Factors associated with nurses' perceptions of patient safety culture in one university hospital in China

Patient safety is an important issue in healthcare organizations. The impact of medical errors has been widely reported and discussed. According to a World Health Organization (WHO) report, one out of every 10 hospital patients in many developed countries experiences an adverse event which can lead to serious injury and death. The situation in developing countries may be even worse (WHO, 2005). In the United States, medical errors are estimated to have caused approximately 238,337 potentially preventable deaths among Medicare patients between 2004 and 2006 (Health Grades, 2008), and up to 24,000 deaths yearly in Canada (Canadian Institute for Health Information, 2004). The traditional blame and shame culture in healthcare organizations has been criticized for impeding the possibility of learning from the errors and being responsible largely for causing medical errors. There is a growing recognition of the necessity to transform healthcare organizational culture in order to build a safer healthcare environment.;A cross-sectional design with a self-administered questionnaire survey was administered to a total of 300 registered nurses and nurse managers from one university hospital in the Southwest part of China in September and October 2008. The valid participants were 248. The results showed that most (61.3%) nurses positively perceived the patient safety culture. Nurses responded most positively to two dimensions: teamwork within units and organizational learning. Nurses responded most negatively to another two dimensions: staffing and nonpunitive response to errors. Four factors were found to be associated with patient safety culture: nurses' perceived trustworthiness of managers, organizational safety prioritization, managers' safety commitments, and nurses' unit experiences. There was a statistically significant difference between nursing managers and registered nurses in perceptions of patient safety culture.;The findings of this study will be used as the baseline data for future intervention studies and will add to the knowledge of patient safety culture internationally.;In China, there have been no official reports concerning the medical error rates and little is known about the Chinese nurses' perceptions of patient safety culture. The purposes of this study are to understand nurses' perceptions of patient safety culture in one Chinese university hospital and to explore the factors that are associated with those perceptions.