Attitude toward Safety among Staffs in the Iranian Maternity Care Units of Public Hospitals with High Maternal Death Rate, 2015-2016

Abstract

Background: Although extensive Mother-friendly Hospital initiatives have been improved the quality of maternity care in Iran, recent national reports have been indicated that obstetrics errors are still common. The current study aimed to assess safety attitude in the maternity care units of public hospitals in a region with high rate of maternal death in Iran. Materials and Methods: Data was collected from 314 midwives, specialist and also managers working in all public hospitals in 2016. The Cronbach's alpha coefficient was used to analyze psychometric features of the Safety Attitudes Questionnaire (SAQ). Results: 86.2% of the participants (n = 314) completed the questionnaire. Results showed that lower scores in teamwork, safety climate and also job satisfaction subcomponents. The working conditions and stress recognition had the highest negative scores. There was a significant relationship between the following subcomponents and work load: teamwork (r = −0.416, P-value = 0.05), stress recognition (r = 0.40, P-value = 0.05) and also working conditions (r = 0.421; P-value = 0.02). The score of midwives was significantly lower than specialists regarding job satisfaction (P-value = 0.014), working conditions (P-value = 0.02) and also the overall safety attitude score (P-value = 0.001). About 63% of respondents reported no error during the last year. The mean of error reporting during the last year significantly increased among specialists compared to midwives (P-value = 0.001). Conclusion: Maternity care units in the region with high maternal death have been faced with many intangible barriers related to safety attitude such as poor teamwork climate, working condition and also poor stress recognition. It is now needed to promote supportive environment for midwives and also strengthening staff cohesion 387through guiding the strategic direction of current maternity risk management system in creating open and just culture, improving leadership behaviors among senior managers and also addressing poor staffing levels.

Factors Relating to a Safety Culture in the University Perinatal Center: The Nurses’ and Midwives’ Perspective

“…We found that the mean score of responses in this factor was 3.28 (0.65). According to the results of other studies, the mean response score for this factor ranged from 2.79 to 3.62 [ 13 , 28 , 29 ].…”

“…The domain of work conditions allows for the evaluation of the strengths of a hospital’s organizational structure, such as training and supervision for new personnel and the process of providing necessary information about diagnostic and therapeutic decisions [ 28 , 29 ]. The results of our study, and those conducted in Chinese and Danish hospitals [ 18 , 30 ], showed that 57% of respondents agreed or strongly agreed with these statements.…”