Table 2A.
Characteristics of patient safety culture and major findings (N = 21).
| References | Country | Study design | Setting | Participant | Instrument | Major findings | ||
|---|---|---|---|---|---|---|---|---|
| Positive results | Negative results | Predictors of safety culture | ||||||
| Aini (30) | Indonesia | Cross-sectional | Individual hospital | Nurses (N = 149) |
The Modify Safety Attitudes Questionnaire | Not applicable | Not applicable | The significance values of workload and work stress were both significant (p < 0.001) |
| Wijaya et al. (31) | Indonesia | Quasi-experimental study | Individual hospital | Healthcare providers (Intervention group = 87 Control group = 103) |
The Hospital Survey on Patient Safety Culture | Teamwork within unit (80%) Supervisor/manager expectations and actions promoting patient safety (77%) Organizational learning and continuous improvement (75%) |
Handoffs and transitions (63%) Non-punitive responses to an error (63%) Staffing (68%) |
The treatment significantly increased the patient safety culture (β = 0.738, SE = 0.258, p = 0.007) |
| Setiowati (21) | Indonesia | Cross-sectional | Individual hospital | Head nurses (N = 30) |
Patient Safety Culture Questionnaires developed by the researcher | Most participants were enough to apply patients' safety culture (64.5%) | Head nurses had low level of patients' safety culture application (7.6%) | There was a relationship between head nurses' transformational leadership and the implementation of patient safety culture |
| Buhari et al. (22) | Indonesia | Cross-sectional | Two accredited hospitals | Nurses (N = 226) |
Safety Attitudes Questionnaire | Teamwork climate (73%) Job satisfaction (68.1%) |
Working condition (44.2%) Stress recognition (52.2%) |
Significant relationships were found between teamwork, safety culture, stress, management, and working condition with the implementation of patient safety practices (p < 0.001 to 0.017), whereas job satisfaction was non-significantly related to patient safety (p = 0.928) |
| Harsul et al. (32) | Indonesia | Cross-sectional | Individual hospital | Nurses (N = 100) |
The Hospital Survey on Patient Safety Culture | Feedback and communication about error (57%) | Overall perceptions of safety (30%) Frequency of event reporting (48%) |
Self-efficacy was non-significantly correlated with the culture of patient safety incident reporting (p = 0.116) |
| Iriviranty (14) | Indonesia | Mixed-methods | Healthcare providers (N = 152) |
The Hospital Survey on Patient Safety Culture | Teamwork within units (91.67%) Organizational learning and continuous improvement (89.8%) Supervisor/manager expectations and actions promoting patient safety (73.03%) |
Staffing (22.7%) Non-punitive responses to an error (37.13%) Hospital handoffs and transitions (52.98%) |
Not applicable | |
| Kusumawati et al. (33) | Indonesia | Cross-sectional | Three hospitals | Nurses (N = 400) |
The Hospital Survey on Patient Safety Culture | Teamwork within units (82.84%) Organizational learning and continuous improvement (79%) Feedback and communication about error (76.4%) |
Staffing (64.5%) Overall perceptions of patient safety (70.42%) Hospital handoffs and transitions (73.5%) |
Significant relationships existed between patient safety culture and nurses' attitudes toward incident reporting (r = 0.838, p = 0.005) |
| Wijaya et al. (34) | Indonesia | Quasi-experimental study | Three hospitals | Healthcare providers (N = 484) |
The Hospital Survey on Patient Safety Culture | Teamwork within units Organization learning-continuous improvement |
Teamwork across units Handoffs and transitions |
Shift schedule realignment was associated with patient cultural safety |
| Samsuri et al. (35) | Malaysia | Cross-sectional | 3 public hospitals and 27 health clinics | Pharmacists (N = 117) |
Safety Attitudes Questionnaire | Stress recognition (58.1%) Job satisfaction (46.2%) |
Working conditions (15.4%) Safety climate (33.3%) |
Not applicable |
| Alex Kim et al. (20) | Malaysia | Cross-sectional | Individual hospital | Healthcare providers (N = 500) |
The Hospital Survey on Patient Safety Culture | Organizational learning and continuous improvement (80%) | Non-punitive responses to an error (18%) Staffing (18%) |
Not applicable |
| Odu et al. (36) | Malaysia | Cross-sectional | Individual university | Educators (N = 44) |
The Modify Safety Attitude Questionnaire | 42.5% had positive attitudes toward safety culture | 27.5% participants had good knowledge of safety culture, and 32.5% practiced safety culture | Factors that were significantly associated with safety culture practice were job title (p =0.041) and length of service (p = 0.010). Age (p = 0.039) was significantly associated with safety practice |
| Jabonete and Concepcion (17) | Philippines | Cross-sectional | 4 hospitals | Healthcare providers (N = 530) |
Manchester Patient Safety Culture Assessment Tool | At proactive level, personnel management (69%), system errors and individual responsibility (66%), and learning and effecting change (61%) | At proactive level, dimensions of patient safety culture was low level including priority given to safety (47%), recording incidents (44%), and teamwork (40%) | Age group was significantly different among healthcare providers who perceived safety culture at reactive (F-5.45), bureaucratic (F-4.26), and proactive (F-3.66) maturity levels. Job position was found significantly different to those who perceived it at generative (F-3.95) level. Only participants who have perceived safety culture at reactive (F-2.26) level have significant differences in their scores together with length of experience at reactive (F-2.86) level. A significant difference was found to type of hospital to almost all safety culture level except at bureaucratic level. |
| Ramos and Calidgid (19) | Philippines | Cross-sectional | Individual hospital | Nurses (N = 292) |
The Hospital Survey on Patient Safety Culture | Teamwork within units (91.50%) Organizational learning and continuous improvement (86.89%) Supervisor/manager expectations and actions promoting patient safety (67.34%) |
Non-punitive responses to an error (17.65%) Staffing (27.55%) Overall perceptions of safety (50.78%) |
Not applicable |
| Koh et al. (37) | Singapore | Cross-sectional | Healthcare providers (N = 600) |
Patient Safety Culture Questionnaires developed by the researcher | 88.0 and 85.6% agreed that clinical quality and patient safety are important and relevant to their work | 36.2% of participants intervened when they see unsafe practice and 27.2% saw the importance of reporting near-miss events | Not applicable | |
| Phasinee Koetbungphra (38)* | Thailand | Cross-sectional | Individual hospital | Healthcare providers (N = 176) | The Hospital Survey on Patient Safety Culture | Supervisor/manager expectations and actions promoting patient safety (M = 3.91 ± 0.51) Organizational learning and continuous improvement (M = 3.82 ± 0.46) Teamwork within units (M = 3.80 ± 0.50) |
Staffing (M = 3.43 ± 0.59) Hospital management support for patient safety (M = 3.63 ± 0.62) Non-punitive response to an error (M = 3.54 ± 0.63) |
Administrators, teamwork, employees' responsibilities of patient safety, work environment, and experience of receiving training on patient safety predicted patient safety culture |
| Potaya (39)* | Thailand | Cross-sectional | Individual hospital | Healthcare providers (N = 664) |
The Hospital Survey on Patient Safety Culture | Teamwork within units (M = 4.27 ± 0.48) Organizational learning and continuous improvement (M = 4.11 ± 0.42) Supervisor/manager expectations and actions promoting patient safety (M = 4.09 ± 0.51) |
Non-punitive responses to an error (M = 3.06 ± 0.85) Teamwork across hospital units (M = 3.07 ± 0.69) Staffing (M = 3.23 ± 0.70) |
Executive nurses had significantly higher patient safety culture scores than did staff nurses (p = 0.006) |
| Sukhnim et al. (40) | Thailand | Cross-sectional | Individual hospital | Healthcare providers (N = 380) |
The Hospital Survey on Patient Safety Culture | Organizational learning and continuous improvement | Staffing (M = 3.10 ± 0.74) Non-punitive response to an error (M = 3.13 ± 0.90) Hospital handoffs and transitions (M = 3.12 ± 0.75) |
Not applicable |
| Sayamol (41)* | Thailand | Cross-sectional | Individual hospital | Nurses (N = 102) |
Patient Safety Culture Questionnaires was modified by the researcher based on framework of Nieva and Sorra (43) | Hospital handoffs and transitions (M = 4.48 ± 0.57) Communication openness (4.47 ± 0.46) Feedback and communication about errors (M = 4.22 ± 0.69) |
Non-punitive responses to an error (M = 3.15 ± 0.92) Staffing (M = 2.08 ± 0.82) Hospital management support for patient safety (M = 3.19 ± 0.43) |
A significant positive and moderate correlation was found between patient safety culture and nursing service quality (r = 0.462, p < 0.01). |
| Somporn et al. (42)* | Thailand | Cross-sectional | Regional and general hospitals | Nurses (N = 500) |
The Hospital Survey on Patient Safety Culture | Supervisor/manager expectations and actions promoting patient safety Teamwork within units |
Supervisor/manager expectations and actions Teamwork across units |
Teamwork in support for safety culture did non-significantly differ (p = 0.11) between nurses from regional hospitals and those from general hospitals |
| Luong (16) | Vietnam | Cross-sectional | 10 hospitals | Healthcare providers (N = 1,500) |
The Hospital Survey on Patient Safety Culture | Teamwork within hospital units (81%) Organizational learning and continuous improvement (75%) Hospital management support for patient safety (72%) |
Non-punitive response to an error (44%) Hospital handoffs and transitions (47%) Staffing (55%) |
Not applicable |
| Nguyen (15) | Vietnam | Cross-sectional | Two urban public hospitals | Nurses (N = 189) |
The Safety Attitudes Questionnaire | Teamwork climate (51.4–93.8) Working conditions (50.0–94.1) |
Stress recognition (7.1–57.1) Safety climate (21.1–81.3) |
Not applicable |
*
Originally written in Thai language with English abstract and converted to English for analysis.