Safety culture and systems thinking for predicting safety competence and safety performance among registered nurses in Saudi Arabia: a cross-sectional study

Abstract

Background Medical errors are a worldwide concern and the contribution of nurses’ safety competence and performance to these errors is a high priority. It has been over 20 years since the first report of the need to address medical errors. New approaches are needed for enhancing safety competence and performance. Aims This study explored the relationships among systems thinking, educational level, safety culture, safety competence and safety performance among registered nurses working in medical and surgical units in Saudi Arabia. Methods A correlational cross-sectional design with a convenience sample of 84 registered nurses was used. Results Systems thinking predicted 16% of safety knowledge ( F[2, 81] = 7.61, P = 0.001), while safety culture, baccalaureate education and completion of safety training predicted 19% of safety skill ( F[3, 78] = 2.80, P = 0.001). A safety culture that promoted learning from mistakes predicted 15% of safety performance measured based on nurses’ self-report of the number of errors in the past 3 months ( F[3, 75] = 2.86, P = 0.008). Conclusions Professional development including systems thinking and safety training are the necessary next steps for nurses. In addition, policy changes facilitating organisations to support learning from mistakes will contribute to reducing medical errors.

The association of professionalism and systems thinking on patient safety competency: A structural equation model

“…In addition to professionalism, systems thinking has emerged as an important predictor of patient safety competency in our study, which is supported by previous findings (Mahsoon & Dolansky, 2021; Rizany et al, 2018). Nurses should be encouraged to engage systems thinking to view complex care systems for safety and quality of care (Dolansky & Moore, 2013).…”

The impact of nurses' perceptions of systems thinking on occurrence and reporting of adverse events: A cross‐sectional study

“…Major AEs can lead to delayed discharge, patient disability and death (Schwendimann et al, 2018). Studies have estimated that unsafe care due to adverse AEs is the 14th leading cause of death and disability worldwide, around 50% of these AEs are preventable (Mahsoon & Dolansky, 2021; Makary & Daniel, 2016). In low‐ and middle‐income countries, 134 million AEs existed in hospitals annually, resulting in nearly three million deaths (National Academies of Sciences & Medicine, 2018).…”

Head Nurses' Professionalism, Systems Thinking and its Relation to Safe Nursing Care

“…The association of professionalism and systems thinking on patient safety competency (Kakemam, et al, 2022). Safety culture and systems thinking for predicting safety competence and safety performance among registered nurses in Saudi Arabia (Dolansky, & Mahsoon, 2021). No attempts were done to examine head nurses' professionalism, systems thinking and its relation to safe nursing care at Oncology Center.…”

“…The ultimate objective of a systems-thinking style is to form a safe setting in which wholly participants can find out the unseen results of their collected acts and challenge their thinking. Systems thinking is aimed to deliver safe patient care through the awareness of the whole healthcare system, its elements, their interactions and the efficiency of utilizing the system resources (Dolansky, & Mahsoon, 2021).…”