الفهرس 
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Abstract
Patient safety practice begins with defining an organizations’ patient safety culture that can be measured, analyzed, and effectively implemented. This process requires an understanding that will not happen overnight and will involve a diligent effort continuously from all departments throughout the organization. Healthcare organizations should create opportunities to improve patient safety culture and practices. As it can be created when the patterns of behavior remain on the safety of the patient and become part of the daily routine.
Aim of the study:
The study aims to compare between nurses’ perception toward patient safety culture at Kafer El Sheikh University Hospital and Kafer El Sheikh General Hospital.
Research questions:
- What is the level of nurses’ perception regarding patient safety culture at both Kafer El Sheikh University Hospital and Kafer El Sheikh General Hospitals?
- What is the difference between nurses’ perception of patient safety culture at Kafer El Sheikh University Hospital and Kafer El Sheikh General Hospital?
Study design:
A descriptive comparative design was used in this study.
Setting:
The study was conducted in two hospitals from different health sectors at Kafer El sheikh Governorate namely: University Health Sector (Kafer El Sheikh University Hospital) and Ministry of Health and Population (Kafer El Sheikh General Hospital)
A. Kafer El Sheikh University Hospital includes: 7 units with 433 bed capacity classified as follow: Surgical Units, Medical Units, Special Critical Units, Operating Rooms, Outpatient Units, Emergency Department and Recovery Units.
B. Kafer-EL Sheikh General Hospital includes: 7 units with bed capacity 420 bed and classified the same as, Kafer El Sheikh University Hospital units.
Subjects:
A convenience sample of nurses (n=250) with experience more than one year who was available at time of data collection in the previously mentioned units and divided as the following: n=146 nurse from Kafer El Sheikh University Hospital, and n=104 nurse from Kafer El sheikh General Hospital.
Tool: One tool was used in the study.
Hospital Survey on Patient Safety Culture (HSPSC) Instrument:
It was used to assess Nurses’ Perception of Patient Safety Culture. It was developed by Sorra and Nieva 2004 (12) to assess the nurses’ perception of patient safety culture, and validated by the Agency of Health Care Research and Quality on (2016) (20). It consists of 42 items divided into twelve sub-dimensions and grouped into three dimensions namely:
Unit safety culture level, this dimension includes eight sub- dimensions which are: teamwork within Units (4 items), supervisor/manager expectations and actions promoting patient safety (4 items), organizational learning-continuous improvement (3 items), management support for patient safety (3 items), non- punitive response to errors (3 items), staffing (4 items), communication openness (3 items), feedback and communication about error (3 items).
Hospital –wide safety culture: This dimension includes two sub- dimensions which are: teamwork across units (4 items), hospital handoffs and transitions (4 items).
Outcome measures: This dimension includes two sub dimensions which are: overall perceptions of patient safety (4 items), frequency of events reported (3 items).
The result of this study revealed that:
- There were significant differences between Kafer El Sheikh University Hospital and Kafer El Sheikh General Hospital at the three major dimensions of patient safety culture “unit level safety culture, hospital-wide survey and outcome measures” as well as the significant differences at the twelve sub-dimensions of patient safety culture.
- The perception of nurses toward patient safety culture sub-dimensions at Kafer El Sheikh General Hospital was higher than nurses’ perception at Kafer El Sheikh University Hospital.
Based on these findings, the following recommendations were developed
The hospital management should:
1- Encourage the application of the Egyptian patient safety standard on unit based level healthcare and the organization as awhole.
2- Establish a proper staffing to be effective for providing a high quality and safe patient care at the two hospitals.
3- Empower nurses at Kafer El Sheikh University Hospital to establish open communication on a daily basis to discuss situations which raising awareness of patient safety problems.
4- Develop and implement training programs about patient safety specially, at Kafer El Sheikh University Hospital and encourage continuous organizational learning and improvement to improve patient safety outcomes.
5- Encourage front-line nursing managers to provide an environment of trust in which nurses are encouraged to report errors which can or not affect patient safety without holding these mistakes against them but for learning from these mistakes as well as encouraging no-blame culture.
6- Consider safety behaviors as a fundamental aspect of hospital patient safety and as an essential role of hospital nursing leaders.
Recommendations for further studies:
1- Assess/evaluate healthcare providers advocating role for patient safety.
2- Assess/evaluate patient’ perception toward problems which can affect their safety outcomes.
3- Investigate the effects of nurse leaders’ actions that are needed to reducing error and improving patient safety on nursing units.
4- Assess the barriers of performing daily safety activities that would be better to support unit nurse managers for improving patient safety.
5- Assess the effect of building no blame culture on patient outcome.
6- Evaluate the complex relationship between the safety culture, advocacy and the patient outcomes achieved.
7- Assess the necessary steps of nurse managers to consider while building and maintaining a patient safety culture.