Challenges of maintaining patient safety among Iranian nurses: A qualitative study

Document Type : Original Article

Authors

Patient Safety Research Center, Clinical Research Institute, Nursing & Midwifery School, Urmia University of Medical Sciences, Urmia, Iran

10.48307/nms.2023.415758.1262

Abstract

Background: Patient safety is one of the most critical factors influencing the quality of nursing care, but some challenges cause failure to maintain patient safety.
Objectives: This study was conducted to identify the challenges that clinical nurses face in maintaining patient safety.
Methods: This qualitative study was completed in 2021-2022 on clinical nurses of public and private hospitals in selected cities of Iran. Purposive sampling was used to select participants and data were collected through semi-structured in-depth interviews. The interviews were analyzed using Lindgren, Graneheim and Lundman content analysis method.
Results: Three categories of "organizational challenges," “work-related and individual challenges,” and “challenges raised by patients or companions” emerged from the data as factors leading to failure in maintaining patient safety.
Conclusion: Nurses, nursing managers at the organizational level, and nursing policymakers at the national level should be aware of their role in patient safety violations and then manage these challenges by formulating appropriate programs, policies, and interventions.

Highlights

Leyla Alilu [Pubmed] [Google Scholar]
 

Keywords

Main Subjects

References

  1. World Health Organization. Patient safety. Available from: https://www.who.int/news-room/fact-sheets/detail/patient-safety [Last access date 31 October2023].
  2. Mohebi Far R, Safari Variani A, Khoshtarkib H, Ghanati E, Teymouri F, Zakaria Kiaei M, et al. Studying patient safety culture from the viewpoint of staffs in educational hospitals in Tehran City. J Health Saf Work 2015;5(1):57-64.
  3. Slawomirski L, Klazinga N. The economics of patient safety: from analysis to action. 2022. doi:10.1787/761f2da8-en
  4. Eklöf M, Törner M, Pousette A. Organizational and social-psychological conditions in healthcare and their importance for patient and staff safety. A critical incident study among doctors and Safety Sci 2014;70:211-21. doi:10.1016/j.ssci.2014.06.007
  5. Chatzi AV, Malliarou M. The need for a nursing specific patient safety definition, a viewpoint paper. Int J Health Gov 2023;28(2):108-16. doi:10.1108/IJHG-12-2022-0110
  6. Alshammari M, Duff J, Guilhermino M. Barriers to nurse-patient communication in Saudi Arabia: an integrative review. BMC Nurs 2019; 18:61. doi:10.1186/s12912-019-0385-4 PMid:31827387 PMCid:PMC6892156
  7. Liu J, Zheng J, Liu K, Liu X, Wu Y, Wang J, et al. Workplace violence against nurses, job satisfaction, burnout, and patient safety in Chinese hospitals. Nurs Outlook 2019;67(5):558-66. doi:10.1016/j.outlook.2019.04.006 PMid:31202444
  8. Mohammadi J, Nabiamjad R, Amiri S. Evaluation of emotional intelligence and its relationship with job stress and the symptoms of post-traumatic stress disorder among Shiraz pre-hospital emergency technicians in 2020. Int Arch Health Sci 2023; 10(2): 84-90. doi: 10.48307/iahsj.2023.176367
  9. Burgener AM. Enhancing communication to improve patient safety and to increase patient satisfaction. Health Care Manag 2020;39(3):128-32. doi:10.1097/HCM.0000000000000298 PMid:32701609
  10. Rangachari PL. Woods J. Preserving organizational resilience, patient safety, and staff retention during COVID-19 requires a holistic consideration of the psychological safety of healthcare workers. Int J Environ Res Public Health 2020;17(12):4267. doi:10.3390/ijerph17124267 PMid:32549273 PMCid:PMC7345925
  11. Garcia CdL, Abreu LCd, Ramos JLS, Castro CFDd, Smiderle FRN, Santos JAd, et al. Influence of burnout on patient safety: systematic review and meta-analysis. Med 2019;55(9):553. doi:10.3390/medicina55090553 PMid:31480365 PMCid:PMC6780563
  12. Behzadifar M, Behzadifar M, Jahanpanah F, Bragazzi NL. Patient safety culture assessment in Iran using the "Hospital survey on patient safety culture" tool: A systematic review and meta-analysis. Clin Epidemiol Glob Health 2019;7(4):641-7. doi:10.1016/j.cegh.2019.02.008
  13. Chegini Z, Janati A, Babaie J, Pouraghaei M. Exploring the barriers to patient engagement in the delivery of safe care in Iranian hospitals: A qualitative study. Nurs Open 2019;7(1):457-465. doi:10.1002/nop2.411 PMid:31871731 PMCid:PMC6917972
  14. Taj A, Arabasadi R, Ayatnia M. Effective and comprehensive management process against COVID-19: the golden key to increasing safety in the hospital environment. Novel Clin Med 2024;3(1):58-9. doi: 10.22034/ncm.2023.381578.1068
  15. Teymoori S. Study of Nurses' Experiences of Safety Challenges of Social Security Hospital Patients. Nurs Develop Health J 2022;12(2):48-59.
  16. Vaziri S, Fakouri F, Mirzaei M, Afsharian M, Azizi M, Arab-Zozani M. Prevalence of medical errors in Iran: a systematic review and meta-analysis. BMC Health Serv Res. 2019;19(1):1-11. doi:10.1186/s12913-019-4464-8 PMid:31477096 PMCid:PMC6720396
  17. Lindgren B-M, Lundman B, Graneheim UH. Abstraction and interpretation during the qualitative content analysis process. Int J Nurs Stud 2020;108:103632. doi:10.1016/j.ijnurstu.2020.103632 PMid:32505813
  18. Guba EG, Lincoln YS. Fourth generation evaluation: Sage; 1989.
  19. Sayed Desouky Desouky F, Abd Elazem Mostafa H, Ali Hassan H. Challenges Facing Staff Nurses to Maintain Patient Safety. Egypt J Health Care 2021;12(4):762-72. doi:10.21608/ejhc.2021.204425
  20. Yen PY, Kellye M, Lopetegui M, Saha A, Loversidge J, Chipps EM, et al. Nurses' time allocation and multitasking of nursing activities: a time motion study. InAMIA annual symposium proceedings 2018. American Medical Informatics Association.
  21. Huang C-H, Wu H-H, Lee Y-C. The perceptions of patient safety culture: a difference between physicians and nurses in Taiwan. Appl Nurs Res 2018;40:39-44. doi:10.1016/j.apnr.2017.12.010 PMid:29579497
  22. White EM, Aiken LH, McHugh MD. Registered nurse burnout, job dissatisfaction, and missed care in nursing homes. J Am Geriat Soc 2019; 67(10):2065-71. doi:10.1111/jgs.16051 PMid:31334567 PMCid:PMC6800779
  23. Ball JE, Bruyneel L, Aiken LH, Sermeus W, Sloane DM, Rafferty AM, et al. Post-operative mortality, missed care and nurse staffing in nine countries: A cross-sectional study. Int J Nurs Stud 2018;78:10-5. doi:10.1016/j.ijnurstu.2017.08.004 PMid:28844649 PMCid:PMC5826775
  24. Siman A, Braga L, Amaro M, Brito M. Practice challenges in patient safety. Rev Bras Enferm 2019;72:1504-11. doi:10.1590/0034-7167-2018-0441 PMid:31644737
  25. Murray M, Sundin D, Cope V. Benner's model and Duchscher's theory: Providing the framework for understanding new graduate nurses' transition to practice. Nurse Educ Pract 2019;34:199-203. doi:10.1016/j.nepr.2018.12.003 PMid:30599429
  26. hen F, Liu Y, Wang X, Dong H. Transition shock, preceptor support and nursing competency among newly graduated registered nurses: A cross-sectional study. Nurse Educ Today 2021;102:104891. doi:10.1016/j.nedt.2021.104891 PMid:33866200
  27. Murray M, Sundin D, Cope V. New graduate registered nurses' knowledge of patient safety and practice: A literature review. J Clin Nurs 2018;27(1-2):31-47. doi:10.1111/jocn.13785 PMid:28252838
  28. Johnson M, Sanchez P, Langdon R, Manias E, Levett‐Jones T, Weidemann G, et al. The impact of interruptions on medication errors in hospitals: an observational study of nurses. J Nurs Manag 2017;25(7):498-507. doi:10.1111/jonm.12486 PMid:28544351
  29. Thomas L, Donohue-Porter P, Fishbein JS. Impact of interruptions, distractions, and cognitive load on procedure failures and medication administration errors. J Nurs Care Qual 2017;32 (4): 309-17. doi:10.1097/NCQ.0000000000000256 PMid:28448299
  30. Cho H, Steege LM. Nurse fatigue and nurse, patient safety, and organizational outcomes: A systematic review. West J Nurs Res 2021; 43(12):1157-68. doi:10.1177/0193945921990892 PMid:33554767
  31. Di Muzio M, Dionisi S, Di Simone E, Cianfrocca C, Di Muzio F, Fabbian F, et al. Can nurses' shift work jeopardize the patient safety? A systematic review. Eur Rev Med Pharmacol Sci 2019;23(10).
  32. Di Muzio M, Reda F, Diella G, Di Simone E, Novelli L, D'Atri A, et al. Not only a problem of fatigue and sleepiness: changes in psychomotor performance in italian nurses across 8-h rapidly rotating shifts. J Clin Med 2019;8(1):47. doi:10.3390/jcm8010047 PMid:30621274 PMCid:PMC6352064
  33. Pourhadi S, Moradi Z. Assessment of barriers to elderly health education from health care providers opinions in the urban family physician plan of Babol city in 1399. J Gerontol 2022;7(1):29-39.
  34. Van Rosse F, de Bruijne M, Suurmond J, Essink-Bot M-L, Wagner C. Language barriers and patient safety risks in hospital care. A mixed methods study. Int J Nurs Stud 2016;54:45-53. doi:10.1016/j.ijnurstu.2015.03.012 PMid:25840899
  35. Shahmari M, Hasanpour M. Impact of Language Barriers on Patient Education: A Scoping Review. Payesh (Health Monitor) 2021;20(3):301-10. doi:10.52547/payesh.20.3.301
  36. Khaleghparast S, Mayelafshar M, Hanifi Z, Sari L, Kalaei M, Ghanbari B. Barriers to patient education from the perspective of patients, nurses and doctors in Rajaee cardiovascular medical and research center. J Cardiovasc Nurs 2018;7(1):14-23.
  37. Arian M, Mortazavi H, TabatabaeiChehr M, Tayebi V, Gazerani A. The Comparison between Motivational Factors and Barriers to Patient Education Based on the Viewpoints of Nurses and Nurse Managers. J Nurs Educ 2015;4(3):66-77.
  38. Varghaei-Paidar A, Gavgani V, Hassannejhad N, Ranjbar S, Hosseinzadeh M, Imani S. A Survey of Nurses' and Patients' Opinions about Patient Education and Training and Possible Barriers in Madani Cardiovascular Health and Education Center. Depict Health 2017;7(4):22-9.
Nursing and Midwifery Studies
Volume 13, Issue 1
February 2024
Pages 40-47

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History

  • Receive Date: 11 September 2023
  • Revise Date: 20 November 2023
  • Accept Date: 25 November 2023

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