Patient Safety Culture In Psychiatric Settings:A Cross-Sectional Survey

Background:Patient Safety Culture(PSC)refers to the common attitude,belief and value trend of all employees in the organization towards patient safety.The Institute of Medicine emphasizes that establishing patient safety culture in health organizations can improve patient safety.Psychiatric nurses are at the forefront of patient safety and play a vital role in preventing medical errors and promoting safety.Therefore,it is necessary to evaluate the patient safety culture of psychiatric nurses,describe the current situation of patient safety culture in the field of mental health in China,and provide baseline information for improving the patient safety culture of psychiatric nurses.In addition,through the investigation,analysis and comparison of the patient safety culture of psychiatric nurses in different class of hospitals,it can provide the basis for the targeted training of patient safety culture in different class hospitals in the future.Objectives:(1)To describe the current PSC of psychiatric nurses in seven geographical regions of China.(2)To analyze the differences of PSC among psychiatric nurses in different class of hospitals.Methods:Using the convenient sampling method,a total of 2624 nurses in psychiatric department from 7 regions of China were selected as the research objects from September 2019 to December 2019.The Self-designed General Information Questionnaire and Hospital Survey on Patient Safety Culture(HSOPSC)were used for the survey.All statistical analyses were performed using SPSS 23.0.Results:(1)The total HSOPSC score of 2624 psychiatric nurses was(153.29±18.02).The positive response rate of all dimensions of HSOPSC was from 43.30%to 83.30%.The positive responses ratings(PRRs)for "teamwork within units","organizational learning/continuous improvement" and "feedback and communications about error" were≥75%,which denoted strengths,and the PPRs for "staffing","non-punitive response to error" and "frequency of events reported" were≤50%,which denoted weaknesses in psychiatric settings.There are four PSC dimensions can affect the "adverse event reporting frequency",together explaining 15.80%of the total variation.Seven dimensions of PSC that predicted the "overall perception of safety",together explaining 41.20%of the total variation.(2)There are differences in the total score of PSC among psychiatric nurses in different class of hospitals(P<0.001).Different positions,length of service,night shift and daily overtime hours all affected the score of PSC of psychiatric nurses(P<0.05).Conclusions:(1)The PSC of psychiatric nurses needs to be improved.It is suggested that managers can improve the PSC of psychiatric nurses in China by recruiting enough nurses,reconstructing the non-punitive system in the hospital,increasing the hospital management’s attention to patient safety,promoting effective feedback and communication in the department,and giving more training and attention in the process of nurse shift and transfer to improve the PSC of psychiatric nurses in China.(2)There are differences in PSC among psychiatric nurses in different class of hospitals.Different positions,length of service,night shift and daily overtime hours will affect the PSC of psychiatric nurses.It is suggested that managers of hospitals at all class can improve the patient safety of nurses by training nurses in communication skills,encouraging nurses to express their opinions freely on the decisions or actions of authoritative departments,establishing information system for reporting adverse events,reasonably arranging night shift and reducing overtime hours.