The relationship between patient safety culture and adverse events: a questionnaire survey

Background: Patient safety culture is an important factor in the effort to reduce adverse events in the hospital and improve patient safety. A few studies have shown the relationship between patient safety culture and adverse events, yet no such research has been reported in China.

Objectives: This study aimed to describe nurses' perception of patient safety culture and frequencies of adverse events, and examine the relationship between them.

Design: This study was a descriptive, correlated study.

Setting and participants: We selected 28 inpatient units and emergency departments in 7 level-3 general hospitals from 5 districts in Guangzhou, China, and we surveyed 463 nurses.

Methods: The Hospital Survey on Patient Safety Culture was used to measure nurses' perception of patient safety culture, and the frequencies of adverse events which happened frequently in hospital were estimated by nurses. We used multiple logistic regression models to examine the relationship between patient safety culture scores and estimated frequencies of each type of adverse event.

Results: The Positive Response Rates of 12 dimensions of the Hospital Survey on Patient Safety Culture varied from 23.6% to 89.7%. There were 47.8-75.6% nurses who estimated that these adverse events had happened in the past year. After controlling for all nurse related factors, a higher mean score of "Organizational Learning-Continuous Improvement" was significantly related to lower the occurrence of pressure ulcers (OR=0.249), prolonged physical restraint (OR=0.406), and complaints (OR=0.369); a higher mean score of "Frequency of Event Reporting" was significantly related to lower the occurrence of medicine errors (OR=0.699) and pressure ulcers (OR=0.639).

Conclusions: The results confirmed the hypothesis that an improvement in patient safety culture was related to a decrease in the occurrence of adverse events.