The Role of Professional Behavior to Improve Patient Safety Culture in Clinical Nurses: A Cross-Sectional Study
Authors
-
Seyedmohammad Mirhosseini
Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran and Department of Psychiatric Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
https://orcid.org/0000-0002-2087-0164
-
Mohammad Hasan Basirinezhad
Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
https://orcid.org/0000-0002-3672-556X
-
Hossein Ebrahimi
Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran.
https://orcid.org/0000-0001-5731-7103
DOI:
https://doi.org/10.22100/ijhs.v8i2.899Keywords:
Nurse, Patient safety, Professional behaviorAbstract
Background: Safety culture is one of the most important determinants of patient safety in hospitals. Due to the increasing prevalence of medical errors, increasing public attention, and public opinion pressure on this issue as well as the limitations of studies in this area, the current study was conducted to identify the role of professional behavior to improve patient safety culture in clinical nurses.
Methods: This cross-sectional study was performed on 230 nurses in Shahroud Iran. Data collection instruments included a demographic information form, the Hospital Survey on Patient Safety Culture questionnaire, and the Nursing Professional Behaviors Scale. Stratified random sampling was used and data were analyzed by using descriptive and inferential statistics (linear regression analysis).
Results: Participants’ mean scores of patient safety culture and professional behavior were 132.51 ±15.97 and 109.57±18.01, respectively. A high score of nurses' professional behavior was directly associated with a higher level of patient safety culture. In addition, the number of working hours per week and change in the workplace were significantly related to patient safety culture level (Pvalue=0.002).
Conclusions: Professional behavior is an effective factor in enhancing safety culture in nurses. Therefore, paying attention to the training and proper application of professional behavior in nurses can improve the level of patient safety culture.
Keywords: Nurse, Patient safety, Professional behavior
References
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11. Ball JE, Murrells T, Rafferty AM, Morrow E, Griffiths P. ‘Care left undone’during nursing shifts: associations with workload and perceived quality of care. BMJ Qual Saf. 2014;23(2):116-125.
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38. Shahriari M, Baloochestani E. Applying professional values: the perspective of nurses of Isfahan hospitals. Journal of medical ethics and history of medicine. 2014;7
39. Aouicha W, Tlili MA, Sahli J, et al. Exploring patient safety culture in emergency departments: a Tunisian perspective. International Emergency Nursing. 2021;54:100941.
40. Sorra J, Nieva VF. Hospital survey on patient safety culture. Agency for Healthcare Research and Quality; 2004.
41. Moghri, Ghanbarnezhad Amin, Moghri Mahbobe, Rahimi Forooshani, Akbari Sari Ali Abas, Arab Mohammad. Validation of Farsi version of hospital survey on patient Safety culture questionnaire, using confirmatory factor analysis method. Hospital Journal. 2012;11(2)
42. Heshmati Nabavi F, Rajabpour M, Hoseinpour Z, Hajiabadi F, Esmaily H. Comparison of Nursing Students’ Professional Behavior to Nurses Employed in Mashhad University of Medical Sciences. Iranian Journal of Medical Education. 2014;13(10):809-819.
43. Dincer M, Torun N, Aksakal H. Determining nurses’ perceptions of patient safety culture in palliative care centres. Contemporary nurse. 2018;54(3):246-257.
44. Cho SM, Choi J. Patient safety culture associated with patient safety competencies among registered nurses. Journal of Nursing Scholarship. 2018;50(5):549-557.
45. Lotfi Z, Atashzadeh‐Shoorideh F, Mohtashami J, Nasiri M. Relationship between ethical leadership and organisational commitment of nurses with perception of patient safety culture. Journal of nursing management. 2018;26(6):726-734.
46. National Science Foundation NCfS, Statistics E. Women, Minorities, and Persons with Disabilities in Science and Engineering: 2015, Special Report NSF 15–311. National Science Foundation (NSF), National Center for Science and …; 2015.
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48. Alquwez N, Cruz JP, Almoghairi AM, et al. Nurses’ perceptions of patient safety culture in three hospitals in Saudi Arabia. Journal of Nursing Scholarship. 2018;50(4):422-431.
49. Alqattan H, Cleland J, Morrison Z. An evaluation of patient safety culture in a secondary care setting in Kuwait. Journal of Taibah University Medical Sciences. 2018;13(3):272-280.
50. Battard J. Nonpunitive response to errors fosters a just culture. Nursing management. 2017;48(1):53-55.
51. Granel N, Manresa-Domínguez JM, Barth A, Papp K, Bernabeu-Tamayo MD. Patient safety culture in Hungarian hospitals. International journal of health care quality assurance. 2019;32(2):412-424.
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53. Seabrook M. Intimidation in medical education: students' and teachers' perspectives. Studies in Higher Education. 2004;29(1):59-74.
54. Monrouxe LV, Rees CE, Dennis I, Wells SE. Professionalism dilemmas, moral distress and the healthcare student: insights from two online UK-wide questionnaire studies. BMJ open. 2015;5(5):e007518.
55. Dehghani M, Hayavie Haghighi M, Salimi J, Khorami F. Culture of Patient Safety from Nurses’ Perspective. Iran Journal of Nursing. 2015;28(93):42-54.
56. Wami SD, Demssie AF, Wassie MM, Ahmed AN. Patient safety culture and associated factors: A quantitative and qualitative study of healthcare workers’ view in Jimma zone Hospitals, Southwest Ethiopia. BMC health services research. 2016;16(1):495.
57. Alrabae YMA, Aboshaiqah AE, Tumala RB. The association between self‐reported workload and perceptions of patient safety culture: a study of intensive care unit nurses. Journal of Clinical Nursing. 2021;ahead of printdoi:10.1111/jocn.15646
58. Kowalski SL, Anthony M. CE: Nursing's evolving role in patient safety. AJN The American Journal of Nursing. 2017;117(2):34-48.
59. Hall LH, Johnson J, Watt I, Tsipa A, O’Connor DB. Healthcare staff wellbeing, burnout, and patient safety: a systematic review. PloS one. 2016;11(7)
2. Al Nadabi W, McIntosh B, McClelland T, Mohammed M. Patient safety culture in maternity units: a review. International journal of health care quality assurance. 2019;32(4):662-676.
3. Agency for Healthcare Research and Quality (AHRQ). Hospital survey on patient safety culture. 2017;
4. Santa R, Borrero S, Ferrer M, Gherissi D. Fostering a healthcare sector quality and safety culture. International journal of health care quality assurance. 2018;31(7)
5. Keogh B. Review into the quality of care and treatment provided by 14 hospital trusts in England: overview report. 2013. 2017.
6. Armstrong GE, Dietrich M, Norman L, Barnsteiner J, Mion L. Development and psychometric analysis of a nurses’ attitudes and skills safety scale: Initial results. Journal of nursing care quality. 2017;32(2):E3.
7. Colet PC, Cruz JP, Cacho G, Al‐Qubeilat H, Soriano SS, Cruz CP. Perceived infection prevention climate and its predictors among nurses in Saudi Arabia. Journal of Nursing Scholarship. 2018;50(2):134-142.
8. Boughaba A, Aberkane S, Fourar Y-O, Djebabra M. Study of safety culture in healthcare institutions: case of an Algerian hospital. International journal of health care quality assurance. 2019;32(7):1081-1097.
9. Keykaleh MS, Safarpour H, Yousefian S, Faghisolouk F, Mohammadi E, Ghomian Z. The relationship between nurse’s job stress and patient safety. Open access Macedonian journal of medical sciences. 2018;6(11):2228.
10. Simsekler MCE. The link between healthcare risk identification and patient safety culture. International journal of health care quality assurance. 2019;32(3):574-587.
11. Ball JE, Murrells T, Rafferty AM, Morrow E, Griffiths P. ‘Care left undone’during nursing shifts: associations with workload and perceived quality of care. BMJ Qual Saf. 2014;23(2):116-125.
12. Jones TL, Hamilton P, Murry N. Unfinished nursing care, missed care, and implicitly rationed care: State of the science review. International journal of nursing studies. 2015;52(6):1121-1137.
13. Kalisch BJ, Xie B. Errors of omission: missed nursing care. Western Journal of Nursing Research. 2014;36(7):875-890.
14. Schubert M, Ausserhofer D, Desmedt M, et al. Levels and correlates of implicit rationing of nursing care in Swiss acute care hospitals—a cross sectional study. International journal of nursing studies. 2013;50(2):230-239.
15. Kim K-J, Yoo MS, Seo EJ. Exploring the influence of nursing work environment and patient safety culture on missed nursing care in Korea. Asian nursing research. 2018;12(2):121-126.
16. Aiken LH, Sermeus W, Van den Heede K, et al. Patient safety, satisfaction, and quality of hospital care: cross sectional surveys of nurses and patients in 12 countries in Europe and the United States. Bmj. 2012;344:e1717.
17. Wilson RM, Michel P, Olsen S, et al. Patient safety in developing countries: retrospective estimation of scale and nature of harm to patients in hospital. Bmj. 2012;344:e832.
18. Schwendimann R, Zimmermann N, Küng K, Ausserhofer D, Sexton B. Variation in safety culture dimensions within and between US and Swiss Hospital Units: an exploratory study. BMJ Qual Saf. 2013;22(1):32-41.
19. Chaboyer W, Chamberlain D, Hewson-Conroy K, et al. CNE article: safety culture in Australian intensive care units: establishing a baseline for quality improvement. American Journal of Critical Care. 2013;22(2):93-102.
20. Ebrahimzadeh N, Saravani S, Soltani A, Bazzi M. Hospital survey on patient safety culture in Iran. Journal of Pharmaceutical Sciences and Research. 2017;9(10):1765-1767.
21. Fan CJ, Pawlik TM, Daniels T, et al. Association of safety culture with surgical site infection outcomes. Journal of the American College of Surgeons. 2016;222(2):122-128.
22. Berry JC, Davis JT, Bartman T, et al. Improved Safety Culture and Teamwork Climate Are Associated With Decreases in Patient Harm and Hospital Mortality Across a Hospital System. Journal of patient safety. 2016;
23. Sexton JB, Adair KC, Leonard MW, et al. Providing feedback following Leadership WalkRounds is associated with better patient safety culture, higher employee engagement and lower burnout. BMJ quality & safety. 2018;27(4):261-270.
24. Rajalatchumi A, Ravikumar TS, Muruganandham K, et al. Perception of patient safety culture among health-care providers in a Tertiary Care Hospital, South India. Journal of natural science, biology, and medicine. 2018;9(1):14.
25. Siddharth V, Vipin K Koushal, Vineet G. Patient Safety is the Need of the Hour: A Study in Nursing Department of a Tertiary Care Teaching Hospital. International Journal of Research Foundation of Hospital and Healthcare Administration. 2017;5(2):55 - 59.
26. Famolaro T, Yount ND, Burns W, Flashner E, Liu H, Sorra J. Hospital survey on patient safety culture: 2016 user comparative database report. Agency for Healthcare Research and Quality; 2016.
27. Organization WH. Patient safety. 2016;
28. Galvão TF, Lopes MCC, Oliva CCC, Araújo MEdA, Silva MT. Patient safety culture in a university hospital. Revista latino-americana de enfermagem. 2018;26
29. Arrieta A, Suárez G, Hakim G. Assessment of patient safety culture in private and public hospitals in Peru. International Journal for Quality in Health Care. 2018;30(3):186-191.
30. Asefzadeh S, Kalhor R, Tir M. Patient safety culture and job stress among nurses in Mazandaran, Iran. Electronic physician. 2017;9(12):6010.
31. Jabari F, Ooshaksaraie M, Azadehdel M, Mehrabian F. Relationship between patient safety culture and professional conduct of nurses in context of clinical governance implementation. Journal of Holistic Nursing And Midwifery. 2015;25(3):27-33.
32. Kinoshita K, Tsugawa Y, Barnett PB, Tokuda Y. Challenging cases of professionalism in Japan: improvement in understanding of professional behaviors among Japanese residents between 2005 and 2013. BMC medical education. 2015;15(1):42.
33. Kowalski K. Professional Behavior in Nursing. The Journal of Continuing Education in Nursing. 2016;47(4):158-159.
34. Mathooko JM. Leadership and organizational ethics: the three dimensional African perspectives. BMC medical ethics. 2013;14(1):S2.
35. Clark DK. Professional values: a study of education and experience in nursing students and nurses. Capella University; 2009.
36. Babadağ K. Hemşirelik ve değerler. Ankara: Alter Yayıncılık. 2010:31-55.
37. Krautscheid LC. Defining professional nursing accountability: a literature review. Journal of Professional Nursing. 2014;30(1):43-47.
38. Shahriari M, Baloochestani E. Applying professional values: the perspective of nurses of Isfahan hospitals. Journal of medical ethics and history of medicine. 2014;7
39. Aouicha W, Tlili MA, Sahli J, et al. Exploring patient safety culture in emergency departments: a Tunisian perspective. International Emergency Nursing. 2021;54:100941.
40. Sorra J, Nieva VF. Hospital survey on patient safety culture. Agency for Healthcare Research and Quality; 2004.
41. Moghri, Ghanbarnezhad Amin, Moghri Mahbobe, Rahimi Forooshani, Akbari Sari Ali Abas, Arab Mohammad. Validation of Farsi version of hospital survey on patient Safety culture questionnaire, using confirmatory factor analysis method. Hospital Journal. 2012;11(2)
42. Heshmati Nabavi F, Rajabpour M, Hoseinpour Z, Hajiabadi F, Esmaily H. Comparison of Nursing Students’ Professional Behavior to Nurses Employed in Mashhad University of Medical Sciences. Iranian Journal of Medical Education. 2014;13(10):809-819.
43. Dincer M, Torun N, Aksakal H. Determining nurses’ perceptions of patient safety culture in palliative care centres. Contemporary nurse. 2018;54(3):246-257.
44. Cho SM, Choi J. Patient safety culture associated with patient safety competencies among registered nurses. Journal of Nursing Scholarship. 2018;50(5):549-557.
45. Lotfi Z, Atashzadeh‐Shoorideh F, Mohtashami J, Nasiri M. Relationship between ethical leadership and organisational commitment of nurses with perception of patient safety culture. Journal of nursing management. 2018;26(6):726-734.
46. National Science Foundation NCfS, Statistics E. Women, Minorities, and Persons with Disabilities in Science and Engineering: 2015, Special Report NSF 15–311. National Science Foundation (NSF), National Center for Science and …; 2015.
47. US Department of Education NCfES. Bachelor’s, master’s, and doctor’s degrees conferred by postsecondary institutions, by sex of student and discipline division: 2011-12. 2013;
48. Alquwez N, Cruz JP, Almoghairi AM, et al. Nurses’ perceptions of patient safety culture in three hospitals in Saudi Arabia. Journal of Nursing Scholarship. 2018;50(4):422-431.
49. Alqattan H, Cleland J, Morrison Z. An evaluation of patient safety culture in a secondary care setting in Kuwait. Journal of Taibah University Medical Sciences. 2018;13(3):272-280.
50. Battard J. Nonpunitive response to errors fosters a just culture. Nursing management. 2017;48(1):53-55.
51. Granel N, Manresa-Domínguez JM, Barth A, Papp K, Bernabeu-Tamayo MD. Patient safety culture in Hungarian hospitals. International journal of health care quality assurance. 2019;32(2):412-424.
52. Improvement N, England N. Freedom to speak up: raising concerns (whistleblowing) policy for the NHS. See https://improvement nhs uk/resources/freedom-to-speak-up-whistleblowing-policy-for-the-nhs/(last checked 31 May 2016). 2016;
53. Seabrook M. Intimidation in medical education: students' and teachers' perspectives. Studies in Higher Education. 2004;29(1):59-74.
54. Monrouxe LV, Rees CE, Dennis I, Wells SE. Professionalism dilemmas, moral distress and the healthcare student: insights from two online UK-wide questionnaire studies. BMJ open. 2015;5(5):e007518.
55. Dehghani M, Hayavie Haghighi M, Salimi J, Khorami F. Culture of Patient Safety from Nurses’ Perspective. Iran Journal of Nursing. 2015;28(93):42-54.
56. Wami SD, Demssie AF, Wassie MM, Ahmed AN. Patient safety culture and associated factors: A quantitative and qualitative study of healthcare workers’ view in Jimma zone Hospitals, Southwest Ethiopia. BMC health services research. 2016;16(1):495.
57. Alrabae YMA, Aboshaiqah AE, Tumala RB. The association between self‐reported workload and perceptions of patient safety culture: a study of intensive care unit nurses. Journal of Clinical Nursing. 2021;ahead of printdoi:10.1111/jocn.15646
58. Kowalski SL, Anthony M. CE: Nursing's evolving role in patient safety. AJN The American Journal of Nursing. 2017;117(2):34-48.
59. Hall LH, Johnson J, Watt I, Tsipa A, O’Connor DB. Healthcare staff wellbeing, burnout, and patient safety: a systematic review. PloS one. 2016;11(7)
Published
2021-09-11
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How to Cite
The Role of Professional Behavior to Improve Patient Safety Culture in Clinical Nurses: A Cross-Sectional Study. (2021). International Journal of Health Studies (Undergoing Change to Shahroud Journal of Medical Sciences), 8(2), 7-12. https://doi.org/10.22100/ijhs.v8i2.899
