Nurses' Perceptions of Patient Safety Culture in Intensive Care Units: A Cross-Sectional Study

Abstract

BACKGROUND: Patient safety culture is a relatively new focus where little is known about its current status in Egypt’s teaching hospitals, mainly intensive care units (ICUs). Therefore, the authors of this study attempted to assess the patient safety culture dimensions from the nurses’ perspective.
 METHODS: An exploratory cross-sectional study was conducted in two ICUs (pediatric ICU and adult ICU) at the University Hospital over 3 months from October till December 2018. Sixty nurses were interviewed using the Hospital Survey on Patient Safety Culture.
 RESULTS: The current study findings revealed an average positive response to individual items ranging from 6% to 51%. The “Organizational learning” dimension had the highest average percent positive patient safety dimension score (51%) among all respondents, while the “Frequency of events reported” dimension had the lowest one (6%). No statistically significant difference was reported between the pediatric and adult ICUs for all mean scores except for the “Non-punitive response to error” dimension which was reported to be greater in the pediatric intensive care unit (PICU) compared to adult ICU (P < 0.005). The overall patient safety grade was rated acceptable by 47.5% of the interviewed nurses.
 CONCLUSION: The current study shows that patient safety is fragile in ICUs, and more effort is recommended to increase the awareness of health care providers. Also, hospital managers need to enhance the performance and practices of patient safety within a non-punitive reporting environment.

The association between self‐reported workload and perceptions of patient safety culture: A study of intensive care unit nurses

“…This result is also consistent with that of a previous study (Gurková et al, 2019). Likewise, the result is similar with those of studies in Egypt (Salem et al, 2019) and Indonesia (Imelda & AdikWibowo, 2018). The management support for patient safety also had a positive perception when the actions of hospital management exhibited that patient safety is a topmost priority.…”

“…This safety outcome variable is closely linked with other dimensions, such as nonpunitive response to errors, which showed a fair culture of reporting events and adequate staffing in the ICU. Correspondingly, this result is also inconsistent with those of another study in Egypt, in which the majority of respondents indicated that the items on the dimension of frequency of events reported had the lowest positive scores, as reported by the ICU staff of the study setting (Salem et al, 2019). Most of the participants gave a positive perception for feedback and communication about error.…”

Assessment of patient safety culture perception among healthcare workers in intensive care units of Alexandria Main University Hospital, Egypt

“…The lowest reported score (12.0%) was for "Non-Punitive Response to Errors" composite. This is similar to the scores of 16.0% by Salem et al in 2019 [15], 19.8% by Aboul-Fotouh et al in 2012 [31], 21.0% in Jordanian study in 2015, [28] and 26.8% in a Saudi Arabian study in 2014 [32]. However, higher score (44.0%) was reported in a study in USA hospitals 2010 [25].…”

“…The present study revealed a friable PSC in most composites. Positive response percentages to individual items ranged from 2.7% to 79.2% with a mean total of 37.3%.Similarly, Salem M et al in 2019 [15] and El-Shabrawy et al in 2015 [16], reported scores of 39.3% and 40%consecutively. However, studies conducted in year 2017 in Cairo [17] and Iran, [18] showed higher scores (62.0%) and (57.7%) respectively [17,18].…”

“…This may increase the chances of errors and AEs [30]. "Organizational learning-continuous improvement" composite had the highest score (51.0%) by Salem et al in 2019 [15].…”