Attitudes Towards Patient Safety Among Physicians and Nurses in Iranian Governmental Teaching Hospitals: A Cross-Sectional Survey Publisher Pubmed



Kakemam E¹ ; Miri F² ; Sadeghpour S³ ; Mirzaei A⁴ ; Saeidpour J⁵ Show Affiliations
Source: BMJ Open Published:2024

Abstract

Objectives To assess and compare attitudes towards patient safety among physicians and nurses in Iranian governmental teaching hospitals and to identify factors associated with attitudes towards patient safety. Design An institution-based, cross-sectional survey was carried out from July to August 2023. Setting 10 governmental teaching hospitals in Tehran, Iran. Participants The study participants comprised a random sample of 186 nurses and 90 physicians who had worked for at least 6 months in their current hospitals. Outcome measures The primary outcome measures were mean and SD scores for individual items and the nine main patient safety domains assessed by the Attitudes Toward Patient Safety Questionnaire-III. The secondary outcome measure was the proportion of physicians and nurses who responded positively to each item, expressed as percentages for each group. Results Physicians and nurses exhibited moderately positive attitudes towards patient safety (mean scores of 3.79±0.33 and 3.83±0.36, respectively). Both professional groups reported the most positive attitudes in the same dimensions: 'team functioning' and 'working hours as a cause for error' (mean scores of >4 out of 5). Conversely, the lowest scores were observed in 'importance of patient safety in the curriculum', indicating potential gaps in their understanding of patient safety (mean scores of <3.5 out of 5). Physicians displayed significantly more positive attitudes in the domain of 'error inevitability', while nurses held more positive attitudes in 'error reporting confidence' and 'disclosure responsibility' (p<0.05). Multiple linear regression analysis demonstrated that the factors associated with more positive attitudes towards patient safety included lower workload (B=0.131; 95% CI 0.047 to 0.215; p=0.002), reporting of adverse events (B=0.100; 95% CI 0.009 to 0.191; p=0.030) and receiving patient safety training (B=0.134; 95% CI 0.019 to 0.249; p< 0.023). Conclusion Both professional groups demonstrated moderately positive attitudes towards patient safety. However, the findings highlighted the need for future patient safety training to prioritise enhancement of healthcare professionals' understanding of medical errors. Such training initiatives should be engaging and directly relevant to the specific needs of both nurses and physicians, ensuring its perceived value to their ongoing professional development. Furthermore, fostering a supportive and blame-free environment that encourages the reporting of medical errors is crucial. © Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.