Volume 5 , Issue 2 , April 2016 , Pages: 52 - 58
Patient Safety Culture and Application of Medication Safety Rules as Perceived by Nurses
Sabah Mahmoud Mahran, Nursing Administration Department, Faculty of Nursing, Port Said University, Port Said, Egypt
Sanaa Abd El Azim Ibrahim, Nursing Administration Department, Faculty of Nursing, Port Said University, Port Said, Egypt
Received: Mar. 19, 2016;       Accepted: Mar. 25, 2016;       Published: Apr. 8, 2016
DOI: 10.11648/j.ajns.20160502.13        View        Downloads  
Background: Patient safety is one of the biggest challenges in health care through providing safe, effective care, and one of the most significant areas of opportunity for improvement is medication safety, which is a top priority for patient harm prevention from medication errors. Aim: To assess nurses’ perceptions concerning patient safety culture and the applicability of medication safety rules. Design: A descriptive correlational design was utilized. Settings: Six hospitals affiliated to the Ministry of Health from three governorates in Egypt. Participants: A sample of 421 nurses was chosen from the selected hospitals to participate in a structured questionnaire dealing with twelve dimensions to determine the level of nurses’ awareness and their perceptions of patient safety culture, and the application of medication safety rules was measured by 99 questions under thirteen dimensions to collect the study data. The results revealed that only 26.13% of studied nurses indicated a high perception of overall patient safety culture, although 77.90% reported no adverse events during the last six months. Furthermore, 76.72% reported that they applied overall medication rules to prevent errors. Based on the study findings, it is recommended to develop strategies to disseminate patient safety culture and reduce punitive culture in health organizations, creating a climate of open communication and continuous learning. The development and optimizing of data collection and reporting systems and evidence-based programs for improving culture of patient safety in hospitals is necessary, and nurses must be encouraged to learn more about incident reports and how to write medication administration error reports.
Patient Safety, Culture, Nurses, Medication Safety
To cite this article
Sabah Mahmoud Mahran, Sanaa Abd El Azim Ibrahim, Patient Safety Culture and Application of Medication Safety Rules as Perceived by Nurses, American Journal of Nursing Science. Vol. 5, No. 2, 2016, pp. 52-58. doi: 10.11648/j.ajns.20160502.13
Copyright © 2016 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License ( which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
[ 1 ]
Aboul-Fotouh AM, Ismail NA, Ez Elarab HS, Wassif GO (2012). Assessment of patient safety culture among healthcare providers at a teaching hospital in Cairo, Egypt. Eastern Mediterranean Health Journal, 18(4): 372-377.
[ 2 ]
Ahmed, NG, Adam SM, Abd Al-Moniem II (2011). Patient safety: Assessing nurses’ perception and developing an improvement plan. Life Science Journal, 8(2): 53-64.
[ 3 ]
Al-Ahmadi TA (2009). Measuring patient safety culture in Riyadh’s hospitals: A comparison between public and private hospitals. Journal of the Egyptian Public Health Association, 84(5-6): 479-500.
[ 4 ]
Alkorashy HA (2013). Factors shaping patient safety management in the Middle East hospitals from nursing perspective: A focus group study. Middle-East Journal of Scientific Research, 15(10): 1375-1384.
[ 5 ]
Australian Commission on Safety and Quality in Health Care (ACSQHC) (2012). Safety and Quality Improvement Guide Standard 4. Sydney: ACSQHC.
[ 6 ]
Bahrami MA, Montazeralfaraj R, Chalak M (2013). Patient safety culture challenges: Survey results of Iranian educational hospitals. Middle-East Journal of Scientific Research, 14(5): 641-649.
[ 7 ]
Braithwaite J, Coiera E (2010). Beyond patient safety Flatland. Journal of the Royal Society of Medicine, 103(6): 219-225.
[ 8 ]
Brown BW, Hollander M (1997). Statistics: A biomedical introduction. New York: Wiley.
[ 9 ]
Centers for Disease Control and Prevention (2008). Campaign to prevent antimicrobial resistance in healthcare settings: 12 steps [online]. Available at: drug resistance/ healthcare/.. [last accessed 10 March 2016].
[ 10 ]
Dodek PM, Wong H, Jaswal D, Heyland DK, Cook DJ, Rocker GM, Kutsogiannis D J, Dale C, Fowler R, Ayas NT (2011). Organizational and safety culture in Canadian intensive care units: Relationship to size of intensive care unit and physician management model. Journal of Critical Care, 27(1): 11-7.
[ 11 ]
Emergency Care Research Institute (2008). Self-assessment questionnaires 10: Continuing care risk management. Available at
[ 12 ]
Fahmy AM, Khalifa MA, Abdalla SM, Abdel-Rahman SM (2010). Measuring nurses’ compliance with patients’ safety measures during hemodialysis at Minia University and General Hospital. Zagazig Nursing Journal, 6(11): 68-82.
[ 13 ]
Fracica P, Lafeer M, Minnich M, Fabius R (2006). Patient safety checklist: Keys to successful implementation. The Physician Executive, 32(4): 46-53.
[ 14 ]
Health Care Association of New Jersey (HCANJ) (2007). Medication Management Guideline. Trenton, NJ: HCANJ.
[ 15 ]
Patient Safety Group (2012). Hospital survey on patient safety culture [online]. Available at: [last accessed 18 January 2016].
[ 16 ]
Huang DT, Clermont G, Kong L, Weissfeld LA, Sexton JB, Rowan KM, Angus DC (2010). Intensive care unit safety culture and outcomes: US multicenter study. International Journal of Quality Health Care, 22(3): 151-61.
[ 17 ]
Mardon RE, Khanna K, Sorra J, Dyer N, Famolaro T (2010). Exploring relationships between hospital safety culture and adverse events. Journal of Patient Safety, 6(4): 226-232.
[ 18 ]
Rockville W, Sorra J, Famolaro T, Dyer N, Nelson D, Smith, SA (2012). Hospital Survey on Patient Safety Culture: User comparative database report. Washington, DC: US Department of Health and Human Services, Agency for Healthcare Research and Quality. AHRQ Publication No. 12-0017.
[ 19 ]
Singer S, Lin S, Falwell A, Gaba D, Baker L (2009). Relationship of safety climate and safety performance in hospitals. Health Services Research, 44(2), 399-421.
[ 20 ]
Tomazoni A, Rocha PK, Kusahara DM, Souza AI, Macedo TR (2015). Evaluation of the patient safety culture in neonatal intensive care. Text Context Nursing, 24(1): 161-9.
[ 21 ]
Ulrich B, Kear T (2014). Patient safety and patient safety culture: Foundations of excellent health care delivery. Nephrology Nursing Journal, 41(5): 447-456.
[ 22 ]
Wagner C, Smits M, Sorra J, Huang CC (2013). Assessing patient safety culture in hospitals across countries. International Journal of Quality Health Care, 25(3): 213-21.
[ 23 ]
World Health Organization (2013). Learning from error: Role of reporting error, components of a reporting system, sources of information about patient safety, national reporting systems, characteristics of successful reporting systems. Geneva: WHO.
[ 24 ]
World Health Organization (2014). Guide for Developing National Patient Safety Policy and Strategic Plan. Geneva: WHO, Patient Safety Unit.
[ 25 ]
Zein ElDin YK, Abd ElAal NH (2013). The relationship between perceived safety climate, nurse s’ work environment and barriers to medication administration errors. Life Science Journal, 10(1): 950-961.
Browse journals by subject