TABLE 3.

Characteristics of the instruments used to assess nurses' safety attitudes in the included studies

Instrument	Studies using this instrument	Constructs / Domains being examined	Scoring	Reliability
Hospital Survey on Patient Safety Culture (HSOPSC) (7 items)	Lee et al. (2018) Olds et al. (2017)	7 items of HSOPSC; ‐Staff feel like their mistakes are held against them. ‐Important patient care information is often lost during shift changes. ‐Things “fall between the cracks” when transferring patients from one unit to another. ‐Staff feel free to question the decisions or actions of those in authority. ‐In this unit, we discuss ways to prevent errors from happening again. ‐We are given feedback about changes put into place based on event reports. ‐The actions of hospital/organization management show that patient safety is a top priority.	5‐point Likert scale Agreement ranges from 1 = strongly disagree to 5 = strongly agree. or Frequency ranges from 1 = never to 5 = always. Mean score above 2.5 (or 50% for percentages) indicates a positive safety culture	Cronbach α was between 0.76 to 0.80
Hospital Survey on Patient Safety Culture (HSOPSC)	Brown and Wolosin (2013) Han et al. (2020) Hessels et al. (2019 Wang et al. (2014)	12 subscales of HSOPSC measured by 42 and 44 items. ‐Teamwork within units. ‐Supervisor/manager expectations and actions promoting patient safety. ‐Organizational learning continuous improvement. ‐Management support for patient safety. ‐Overall perceptions of patient safety. ‐Feedback and communication about error. ‐Communication openness. ‐Frequency of events reported. ‐Teamwork across units. ‐Staffing. ‐Handoffs and transition. ‐Non‐punitive response to error.	5‐point Likert scale Agreement ranges from 1 = strongly disagree to 5 = strongly agree. or Frequency ranges from 1 = never to 5 = always. Mean score above 2.5 indicates a positive safety culture	Cronbach α was between 0.64 to 0.95
Safety Organizing Scale (SOS)	Ausserhofer et al. (2013)	Unidimensional instrument, consisting of nine items ‐We have a good “map” of each other's talents and skills. ‐We talk about mistakes and ways to learn from them. ‐We discuss our unique skills with each other so we know who on the unit has relevant specialized skills and knowledge. ‐We discuss alternatives as to how to go about our normal work activities. ‐When giving report to an oncoming nurse, we usually discuss what to look out for. ‐When attempting to resolve a problem, we take advantage of the unique skills of our colleagues. ‐We spend time identifying activities we do not want to go wrong. ‐When errors happen, we discuss how we could have prevented them. ‐When a patient crisis occurs, we rapidly pool our collective expertise to attempt to resolve it.	7‐points Likert scale Likert scale range from 1 = not at all, 2 = to a very limited extent, 3 = to a limited extent 4 = to a moderate extent 5 = to a considerable extent 6 = to a great extent 7 = to a very great extent Mean score above 3.5 indicates a positive safety culture.	Cronbach's alpha reported for previous studies was >0.79
Safety Attitudes Questionnaire (SAQ)	Taylor et al. (2012)	Five subscales of SAQ measured by 27 items. ‐Teamwork Climate. ‐Safety Climate. ‐Morale. ‐Perception of Management. ‐Working Conditions.	5‐point Likert scale Range from 1 = strongly disagree to 5 = strongly agree. Scores converted to a percentage scale using the following method: Responses are converted to 1 = 0%, 2 = 25%, 3 = 50%, 4 = 75% and 5 = 100% Mean percentage above 50% indicates a positive safety attitude.	Cronbach's alpha for SAQ domain ‐Teamwork Climate =0.77 ‐Safety Climate =0.75 ‐Morale =0.87 ‐Perception of Management =0.75 ‐Working Conditions =0.69
Zohar Safety Climate Scale (ZSCS) (9 items).	Hofmann and Mark (2006)	Three subscales of ZSCS measured by 9 items. ‐Job duties (three items). ‐Social standing (three items). ‐Management attitudes (three items).	5‐point Likert scale Range from 1 = strongly disagree to 5 = strongly agree. Mean score above 2.5 indicates a positive safety culture.	Internal consistency reliability ‐Job duties =0.97 ‐Social standing =0.71 ‐Management attitude =0.79
Error Orientation Scale (EOS) (13 items)	Hofmann and Mark (2006)	Three subscales of EOS measured by 13 items. ‐Reveal errors (four items). ‐Communication about errors (four items). ‐Think about errors (five items).	5‐point Likert scale Range from 1 = strongly disagree to 5 = strongly agree. Mean score above 2.5 indicates a positive safety culture.	Internal consistency reliability ‐Reveal errors =0.83 ‐Communication about errors =0.86 ‐Thinking about errors =0.92.