The Culture of Patient Safety in United States Hospitals

Patient safety is one foundation of high quality care, and the Institute of Medicine recommends that all healthcare facilities across the care continuum develop and maintain a culture of patient safety.  According to the Agency for Healthcare Research and Quality (AHRQ), a culture of safety is a commitment at all levels of the organization to minimize adverse patient events in the face of inherently complex and potentially hazardous procedures.  It also signals the attitudes, beliefs, values, and perceptions that employees share about the way “safety is done” in their job settings.  Patient safety culture in hospitals has been given considerable recent attention, and there is an emerging body of evidence that indicates that it is an important predictor of adverse patient events in health care settings. However, less is known of registered nurses perceptions of safety practices in United States (U.S.) hospitals. The purpose of this presentation is to describe nurses’ ratings of safety practices (nonpunitive response to error, manager safety practices, feedback and communication about error, organizational learning-continuous improvement, and event reporting) in a national sample of hospitals in the U.S.

A descriptive design was used. Data from the Agency for Healthcare Research and Quality 2014 national dataset of registered nurses who worked in U.S. acute care hospitals that voluntarily submitted their data to AHRQ and who responded to items on the Hospital Survey on Patient Safety Culture was analyzed. The sample of registered nurses in this study is over 100,000, and the hospital sample is approximately 550 U.S. acute care hospitals. Descriptive statistics including frequencies, means and standard deviations were computed to describe nurses’ perceptions of patient safety practices. The findings from this patient safety research will provide research-based evidence to build or expand a culture of patient safety in U.S. hospitals and, ultimately, to improve patient outcomes.