Influence of Training on Patient Safety Culture: a Nurse Attitude Improvement Perspective


1 Department of Health Services Administration, Islamic Azad University-Science and Research Branch, Tehran, Iran

2 Department of Health Services Administration, Tehran University of Medical Sciences, Tehran, Iran

3 School of Public Health, Tehran University of Medical Sciences, Tehran, Iran


Background and Objectives: Medical Errors and adverse events have recently turned into one of the predominant concerns of health-policy makers and health services providers. Promoting safety culture is fundamental to sustainable safety improvement in healthcare settings. The purpose of this study was to examine the effect of training on nurses’ attitudes towards safety culture.   Methods: A cross-sectional study was conducted over the period of April to September 2011. The nursing staff in Shahid Modarres Hospital were invited to participate in the study (n = 143). A Persian version of Safety Attitude Questionnaire (SAQ) was developed and used for measuring safety culture. To evaluate the effect of training on nurses’ safety attitudes, the safety culture survey was carried out twice on the sample, ones before training and once after training and the results were compared. The training course contained material on causes of failure in safety systems, harms due to unsafe medical conditions and their outcomes, and concepts and dimensions of safety culture. The second safety culture measurement was carried out three months after the end of the training course. The results of the two evaluations were compared using analytical statistics.   Findings: Significant improvement in nurse attitudes towards most safety culture dimensions was observed after training. While the highest improved dimension was Perception of Management (43.3%), Stress Recognition showed the lowest increase (7%) following the training. The training was found to enhance the average nurses’ safety attitudes by 44%. Meanwhile, the results of path analysis showed a similar pattern of interrelations be‌tween safety attitude dimensions and overall measure of safety culture before and after training.   Conclusions: Training is an effective strategy for improving nurse attitudes towards safety.