Nurse perceptions of organizational culture and its association with the culture of error reporting: a case of public sector hospitals in Pakistan

Abstract

BackgroundThere is an absence of formal error tracking systems in public sector hospitals of Pakistan and also a lack of literature concerning error reporting culture in the health care sector. Nurse practitioners have front-line knowledge and rich exposure about both the organizational culture and error sharing in hospital settings. The aim of this paper was to investigate the association between organizational culture and the culture of error reporting, as perceived by nurses.MethodsThe authors used the “Practice Environment Scale-Nurse Work Index Revised” to measure the six dimensions of organizational culture. Seven questions were used from the “Survey to Solicit Information about the Culture of Reporting” to measure error reporting culture in the region. Overall, 309 nurses participated in the survey, including female nurses from all designations such as supervisors, instructors, ward-heads, staff nurses and student nurses. We used SPSS 17.0 to perform a factor analysis. Furthermore, descriptive statistics, mean scores and multivariable logistic regression were used for the analysis.ResultsThree areas were ranked unfavorably by nurse respondents, including: (i) the error reporting culture, (ii) staffing and resource adequacy, and (iii) nurse foundations for quality of care. Multivariable regression results revealed that all six categories of organizational culture, including: (1) nurse manager ability, leadership and support, (2) nurse participation in hospital affairs, (3) nurse participation in governance, (4) nurse foundations of quality care, (5) nurse-coworkers relations, and (6) nurse staffing and resource adequacy, were positively associated with higher odds of error reporting culture. In addition, it was found that married nurses and nurses on permanent contract were more likely to report errors at the workplace.ConclusionPublic healthcare services of Pakistan can be improved through the promotion of an error reporting culture, reducing staffing and resource shortages and the development of nursing care plans.

Assessing the patient safety culture and ward error reporting in public sector hospitals of Pakistan

“…There is a grave need for the formal and hidden curriculum, on-the-job training, and official ward objectives to include plans for the sharing and mitigation of errors, which is currently not a reality in the health sector of the country [38,39]. The results extend our previous research, which found that when a favorable organizational culture exists, the hospital and ward response to error reporting and patient safety will be more favorable [22]. It was found that majority of the student nurses believed that hospital seniors did communicate that patient safety is a high priority.…”

“…Regression tests of association between organizational culture and patient safety have been reported in a previous paper [22]. For this paper, descriptive statistics have been used to show the socio-demographic characteristics of nurse respondents, the culture of patient safety in hospitals as perceived by each nurse designation, and the culture of patient safety across different wards in the country.…”

“…This study is part of a PhD dissertation from which other sub-parts related to organizational culture, ethical violations, and workplace violence have already been published [22][23][24]. The study uses a quantitative study design based on cross-sectional data.…”

“…Only nurses who had worked for more than 1 year in a public sector tertiary care hospital of Pakistan were included in the sample. Further details about sample have been reported in another paper [22].…”

“…This sample, included in the final analysis, comprised of two nurse supervisors (one from each hospital), 205 staff nurses, 40 nurse ward heads, 11 nurse instructors, and 51 nurse students. Complete details of the data collection and sample can be found in a previous publication [22].…”