Safety culture in health care teams: A narrative review of the literature

Abstract

Aim Explore the recent literature to examine the factors that affect safety culture within health care teams. Background Health care organisations must understand and improve their safety culture. However, safety culture is a complex phenomenon which interacts with a myriad of factors, making it difficult to define, measure and improve. Evaluation A comprehensive search strategy was used to search four major databases. Peer‐reviewed which were published in English between 2006 and 2017 and presented research studies related to safety culture in health care teams were included. A narrative analysis was undertaken. Key issues Issues relevant to the definition, measurement and improvement of safety culture, the impact of teamwork and communication on safety culture, the role of leaders and accountability are explored. Conclusion The above themes inform our understanding of developing, measuring and sustaining safety culture in health care teams. However, further research is warranted to accurately understand how to measure and improve safety culture. Implications for nursing management To support a safety culture, initiatives to facilitate effective communication between nurse practitioners and other health care professionals must be introduced. Nurse managers should adopt leadership strategies that will support nurses’ psychological safety and create a just culture.

Assessment of patient safety climate by nurses in Slovak Public and private hospitals

“…Consistently with previous Slovak studies (Mikušová et al, 2012; Sováriová Soósová et al, 2017), recent syntheses of studies (Okuyama et al., 2018; Reis et al., 2018) or national reports (e.g., Famolaro et al, 2018), we found that the dimensions with the lowest percentage of positive responses that need improvement within hospitals are as follows: ‘Non‐punitive Response to Error’, ‘Staffing’ and ‘Teamwork across units’. Communication problems and difficulties in teamwork, staff allocation, workload and a punitive culture were identified as the dominant factors that contribute to patient safety issues (Khater, Akhu‐Zaheya, AL‐Mahasneh, & Khater, 2015; Mattson, Hellgren, & Göransson, 2015; O'Donovan, Ward, De Brún, & McAuliffe, 2019). Moreover, workplace conditions such as workload, lack of teamwork and fear of punishment may also contribute to nurses' intention to leave.…”

Exploring the influence of workplace violence and bystander behaviour on patient safety in Korea: A pilot study

“…Thus, this study included a tertiary hospital to control organisational‐level variances, and patient safety culture and workplace violence as control variables to identify the influence of bystander behaviour on patient safety. A medical institution's patient safety culture is a product of members’ beliefs and values towards patient safety, formed by communication and leadership (Feng, Bobay, & Weiss, 2008; O’Donovan, Ward, De Brún, & McAuliffe, 2019). The patient safety culture influences nurse‐assessed patient safety (DiCuccio, 2015).…”

A qualitative descriptive inquiry of the influences on nurses’ missed care decision‐making processes in acute hospital paediatric care

“…Patient safety in particular is high on policymakers’ agendas internationally (O'Donovan et al, 2018; Woodward, 2016). This call to action began back in 2006, when the World Health Organization highlighted the necessity to address nursing shortages due to its direct impact on the quality of care (World Health Organization, 2006).…”

“…It is widely acknowledged that missed care is widespread across acute hospital environments (Kalisch & Xie, 2014) despite ongoing concerns about safety and a commitment to quality care (O'Donovan, Ward, De, Brún, & McAuliffe, 2018; Woodward, 2016). While actions are underway to consider policy to prevent missed care across health care settings internationally (Palese et al, 2019; Rancare, 2018a, 2018b), there is an emerging discourse that missed care is no longer deemed ethically correct, urging ethical and professional action by nurses to rectify the situation (Suhonen & Scott, 2018).…”