A baseline assessment of patient safety culture and its associated factors from the perspective of critical care nurses: Results from 10 hospitals

Mohamed Ayoub Tlili; Wiem Aouicha; Jihene Sahli; Chekib Zedini; Mohamed Ben Dhiab; Souad Chelbi; Ali Mtiraoui; Houyem Said Latiri; Thouraya Ajmi; Mohamed Ben Rejeb; Manel Mallouli

doi:10.1016/j.aucc.2020.09.004

A baseline assessment of patient safety culture and its associated factors from the perspective of critical care nurses: Results from 10 hospitals

Aust Crit Care. 2021 Jul;34(4):363-369. doi: 10.1016/j.aucc.2020.09.004. Epub 2020 Oct 26.

Authors

Affiliations

¹ University of Sousse, Faculty of Medicine of Sousse (Tunisia), Laboratory of Research LR12ES03 «Qualité des soins et management des services de santé maternelle» - University of Sousse, Higher School of Health Sciences and Techniques of Sousse, Tunisia. Electronic address: [email protected].
² University of Sousse, Faculty of Medicine of Sousse (Tunisia), Laboratory of Research LR12ES03 «Qualité des soins et management des services de santé maternelle» - University of Sousse, Higher School of Health Sciences and Techniques of Sousse, Tunisia.
³ University of Sousse, Faculty of Medicine of Sousse (Tunisia), Department of Community and Family Health, Laboratory of Research LR12ES03 «Qualité des soins et management des services de santé maternelle», Tunisia.
⁴ University of Sousse, Faculty of Medicine of Sousse, Tunisia.
⁵ University of Sousse, Faculty of Medicine of Sousse (Tunisia) - University of Sousse, Higher School of Health Sciences and Techniques of Sousse, Tunisia.
⁶ University of Sousse, Faculty of Medicine of Sousse (Tunisia)- University Hospital Sahloul (Sousse,Tunisia), Department of Prevention and Safety Care, Tunisia.

PMID: 33121872
DOI: 10.1016/j.aucc.2020.09.004

Abstract

Introduction: Critical care nurses are considered the key to patient safety improvement and play a vital role in enhancing quality of care in intensive care units (ICUs) where adverse events are frequent and have severe consequences. Moreover, there is recognition of the importance of the assessment and the development of patient safety culture (PSC) as a strategic focus for the improvement of patient safety and healthcare quality, notably in critical care settings.

Objectives: This study aimed to assess critical care nurses' perception of PSC and to determine its associated factors.

Methods: This cross-sectional study was conducted among nurses working in the ICUs of the Tunisian centre (six Tunisian governorates). The study instrument was the French validated version of the Hospital Survey on Patient Safety Culture questionnaire, comprising 10 dimensions and a total of 50 items.

Results: A total of 249 nurses from 18 ICUs participated in the study, with a participation rate of 87.36%. The dimensions scores ranged between 17.2% for the dimension "frequency of events reported" and 50.1% for the dimension "teamwork within units". Multivariable logistic regression indicated that respondents who worked in private hospitals were five times more likely to have a developed PSC (adjusted odds ratio [AOR]: 5.34; 95% confidence interval [CI], [2.28, 12.51]; p < 10^-3). Similarly, participants who worked in a certified hospital were two times more likely to have a more developed PSC than respondents who work in noncertified hospitals (AOR: 2.51; 95% CI, [.92-6.82]; p = 0.041). In addition, an increased nurse-per-patient ratio (i.e., reduced workload) increased PSC (AOR: 1.10; 95% CI, [1.02-1.12]; p = 0.018).

Conclusion: This study has shown that the state of critical care nurses' PSC is critically low and these baseline results can help to form a plan of actions for improvements.

Keywords: Critical care; Intensive care units; Nursing care; Patient safety; Patient safety culture; Quality of care.

MeSH terms

Critical Care
Cross-Sectional Studies
Hospitals, Private
Humans
Nurses*
Patient Safety*
Safety Management
Surveys and Questionnaires