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

Autores/as

DOI:

https://doi.org/10.15649/cuidarte.2872

Palabras clave:

Patient Safety, Culture, Hospital, Operating Room, Healthcare Workers, Benchmarking

Resumen

Highlights:

Studies show that the level of safety culture of health workers is not at the desired level and progress is very slow.

Similar to the first evaluation 10 years ago in Turkey, the patient safety culture level of operating room health professionals was found to be low (41%).

Compared to the previous study, there was a positive change in 8 dimensions and a negative change in 3 dimensions. There was no change in a dimension.

Lowest average percentage of positive responses were “frequency of events reported (18%)” and “non-punitive response to error (19%). The scores of all 12 dimensions were lower than the AHRQ score.

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.

How to cite this article: Fíliz Emel. Safety culture among operating room healthcare workers: still a long way to go. an analytical cross-sectional study from Turkey. Revista Cuidarte 2023;14(2):e2872. http://dx.doi.org/10.15649/cuidarte.2872

Biografía del autor/a

Emel Filiz, Selcuk University

Assistant Professor of Selcuk University, Faculty of Health Sciences, Department of Health Management, Konya Turkey

Referencias

Kohn LT, Corrigan JM, Donaldson MS. To err is human: Building a safer health system. Institute of Medicine: National Academy Pres. 2000. http://nap.edu/9728

Kruk ME, Gage AD, Arsenault C, Jordan K, Leslie HH, Roder-DeWan S, et al. High-quality health systems in the Sustainable Development Goals era: time for a revolution. Lancet Glob Health. 2018;6(11): e1196-e1252. https://doi.org/10.1016/S2214-109X(18)30386-3

Slawomirski L, Auraaen A, Klazinga N. The economics of patient safety: Strengthening a value-based approach to reducing patient harm at national level. OECD Health Working Papers. 2017. https://www.bundesgesundheitsministerium.de/fileadmin/Dateien/3_Downloads/P/Patientensicherheit/The_Economics_of_patient_safety_Web.pdf

Çarıkçı F, Eslek S, Kırbaş Ç, Aktaşçı B, Baştimur F. A retrospective review on medical practice errors reflected in daily newspapers. Journal of Medical Sciences, 2021; 2(4), 59-66. https://jms.yeniyuzyil.edu.tr/en/a-retrospective-review-on-medical-practice-errors-reflected-in-daily-newspapers/

Kahyaoğlu Khalil E. 2015-2020 Yılları Arasında Yargıtay’a İntikal Etmiş Malpraktis Dosyalarının Sağlık Yönetimi Açısından Analizi. 2022. (Master's thesis, Sağlık Bilimleri Enstitüsü). http://earsiv.odu.edu.tr/xmlui/bitstream/handle/11489/223/10447650.pdf?sequence=1&isAllowed=y

WHO, Patient Safety. ‎2009‎. WHO guidelines for safe surgery 2009: safe surgery saves lives. World Health Organization. 2022. https://apps.who.int/iris/handle/10665/44185

Rockville W, Sorra J, Gray L, Streagle S, Famolaro T, Yount N, et al. AHRQ Hospital Survey on Patient Safety Culture: User’s Guide. (Prepared by Westat, under Contract No. HHSA290201300003C). AHRQ Publication No. 18-0036-EF (Replaces 04-0041, 15(16)-0049-EF). Rockville, MD: Agency for Healthcare Research and Quality. 2018. https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patientsafetyculture/hospital/userguide/hospitalusersguide.pdf

WHO & Patient Safety. Draft Global patient safety action plan 2021–2030: towards eliminating avoidable harm in health care. World Health Organization. 2021. https://cdn.who.int/media/docs/default-source/patient-safety/gpsap/global-patient-safety-action-plan_12-apr-2021.pdf?sfvrsn=58ad8e9e_10

Pronovost PJ, Thompson DA, Holzmueller CG, Lubomski LH, Morlock LL. Defining and measuring patient safety. Crit Care Clin. 2005;21(1):1-19. https://doi.org/10.1016/j.ccc.2004.07.006

Reis CT, Paiva SG, Sousa P. The patient safety culture: a systematic review by characteristics of hospital survey on patient safety culture dimensions. Int J Qual Health Care. 2018; 30(9):660-677. https://doi.org/10.1093/intqhc/mzy080

Gurková E, Zeleníková R, Friganovic A, Uchmanowiccz I, Jarošová D, Papastavrou E, et al. Hospital safety climate from nurses’ perspective in four European countries. Int Nurs Rev. 2020; 67(2):208-217. https://doi.org/10.1111/inr.12561

AHRQ. Survey on Patient Safety Culture Bibliography. 2022 https://www.ahrq.gov/sops/bibliography/index.html?f%5B0%5D=facets_sops_biblio_healthcare_setting%3A14551

Magalhães EV, de Paiva FO, Alves MES, de Almeida MC. Cultura de segurança do paciente entre profissionais de Enfermagem em um hospital filantrópico de Minas Gerais. Rev Cuid. 2021; 12(3). e1990. http://dx.doi.org/10.15649/cuidarte.1990

Tran HTN, Pham TQ, Tran HL, Nguyen HD, Nguyen TM, Bui HTT. Patient Safety Culture in 2 Public Hospitals in Vietnam: A Mixed Method Study. J Nurs Care Qual. 2022; 37(3): 39-47. https://doi.org/10.1097/NCQ.0000000000000597

Nieva VF, Sorra J. Safety culture assessment: a tool for improving patient safety in healthcare organizations. BMJ Qual Saf. 2003;12(2):17-23. http://dx.doi.org/10.1136/qhc.12.suppl_2.ii17

Bacaksız FE, Taşkıran Eskici GT, Uğuz G, Seren AKH. Türkiye’de “Hasta Güvenliği” Konusunda Son On Yılda (2008-2017) Yayımlanan Ulusal Çalışmaların Değerlendirilmesi: Bibliyografik Bir İnceleme. JAREN. 2020;6(3):523-37. https://www.researchgate.net/publication/346975096_Turkiye'de_Hasta_Guvenligi_konusunda_son_on_yilda_2008-2017_yayimlanan_ulusal_calismalarin_degerlendirilmesi_bibliyografik_bir_inceleme

Filiz E. Hastanede hasta güvenliği kültürü algılamasının ve sağlık çalışanları ile toplumun hasta güvenliği hakkındaki tutumunun. Selçuk Üniversitesi Sağlık Bilimleri Enstitüsü. 2009. https://tez.yok.gov.tr/UlusalTezMerkezi/tezSorguSonucYeni.jsp

Bodur S, Filiz E. Validity and reliability of Turkish version of" Hospital Survey on Patient Safety Culture" and perception of patient safety in public hospitals in Turkey. BMC Health Serv Res. 2010;10(28):1-9. https://bmchealthservres.biomedcentral.com/articles/10.1186/1472-6963-10-28#:~:text=Conclusion,patient%20safety%20culture%20in%20Turkey

Famolaro T, Yount N, Hare R, et al. Hospital Survey on Patient Safety Culture 2018 User Database Report. AHRQ. 2018. No. 18-0025-EF. https://psnet.ahrq.gov/issue/hospital-survey-patient-safety-culture-2018-user-database-report

Filiz E. Patient Safety Culture, Mendeley Data. 2023. https://doi.org/10.17632/bzcrpt47zz.1

Kuosmanen A, Tiihonen J, Repo‐Tiihonen E, Eronen M, Turunen H. Changes in patient safety culture: a patient safety intervention for Finnish forensic psychiatric hospital staff. J Nurs Manage. 2019;27(4):848-857. https://doi.org/10.1111/jonm.12760

Singer SJ, Gaba DM, Falwell A, Lin S, Hayes J, Baker L. Patient safety climate in 92 US hospitals: differences by work area and discipline. Medical care. 2009;47(1):23-31. https://www.jstor.org/stable/40221833

Abdi Z, Delgoshaei B, Ravaghi H, Abbasi M, Heyrani A. The culture of patient safety in an Iranian intensive care unit. J Nurs Manage. 2015;23(3):333-345. https://doi.org/10.1111/jonm.12135

Haugen AS, Søfteland E, Eide GE, Nortvedt MW, Aase K, Harthug S. Patient safety in surgical environments: cross-countries comparison of psychometric properties and results of the Norwegian version of the Hospital Survey on Patient Safety. BMC Health Serv Res. 2010;10 (1):1-10. http://www.biomedcentral.com/1472-6963/10/279 0

Marsteller JA, Wen M, Hsu YJ,Thompson DA, Wahr JA, Martinez EA, et al. Safety culture in cardiac surgical teams: data from five programs and national surgical comparison. Ann Thorac Surg. 2015;100(6):2182-2189. https://doi.org/10.1016/j.athoracsur.2015.05.109

Pimentel MPT, Choi S, Fiumara K, Kachalia A, Urman RD. Safety culture in the operating room: variability among perioperative healthcare workers. J Patient Saf. 2021;17(6): 412-416. https://pubmed.ncbi.nlm.nih.gov/28574955/

Scherer D, Fitzpatrick JJ. Perceptions of patient safety culture among physicians and RNs in the perioperative area. AORN J. 2008;87(1):163-175. https://doi.org/10.1016/j.aorn.2007.07.003

Kaissi A, Johnson T, Kirschbaum MS. Measuring teamwork and patient safety attitudes of high-risk areas. Nursing Economics. 2003; 21(5): 211-8. https://pubmed.ncbi.nlm.nih.gov/14618970/

de Vries EN, Ramrattan MA, Smorenburg SM, Gouma DJ, Boermeester MA. The incidence and nature of in-hospital adverse events: a systematic review. BMJ Qual Saf. 2008; 17(3):216-223. http://dx.doi.org/10.1136/qshc.2007.023622

Wang M, Tao H. How does patient safety culture in the surgical departments compare to the rest of the county hospitals in Xiaogan City of China? Int J Environ Res Public Health. 2017; 14(10):1123. https://www.proquest.com/docview/1965687894/fulltextPDF/5F3C1FE0A8F64B0CPQ/1?accountid=16935

Vlayen A, Schrooten W, Wami W, Aerts M, Barrado LG, Claes N, et al. Variability of patient safety culture in Belgian acute hospitals. J Patient Saf. 2015; 11(2):110-121. https://www.jstor.org/stable/pdf/ 26633087.pdf

Kayral İH. Dünya’da ve Türkiye'de sağlık hizmetleri akreditasyonu. Sağlıkta Kalite ve Akreditasyon Dergisi. 2018;1(1): 27-31. https://dergipark.org.tr/en/download/article-file/479122

Resmi Gazete. Hasta ve Çalışan Güvenliğinin Sağlanmasına Dair Yönetmelik. 2011. http://www.resmigazete.gov.tr/eskiler/2011/04/20110406-3.htm

Resmi Gazete. Sağlıkta Kalitenin Geliştirilmesi ve Değerlendirilmesine Dair Yönetmelik. CUMARTESİ. 2015; (27). https://www.resmigazete.gov.tr/eskiler/2015/06/20150627-2.htm

Nekoei‐Moghadam M, Raadabadi M, Heidarijamebozorgi M. Patient safety culture in university hospital's emergency departments: A case study. Int J Health Plann Manage. 2020;35(4):852-858. https://onlinelibrary.wiley.com/doi/pdf/10.1002/hpm.2948

Aiken LH, Ceron C, Simonetti M, Lake ET, Galiano A, Garbarini A, et al. Hospital nurse staffing and patient outcomes. Revista Médica Clínica Las Condes. 2018;29(3):322-327. https://www.sciencedirect.com/science/article/pii/S0716864018300609

Ball JE, Bruyneel L, Aiken LH, Sermeus W, Sloane DM, Rafferty AM, et al. Post-operative mortality, missed care and nurse staffing in nine countries: a cross-sectional study. Int J Nurs Stud. 2018; 78:10-15. https://www.sciencedirect.com/science/article/pii/S0020748917301761

Needleman J, Liu J, Shang J, Larson EL, Stone PW. Association of registered nurse and nursing support staffing with inpatient hospital mortality. BMJ Qual Saf. 2020; 29 (1):10-18. https://dergipark.org.tr/en/download/article-file/35839

Sayan İÖ, Küçük A. Türkiye’de kamu personeli istihdamında dönüşüm: sağlık bakanlığı örneği. Ankara Üniversitesi SBF Dergisi. 2012;67(01):171-203. https://www.jstor.org/stable/pdf/ 26633087.pdf

Üner S, Okyay P. (Ed.). Türkiye Sağlık Raporu 2020. Ankara: Hipokrat Yayınevi. 2020. ISBN: 978-605-7874-83-2.

Kim KJ, Yoo,MS, Seo EJ. Exploring the influence of nursing work environment and patient safety culture on missed nursing care in Korea. Asian Nurs Res. 2018;12(2):121-126. https://www.sciencedirect.com/science/article/pii/S1976131717306837

Donaghy C, Doherty R, Irwin T. Patient safety: A culture of openness and supporting staff. Surgery (Oxford). 2018;36(9):509-514. https://www.sciencedirect.com/science/article/pii/ S0263931918301376

Kirwan M, Matthews A, Scott PA. The impact of the work environment of nurses on patient safety outcomes: a multi-level modelling approach. Int J Nurs Stud. 2013;50(2):253-263. https://www.sciencedirect.com/science/article/pii/S0020748912003021

Alswat K, Abdalla RAM, Titi MA, Bakash M, Mehmood F, Zubairi B, et al. Improving patient safety culture in Saudi Arabia (2012–2015): trending, improvement and benchmarking. BMC Health Serv Res. 2017;17(1):1-14. https://pubmed.ncbi.nlm.nih.gov/14618970/

Alves MDFT, de Carvalho DS, de Albuquerque GSC. Barriers to patient safety incident reporting by Brazilian health professionals: an integrative review. Ciencia & saude coletiva. 2019;24: 2895-2908. https://www.scielosp.org/article/csc/2019.v24n8/2895-2908/en/

Sözer E. Tıbbi Hatanın Hasta Yakınları ile Paylaşılması. İçinde: Çakmakçı M, Akalın HE, editör. Hasta Güvenliġi: Türkiye ve Dünya. Füsun Sayek TTB Raporları. Birinci Baskı,Ankara: Türk Tabipleri Birliği Yayınları. 2011; 71. https://www.ttb.org.tr/kutuphane/fsayek10_hastaguvenlik.pdf

WHO. World alliance for patient safety: WHO draft guidelines for adverse event reporting and learning systems: from information to action. World Health Organization. 2005; 12, 2022. https://apps.who.int/iris/handle/10665/69797

Security Reporting System. Güvenlik Raporlama Sistemi 2016 Yılı İstatistik ve Analiz Raporu, Sağlık Hizmetleri Genel Müdürlüğü Sağlıkta Kalite ve Akreditasyon Daire Başkanlığı, Ankara. SRS. 2016; 10, 2022. https://shgmkalitedb.saglik.gov.tr/TR,15234/guvenlik-raporlama-sistemi-2016-yili-raporu-yayinlandi.html

Sağlık Bakanlığı. SHGM Sağlıkta Verimlilik Kalite ve Akreditasyon Dairesi Başkanlığı. Güvenlik Raporlama Sistemi 2017 Yılı İstatistik ve Analiz Raporu. Ankara (Türkiye); 2017. https://www.saglikaktuel.com/d/file/28439,grs2017-sonpdf.pdf

Badir A. The development of patient safety in Turkey: constraints and limitations. J Nurs Care Qual. 2009;24(4):348-353. https://journals.lww.com/jncqjournal/FullText /2009/10000/The_Development_of_Patient_Safety_in_Turkey_.11.aspx

Beauregard K. Patient safety, elephants, chickens, and mosquitoes. Plast Surg Nurs. 2006; 26(3):123-125. https://journals.lww.com/psnjournalonline/Fulltext/2006/07000/Patient_ Safety,_Elephants,_Chickens,_and.5.aspx

Sevdalis N, Hull L, Birnbach DJ. Improving patient safety in the operating theatre and perioperative care: obstacles, interventions, and priorities for accelerating progress. Br J Anaesth. 2012;109(suppl_1): i3-i16. https://academic.oup.com/bja/article/109/suppl_1/ i3/292754 /

Mitchell I, Schuster A, Smith K, Pronovost P, Wu A. Patient safety incident reporting: a qualitative study of thoughts and perceptions of experts 15 years after ‘To Err is Human’. BMJ Qual Saf. 2016;25(2):92-99. https://pubmed.ncbi.nlm.nih.gov/26217037/

Publicado

2023-05-19

Cómo citar

1.
Filiz E. Safety culture among operating room healthcare workers: still a long way to go. An analytical cross-sectional study from Turkey. Revista Cuidarte [Internet]. 19 de mayo de 2023 [citado 15 de diciembre de 2024];14(2). Disponible en: https://revistas.udes.edu.co/cuidarte/article/view/2872

Número

Sección

Artículos de Investigación

Categorías

Altmetrics

Descargas

Los datos de descargas todavía no están disponibles.