The implementation of patient safety culture in nursing practice

Objective: To summarize the implementation of patient safety culture in nursing practice at the hospitals. Method: We did a literature review of the peer-reviewed articles published between 2009 until 2018 from four online databases: Emerald Insight, EBSCO, ScienceDirect, and Wiley Online, using the keywords “patient safety culture”, “nurse,” and “hospital.” For the selection of articles, we used the PRISMA Groove Model with a three-step procedure (i.e. reviewing the titles, abstracts, and full contents of the articles). Selected articles were analyzed based on the 12 dimensions of patient safety culture as proposed by Agency for Healthcare Research and Quality (AHRQ). Results: 11 articles were included in the final review. We categorized the results into three categories: strengths, weaknesses, and predictors of the patient safety culture of the nursing practice. The strengths consisted of four dimensions: (1) teamwork within units, (2) organizational learning and continuous improvement, (3) the support of the hospital management to the safety of patient, and (4) frequency of events reported. On the other side, weaknesses included: (1) assumptions about the safety of the patient as a whole, (2) handover and transfer, (3) open communication, (4) staffing, (5) nonpunitive response to errors, and (6) teamwork across hospital units. Lastly, the predictors of the patient safety culture were: (1) feedback and communication about errors and (2) supervisor/manager hopes and actions that promote safety. Conclusion: Our findings can inform the hospital management to enhance the patient safety culture among nurses. It can also inform the strategy to manage the potential threats and opportunity of the patient safety implementation at the hospital.