Safety culture among operating room healthcare workers: still a long way to go. An analytical cross-sectional study from Turkey

Introduction: safety culture attitudes of health workers are still not at the desired level. Although the creation of patient safety culture is important for all health care environments, it is more vital for critical units. Objective: to determine the patient safety culture levels of those working in the operating room environment and compare them with the 2008 results of the same hospitals. Materials and Methods: an analytical cross-sectional study was conducted in 2017-2018. The Turkish version of the Hospital Survey on Patient Safety Culture was administered to nurses, anesthesia technicians, assistant physicians, and specialist physicians working in the Operating Rooms (n=258) of two university hospitals in Konya, a large city in Anatolian region of Turkey. Results: average percent positive response to the 42 items was low (41%, n=258). While there was no change in one dimension of the questionnaire compared to 2008; there was a positive change in 8 dimensions and a negative change in 3 dimensions. All 12 dimensions were lower than the Agency for Healthcare Research and Quality score. Discussion: Despite many studies, policy developments and interventions on patient safety, the improvement of a patient safety culture is very slowly in Turkey as in other countries. Conclusion: non-reporting of errors and a punitive approach in case of errors are still considered the most important problems.

Introducción: las actitudes del personal de salud frente a la cultura de la seguridad siguen sin alcanzar su nivel deseado. Aunque la creación de una cultura de seguridad del paciente es importante en todos los entornos de cuidado, es vital en las unidades de cuidado crítico. Objetivo: determinar los niveles de cultura de seguridad del paciente de quienes trabajan en quirófanos y compararlos con los 2008 resultados de los mismos hospitales. Materiales y métodos: se realizó un estudio transversal analítico entre 2017 y 2018. La versión en turco de la Encuesta Hospitalaria sobre Cultura de Seguridad del Paciente se administró a profesionales de enfermería, anestesistas, médicos auxiliares y médicos especialistas que trabajaban en los quirófanos (n=258) de dos hospitales universitarios de Konya, una ciudad de la región de Anatolia en Turquía. Resultados: El porcentaje medio de respuestas positivas a los 42 ítems fue bajo (41%, n=258). Si bien no hubo cambios en una dimensión del cuestionario en comparación con los 2008 resultados, hubo un cambio positivo en 8 dimensiones y un cambio negativo en 3 dimensiones. Las 12 dimensiones presentaron una puntuación inferior a la de la Agencia para la Investigación y la Calidad del Cuidado de la Salud. Discusión: A pesar de los numerosos estudios, desarrollos en política e intervenciones en materia de seguridad del paciente, la mejora de la cultura de seguridad del paciente es muy lenta en Turquía, al igual que en otros países. Conclusión: No notificar errores y un enfoque punitivo en caso de error siguen considerándose los problemas más importantes.

Introdução: as atitudes de cultura de segurança dos profissionais de saúde ainda não estão no nível desejado. Embora a criação da cultura de segurança do paciente seja importante para todos os ambientes de assistência médica, ela é mais vital para as unidades críticas. Objetivo: determinar os níveis de cultura de segurança do paciente daqueles que trabalham no ambiente da sala de cirurgia e compará-los com os resultados de 2008 dos mesmos hospitais. Materiais e Métodos: um estudo analítico de corte transversal foi realizado em 2017-2018. A versão turca da Pesquisa Hospitalar sobre Cultura de Segurança do Paciente foi aplicada a enfermeiros, técnicos de anestesia, médicos assistentes e médicos especialistas que trabalham nas salas de cirurgia (n=258) de dois hospitais universitários em Konya, uma grande cidade na região da Anatólia, Turquia. Resultados: a porcentagem média de respostas positivas aos 42 itens foi baixa (41%, n=258). Embora não tenha havido alteração em uma dimensão do questionário em comparação com 2008, houve uma alteração positiva em 8 dimensões e uma alteração negativa em 3 dimensões. Todas as 12 dimensões foram inferiores à pontuação da Agency for Healthcare Research and Quality. Discussão: Apesar de muitos estudos, desenvolvimentos de políticas e intervenções sobre a segurança do paciente, o aprimoramento de uma cultura de segurança do paciente é muito lento na Turquia, assim como em outros países. Conclusão: a não notificação de erros e uma abordagem punitiva em caso de erros ainda são considerados os problemas mais importantes.

Turkish adaptation and validation of revised Hospital Survey on Patient Safety Culture (TR - HSOPSC 2.0).

AIM: This study is aimed to determine the validity and reliability of the Turkish adaptation of the HSOPSC 2.0 for Turkish hospitals. METHODS: This two-stage psychometric study was conducted with 613 nurses (The response rate of the nurses participated in the study is 72.11%.) at a university hospital between July 2021 and February 2022. In the first stage, the adaptation of the scale was performed. Construct validity was determined at the second stage using confirmatory factor analysis. Reliability was tested using the internal consistency coefficient. RESULTS: The adaptation results showed that the Turkish version of the scale was adequate for language and content validation. This scale, consisting of 32 items and ten subscales, showed a significantly good fit with the original scale according to confirmatory factor analysis. The Cronbach's alpha coefficient for the subscales ranged between 0.72 and 0.82. CONCLUSIONS: The Turkish version of the Hospital Survey on Patient Safety Culture consistently showed acceptable psychometric reliability and validity characteristics.

Validity and reliability of Turkish version of "Hospital Survey on Patient Safety Culture" and perception of patient safety in public hospitals in Turkey.

BACKGROUND: The Hospital Survey on Patient Safety Culture (HSOPS) is used to assess safety culture in many countries. Accordingly, the questionnaire has been translated into Turkish for the study of patient safety culture in Turkish hospitals. The aim of this study is threefold: to determine the validity and reliability of the translated form of HSOPS, to evaluate physicians' and nurses' perceptions of patient safety in Turkish public hospitals, and to compare finding with U.S. hospital settings. METHODS: Physicians and nurses working in all public hospitals in Konya, a large city in Turkey, were asked to complete a self-administrated patient safety culture survey (n = 309). Data collection was carried out using the Turkish version of HSOPS, developed by Agency for Healthcare Research and Quality (AHRQ). Data were summarized as percentages, means, and SD values. Factor analysis, correlation coefficient, Cronbach's alpha, ANOVA, and t tests were employed in statistical analyses. Items on patient safety were categorized into 10 factors. Factor loadings and internal consistencies of dimension items were high. RESULTS: Most of the scores related to dimensions, and the overall patient safety score (44%) were lower than the benchmark score. "Teamwork within hospital units" received the highest score (70%), and the lowest score belonged to the "frequency of events reported" (15%). The study revealed that more than three quarters of the physicians and nurses were not reporting errors. CONCLUSION: The Turkish version of HSOPS was found to be valid and reliable in determining patient safety culture. This tool will be helpful in tracking improvements and in heightening awareness on patient safety culture in Turkey.

A survey on patient safety culture in primary healthcare services in Turkey.

OBJECTIVE: To evaluate the patient safety culture in primary healthcare units. DESIGN: A cross-sectional study, utilizing the Turkish version of the Hospital Survey on Patient Safety Culture developed by the Agency for Healthcare Research and Quality and a demographic questionnaire. SETTING: Twelve primary healthcare centers in the center of the city of Konya, Turkey. PARTICIPANTS: One hundred and eighty healthcare staff, including general practitioners (GPs), nurses, midwives and health officers. INTERVENTION: None. MAIN OUTCOME MEASURE(S): The patient safety culture score including subscores on 12 dimensions and 42 items; patient safety grade and number of events reported. RESULTS: Fifty-four (30%) of the participants were GPs, 48 (27%) were nurses, 51 (28%) were midwives and 27 (15%) were health officers. The mean overall score for positive perception of patient safety culture in primary healthcare units was 46 +/- 20 (43-49 CI). No differences were found by staff members' profession. Among the dimensions of patient safety, those with the highest percentage of positive ratings were teamwork within units (76%) and overall perceptions of safety (59%), whereas those with the lowest percentage of positive ratings were the frequency of event reporting (12%) and non-punitive response to error (18%). Reporting of errors was infrequent with 87% of GPs, 92% of nurses and 91% of other health staff indicating that they did not report or provide feedback about errors. CONCLUSIONS: Improving patient safety culture should be a priority among health center administrators. Healthcare staff should be encouraged to report errors without fear of punitive action.