Main Article Content
Abstract
Patient Safety Culture (PSC) is critical in healthcare organizations, influencing patient outcomes and care quality. This study is a systematic review that provides a comprehensive understanding of PSC in hospitals by synthesizing the current literature using the PRISMA framework and focusing on identifying key components, determinants, and factors influencing healthcare professionals’ attitudes and perceptions toward PSC. A systematic search of the SCOPUS database identified 19,129 documents on PSC, of which 21 were included after rigorous screening and application of eligibility criteria. Key findings highlight the importance of effective leadership, communication, teamwork, and organizational learning in fostering a positive PSC. Supportive leadership and non-punitive environments encourage error reporting, whereas continuous professional development and stress-reduction programs enhance safety culture. Factors such as work-related stress, professional commitment, and organizational culture significantly impact PSC. Understanding these factors is essential for designing strategies to deal with healthcare professionals’ specific needs and challenges. This systematic review also reveals gaps in research on the causal relationships and mechanisms that shape PSC, suggesting that further studies are needed to develop more effective interventions. Practical implications emphasize the importance of leadership training, regular safety training sessions, stress reduction programs, and evidence-based practices. This review provides actionable insights for healthcare administrators, policymakers, and practitioners aiming to improve patient safety, offering a comprehensive understanding of PSC components and strategies for enhancement. This study contributes to efforts to create safer healthcare environments and improve patient outcomes by bridging the gap between theory and practice, underscoring the necessity of integrated, continuous approaches to PSC.
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References
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- Al Muharraq, E. H., Abdali, F., Alfozan, A., Alallah, S., Sayed, B., & Makakam, A. (2024). Exploring the perception of safety culture among nurses in Saudi Arabia. BMC Nursing, 23(1), Article 412. https://doi.org/10.1186/s12912-024-02077-7
- Ali, M., Sewunet, A., Shumiye, M., & Hamza, A. (2024). Patient safety culture and associated factors among healthcare workers in south Wollo zone public hospitals, northeast Ethiopia. Perioperative Care and Operating Room Management, 35, Article 100374. https://doi.org/10.1016/j.pcorm.2024.100374
- Alsulami, A., A’aqoulah, A., & Almutairi, N. (2022). Patient safety culture awareness among healthcare providers in a tertiary hospital in Riyadh, Saudi Arabia. Frontiers in Public Health, 10, Article 953393. https://doi.org/10.3389/fpubh.2022.953393
- Arbianti, K. (2023). Patient safety culture analysis in dental hospital using dental office survey on patient safety culture questionnaire: A cross-cultural adaptation and validation study. Journal of Patient Safety, 19(7), 429-438. https://doi.org/10.1097/pts.0000000000001153
- Bartoníčková, D., Kohanová, D., Žiaková, K., Młynarska, A., Kolarczyk, E., & Steven, A. (2024). Nursing students’ evaluation of patient safety culture in three central European countries: A cross-sectional study. International Journal of Nursing Education Scholarship, 21(1). https://doi.org/10.1515/ijnes-2023-0084
- Batalha, E. M. S. D. S., Borges, E. M. D. N., & Melleiro, M. M. (2024). Association between patient safety culture and professional quality of life among nursing professionals. Revista da Escola de Enfermagem da USP, 58, Article e20230359. https://doi.org/10.1590/1980-220X-REEUSP-2023-0359en
- Brás, C. P. D. C., Figueiredo, M. D. C. A. B. D., & Ferreira, M. M. C. (2024). Safety culture in maternity hospital: Perception of nurse-midwives. Journal of Advanced Nursing, 80(5), 2091-2105. https://doi.org/10.1111/jan.15969
- Çatal, A. T., Cebeci, F., & Uçak, A. (2024). Intern nursing students’ perceptions of patient safety culture and their experiences with factors affecting the safety of care in hospital settings: A mixed method study. Nurse Education Today, 135, Article 106120. https://doi.org/10.1016/j.nedt.2024.106120
- Diriba, D. C., & Tilahun, T. (2024). Nurses’ perception of the hospitals’ culture and readiness of evidence-based practice integration in the hospital’s system in western Ethiopia. BMC Nursing, 23(1), Article 103. https://doi.org/10.1186/s12912-024-01741-2
- Farokhzadian, J., Eskici, G. T., Molavi-Taleghani, Y., Tavan, A., & Farahmandnia, H. (2024). Nursing students’ patient safety competencies in the classroom and clinical settings: A cross-sectional study. BMC Nursing, 23(1), Article 47. https://doi.org/10.1186/s12912-024-01708-3
- Fassi, C. F., Mourajid, Y., Azilagbetor, D. M., Sabri, A., Chahboune, M., & Hilali, A. (2024). Assessment of patient safety culture in Moroccan primary health care: A multicentric study. BMC Nursing, 23(1), Article 189. https://doi.org/10.1186/s12912-024-01864-6
- Finn, M., Walsh, A., Rafter, N., Mellon, L., Chong, H. Y., Naji, A., O’Brien, N., Williams, D. J., & McCarthy, S. E. (2024). Effect of interventions to improve safety culture on healthcare workers in hospital settings: A systematic review of international literature. BMJ Open Quality, 13(2), Article e002506. https://doi.org/10.1136/bmjoq-2023-002506
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- Hassan, A. E., Mohammed, F. A., Zakaria, A. M., & Ibrahim, I. A. (2024). Evaluating the effect of TeamSTEPPS on teamwork perceptions and patient safety culture among newly graduated nurses. BMC Nursing, 23(1), Article 170. https://doi.org/10.1186/s12912-024-01850-y
- Hassan, N. A. H., Rahman, H. A., Knights, J., Hashim, S., Sharbini, S., & Abdul-Mumin, K. H. (2024). Cultivating patient safety culture in midwifery practices through incident reporting. British Journal of Midwifery, 32(7), 388-394. https://doi.org/10.12968/bjom.2024.32.7.388
- Herak, I. (2023). Zdravstvena njega i njezin utjecaj na kulturu sigurnosti. Sestrinski Glasnik/Nursing Journal, 28(2), 96-104. https://doi.org/10.11608/sgnj.28.2.4
- Huang, C., Wu, H., & Lee, Y. (2023). A comparative study on patient safety culture among high-risk hospital staff in the context of the COVID-19 and non-COVID-19 pandemic: A cross-sectional study in Taiwan. Frontiers in Public Health, 11, Article 1200764. https://doi.org/10.3389/fpubh.2023.1200764
- Kiljunen, O., Savela, R.-M., Välimäki, T., & Kankkunen, P. (2024). Managers’ perceptions of the factors affecting resident and patient safety work in residential settings and nursing homes: A qualitative systematic review. Research in Nursing and Health, 47(4), 397-408. https://doi.org/10.1002/nur.22382
- Kim, J., Jang, S., Gilbert, J., & Cruickshank, M. (2020). A critical appraisal of what organisational approaches are pivotal to improve patient safety. Journal of Hospital Administration, 9(1), 26. https://doi.org/10.5430/jha.v9n1p26
- Lee, S., & Dahinten, V. (2021). Using dominance analysis to identify the most important dimensions of safety culture for predicting patient safety. International Journal of Environmental Research and Public Health, 18(15), 7746. https://doi.org/10.3390/ijerph18157746
- Li, Z.-Y., Yang, Y.-P., Wang, Q., Zhang, M.-X., Luo, C.-W., Zhu, L.-F., Tung, T.-H., & Chen, H.-X. (2024). Association between abusive supervision and nurses’ withholding voice about patient safety: The roles of impression management motivation and speak up-related climate. BMC Nursing, 23(1), Article 256. https://doi.org/10.1186/s12912-024-01921-0
- Mehralian, G., Yusefi, A. R., Ahmadinejad, P., Bahmaei, J., & Bordbar, S. (2024). Investigating theprofessional commitment and its correlation with patient safety culture and patient identification errors: Evidence from a cross-sectional study from nurses’ perspectives. Open Public Health Journal, 17, Article e18749445292305. https://doi.org/10.2174/0118749445292305240416101923
- Mistri, I. (2023). Enhancing patient safety culture in hospitals. Cureus. https://doi.org/10.7759/cureus.51159
- O’Brien, N., Soomro, M., Shaw, A., Latif, K., Wu, Y., Ahmed, Z., & Durkin, M. (2024). Regional perspectives on patient safety policies and initiatives: A focus group study with patient safety leaders in the Middle East and Asian regions. BMJ Open Quality, 13, Article e002573. https://doi.org/10.1136/bmjoq-2023-002573
- Reyes Ramos, M. J., & Costa Abós, S. (2024). Patient safety culture: Nurses’ perspective in the hospital setting. Healthcare (Switzerland), 12(10), Article 1010. https://doi.org/10.3390/healthcare12101010
- Sani, M. M., Jafaru, Y., Ashipala, D. O., & Sahabi, A. K. (2024). Influence of work-related stress on patient safety culture among nurses in a tertiary hospital: A cross-sectional study. BMC Nursing, 23(1), Article 81. https://doi.org/10.1186/s12912-023-01695-x
- Venny, V. (2024). The influence of healthcare practitioners’ attitudes, the role of teamwork, and the physical environment on patient safety culture in Jakarta hospitals. Eduvest - Journal of Universal Studies, 4(5), 4079-4090. https://doi.org/10.59188/eduvest.v4i5.1234
References
Abel, C., Ezechi, O., & Folahanmi, A. (2023). Assessing patient safety culture among healthcare professionals in Ibadan South-West region of Oyo State, Nigeria. Journal of Patient Safety and Risk Management, 28(3), 116-125. https://doi.org/10.1177/25160435231172826
Al Muharraq, E. H., Abdali, F., Alfozan, A., Alallah, S., Sayed, B., & Makakam, A. (2024). Exploring the perception of safety culture among nurses in Saudi Arabia. BMC Nursing, 23(1), Article 412. https://doi.org/10.1186/s12912-024-02077-7
Ali, M., Sewunet, A., Shumiye, M., & Hamza, A. (2024). Patient safety culture and associated factors among healthcare workers in south Wollo zone public hospitals, northeast Ethiopia. Perioperative Care and Operating Room Management, 35, Article 100374. https://doi.org/10.1016/j.pcorm.2024.100374
Alsulami, A., A’aqoulah, A., & Almutairi, N. (2022). Patient safety culture awareness among healthcare providers in a tertiary hospital in Riyadh, Saudi Arabia. Frontiers in Public Health, 10, Article 953393. https://doi.org/10.3389/fpubh.2022.953393
Arbianti, K. (2023). Patient safety culture analysis in dental hospital using dental office survey on patient safety culture questionnaire: A cross-cultural adaptation and validation study. Journal of Patient Safety, 19(7), 429-438. https://doi.org/10.1097/pts.0000000000001153
Bartoníčková, D., Kohanová, D., Žiaková, K., Młynarska, A., Kolarczyk, E., & Steven, A. (2024). Nursing students’ evaluation of patient safety culture in three central European countries: A cross-sectional study. International Journal of Nursing Education Scholarship, 21(1). https://doi.org/10.1515/ijnes-2023-0084
Batalha, E. M. S. D. S., Borges, E. M. D. N., & Melleiro, M. M. (2024). Association between patient safety culture and professional quality of life among nursing professionals. Revista da Escola de Enfermagem da USP, 58, Article e20230359. https://doi.org/10.1590/1980-220X-REEUSP-2023-0359en
Brás, C. P. D. C., Figueiredo, M. D. C. A. B. D., & Ferreira, M. M. C. (2024). Safety culture in maternity hospital: Perception of nurse-midwives. Journal of Advanced Nursing, 80(5), 2091-2105. https://doi.org/10.1111/jan.15969
Çatal, A. T., Cebeci, F., & Uçak, A. (2024). Intern nursing students’ perceptions of patient safety culture and their experiences with factors affecting the safety of care in hospital settings: A mixed method study. Nurse Education Today, 135, Article 106120. https://doi.org/10.1016/j.nedt.2024.106120
Diriba, D. C., & Tilahun, T. (2024). Nurses’ perception of the hospitals’ culture and readiness of evidence-based practice integration in the hospital’s system in western Ethiopia. BMC Nursing, 23(1), Article 103. https://doi.org/10.1186/s12912-024-01741-2
Farokhzadian, J., Eskici, G. T., Molavi-Taleghani, Y., Tavan, A., & Farahmandnia, H. (2024). Nursing students’ patient safety competencies in the classroom and clinical settings: A cross-sectional study. BMC Nursing, 23(1), Article 47. https://doi.org/10.1186/s12912-024-01708-3
Fassi, C. F., Mourajid, Y., Azilagbetor, D. M., Sabri, A., Chahboune, M., & Hilali, A. (2024). Assessment of patient safety culture in Moroccan primary health care: A multicentric study. BMC Nursing, 23(1), Article 189. https://doi.org/10.1186/s12912-024-01864-6
Finn, M., Walsh, A., Rafter, N., Mellon, L., Chong, H. Y., Naji, A., O’Brien, N., Williams, D. J., & McCarthy, S. E. (2024). Effect of interventions to improve safety culture on healthcare workers in hospital settings: A systematic review of international literature. BMJ Open Quality, 13(2), Article e002506. https://doi.org/10.1136/bmjoq-2023-002506
Gómez-Moreno, C., Vélez-Vélez, E., Garrigues Ramón, M., Rojas Alfaro, M., & García-Carpintero Blas, E. (2024). Patient safety in surgical settings: A study on the challenges and improvement strategies in adverse event reporting from a nursing perspective. Journal of Clinical Nursing, 33(6), 2324-2336. https://doi.org/10.1111/jocn.17047
Hassan, A. E., Mohammed, F. A., Zakaria, A. M., & Ibrahim, I. A. (2024). Evaluating the effect of TeamSTEPPS on teamwork perceptions and patient safety culture among newly graduated nurses. BMC Nursing, 23(1), Article 170. https://doi.org/10.1186/s12912-024-01850-y
Hassan, N. A. H., Rahman, H. A., Knights, J., Hashim, S., Sharbini, S., & Abdul-Mumin, K. H. (2024). Cultivating patient safety culture in midwifery practices through incident reporting. British Journal of Midwifery, 32(7), 388-394. https://doi.org/10.12968/bjom.2024.32.7.388
Herak, I. (2023). Zdravstvena njega i njezin utjecaj na kulturu sigurnosti. Sestrinski Glasnik/Nursing Journal, 28(2), 96-104. https://doi.org/10.11608/sgnj.28.2.4
Huang, C., Wu, H., & Lee, Y. (2023). A comparative study on patient safety culture among high-risk hospital staff in the context of the COVID-19 and non-COVID-19 pandemic: A cross-sectional study in Taiwan. Frontiers in Public Health, 11, Article 1200764. https://doi.org/10.3389/fpubh.2023.1200764
Kiljunen, O., Savela, R.-M., Välimäki, T., & Kankkunen, P. (2024). Managers’ perceptions of the factors affecting resident and patient safety work in residential settings and nursing homes: A qualitative systematic review. Research in Nursing and Health, 47(4), 397-408. https://doi.org/10.1002/nur.22382
Kim, J., Jang, S., Gilbert, J., & Cruickshank, M. (2020). A critical appraisal of what organisational approaches are pivotal to improve patient safety. Journal of Hospital Administration, 9(1), 26. https://doi.org/10.5430/jha.v9n1p26
Lee, S., & Dahinten, V. (2021). Using dominance analysis to identify the most important dimensions of safety culture for predicting patient safety. International Journal of Environmental Research and Public Health, 18(15), 7746. https://doi.org/10.3390/ijerph18157746
Li, Z.-Y., Yang, Y.-P., Wang, Q., Zhang, M.-X., Luo, C.-W., Zhu, L.-F., Tung, T.-H., & Chen, H.-X. (2024). Association between abusive supervision and nurses’ withholding voice about patient safety: The roles of impression management motivation and speak up-related climate. BMC Nursing, 23(1), Article 256. https://doi.org/10.1186/s12912-024-01921-0
Mehralian, G., Yusefi, A. R., Ahmadinejad, P., Bahmaei, J., & Bordbar, S. (2024). Investigating theprofessional commitment and its correlation with patient safety culture and patient identification errors: Evidence from a cross-sectional study from nurses’ perspectives. Open Public Health Journal, 17, Article e18749445292305. https://doi.org/10.2174/0118749445292305240416101923
Mistri, I. (2023). Enhancing patient safety culture in hospitals. Cureus. https://doi.org/10.7759/cureus.51159
O’Brien, N., Soomro, M., Shaw, A., Latif, K., Wu, Y., Ahmed, Z., & Durkin, M. (2024). Regional perspectives on patient safety policies and initiatives: A focus group study with patient safety leaders in the Middle East and Asian regions. BMJ Open Quality, 13, Article e002573. https://doi.org/10.1136/bmjoq-2023-002573
Reyes Ramos, M. J., & Costa Abós, S. (2024). Patient safety culture: Nurses’ perspective in the hospital setting. Healthcare (Switzerland), 12(10), Article 1010. https://doi.org/10.3390/healthcare12101010
Sani, M. M., Jafaru, Y., Ashipala, D. O., & Sahabi, A. K. (2024). Influence of work-related stress on patient safety culture among nurses in a tertiary hospital: A cross-sectional study. BMC Nursing, 23(1), Article 81. https://doi.org/10.1186/s12912-023-01695-x
Venny, V. (2024). The influence of healthcare practitioners’ attitudes, the role of teamwork, and the physical environment on patient safety culture in Jakarta hospitals. Eduvest - Journal of Universal Studies, 4(5), 4079-4090. https://doi.org/10.59188/eduvest.v4i5.1234
