Reliability And Validity Of Chinese Version Of Nursing Home Survey On Patient Safety Culture

Objective: 1. To provide assistance for choosing appropriate patient safety culture assessment instruments and to give reference for future development of patient safety culture assessment instruments which suit the different types medical institutions in China by systematic review of domestically developed patient safety culture assessment instruments. 2. To translate the English version of Nursing Home Survey on Patient Safety Culture(NHSOPSC) into Chinese,and to test the reliability and validity of the Chinese version of NHSOPSC for providing an effective assessment instrument for patient safety culture research of nursing homes in China.Methods: 1. Chinese patient safety culture assessment instruments were collected by systematic review according to literatures and analyzed by comparative study, including the scope of application, content dimensions and psychometric characteristics. 2. In accordance with the guide which American Academy of Orthopaedic Surgeons Evidence Based Medicine Committee recommended, the NHSOPSC was translated and adapted according to Chinese culture. The reliability and validity of the Chinese version of NHSOPSC were tested among 322 staff members in 6 nursing homes by expert opinion, factor analysis, and calculating reliability coefficients.Results: 1. There are seven patient safety culture assessment instruments in China and all of these apply to hospitals. The content dimensions of these instruments varied between 5 to 12, with most tested by Cronbach’s α coefficients, and the construct validities were developed by factor analysis. 2. Formed the Chinese version of NHSOPSC which consisted of 23 items through the introduction of the English version. Six factors were extracted by exploratory factor analysis,which could explain 65.28% of the total variance and the factor loading of each item was in the range from 0.451 to 0.892. The six sub-scales include:(1)organizational learning(6 items);(2)management support for resident safety(4 items);(3)handoffs and communication(5 items);(4)staffing(4 items);(5)teamwork(2 items);(6)compliance with procedures(2 items). The Cronbach’s α of the total scale was 0.884 and the Cronbach’s α of subscales were 0.841, 0.804, 0.737, 0.757, 0.866, and 0.815 respectively. The test-retest reliability of the total scale was 0.904 and the test-retest reliability of subscales were 0.913, 0.786, 0.963, 0.895, 0.951, and 0.709 respectively(P<0.001).Conclusion: 1. The domestic patient safety culture assessment instruments are of different scopes of application, content dimensions and psychometric characteristics and researchers should choose appropriate one based on their purpose and improve it in actual use. 2. The institutions in which research on patient safety culture assessment instruments were carried out mainly focus on general hospitals in China and it is necessary to develop a patient safety culture assessment instrument for Chinese nursing homes. 3. The Chinese version of NHSOPSC is reliable and valid,and can be used to be an effective instrument for assessing the patient safety culture of nursing homes in China.