Striving for Excellence: Navigating the Challenges of Writing a Patient Safety Culture Dissertation

Embarking on the journey of writing a dissertation is a significant endeavor, one that demands
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dissertation topics, delving into the realm of patient safety culture presents its own unique set of
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sociology. Researchers must navigate through a wealth of literature, theories, and methodologies to
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behaviors, and outcomes. Moreover, the dynamic nature of healthcare environments, coupled with
evolving regulatory frameworks and technological advancements, adds another layer of complexity
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One of the foremost challenges encountered by aspiring scholars is the task of synthesizing disparate
sources of information into a coherent narrative that contributes meaningfully to the existing body of
knowledge. From conducting thorough literature reviews to designing robust research
methodologies, every stage of the dissertation journey demands meticulous attention to detail and a
keen analytical eye. Moreover, grappling with issues of data collection, analysis, and interpretation
requires researchers to employ a diverse array of qualitative and quantitative techniques, further
adding to the complexity of the endeavor.

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practical constraints such as time limitations, resource constraints, and institutional requirements.
Balancing the demands of coursework, research commitments, and personal obligations can often
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Journal of Manufacturing and Materials Processing (JMMP). Learn Success Stories Insights Gain
insights about the role of data in healthcare transformation and outcomes improvement. How can we
accurately measure and assess staff attitudes towards safety. In general, female nurses had a more
positive view of the prevalent PSC than did their male counterparts. Within a hospital, every unit
serves a specific function and experiences unique challenges and victories. The CQC will be using a
new single assessment framework (SAF) to assess the quality of care provided by these healthcare
providers. These results confirm that the healthcare industry greatly relies on interdisciplinary teams
of specialists with the skill sets needed to perform specialized tasks. Visit our dedicated information
section to learn more about MDPI. We’re sharing this material with our audience ONLY for
educational purpose. It is autonomous in its administration and in the selection of its members,
sharing with the National Academy of Sciences the responsibility for advising the federal
government. 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. Since little research has been conducted
with nurses, it is difficult to compare the findings with previous studies. First, articles mainly used
quantitative approaches to measure PSC, where these methods are not efficient for measuring
complex and dynamic attributes such as culture. Methods used to determine the level of safety
culture can include. The abstracts for the remaining 261 titles were read, which led to the selection
of 137 relevant articles whose entire texts were analyzed. Continue Name (Required) First Last
Organization Email (Required) Comments. Therefore, while it could be concluded that teamwork is
one of the important factors that impact PS, there are always opportunities for improvement. A data
extraction template from the Hawker Assessment Tool was used to collect data regarding the
properties of the adopted studies. A high level of correlation was observed among feedback,
managerial support, organizational learning, and improved patient safety. Note that from the first
issue of 2016, this journal uses article numbers instead of page numbers. This structure gives health
systems a roadmap to improved patient safety, better healthcare and employee outcomes, and lower
costs. Visit Advanced Clinical Solutions Ltd for compete details. Nancy Brumley Gessling, MSN,
CIC Infection Prevention Copper Basin Medical Center. This way, survey participants recognize the
timeliness of completing and submitting the survey. The map of the co-occurrence of terms in the
title and abstract. Additionally, teamwork is the most factor that has a relationship with the other
characteristics of PS. The reviewed articles reported several limitations concerning the applied
methodology and results. See how Advanced Clinical Solutions can help you with improving your
Patient Safety Culture Book a free consultation with our clinical team here. or. Acronyms AHRQ
Agency for Healthcare Research and Quality NH SOPS Nursing Home Survey of Patient Safety.
This comprehensive blog post explores the crucial role of well-trained healthcare professionals in
delivering high-quality patient care, boosting staff confidence, and ensuring compliance with CQC
regulations.
In simple terms safety culture can be referred to as “the way we do things around here” and can be
both positive and negative towards safety. A culture of blame was evident in 22 studies, representing
43% of those examined. Because the surveys ask questions that have been developed and pilot tested
using a consistent methodology across a large sample of respondents, they are standardized and
validated measures of patient safety culture. Frequency of events reported had the lowest average.
The map of the co-occurrence between safety culture and other high-frequency terms. You should
also collect followup data, approximately a year to 18 months after you started collecting the
baseline data, to determine any changes. Discipline had an impact on the differences at management
level: senior managers had less differences than frontline workers. Facilitator: Prof. Dianne Parker
University of Manchester and Safety Culture Associates Limited. Further analysis was required to
eliminate duplicate titles, which resulted in 601 duplicates being discarded. Harm can be measured
by the frequency of reported events. Committee on the Work Environment for Nurses and Patient
Safety. Reporting errors and safety awareness, gender and demographics, work experience, and
staffing levels have also been identified as essential factors. Non-punitive responses to errors and
staffing had low positive response rates at 22% and 31%, respectively, representing areas for
improvement. The abstracts for the remaining 261 titles were read, which led to the selection of 137
relevant articles whose entire texts were analyzed. Additionally, to determine the ability to convert
HSOPS scores to SAQ scores. Therefore, the availability of adequate staffing plays a critical role in
perceiving the PSC because employees’ focuses might be harmed due to overload. 5. Study
Limitations The present study has some important limitations. There was a significant correlation
between hospital bed size, teaching status, and ownership and the PSI composite. The Hawker
Assessment Tool was also implemented in this paper to enable the researcher to score the quality of
the papers reviewed. How do you measure fall rates and fall prevention practices? 5.1. How do you
measure fall and fall-related injury rates? 5.2. How do you measure fall prevention practices? 5.3.
Checklist for measuring progress 6. Hospital managers in both China and the U.S. reported a better
patient safety climate than other staff. A common misconception is that patient safety is about
reminding people to be more careful. Subscribe to receive issue release notifications and newsletters
from MDPI journals. The research methods used to survey and evaluate PSC in healthcare settings
are also explored. Additional Reading Would you like to learn more about this topic. General patient
safety was rated as very good by 60%, acceptable by 33%, and poor by 7% of the respondents.
Demonstrate your commitment to worker safety, support your business values and positive culture by
prioritizing health and safety that minimizes risks and supports accident, injury and illness prevention
with effective control measures. The overall average positive response rate was 58%. Differentiate
between audit and research with this informative article. We use cookies on our website to ensure
you get the best experience. Although organizational and behavioral learning had positive responses,
the outcome dimension, frequency of events reported, did not have positive responses in all the
studies included in this review.
Follow the guidelines for scoring and for calculating percentages of positive, negative, and neutral
responses. PS can also improve by enhancing relevant personnel’s skills and knowledge based on
incident analysis. The thickness of links between nodes represents the strength of the co-occurrence
relationships. 4. Discussion In this section, two research questions are answered in two subsections of
PSC instruments and PSC dimensions. 4.1. PSC Instruments This review identified five primary
instruments that have been used to assess PSC in hospital settings. Pearson’s correlation coefficient
was used to examine the correlations between the participants’ perception of a just culture,
empowerment, and patient safety activities. Furthermore, a great variance in PS perception was
observed within specific hospital units compared with differences between units. Nurses are more
likely to stay in health care organizations that implement many of the management, workforce, and
work design practices recommended in this report. The paper reviewed 66 studies that were
identified based on carefully selected keywords. Regarding the psychological safety of members, it
is essential to understand the notion of “just culture” related to error reporting in an organization.
You should also collect followup data, approximately a year to 18 months after you started
collecting the baseline data, to determine any changes. A positive perception of PS was observed
among medical personnel in China and U.S. managers. In both countries, these individuals expressed
a higher level of perceived PS compared with front-line personnel. A large number of hospitals in
many different countries have been studied and the specific characteristics of the healthcare
management systems in these countries greatly vary. International Journal of Environmental Research
and Public Health. 2021; 18(5):2466. Good health care requires a nursing workforce appropriate in
size and expertise, and unconstrained in its ability to provide patient care safely. Their forthrightness
helps us all see clearly the real-life implications of the issues addressed in this report. Nursing actions
such as ongoing monitoring of patient health status have been shown to be directly related to better
patient outcomes. While few hospitals manage to achieve a 90 percent response rate, many hospitals
experience an 80 percent response rate. Generic safety climate items and patient-specific items had
strong impacts on safety outcome measures. This comprehensive blog post explores the crucial role of
well-trained healthcare professionals in delivering high-quality patient care, boosting staff
confidence, and ensuring compliance with CQC regulations. The reviewed articles reported several
limitations concerning the applied methodology and results. Some key questions to ask when
reviewing culture in your organisation are. Gout, Urate, and Crystal Deposition Disease (GUCDD).
A high level of correlation was observed among feedback, managerial support, organizational
learning, and improved patient safety. A data extraction template from the Hawker Assessment Tool
was used to collect data regarding the properties of the adopted studies. Response rate was 87.5%.
HSPSC Persian version used. You should allow everybody in your unit to have a voice and
participate in this HSOPS survey. Some of the questionnaires were long and some of the respondents
may have become distracted during the process, lost interest, or answered some questions
inaccurately. Funding This research was funded by National Research Foundation of Korea (NRF)
funded by the Ministry of Education, NRF-2019R1F1A1061653. Just culture, empowerment, and
patient safety activities of the participants were placed in the regression model. This tool also enables
the user to analyze the study’s implications concerning the topic under review and indicates how the
findings can be converted into policies. In this study, unit managers were considered to have a high
awareness of just culture and empowerment because of high confidence in their work and high
awareness of responsibility toward patients based on various experiences of nursing practice.
Staffing, non-punitive response to errors, and management support attained low positive scores
among the respondents. The factors were: Teamwork Climate, Safety Climate, Perceptions of
Management, Job Satisfaction, Working Conditions, and Stress Recognition. PSCHO is considered
to be the first tool that analyzed safety constituents and provided information by measuring the
safety climate in corporations outside hospitals. The overall perception of senior nurses was 51.5%
before education and 60.6% after educational sessions. Data Availability Statement Not relevant to
this study. The map of the co-occurrence of terms in included papers is depicted in Figure 4. This
article is an open access article distributed under the terms and conditions of the Creative Commons
Attribution (CC BY) license ( ). Level of Just culture, Empowerment, and Patient Safety Activities.
This study determined the effects of hospital organizations’ just culture and empowerment on
patient safety activities of nurses, and it is relevant in that it confirmed that a just culture and
empowered nurses have significant effects on patient safety activities. Five Belgian acute hospitals
(three private hospitals and one public hospital) Hospital management support for patient safety
needed the most improvement. Assessing Patient Safety Culture in Hospital Settings. Int. J. Environ.
Res. Public Health 2021, 18, 2466. Fall prevention involves managing a patient's underlying fall risk
factors and optimizing the hospital's physical design and environment. It does so by explaining in
detail how health care organizations should implement key recommendations of To Err Is Human
and Crossing the Quality Chasm, examining aspects of work environments not addressed in those
prior reports, and unifying the evidence from the two prior reports and this report into a strong
framework for building work environments that promote the practice of safe nursing care. A list of
academic databases was searched from 2006 to 2020 to form a comprehensive view of PSC’s
current applications. HIMSS levels, however, don’t measure patient safety and culture of safety
issues. 3. Gives Frontline Clinicians a Voice in Decision Making When decision making is relegated
to and centralized at healthcare IT higher management levels, frontline caregivers are less able to
quickly act on safety issues they identify. Note that from the first issue of 2016, this journal uses
article numbers instead of page numbers. Videos Watch videos about the digital future of healthcare,
quality improvement, and much more. The rate of positive perceptions of safety was 50.7% among
respondents. 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. For example, one aspect of the Australian culture “ she’ll be right mate ” can impact
upon and organisation’s safety culture by contributing to a sense of complacency. If someone with
copyrights wants us to remove this content, please contact us immediately. This tool also includes
assessments of other aspects, such as support service personnel, as these workers are an essential part
of the hospital and healthcare setting. Areas identified for improvement included staffing and non-
punitive responses to errors. The first instrument, the Hospital Survey on Patient Safety Culture
(HSPSC), was used in 54 studies. Continuous improvement in Japan and the reporting of near-miss
events in Taiwan received low scores compared with the other countries. Examining the validity and
reliability of the instruments. This step was followed by the application of exclusion criteria, as
previously described. A positive perception of PS was observed among medical personnel in China
and U.S. managers. In both countries, these individuals expressed a higher level of perceived PS
compared with front-line personnel. As discussed earlier, safety culture is a constructed idea,
ultimately composed of these 10 dimensions. Responsibility for the final content of this report rests
entirely with the authoring committee and the institution.
These results confirm that the healthcare industry greatly relies on interdisciplinary teams of
specialists with the skill sets needed to perform specialized tasks. Non-punitive response to errors
and staffing received low feedback. There are a number of barriers that are difficult to quantify, such
as lack of openness, mistrust between employees, undervaluing staff and lack of transparency. A high
level of correlation was observed among feedback, managerial support, organizational learning, and
improved patient safety. Teamwork within units scored 48% while non-punitive error responses
scored 12%. Register for a free account to start saving and receiving special member only perks.
Figure 1: A sociotechnical approach to improving patient safety A patient safety culture based on
sociotechnical framework has seven key strengths: 1. They also proposed that such an appraisal
should be performed through the use of appropriate appraising tools. However, bridging the gap
between care quality improvement and regulatory compliance can be challenging. Videos Watch
videos about the digital future of healthcare, quality improvement, and much more. Level of Just
culture, Empowerment, and Patient Safety Activities. Assessing Patient Safety Culture in Hospital
Settings. Int. J. Environ. Res. Public Health 2021, 18, 2466. Secondly, you can see feedback,
potential incentives, and corrective action practices. The present focus should be on a more
fundamental part of building patient safety culture, related to the psychological aspects of its
members. Appointed by the National Research Council and Institute of Medicine, they were
responsible for making certain that an independent examination of this report was carried out in
accordance with institutional procedures and that all review comments were carefully considered. A
common misconception is that patient safety is about reminding people to be more careful. 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 best
evidence for improving safety culture comes from interventions that use multiple components. Some
key questions to ask when reviewing culture in your organisation are. However, it is evident that if a
hospital lacks a just culture environment and does not empower nurses, the patient safety activities of
the nurses may be low. Inadequate teamwork and communication—caregivers in the operating room
have different perceptions of teamwork by role (e.g., surgeons versus nurses), potentially impacting
safety coordination efforts. Regarding the psychological safety of members, it is essential to
understand the notion of “just culture” related to error reporting in an organization. Methods used to
determine the level of safety culture can include. The technical work will instruct you on what to do
while the adaptive work requires you to adapt to the needs of your work environment. Therefore,
while it could be concluded that teamwork is one of the important factors that impact PS, there are
always opportunities for improvement. Such a limitation may hamper current efforts to improve
patient safety worldwide. Note that from the first issue of 2016, this journal uses article numbers
instead of page numbers. A total of 66 articles that met all eligibility criteria and that had been
published between 2006 and 2020 were selected for the study. It has been used to measure safety
culture within the clinical units of hospitals. MSI-2006 was developed for a wide range of hospital
settings with the aim of generating relevant and accurate data over the long term. 4.2. PSC
Dimensions To understand the effect of PS on healthcare organizations and their staff, the process
and structure of each system needs to be broken into subsystems. The type of instruments and their
varying dimensions, as well as the groups targeted in each study, were among the most interesting
points to be considered when attempting to understand PS.
However, it is evident that if a hospital lacks a just culture environment and does not empower
nurses, the patient safety activities of the nurses may be low. The results of the present study suggest
that nurses in general hospitals need to make efforts to improve their awareness about the
characteristics of a just culture. To ensure that staff are comfortable speaking up, leadership must
uphold an environment of non-negotiable mutual respect for all team members. 6. Treats a Safety
Issue in One Area as a Potential Systemwide Risk An IT-related safety issue in one unit of a health
system may indicate risk throughout the system. General patient safety was rated as very good by
60%, acceptable by 33%, and poor by 7% of the respondents. Upon the authority of the charter
granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the
federal government on scientific and technical matters. Note that from the first issue of 2016, this
journal uses article numbers instead of page numbers. Bronwyn Schrecker at the Institute of
Medicine and Jennifer Pinkerman at the National Research Council facilitated the external review
process with great efficiency and attention to detail. All of those people can participate in HSOPS
because they are all part of that unit. Acronyms AHRQ Agency for Healthcare Research and Quality
NH SOPS Nursing Home Survey of Patient Safety. Safety culture is not static; so, you have the
potential to transform it. Some items are worded positively, and some are worded negatively, and the
scoring guidelines show you how to account for the responses to both types of questions. Non-
punitive response to errors had the lowest positive feedback. For respondents that reported errors, an
accusatory culture existed in the ward. 70% of respondents reported a lack of support. Examining
the validity and reliability of the instruments using HSPSC and SAQ. The map of the co-occurrence
of terms in included papers is depicted in Figure 4. Based on results from the Safety Attitudes
Questionnaire (SAQ), as workforce attitudes towards safety improved, all-hospital harm decreased
significantly, as did serious safety events. Therefore, while it could be concluded that teamwork is
one of the important factors that impact PS, there are always opportunities for improvement. Why do
some hospitals have higher rates of accident and errors involving patients. More strictly speaking, a
just culture should be based on the achievement of substantive, procedural, and restorative
justice—thereby improving safety. Train yourself and workers on hazard recognition and how to
work safely and you’ll see a shift in mindset and increased engagement. These can be used to help
determine the direction for your safety culture journey. Based on feedback from you, our users,
we've made some improvements that make it easier than ever to read thousands of publications on
our website. This cross-sectional study included 189 nurses from four hospitals in South Korea.
European Journal of Investigation in Health, Psychology and Education (EJIHPE). We’re sharing
this material with our audience ONLY for educational purpose. Women nurses formed the majority
of respondents, with five years or less in terms of work experience in their respective hospital. The
present report builds on these prior studies by examining patient safety from a new perspective—the
characteristics of the work environment in which patient care is provided. We highly encourage our
visitors to purchase original books from the respected publishers. Examining the validity and
reliability of the instruments. Editor’s Choice articles are based on recommendations by the scientific
editors of MDPI journals from around the world.
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. A systematic literature review was conducted using the
PRISMA protocol for the period of 2006 to 2020. More and more hospitals and healthcare managers
are trying to understand the nature of the culture within their organisations and implement strategies
for improving patient safety. Effects of Just Culture and Empowerment on Patient Safety Activities
of Hospital Nurses. The HSPSC is available in different languages, including Arabic, Spanish,
French, and Dutch. Five instruments were used in the reviewed studies to measure PSC within the
healthcare facilities examined. Non-punitive response to errors, frequency of reporting,
communication, management support, and staffing had low scores at 17%, 35%, 36%, 37%, and
38%, respectively. Data were collected from willing nurses between October and December 2019.
Want to motivate your staff and boost your bottom line. Explore evidence categories and stay up-to-
date with the latest updates. The Surveillance Module helps detect, monitor, and prevent patient
safety events and automates reporting to provide predictive data and all-harm identification and
analysis. 5. Encourages Frontline Clinicians to Report Safety and Quality Issues With an
organizational culture in which frontline staff are comfortable reporting any safety or quality
concerns, health systems can more accurately measure safety issues (an essential step in reducing
risk). Although organizational and behavioral learning had positive responses, the outcome
dimension, frequency of events reported, did not have positive responses in all the studies included
in this review. Whether you're a healthcare provider seeking to improve patient outcomes or a
stakeholder in the health sector, this blog post offers valuable insights and actionable strategies. PS
can also improve by enhancing relevant personnel’s skills and knowledge based on incident analysis.
The review comments and draft manuscript remain confidential to protect the integrity of the
deliberative process. Only Nurses in one Tertiary care hospital considered for collecting data. In other
words, a study confirming the relationship between the just culture of the organization to which the
nurses belong, and the patient safety activities based on their empowerment will be relevant in
establishing a patient safety culture and improving the quality of nursing services. First, articles
mainly used quantitative approaches to measure PSC, where these methods are not efficient for
measuring complex and dynamic attributes such as culture. Among respondents, 53.2% had not
reported any errors in the past year. Feature papers represent the most advanced research with
significant potential for high impact in the field. A Feature. Improvements in dimensions of patient
safety from 2012 to 2015 indicated an improvement in performance. Our mission is to deliver top-
tier medical content to our readers, encompassing career guidance, interviews, medical mnemonics,
and comprehensive study materials. The rate of positive perceptions of safety was 50.7% among
respondents. 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. Non-punitive response to errors had the lowest positive feedback. The
best evidence for improving safety culture comes from interventions that use multiple components.
The survey also showed that respondents working in pediatrics, rehabilitation, and psychiatry
departments (units) provided more positive feedback about perceived PSC. Effects of Just Culture
and Empowerment on Patient Safety Activities of Hospital Nurses. Journal of Manufacturing and
Materials Processing (JMMP). Follow the guidelines for scoring and for calculating percentages of
positive, negative, and neutral responses.