Professional practices environment and patient safety culture as perceived by nurses in hospitals in the province of Antique

Abstract

This study determined the relationship between professional practice environment and patient safety culture as perceived by nurses in hospitals in the Province of Antique. Specifically, this study aimed to determine (a) the characteristics of the nurses in terms of sex, primary work area, years of experience, type of hospital and type of employment; (b) their perception regarding professional practice environment and (c) patient safety culture; (d) if there are significant differences in the perception of their professional practice environment according to sex, primary work area, years of experience, type of hospital and type of employment; (e) if there are significant differences in the perception of their patient safety culture according to sex, primary work area, years of experience, type of hospital and type of employment; and (f) if there is a significant relationship between the nurses’ perception regarding professional practice environment and that of their patient safety culture.

This is a descriptive relational study that utilized a one shot survey design. The study was conducted in August 2016 to nurses in hospitals in the Province of Antique. The three-part questionnaire used to gather data needed for the study consisted of the respondent’s characteristics, the Practice Environment Scale of the Nursing Work Index Revised (PES-NWIR) and the Hospital Survey on Patient Safety Culture (HSPSC). After the retrieval of the questionnaire, the data were computer processed and analyzed. The statistical tools employed were means, frequency, and percentage for descriptive analysis. Man-Whitney U Test, Kruskal-Wallis Test and Spearman’s Rank Order Correlation were used in inferential statistics set at 5 percent level of significance.

Results of the study revealed that majority of the nurses were female, and most of them were assigned in General Wards. Majority had work experience for 1 to 5 years and working in public hospitals. Furthermore, majority of the nurses were not permanent in their employment. The overall mean composite score of the PES-NWI is 2.98 on a 4- point scale. Four of the five mean subscale scores are above the midpoint of 2.5 indicate an overall favorable work environment (Lake & Friese, 2006). The highest mean subscale scores are for Collegial Nurse-Physician Relations (M=3.17) and Nurse Manager Ability, Leadership, and Support of Nurses (M=3.05), followed by Nursing Foundations for Quality Care (M=2.98) and Nurse Participation in Hospital Affairs (M=2.90). The only subscale that fall below the mid-point is Staffing and Resource Adequacy (M=2.43). Dimensions of the HSPSC tool, where the percentages of the positive responses exceeded 50% included: (1) Teamwork Within Units = 86%, (2) Supervisor/Manager Expectations & Actions Promoting Safety = 55%, (3) Organizational Learning-Continuous Improvement = 84%, (4) Management Support for Patient Safety = 60%, (5) Feedback and Communication about Error = 65%, (6) Communication Openness = 55%, (7) Teamwork Across Units = 65%, (8) Handoffs & Transitions = 50%. The data show significant differences in the professional practice environment of nurses according to sex, primary work area and type of hospital. However, no significant differences were noted when it was grouped according to years of experience and type of employment. Significant differences were also found in the Patient Safety Grade of nurses according to sex, type of hospital and type of employment, however, no significant differences were found when grouped according to primary work area and years of experience. Moreover, significant relationships were found between Nurse Participation in Hospital Affairs, Nursing Foundations for Quality Care, Staffing and Resource Adequacy, and Nurse Manager Ability, Leadership, and Support for Nurses, and Patient Safety Culture (using the Overall Patient Safety Grade) of nurses. Only one of the five subscales of PES NWI is not significantly correlated with patient safety culture, that is Collegial Nurse-Physician Relations.