Patient Safety Culture in a Turkish Public Hospital: A Study of Nurses' Perceptions About Patient Safety

TOP M., Tekingunduz S.

SYSTEMIC PRACTICE AND ACTION RESEARCH, vol.28, no.2, pp.87-110, 2015 (SSCI) identifier identifier


The objective of this study was to investigate nurses' perceptions about the culture of patient safety in a Turkish public hospital. The study adopted a cross-sectional research design and utilized the hospital survey of patient safety culture. The population studied consisted of approximately 300 nurses from which 200 nurses were surveyed. The response rate was 66.6 % of the population. Nurses responded most positively to two dimensions, hospital management support for patient safety (80 %) and supervisor/manager expectations and actions promoting patient safety (79 %). Four dimensions with a positive response rate of < 50 % ('Frequency of events reported', 'Nonpunitive response to error', 'Communication openness' and 'Hospital handoffs and transitions') were considered as potential targets for improvement in our study. This study revealed six significant predictors of Overall Perceptions of Safety: Organizational Learning-Continuous Improvement; Communication Openness; Teamwork within Units; Staffing; Frequency of Event Reporting; and the Patient Safety Grade (of the Hospital Unit). Additionally, four significant predictors of the Patient Safety Grade (of the Hospital Unit) emerged: Feedback and Communication about Error; Organizational Learning-Continuous Improvement; Hospital Management Support for Patient Safety; and Supervisor/Manager Expectations and Actions Promoting Safety. Interventions designed to improve the safety culture in Turkish hospitals should be focused on the concerns of staff nurses and the improvement of communication between these nurses and their managers. The determination and evaluation of the patient safety culture level in hospitals should be viewed as a continuous process in Turkey where a need for continuous improvements in the hospital patient safety culture exists. To improve the patient safety level, nurses' perceptions about patient safety appear to be essential. Nurses are important for the improvement of the patient safety culture in health care organizations. Moreover, some hospitals have recognized that providing patients with safe, high-quality care is fundamental to protecting the financial assets of the institution and therefore, falls within risk management's role. In this new landscape, risk management and patient safety professionals are engaged in a close working relationship.