Patient Safety and Security in Hospitals: Best Practices (Updated Review Article)

Abstract

Background: Adverse events (AEs) are a significant cause of patient harm and death worldwide, affecting 10-25% of hospitalized patients, with an estimated 50% being preventable. In healthcare, patient safety is increasingly recognized as a critical area requiring effective monitoring and improvement. One key aspect of patient safety is the concept of patient safety culture (PSC), which refers to the collective attitudes and behaviors aimed at safeguarding patient welfare. A growing body of research suggests that a strong safety culture can reduce AE rates. This review aims to synthesize the evidence regarding the relationship between PSC scores and AE rates in healthcare settings.

Aim: This scoping review aims to summarize existing evidence on the association between PSC scores and AE rates, map the characteristics and research methodologies of studies, and assess the strengths and limitations of the research.

Methods: A scoping review methodology was employed, following the PRISMA-ScR guidelines. Studies included in the review were selected based on their relevance to PSC and AE rates, focusing on hospital settings. The evidence was synthesized to identify patterns and gaps in the existing literature, particularly concerning low- and middle-income countries.

Results: The review found a statistically significant inverse relationship between higher PSC scores and reduced AE rates in the majority of studies. Dimensions such as teamwork climate, safety climate, leadership perception, and management support were frequently associated with lower AE rates. However, some studies reported mixed or non-significant associations, pointing to potential methodological issues such as small sample sizes and low response rates.

Conclusion: Strengthening PSC, particularly in the areas of leadership, communication, and teamwork, can contribute to reducing AEs in healthcare settings. However, variations in research methods, sample sizes, and measurement tools pose challenges to drawing definitive conclusions. Future research should aim for larger sample sizes, standardized PSC measurement tools, and more comprehensive studies in low- and middle-income settings.