 0.05) in mean score. Conclusion This research shows that the studied patient safety intervention (implementation of the patient safety incident reporting system) significantly influences patient safety culture. Implications for Nursing Management Nursing managers should utilize a variety of patient safety interventions to improve patient safety and focus on leveraging information from patient safety incidents to advance patient safety culture.

Safety culture refers to the way patient safety is regarded and implemented within an organization and the structures and procedures in place to support this. The aim of this study was to evaluate patient safety culture, identify areas for improvement, and establish a baseline for improving state hospitals in Finland. Cross-sectional design data were collected from two state-run forensic hospitals in Finland using an anonymous, Web-based survey targeted to hospital staff based on the Hospital Survey on Patient Safety Culture questionnaire. The response rate was 43% (n = 283). The overall patient safety level was rated as excellent or very good by 58% of respondents. The highest positive grade was for "teamwork within units" (72%). The lowest rating was for "nonpunitive response to errors" (26% positive). Good opportunities for supplementary education had a statistically significant (p ≤ 0.05) effect on 9 of 12 Hospital Survey on Patient Safety Culture dimensions. Statistically significant (p ≤ 0.05) differences in patient safety culture were also found in the staff's educational background, manager status, and between the two hospitals. These findings suggest there are a number of patient safety problems related to cultural dimensions. Supplementary education was shown to be a highly significant factor in transforming patient safety culture and should therefore be taken into account alongside sufficient resources.

Background: Although forensic nurses work with the most challenging psychiatric patients and manifest a safety culture in their interactions with patients there have been few studies on patient safety culture in forensic psychiatric nursing. Objectives: The aim of this qualitative study was to describe nurses' views of patient safety culture in their working unit and daily hospital work in two forensic hospitals in Finland. Methods: Data were collected over a period of one month by inviting nurses to answer an openended question in an anonymous web-based questionnaire. A qualitative inductive analysis was performed on nurses' (N=72) written descriptions of patient safety culture in state-owned forensic hospitals where most Finnish forensic patients are treated. Results: Six main themes were identified: 'Systematization of an open and trusting communication culture', 'Visible and close interaction between managers and staff', 'Non-punitive responses to errors, learning and developing', 'Balancing staff and patient perspectives on safety culture', 'Operational safety guidelines', and 'Adequate human resources to ensure safety'. Conclusions: The findings highlight the influence of the prevailing culture on safety behaviors and outcomes for both healthcare workers and patients. Additionally, they underline the importance of an open culture with open communication and protocols.

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