Evaluation of patient safety culture: comparative study in university hospitals

To conduct a benchmarking comparison of the composites of patient safety culture based on the evaluation of Brazilian and Portuguese nurses working in university hospitals.

Method:

Quantitative, cross-sectional, comparative survey. Data collected between April and December 2014, in two teaching hospitals, applying the instrument Hospital Survey on Patient Safety Culture, in the versions translated and adapted to the countries.

Results:

762 nurses distributed in four services participated in the study, 195 Brazilians and 567 Portuguese. Seven of the 12 composites of safety culture showed significant differences between hospitals. The highlights were those related to: “management support for patient safety” (±17); “handoffs and transitions” (±15); “teamwork across units” (±14); and “overall perceptions of patient safety” (±10).

Conclusion:

The dimension that had the highest significant difference between the studied institutions was “management support for patient safety”. These data may support the managers of the study hospitals, enabling continuous improvements and advancements.

DESCRIPTORS:
Patient Safety; Organizational Culture; Quality of Health Care; Hospitals; Nursing, Team

Composites of Patient Safety Culture of the HSOPSC
D1 − Teamwork within units
D2 − Supervisor expectations and actions promoting patient safety
D3 − Organizational learning
D4 − Feedback and communication about error
D5 − Communication openness
D6 − Staffing
D7 - Non-punitive response to error
D8 − Management support for patient safety
D9 − Teamwork across units
D10 − Handoffs and transitions
D11 − Overall perceptions of patient safety
D12 − Frequency of events reported

Characterization of Nurses		BH (N=195)		PH (N=567)		Total (N=762)
Characterization of Nurses		n	%	N	%	n	%
Gender	Female	175	89.70	458	80.80	633	83.07
Gender	Male	20	10.30	109	19.20	129	16.93
Participation in the safety center	Yes	10	5.10	32	5.60	42	5.51
Working hours (week)	Up to 40hrs	136	69.70	70	12.30	206	27.03
Working hours (week)	More than 40hrs	59	30.30	497	87.70	556	72.97
Graduate course	Yes	154	79.00	265	46.70	419	54.99
Direct patient care	Yes	190	97.40	562	99.10	752	98.69
Time in the profession	Up to 7 years	110	56.41	139	24.51	249	32.68
Time in the profession	More than 8 years	85	43.59	428	75.49	513	67.32
Time in the institution	Up to 7 years	144	73.80	184	32.50	328	43.04
Time in the institution	More than 8 years	51	26.20	383	67.50	434	56.96
Time in the unit	Up to 7 years	154	79.00	278	49.00	432	56.69
Time in the unit	More than 8 years	41	21.00	289	51.00	330	43.31

Composite	BH		PH		General mean		Significant difference ≥5%
Composite	µ*	σ**	µ*	σ**	µ*	σ**	Significant difference ≥5%
Teamwork within units	68	±10	79	±12	74	±6	Yes
Supervisor expectations and actions promoting patient safety	69	±7	66	±12	68	±2	No
Organizational learning	57	±10	65	±11	61	±4	No
Feedback and communication about error	39	±11	54	±5	47	±8	Yes
Communication openness	59	±15	56	±11	58	±2	No
Staffing	34	±6	43	±18	39	±5	Yes
Nonpunitive response to error	23	±8	28	±12	26	±3	No
Management support for patient safety	15	±2	48	±7	32	±17	Yes
Teamwork across units	23	±8	51	±12	37	±14	Yes
Handoffs and transitions	36	±16	66	±6	51	±15	Yes
Overall perceptions of patient safety	36	±14	56	±4	46	±10	Yes
Frequency of events reported	29	±2	30	±6	30	±1	No

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[1] Corresponding author: Cintia Silva Fassarella Boulevard 28 de Setembro, 157 - Vila Isabel CEP 20551-030 - Rio de Janeiro, RJ, Brazil cintiafassarella@gmail.com