An evaluation of a patient safety culture tool in Saudi Arabia.

摘要

BackgroundudSafety culture is considered to be an essential element of patient safety. Several tools areudavailable to assess patient safety culture in hospitals. One of the most common methods ofudassessing safety culture is the use of safety climate questionnaires.udResearch questionudIs there an existing patient safety culture measure that can be demonstrated to be a valid andudreliable tool for use with the workforce in hospitals in Saudi Arabia?udAim and objectivesudThis study aims to identify whether there is an existing English language tool that would beudsuitable for assessing patient safety culture in Saudi context. The objectives of the study are:ud1. To select an appropriate questionnaire to assess hospital patient safety culture.ud2. To evaluate the face validity of the selected patient safety climate questionnaire.ud3. To assess the psychometric properties of the selected patient safety climateudquestionnaire in hospitals in Saudi Arabia.ud4. To develop the most appropriate measure for assessing patient safety culture for useudin hospitals in Saudi Arabia.udMethodsudQualitative methods were used to evaluate face validity (n=12 hospital staft). Quantitativeudmethods were used to assess psychometric properties (n=862 doctors and nurses in threeudhospitals in Saudi Arabia).udFindingsudEvaluation of face validity identified a need for minor changes to the Hospital Survey onudPatient Safety Culture (HSOPSC) questionnaire wording before it was used to collect data forudpsychometric assessment. The results of Confirmatory Factor Analysis (CF A) and reliabilityudanalysis showed an unsatisfactory fit for the factor structure of the original HSOPSCudquestionnaire to the Saudi data. Exploratory Factor Analysis (EF A) was used on one half ofudthe Saudi dataset to produce an optimal model(s). This was followed by CFA of the resultingudmeasurement model on the second (validation) half of the data to test the fit of the resultingudoptimal factor structure. The result of EF A showed that eight factors (23 safety climateuditems) is the optimal model to the Saudi data.udIudAll factors consisted of two to four items. The items loading were between 0.43 and 0.97.udThe result of CF A confirmed the eight factors solution (CF A=O.94, RMSEA=0.045,udSRMR=O.040, TLI=O.97). The results of EFA, CFA, correlation and reliability analysisud(Cronbach's alpha) showed that the optimal model for the Saudi data consists of eight patientudsafety culture dimensions (23 safety climate items).udConclusionudThis is one of very few studies to provide an assessment of an American patient safety cultureudtool using data from Saudi Arabia. The results indicate the importance of appropriateudvalidation of patient safety climate questionnaires prior to applying them to populationsudoutside contexts in which they were developed. The validated Saudi English languageudversion of the HSOPSC questionnaire is an appropriate patient safety climate questionnaire toudassess patient safety culture in Saudi hospitals.