Assessment of patient safety culture among the staff of the University Hospital for Gynecology and Obstetrics in Alexandria, Egypt

Abstract

Background Patient safety (PS) is a fundamental component of healthcare quality. Patient Safety Culture (PSC) assessment provides an organization with insight of perceptions and attitudes of its staff related to patient safety. In addition, it is meant to improve performance rather than blaming individuals. This study aimed to assess patient safety culture from the health care staff perspective in El-Shatby University Hospital for Gynecology and Obstetrics. Methods A descriptive cross-sectional study was conducted. The study was conducted at El-Shatby University Hospital for Gynecology and Obstetrics from November 2020 to January 2021. The target participants were assistant lecturers, residents, and head nurses in charge during the field study period. The number of potential participants who fulfilled the inclusion criteria (in charge during the period of data collection and working in the hospital for more than 3 months) was 83; the twelve participants who participated in the pilot study were excluded. The total number of participants who agreed to participate in the study was 66 participants (38 residents, 18 assistant lecturers, and 10 head nurses) out of 71 potential participants representing a 92.9% response rate. A structured self-administered questionnaire format adapted from Hospital Survey on Patient Safety Culture (HSOPSC) questionnaire was distributed anonymously to the participants. The questionnaire has 42 items measuring twelve patient safety culture dimensions: teamwork within the unit, supervisors’ expectations and actions to promote patient safety, feedback and communication about error, organizational learning, communication openness, overall perception of patient safety, hands-off and transitions, teamwork across units, frequency of events reported, management support for patient safety, staffing, and management support for patient safety. Except for two items that are responded on a five-point frequency scale (never, rarely, sometimes, most of the time, and always) the majority of patient safety culture questions are answered on a five-point agreement scale (strongly disagree, disagree, neutral, agree, and strongly agree), with a higher score indicating a more favorable attitude toward patient safety. Results The overall average positive percent score was 45.4%. Average positive response percentages to individual items ranged from 28.8 to 81.8%. No domain had an average positive percent score of more than 75%. Out of the twelve dimensions of patient safety culture included in the HSOPSC questionnaire, “the teamwork within unit” domain had the highest average positive percent score (62.1%) among all participants. On the other hand, the “Non-punitive response to error” domain had the lowest score (18.9%). More than half (57.6%) of the participants rated patient’s safety at the hospital as acceptable. Conclusion Investing in practices that strengthen patient safety is crucial if the hospital is to improve overall performance and quality of services. The present study displays a frail patient safety culture (PSC) in the majority of the domains. All the domains should be considered of high priority focused areas for remark and reformative tasks. Continuous training programs of the staff on patient safety to improve their perception of safety culture are necessary. All PSC composites need improvement starting with regular assessment of PSC along with continuous monitoring and increasing the healthcare providers’ awareness of demanded PSC.

Predictors and outcomes of patient safety culture at King Abdulaziz Medical City, Jeddah, Saudi Arabia. A nursing perspective

“…About two-thirds of nurses (67.4%) in the current study worked an average of 40 to 59 h per week, which indicates a heavy workload on nurses and might lead to more errors that affect the quality of care and patient safety. Two Saudi studies came to similar conclusions [ 20 , 22 ]. They said that insufficient staffing is a common problem that hurts nurses because of heavy workloads and long hours.…”

“…Compared to the previous studies in Saudi Arabia, the observed positive response rate in this study is comparable to those reported in AlSabaani in the Southern region of Saudi Arabia [ 18 ], while the result is lower than that in Aboufour and Subbarayalu’s study [ 19 ], which reported an average of 67.12% in hospitals in the Eastern region. The variation in the reported average and positive patient safety culture could be attributed to the different hospitals' structures, the organization’s awareness of patient safety culture, hospital experience, size, function, types of services, and samples included in each study [ 20 , 21 ]. This finding suggests that hospital management could consider implementing strategies aiming to teach and promote supervisory behaviors that encourage the nursing staff to report information regarding safety and participate in safety initiatives.…”

Evaluation of Patient's Safety Measures in ICU and Surgical Theatre in Hospitals in Menoufia Governorate, Egypt

“…Posting patient's safety standard in all applicable areas was documented in 66.7% and 64.4% of visits in ICU and NICU respectively. Ali et al (12) revealed that patient safety culture among the staff of the University Hospital in Alexandria was 62.1%.…”

Job embeddedness and missed nursing care at the operating theatres: the mediating role of polychronicity

“…This negative attitude was highlighted in studies conducted in the study settings [ 49 – 51 ]. Poor prevailing patient safety culture is a another concern explaining missed perioperative nursing care since previous works in the study settings found poor perception of healthcare providers for patient safety culture [ 52 – 54 ]. Poor staff compliance with patient safety guidelines as well as lack of awareness about risk mitigation are also critical factors explaining the missed care items in our study.…”