|
HSPSC, 2019, Saudi Arabia [12]
|
Investigate the perceptions of healthcare professionals toward PSC in hospitals throughout the Hail region |
Variety of healthcare professionals (nurses, physicians, and administrators/managers) considered for collecting data. Response rate among participants was 99.22%
|
Only four hospitals considered for data collection. |
Healthcare professionals have a positive perception of patient safety. Organizational learning was the strongest area in PSC. Professionals with a greater number of employment years were more willing to communicate. Among respondents, 63.53% stated that they had never reported a case of patient safety. The low rate of reported cases was attributed to fear of the cases being recorded in the respondent’s file.
|
32 |
|
HSPSC, 2012, Saudi Arabia, [13]
|
Identify general strengths and recognize areas of patient safety improvements |
Variety of clinical and medical staff (physicians, nurses, technicians, pharmacists, and others) considered.
|
Response rate among participants was 61%.
Only two general hospitals considered |
Organizational learning/continuous improvement and teamwork within units received positive outcomes at 79% and 77%, respectively. Non-punitive responses to errors and staffing had low positive response rates at 22% and 31%, respectively, representing areas for improvement. The overall percentage of positive responses among dimensions of patient safety was 58%.
|
27 |
|
HSPSC, 2016, Turkey, [14]
|
Explore and describe nurses’ perceptions of PSC |
|
Only nurses in four hospitals (one university hospital and three general hospitals), and nurses consiered for collecting data |
The mean positive response rate for the 12 PSC dimensions of the HSPSC survey was 52%. Within units and organizational learning/continuous improvement were reported. Non-punitive responses to errors and frequency of event reporting were areas for improvement. Nurses who had worked for more than 10 years in their profession showed significantly higher PSC scores in all dimensions. Nurses working in ICUs had higher scores than those working in other units in all patient safety dimensions. 50.2% of the nurses rated the level of patient safety as good or excellent. Among nurses, 80.4% indicated that they had never reported an error. The overall perception of patient safety was 51%.
|
27 |
|
HSPSC, 2012, Egypt, [15]
|
Assess PSC perceptions among healthcare providers and identify factors that may critically affect PSC |
Variety of healthcare professionals (doctors, nurses, and technicians) considered HSPSC Arabic version used.
|
No response rate reported |
An average of 52% was attained for positive responses for the 12 PSC dimensions of the HSPSC survey. Non-punitive responses to errors had 24.2% while frequency of event reporting and staffing were 28.4% and 38.4%, respectively. Poor teamwork across units was identified as having a low response of 48.8%. Areas for improvement included organizational learning, handoffs and transitions, communication, and support from management. Patients started reporting errors after being educated, demonstrating the accusatory culture.
|
27 |
|
HSPSC, 2013, Saudi Arabia, [16]
|
Identify factors that nurses perceive as contributing to the PSC |
|
Only Nurses in one Tertiary care hospital
considered for collecting data. |
Continuous organization learning and management support formed the best areas for the support of patient safety. Other variables such as reporting errors, staffing, and communication required improvement for better patient safety. Respondent variables such as gender, level of education, age, years of experience, length of shifts, and Arabic versus non-Arabic language created a variance in patient safety consideration. Among the nurses interviewed, patient safety was rated as good or excellent.
|
28 |
|
HSPSC, 2012, Egypt, [17]
|
Assess healthcare providers’ perceptions of PSC within the organization and determine factors that play a role in PSC |
Variety of healthcare professionals (physicians, nurses, pharmacists, technicians, and staff) considered. Response rate was 69.1% HSPSC Arabic version used.
|
|
Dimensions with the highest scores included continuous learning and teamwork, reported at 78.2% and 58.1%, respectively. Non-punitive responses to errors had the lowest score of 19.5%, representing a dimension that requires improvement. Adverse event reporting and recording was reported at 33.4%. The hospital is a training institution, exhibiting a bias for continuous learning and low error reporting, as errors are recorded in files.
|
29 |
|
HSPSC, 2013, Iran, [18]
|
Assess the PSC at Islamic Azad University hospitals |
Variety of clinical and diagnostic staff (physicians, nurses, midwives, assistants, staff, and radiologists) considered. Response rate was 87.5%. HSPSC Persian version used.
|
|
Teamwork within units scored 48% while non-punitive error responses scored 12%. Areas identified for improvement included staffing and non-punitive responses to errors. Among respondents, 35% had a positive view of patient safety.
|
24 |
|
HSPSC, 2013. Palestine, [19]
|
Assess the prevalent PSC in Palestinian public hospitals |
Variety of clinical and non-clinical hospital staff (physicians, nurses, paramedical and support services, hospital managers, and supervisors) considered. HSPSC Arabic version used.
|
Response rate was 51.2% |
Dimensions with the highest scores were teamwork within units, organizational learning/continuous improvement, and supervisor/manager expectations and actions promoting patient safety at 71%, 62%, and 56%, respectively. Non-punitive response to errors, frequency of reporting, communication, management support, and staffing had low scores at 17%, 35%, 36%, 37%, and 38%, respectively. Among respondents, 53.2% had not reported any errors in the past year. General patient safety was ranked as excellent or very good by 63.5% of the respondents.
|
25 |
|
HSPSC, 2010, Saudi Arabia, [20]
|
Evaluate the extent to which the culture supports patient safety at
Saudi hospitals |
Variety of health professionals (nurses; physicians/physicians in training; pharmacists; dieticians; unit assistants/clerks/secretaries; respiratory therapists; physical, occupational, or speech therapists; technicians [lab, radiology] administration/management) in 13 general hospitals (9 public and 4 private) considered.
|
|
General patient safety was rated as very good by 60%, acceptable by 33%, and poor by 7% of the respondents. Composites that showed strength included continuous improvement, feedback, teamwork within units, and feedback and communication about errors. Staffing, under-reporting of errors, non-punitive response to errors, and teamwork across hospital units had low scores.
|
31 |
|
HSPSC, 2019, Saudi Arabia, [21]
|
Evaluate the PSC in Saudi hospitals and
improve patient safety and quality of care by implementing safety systems and creating a culture of safety |
Variety of hospital workers (physicians; nurses; pharmacists; dieticians; unit assistants/clerks/secretaries; respiratory therapists; physical, occupational, and speech therapists; technicians [e.g.,lab, radiology], administration/management) considered
|
Only one Tertiary hospital considered |
Feedback and communication about errors had high scores, ranging from 40.7%–71.3%. Leadership, communication openness, error reporting, and teamwork across units represented areas requiring improvement.
|
25 |
|
HSPSC, 2018, Kuwait, [22]
|
Examine the association between the predictors and outcomes of PSC |
Variety of employees (physicians, nurses, pharmacy and laboratory staff, dietary and radiology staff, supervisors, and hospital managers) in 16 public hospitals considered
|
Response rate was 60.5% |
Continuous improvement, teamwork within units, management support for patient safety, feedback and communication about errors, and supervisor/manager expectations and actions promoting patient safety were highly scored among the respondents. General perception of patient safety was scored at 60.6% while frequency of events reported was scored at 59.0%.
|
33 |
|
HSPSC, 2012, Saudi Arabia, [23]
|
Perform an unbiased assessment of the impact of accreditation on PSC |
|
Only nurses in one university hospital
considered for collecting data |
|
30 |
|
HSPSC, 2017, Saudi Arabia, [24]
|
Reassess PSC in a large multi-site healthcare
facility in Riyadh, Kingdom of Saudi Arabia, and compare it with an earlier assessment conducted in 2012, benchmarked against regional and international studies |
Variety of health professionals (physicians, registered nurses, other clinical or non-clinical staff, pharmacists, laboratory technicians, dietary department staff, radiologists, and administrative staff such as managers and supervisors) considered. The results comparied with U.S.
|
Only one Tertiary care teaching hospital considered.
Response rate was 56.7% |
Teamwork within units and organizational learning/continuous improvement were strong areas while staffing and non-punitive responses to errors required improvement. A high level of correlation was observed among feedback, managerial support, organizational learning, and improved patient safety. Improvements in dimensions of patient safety from 2012 to 2015 indicated an improvement in performance. Overall perceptions of patient safety were reported at 59.5%. The frequency of reporting events was 68.8%.
|
33 |
|
HSPSC, 2014, Iran, [25]
|
Assess the safety culture in two educational hospitals |
|
Only nurses in two teaching
hospitals considered |
Non-punitive response to errors, frequency of events reported, and staffing had the lowest positive scores of patient safety dimensions. Among nurses from Afshar and Firoozgar Hospitals, 29% reported positive perceptions of patient safety.
|
29 |
|
HSPSC, 2015, Jordan, [26]
|
Assess PSC in Jordanian hospitals from nurses’ perspectives |
Response rate was 82.2%. 21 hospitals (2 university hospitals, 4 private hospitals, and 15 governmental hospitals) considered. HSPSC Arabic version used.
|
Only nurses considered |
A high positive response was reported for teamwork within units while teamwork across units, handoffs and transitions, communication openness, and non-punitive response to errors needed improvement. Nurses in government hospitals had lower perceptions of patient safety compared with nurses in university hospitals. Overall perceptions of patient safety were reported at 60.07%. Frequency of events reported was 69.15%.
|
34 |
|
SAQ, 2017, Palestine, [27]
|
Assess the perception of nurses regarding PSC and determine whether it is significantly affected by the nurses’ position, age, experience, and working hours |
Response rate was 91.9%. SAQ Arabic version used
|
Only nurses in four public general hospitals considered |
Job satisfaction and perception of management were the top variables affecting patient safety. Variables such as age, nursing position, working hours, and work experience created a variance in PSC perception. Front-line clinicians had a less positive attitude towards patients when compared with nurse managers. The longer the working experience, the higher the likelihood of having a positive attitude towards patient safety Nurses who worked the minimum weekly hours and who were 35 years or older had better attitudes towards all patient safety dimensions except for stress recognition.
|
33 |
|
HSPSC, 2015, Oman, [28]
|
Investigate nurses’ perceptions of PSC and identify the factors needed to develop and maintain a culture of safety among
nurses |
|
Only nurses in four governmental
hospitals considered.
No Response rate reported. |
Feedback and communication about errors, continuous learning, and teamwork within units received high positive scores. Staffing, non-punitive response to errors, and management support attained low positive scores among the respondents. An increased number of years of experience combined with working in a teaching hospital increased the perception of PSC. The rate of positive perceptions of safety was 50.7% among respondents. Frequency of events reported stood at 58.8%.
|
33 |
|
HSPSC, 2014, Oman, [29]
|
Illustrate the PSC in Oman and compare the average positive response rates in PSC between Oman and the U.S., Taiwan, and Lebanon |
Variety of health professionals (nurses, physicians, technicians, pharmacists, physiotherapists, and dieticians) considered. The results compared with U.S., Taiwan, and Lebanon
|
Only five secondary and tertiary care hospitals considered.
No Response rate reported. |
Organizational learning/continuous improvement had the highest positive score. Non-punitive response to errors was poorly rated among respondents. Response rates in Oman, Taiwan, the U.S., and Lebanon were similar. The overall average positive response rate was 58%. Overall perception of patient safety was 53%. Frequency of event reporting was 65%.
|
33 |
|
HSPSC, 2013, Iran, [30]
|
Estimate the relation between PSC and three characteristics of teaching hospitals (number of beds, education condition, and proficiency status) |
Variety of staff (nurses, physicians, laboratory staff, radiology staff, midwives, operation room staff, and general managers without any specialty in therapeutic procedures) in 25 hospitals (11 teaching hospitals and 14 non-teaching hospitals) considered. Response rate was 76.8%
|
|
Highly scored dimensions included teamwork within units and organizational learning/continuous improvement. Non-punitive response to errors and staffing were the lowest positively scored dimensions. Overall perception of safety was 56.56%. Frequency of events reported was 42.85%.
|
29 |
|
HSPSC, 2013, Iran, [31]
|
Assess nurses’
perceptions of PSC in these hospitals |
|
Only nurses in two teaching hospital
sconsidered |
Organizational learning/continuous improvement had the highest positive score. Frequency of events reported, staffing, and non-punitive response to errors had the lowest scores of PSC dimensions. Overall perceptions of safety were 66.22% for the Afshar hospital and 59.5% for the Firouzgar hospital The frequency of events reported was 34.90% for the Afshar hospital and 50.17% for the Firouzgar hospital.
|
21 |
|
HSPSC, 2014, Saudi Arabia, [32]
|
Present findings of a baseline assessment of PSC, compare results with regional and
international studies, and explore the association between PSC predictors and outcomes, considering respondent characteristicsand facility size |
Variety of staff (physicians, nurses, clinical and non-clinical staff, pharmacy and laboratory staff, dietary and radiology staff, supervisors, and hospital managers) considered. Response rate 85.7% reported. The results compared with other studies using HSPSC Arabic version
|
Only one tertiary care university teaching hospital considered |
Teamwork within units and organizational learning/continuous improvement had high positive responses. Staffing, non-punitive response to errors, and communication openness required improvement. A high correlation was indicated between smaller facilities, events reported, and patient safety levels. Overall perception of safety was 65.3%. Frequency of events reported was 59.4%.
|
34 |
|
HSPSC, 2015, Turkey, [33]
|
Investigate nurses’ perceptions of PSC |
|
Only nurses in one public hospital
considered for collecting data |
High positive scores for hospital management support and manager/supervisor expectations and actions supported an increase in patient safety. Frequency of event reporting for medical errors had the lowest positive score. Organizational learning/continuous improvement, hospital management support for patient safety, teamwork within units, and supervisor/manager received high positive scores. Hospital handoffs and transitions, non-punitive response to errors, frequency of events reported, and communication openness were poorly rated. Overall perception of safety was 61%. Frequency of events reported was 40%.
|
30 |
|
HSPSC, 2016, Iran, [34]
|
Evaluate the current status of PSC among hospitals in three central Iran provinces |
Variety of staff (doctors, nurses, administrative staff, and paramedics) in the teaching hospitals considered for collecting data.
|
No Response rate reported |
Organizational learning was reported as the strongest dimension. Handoffs and transitions had the lowest score. Overall perception of safety was 62.93%. Frequency of event reporting was 55.63%.
|
21 |
|
HSPSC, 2012, Turkey, [35]
|
Assess health personnel perspectives of PSC in a 900-bed university hospital in Ankara, Turkey |
Variety of health professionals (doctors, nurses, technicians, secretaries, and other health personnel) considered Using HSPSC Turkish version.
|
Only one university hospital considered.
Response rate was 43% |
Teamwork within units had the highest positive feedback. Frequency of events reported had the lowest average. Women nurses formed the majority of respondents, with five years or less in terms of work experience in their respective hospital. Overall perception of patient safety was 55%. Frequency of events reported was 25%.
|
21 |
|
HSPSC, 2010, Lebanon, [36]
|
Conduct a baseline assessment of PSC in Lebanese hospitals |
12,250 staff (physicians, nurses, clinical and non-clinical staff, and others) in 68 hospitals considered. The results compared with U.S. HSPSC Arabic version used.
|
Response rate was 55.56% |
Organizational learning/continuous improvement, hospital management support for patient safety, and teamwork within units were the strongest areas. Non-punitive response to errors and staffing received low feedback. Small hospitals and accredited hospitals received higher scores on several composites. Overall perception of safety was 72.5%. Frequency of events reported was 67.9%.
|
31 |
|
HSPSC, 2013, Japan and Taiwan, [37]
|
Clarify the impact of long nurse working hours on PSC in Japan, the U.S., and Chinese Taiwan using HSPSC |
14 hospitals in Japan, 884 hospitals in the U.S., 74 hospitals in Taiwan (acute care hospitals) considered. The results compared with U.S.
|
Only nurses considered for collecting data.
Response rate was Japan = 4047 (58.1%)
U.S. = 106,710 (37.0%)
Taiwan = 5714 (56.3%) |
Patient safety levels declined and number of events reported increased as working hours increased Among the 12 sub-dimensions of PSC, teamwork within units and staffing received poor ratings
|
29 |
|
HSPSC, 2013, Japan and Taiwan, [38]
|
Investigate the characteristics of PSC in Japan, Taiwan, and the U.S. |
Variety of health professionals (nurses; patient care assistants/hospital aides/care partners; physicians; pharmacists; dieticians; unit assistants/clerks/secretaries; respiratory therapists; physical, occupational, or speech therapists; technicians (EKG, lab, radiology); administration/management) in 14 hospitals in Japan, 884 hospitals in the U.S., 74 hospitals in Taiwan (acute care hospitals) The results compared with U.S.
|
Response rate in U.S. = 35.2% |
The U.S. had the highest overall positive perception of patient safety grade. Continuous improvement in Japan and the reporting of near-miss events in Taiwan received low scores compared with the other countries. Overall perceptions of patient safety in Japan, the U.S., and Taiwan were 53%, 63%, and 52%, respectively. Frequency of events reported in Japan, the U.S., and Taiwan was 68%, 61%, and 33%, respectively.
|
30 |
|
SAQ, 2015, India, [39]
|
Explore composite patient safety climate, assess various dimensions of patient safety climate in
three hospitals, and identify future directions for developing a strong safety climate |
Variety of health professionals (clinicians, postgraduates, residents, nurses, and paramedical workers) considered. Response rate was 100%
|
Only three tertiary care hospitals considered |
The study hospitals did not have disparities in the patient safety index score. Different categories of medical workers reported different levels for the perception of management and stress recognition and teamwork. A high correlation exists for perception of management and teamwork with the patient safety index score.
|
28 |
|
HSPSC, 2017, Sweden, [40]
|
Investigate the PSC in all Swedish hospitals; compare the culture among managers, physicians, registered nurses, and enrolled
nurses; and identify factors associated with high overall patient safety |
|
Only three work areas: general wards, emergency care, and psychiatry care considered.
Response rate was 47.4% |
Teamwork within units had the most positive feedback. Management support for patient safety received the lowest score. Managers had the highest score for patient safety. Registered nurses had the lowest score for patient safety. Emergency care units showed more patient safety than general wards. Overall perception of patient safety was 58%. Frequency of events reported was 54.4%.
|
30 |
|
HSPSC, 2013 Netherlands, [41]
|
Examine similarities and differences in hospital
PSC in three countries: the Netherlands, the U.S., and Taiwan |
Variety of staff (nursing staff, medical staff, management and administrative staff, other) in 45 hospitals in the Netherlands, 622 in the U.S., and 74 in Taiwan (non-teaching and teaching hospitals) considered. Comparing the results with U.S., and Taiwan
|
U.S. Response rate was 52% |
Handoffs and transitions required improvement in all three countries. Respondents in U.S. hospitals reported higher levels of PSC than the Taiwanese and Dutch. Differences in responses were evident in hospitals in each country. Overall perceptions of patient safety in the Netherlands, Taiwan, and the U.S. were 49%, 52%, and 64%, respectively. Frequency of events reported in the Netherlands, Taiwan, and the U.S. were 36%, 31%, and 60%, respectively.
|
24 |
|
HSPSC, 2017, Pakistan, [42]
|
Present descriptive statistics for patient safety standards |
|
Only two public hospitals considered.
Response rate was 38.4% |
80% of respondents indicated there was no response to reported errors in their wards. For respondents that reported errors, an accusatory culture existed in the ward. 70% of respondents reported a lack of support. Feedback from respondents indicated that error reporting and patient safety standards were not favorable.
|
21 |
|
HSPSC, 201,, Japan, [43]
|
Examine the validity
and applicability of the HSPSC in Japan and compare the factor structure to the original U.S. study |
Variety of healthcare workers (nurses, administrative workers, physicians, technicians, dieticians, pharmacists, therapists, janitors, other) in 13 acute care general hospitals (1 university hospital and 12 teaching hospitals) considered. HSPSC Japanese version used.
|
|
The AHRQ’s 12-factor model provides the best fit to the Japanese HSPSC data for acute care hospital staff compared with two 11-factor models proposed in previous studies. The Japanese HSPSC had acceptable internal consistency for the subscales.
|
31 |
|
HSPSC, 2013, Croatia, [44]
|
Determine whether all 12 dimensions of the U.S. HSPSC are applicable, valid, and reliable for Croatian healthcare workers |
|
Only four Croatian hospitals considered.
Response rate was 32.69% |
Organizational learning/continuous improvement and staffing had low positive feedback. Confirmatory factor analysis confirmed a good fit to the original U.S. model. Overall perception of patient safety was 57%.
|
33 |
|
HSPSC, 2013, Sri Lanka, [45]
|
Assess the current PSC in a tertiary care hospital |
Considering variety of healthcare workers (administrators, consultants, postgraduate trainees, medical officers, house officers, and nursing officers)
|
Considering only one tertiary care hospital.
No Response rate reported |
Organizational learning/continuous improvement and teamwork within units had high positive scores. Staffing and workload had low scores. Patient safety overall perception was 81.3%. Frequency of event reporting was 36.3%.
|
28 |
|
HSPSC, 2012, China, [46]
|
Explore nurses’ perceptions of PSC and factors associated with those perceptions |
|
Considering only nurses in one university teaching hospital.
No Response ratereported |
Organizational learning/continuous improvement and teamwork within units had the highest scores. Low response rates were evident in perceived trustworthiness of managers, non-punitive response to errors, managers, organizational safety prioritization, managers’ safety commitment, and nurses’ years of experience in their units, which had strong correlations with PSC Overall percentage of positive responses regarding patient safety culture was 61.3%.
|
30 |
|
HSPSC, 2013, China, [47]
|
Explore the attitudes and perceptions of PSC for healthcare workers in China and compare the psychometric properties of an adapted
translation of the HSPSC in Chinese hospitals with those of the U.S. |
Considering variety of health professionals (physicians [surgical clinicians and internal clinicians] and nurses in 32 hospitals. Comparing the results with U.S. HSPSC Chinese version used.
|
|
The staffing dimension had the lowest score. Organizational learning/continuous development and teamwork within units had the highest scores. Overall perception of patient safety was 55%.
|
30 |
|
HSPSC, 2013, Slovenia, [48]
|
Study the psychometric properties of a translated version of the HSPSC in a Slovenian setting |
Considering variety of health professionals (clinical and non-clinical staff) Comparing the results with other studies HSPSC Slovene version used.
|
Considering only three acute general hospitals.
Response rate was 55% |
Units had a greater positive patient safety perception compared with hospital level. The dimensions of teamwork across units, hospital management support for patient safety, staffing, and non-punitive response to errors required improvement. Overall perception of safety was 56%. Frequency of events reported was 69%.
|
28 |
|
HSPSC, 2010, Belgium, [49]
|
Describe a PSC improvement approach in five Belgian hospitals |
3940 and 3626 staff (nurses, head nurses, nurse assistants, physicians, head physicians, junior physicians, pharmacists, pharmacy assistants, middle management, technicians, paramedical staff, other) considered. Response rates were 77% and 68%.
|
Five Belgian acute hospitals (three private hospitals
and one public hospital) |
Hospital management support for patient safety needed the most improvement. Progress was observed for supervisor expectations and actions promoting safety. Teamwork within units had the highest scores. Staffing, non-punitive response to errors, and hospital transfers and transitions received the lowest scores and did not show signs of improvement.
|
31 |
|
HSPSC, 2017, Norway, [50]
|
Explore organizational factors influencing patient safety and safety behavior among nurses and other hospital staff |
Considering 3475 health professionals [nurses (n = 750), other personnel (n = 953)] Studying PSC relationships with safety behavior. HSPSC Norwegian version used.
|
Considering only one university hospital.
Response rate was 49% |
Higher values on hospital-level dimensions positively influenced safety leadership and safety climate at the unit level. The organizational factors correlate with the dimensions and illustrate structural relationships that are relevant for variations in the perception of patient safety and safety behavior.
|
34 |
|
HSPSC, 2010, Taiwan, [51]
|
Assess the PSC in Taiwan and attempt to provide an explanation for some of the phenomena that
are unique in Taiwan |
Considering 1000 health professionals (physicians, nurses, and non-clinical staff) 42 teaching hospitals. Response rate was 78.8% Comparing the results with U.S. HSPSC Chinese version used.
|
|
Staffing had the lowest positive feedback. Teamwork within units had the highest score. Statistical examination presented differences between the U.S. and Taiwan in the dimensions of frequency of event reporting, feedback and communication about errors, and communication openness. Overall perception of safety was 65%. Frequency of event reporting was 57%.
|
35 |
|
HSPSC, 2010, U.S., [52]
|
Examine the multilevel psychometric properties of the survey |
|
Response rate was 55% |
Overall, the survey items and dimensions are psychometrically sound at the individual, unit, and hospital levels of analysis and can be used by researchers and hospitals for assessing PSC. A strong correlation existed between patient safety grade and overall perceptions of patient safety and management support for patient safety. Correlation between frequency of event reporting and non-punitive response to errors was poor.
|
33 |
|
MSI-2006, 2015, Canada, [53]
|
Examine in detail
how ease of
reporting, unit norms of openness, and participative leadership influence front-line staff perceptions of PSC within healthcare organizations |
Considering variety of health professionals (nurses, physicians, and pharmacists) in 13 hospitals. Response rate was 17%. Studying PSC relationships with using different outcomes.
|
|
Staff perception of patient safety climate was positively correlated to participative leadership, ease of reporting, and unit norms of openness. Demographic factors such as education level and age influenced perceptions of patient safety climate.
|
35 |
|
SHSQ, 2013, Scotland, [54]
|
Obtain a measure of hospital safety climate from a sample of National Health Service (NHS)
acute hospitals in Scotland and determine whether these scores are associated with worker safety behaviors
and patient and worker injuries |
Considering 8113 NHS clinical staff. Examining the validity and reliability of the instruments. Studying PSC relationships with using different outcomes.
|
Considering only six acute hospitals in Scotland.
Response rate was 23% |
Patient and worker injury measures and workers’ safety behavior had a significant influence on hospital safety climate scores. Generic safety climate items and patient-specific items had strong impacts on safety outcome measures. Overall perception of safety was 56%. Frequency of incident reporting was 56%.
|
27 |
|
HSPSC, 2018, Philippines, [55]
|
Assess PSC among nurses at a government hospital |
|
Only nurses in one tertiary government hospital considered |
Organizational learning and teamwork within units received the highest scores. Non-punitive response to errors had the lowest positive feedback. Overall perception of safety was 50.78%. Frequency of events reported was 54.12%.
|
29 |
|
HSPSC, 2011, Italy, [56]
|
Determine the level of awareness regarding PSC among health professionals working at a hospital in northern Italy |
Respondents consisting of five professional groups (directors/coordinators, physicians, nurses/midwives, physiotherapists, and technicians). HSPSC Italian version used.
|
Only one hospital in northern Italy considered. |
Teamwork within units and organizational learning/continuous improvement received the highest scores. Non-punitive response to errors received the lowest score. Overall perception of patient safety was 64%. Frequency of event reporting was 59%.
|
22 |
|
HSPSC, 2018, South Korea [57]
|
Investigate the relationships between registered nurses’ perceptions of PSC in their workplace and their patient safety competency—attitudes, skills, and knowledge |
Response rate was 79.7%. Studying PSC relationships with using different outcomes their workplace and their patient safety competency—attitudes, skills, and knowledge. Using HSPSC Korean version and the Patient Safety Competency Self-Evaluation (PSCSE)
|
Considering only nurses in in one university hospital |
A strong correlation existed between teamwork within units and overall safety competency. Attitudes had a strong correlation to teamwork across and within units, and supervisor or manager expectations. Skills had a strong correlation to learning and teamwork within units. Knowledge had a strong correlation to organizational learning.
|
28 |
|
HSPSC, 2013, Finland, [58]
|
Explore and compare nurse managers’ s’ and registered nurses views on PSC to discover whether there are differences between their views |
|
Considering only nurses in four acute care hospitals.
Response rate was 17% |
A lack of feedback was evidenced by reporting and communication errors. Expectations and actions of nurse managers at the unit level supporting patient safety had the best positive response from both groups of respondents. Nurse managers at the unit level considered suggestions from staff on how to improve patient safety. Feedback from the survey indicated inadequate hospital-level management support for patient safety.
|
27 |
|
HSPSC, 2018, India, [59]
|
Assess the perceptions of PSC among healthcare providers at a public sector tertiary care hospital in South
India |
Considering variety of health professionals (doctors, nurses, other technical staff, pharmacists, lab technicians, dialysis technicians, operation theater technicians, and dressing technicians). Response rate was 91.7%
|
Considering only one tertiary government hospital |
Organizational learning/continuous improvement, teamwork within units, and supervisor or officer-in-charge expectations received the highest positive responses while handoffs and transitions, communication openness, and frequency of event reporting received the lowest scores. Overall general perception was 60.8%. Frequency of events reported was 41.2%. Overall general perception among doctors, nurses, and technical staff was 51.6%, 52.8%, and 66.1%, respectively. Frequency of events reported among doctors, nurses, and technical staff was 31.5%, 36.7%, and 46%, respectively.
|
28 |
|
HSPSC, 2017, China, [60]
|
Use the HSPSC to survey PSC in a county hospital in Beijing to determine the strengths and weaknesses of PSC in this hospital |
Considering variety of staff (physicians, nurses, and allied health professionals). HSPSC Chinese version used.
|
Considering only one county hospital. |
Frequency of event reporting, communication openness, staffing, and overall perception of patient safety needed potential improvement. Teamwork across units received a high level of positive feedback. Physicians indicated low scores for the majority of the dimensions. Overall perception of safety was 45.0%. Frequency of event reporting was 43.0%.
|
30 |
|
PSCHO, 2015, China, [61]
|
Describe staff’s perceptions of PSC in public hospitals and
determine how perceptions of PSC differ between different types of workers in the U.S. and
China |
Considering variety of staff (managers in administrative offices and clinical departments, non-management physicians, non-management nurses, and others, including medical technicians and others with non-management positions) in six secondary, general public hospitals
|
|
Overall perception of patient safety was positive for most dimensions. Hospital managers in both China and the U.S. reported a better patient safety climate than other staff. Scales of fear of shame and blame had the highest response for hospital workers in China. Fear of shame received the lowest feedback among hospital workers in the U.S.
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26 |
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HSPSC, 2014, Portugal, [62]
|
Determine the validity
and reliability of the AHRQ Hospital Survey on Patient Safety Culture (HSPSC) Portuguese version |
|
Response rate was 21.8% |
Non-punitive response to errors, management support for patient safety, and staffing had the lowest positive scores. Teamwork within units had the highest score. Overall perception of patient safety was 54%. Frequency of events reported was 40%.
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24 |
|
HSPSC, 2014, Jordan, [63]
|
Examine the impact of patient safety educational interventions among senior nurses on their perceptions of safety culture and the rate of reported adverse events, pressure ulcers, and patient falls |
|
Considering only nurses in one specialized hospital.
Response rate was 57% |
Improvements identified by senior nurses included non-punitive response to errors and frequency of event reporting. A reduction in the rate of adverse effects was noted. Pre-education perceptions of safety stood at 51.5% while the post-education perception stood at 60.6%. Frequency of event reporting was 54.2% pre-education and 64.3% post-education.
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34 |
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HSPSC, 2015, Jordan, [64]
|
Examine nurses’ perceptions of the hospital safety culture in Jordan and identify the relationships between aspects of hospital safety culture and selected safety outcomes |
|
Considering only nurses in five Jordanian hospitals.
Response rate was 61% |
Teamwork within units received the highest response Staffing and non-punitive response to errors had the lowest scores Overall perception of patient safety was 43.3% Frequency of event reporting was 37%
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30 |
|
SAQ, 2015, Denmark, [65]
|
Describe and analyze
the patient safety climate in 15 Danish hospital units |
Considering variety of staff (doctors, nurses, nursing assist- ants/similar, physiotherapists, occupational therapists, administrative staff, and hospital porters)
|
Considering only five hospitals |
No differences in positive percentage rates were found between nurses and doctors across age, gender, or work experience. Significant differences were noted between front-line staff and leaders. Individuals within a given unit had varied perceptions compared to units within the hospital.
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26 |
|
HSPSC, 2015, Belgium, [66]
|
Measure differences in safety culture perceptions within Belgian acute hospitals and examine variability based on language, work area, staff position, and work experience |
Considering variety of staff (nurses; patient care assistants/hospital aides/care partners; physicians; pharmacists; dieticians; unit assistants/clerks/secretaries; respiratory therapists; physical, occupational, or speech therapists; technicians [EKG, lab, radiology], administration/management) in 89 acute Dutch- and French-speaking hospitals. Studying PSC relationships with using different outcomes using HSPSC Belgian version
|
Response rate was 51.7% |
Staffing, handoffs and transitions, and management support for patient safety were noted as significant problem areas. Overall, Dutch-speaking hospitals had more positive perceptions of PSC than French-speaking hospitals. Respondents working in rehabilitation, pediatrics, and psychiatry gave more positive feedback on PSC. Staffs working in the emergency department, multiple hospital units, and operating theater had lower positive feedback.
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30 |
|
HSPSC, 2019, Algeria, [67]
|
Measure safety culture
dimensions in order to improve and promote healthcare in Algeria |
Considering variety of staff (nursing assistants, nurses, doctors, administrative staff, other)
|
Considering only one General hospital.
No Response rate reported |
Organization learning/continuous learning and teamwork within units had the highest scores. Communication openness and staffing had the lowest scores. Overall patient safety perception was 76.3%. Frequency of events reported was 56.1%.
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25 |
|
HSPSC, 2009, U.S., [68]
|
Analyze the psychometric properties of the Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture (HSPSC) |
Considering variety of staff (included nurses, physicians, pharmacists, and other hospital staff members) Response rate was 96%. Examining the validity and reliability of the instruments.
|
Only three hospitals (an academic teaching hospital, a managed care organization hospital, and a private not-for-profit community hospital) considered |
Interitem consistency reliability was not less than 0.7 for 5 subscales; the least reliability coefficients were demonstrated by the staffing subscale. The intraclass correlation coefficients were within normal ranges. Similar patterns of high and low scores across the subscales of the HSPSC were noted and compared to the sample from Pacific region hospitals conveyed by the Agency for Healthcare Research and Quality and corresponded to the proportion of items in each subscale that are reverse scored. Most of the unit and hospital dimensions revealed a positive relationship with the Safety Grade outcome measure.
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32 |
|
HSPSC and SAQ, 2012, U.S., [69]
|
Examine the reliability and predictive validity of two patient safety culture surveys- Safety Attitudes Questionnaire (SAQ) and Hospital Survey on Patient Safety Culture (HSPSC)-when administered to the same participants. Additionally, to determine the ability to convert HSOPS scores to SAQ scores. |
Variety of non-physician employees considered. Examining the validity and reliability of the instruments using HSPSC and SAQ. Considering intensive care units (ICUs) in 12 hospitals within a large hospital system in the southern United States
|
Response rate was 54%.
Only non-physician employees considered. |
Frequency of event reporting, perception of general patient safety, and general patient safety grade had a significant relationship with SAQ and HSPSC at individual level, with correlations of r = 0.41 to 0.65 for SAQ and from r = 0.22 to 0.72 for HSOPS. Neither SAQ nor HSPSC predicted the fourth HSOPS outcome, i.e., the number of events reported within the last year. Analyses on regression revealed that HSPSC safety culture dimensions had the best ability to predict frequency of event reporting and general perceptions of patient safety while SAQ and HSPSC dimensions predicted patient safety grade only.
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34 |
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HSPSC, 2010, U.S., [70]
|
Examine relationships between the Agency for Healthcare Research and Quality’s (AHRQ) Hospital Survey of Patient Safety Culture and rates of in-hospital complications and adverse events as measured by the AHRQ Patient Safety Indicators (PSIs) |
|
|
Exploratory analysis done showed that hospitals which scored higher on patient safety culture had fewer reported adverse events, after controlling for hospital bed size, teaching status, and ownership. There was a significant correlation between hospital bed size, teaching status, and ownership and the PSI composite. Larger and private hospitals had higher PSI rates. Almost all tested relationships were aligning to the hypothesis (negative), and 7 of the 15 relationships were statistically significant and HSPSC composite average (47%). All significant relationships had standardized regression coefficients between −0.15 and −0.41, denoting that hospitals with higher positive PSC scores experienced less in-hospital complications/adverse events as measured by PSIs.
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28 |
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HSPSC, 2016, U.S., [71]
|
Analyze how different elements of patient safety
culture is associated with clinical handoffs and perceptions of patient safety |
|
|
Positive patient safety perceptions were influenced by effective information handoff, responsibility, and accountability. There was positive correlation between feedback and communication of errors and conveying of patient information. Teamwork within units and the frequency of events documented had positive correlation to the transference of personal responsibility when changing shifts.
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35 |
|
HSPSC, 2009, U.S., [72]
|
Investigate the existence of a patient safety chain for
hospitals |
|
Response rate was 59.3%. |
TFL has a role in creating a PSC through the actual PSI execution. TFL has an indirect relationship with the implementation of initiatives, and ultimately improved PSO. The characteristics of inspirational leaders are linked with the creation and promotion of a safety culture, making safety a priority and investing resources to PSI to realize maximal improvements in PSO.
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26 |
|
SAQ, 2006, U.S., UK, and NZ, [73]
|
Describe the survey’s background, psychometric characteristics, provide benchmarking data, discuss how the survey can be used, and note emerging areas of research |
|
|
A six-factor model used at both the clinical area and respondent nested within clinical area levels generated attitudes. The factors were: Teamwork Climate, Safety Climate, Perceptions of Management, Job Satisfaction, Working Conditions, and Stress Recognition. With a scale reliability of 0.9, provider attitudes varied significantly within and among organizations. Using SAQ to measure climate in clinical areas permits comparisons between hospitals, patient care areas, and types of caregivers, and tracking of change over time.
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30 |
|
PSCHO, 2007, U.S., [74]
|
Describe the development of an instrument for assessing workforce perceptions of hospital safety culture and to assess its reliability and validity |
|
response rate was 51% |
Nine constructs were acknowledged: three organizational factors, two unit factors, three individual factors, and one additional factor. Constructs showed significant convergent and discriminant validity in the MTA. Cronbach’s a coefficient ranged from 0.50 to 0.89.
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29 |
|
PSCHO, 2009, U.S., [75]
|
Examine the relationship between measures of hospital safety climate
and hospital performance on selected Patient Safety Indicators (PSIs). |
|
Response rate was 52%. |
Hospitals showing better safety climate had lower relative incidence of PSIs. Those with higher scores on safety climate dimensions determining interpersonal beliefs regarding shame and blame. Frontline worker’s perceived lower risk of experiencing PSIs related to better safety climate, however, senior managers did not agree on this.
|
31 |
|
PSCHO, 2011, U.S., [76]
|
Define the relationship between hospital patient safety climate (a measure of hospitals’ organizational culture as related to patient safety) and hospitals’ rates of
rehospitalization within 30 days of discharge |
|
Response rate was 38.5 % |
There was a noteworthy positive correlation between lower safety climate and higher rates of readmission among AMI (acute myocardial infarction) and HF (heart failure) (p 0.05 for both models). Frontline workers perceptions of safety climate were linked to readmission rates (p 0.01), however, the management’s perceptions contradicted this. The results demonstrate that hospital patient safety climate has a connection with readmission outcomes patients with AMI and HF. The associations were specific to management and leadership.
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24 |
|
PSCHO, 2008, U.S., [77]
|
Determine whether frontline workers and supervisors perceive a more negative patient safety climate than senior managers in their institutions. |
|
|
Frontline personnel’s safety climate perceptions were 4.8, percentage points (1.4 times) more problematic than senior managers’, and supervisors’ perceptions were 3.1 percentage points (1.25 times) more problematic than senior managers’. Discipline had an impact on the differences at management level: senior managers had less differences than frontline workers. Additionally, the differences were more pronounced for nurses than physicians and other disciplines.
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34 |
