Knowledge about safety culture improves patient safety (PS) in health-care organizations. The first contact a patient has with health care occurs at the primary level. We conducted a survey to ...measure patient safety culture (PSC) among primary care professionals (PCPs) of health centres (HCs) in Spain and analyzed PS dimensions that influence PSC.
We used Agency for Healthcare Research and Quality (AHRQ) Medical Office Survey on Patient Safety Culture translated and validated into Spanish to conduct a cross-sectional anonymous postal survey. We randomly selected a sample of 8378 PCPs at 289 HCs operated by 17 Regional Health Services. Statistical analysis was performed on sociodemographic variables, survey items, PS dimensions and a patient safety synthetic index (PSSI), calculated as average score of the items per dimension, to identify potential predictors of PSC. We used AHRQ data to conduct international comparison.
A total of 4344 PCPs completed the questionnaire. The response rate was 55.69%. Forty-two percent were general practitioners, 34.9% nurses, 18% administrative staff and 4.9% other professionals. The highest scoring dimension was 'PS and quality issues' 4.18 (4.1-4.20) 'Work pressure and pace' was the lowest scored dimension with 2.76 (2.74-2.79). Professionals over 55 years, with managerial responsibilities, women, nurses and administrative staff, had better PSSI scores. Professionals with more than 1500 patients and working for more than 11 years at primary care had lower PSSI scores.
This is the first national study to measure PSC in primary care in Spain. Results may reflect on-going efforts to build a strong PSC. Further research into its association with safety outcomes and patients' perceptions is required.
corrected To validate a tool to measure patient safety culture in Spanish primary care professionals.
Medical Office Survey on Patient Safety Culture (MOSPSC), from the Agency for Healthcare and ...Research in Quality (AHRQ). The process has been performed in five steps: original version traslation, conceptual equivalence evaluation, acceptability and viability assessment, content validity and questionnaire test and response analysis and psichometric properties assessment.
Primary care.
185 Primary care professionals from different Spanish regions represented the sample test.
Frecuency, response pattern and discrimination power of each item. Cronbach's alpha coefficient and dimensions obtained through factor analysis.
17, 8% of respondents answered all the items and 28, 7% of them did not answer, or answered the option "Don't know/Does not apply", to one to four items. All the sentences, with only one exception, present discrimination capacity. Cronbach's alpha coefficient results 0,96 and information is sumarized in 15 factors obtaining the same items in 7 of the total 12 factors in the original questionnaire.
Traslated, adapted, extended and validated AHRQ questionnaire is, in this setting, a reliable and useful instrument and it must be used for international comparisons.
Resumen Objetivo Validar un instrumento para medir la cultura de seguridad del paciente de los profesionales de atención primaria (AP) en España. Métodos Cuestionario Medical Office Survey on Patient ...Safety Culture (MOSPSC) elaborado por la Agency for Healthcare and Research in Quality (AHRQ). El proceso se realizó en 5 etapas: traducción de la versión original, evaluación de la equivalencia conceptual, valoración de la aceptabilidad y viabilidad, análisis de la validez del contenido y pilotaje del cuestionario adaptado y análisis de la respuesta y evaluación de las propiedades psicométricas. Emplazamiento Atención primaria. Participantes Se solicitó la colaboración de profesionales de AP de distintos servicios de salud siendo la muestra final de 185 profesionales. Mediciones principales Frecuencia, patrón de respuesta y poder de discriminación de cada pregunta. α de Cronbach y dimensiones obtenidas mediante análisis factorial. Resultados El 17,8% de los participantes contestaron todas las preguntas y el 28,7% dejaron sin responder o marcaron la opción «no lo sé/no procede» entre 1 y 4 preguntas. Todas las sentencias, con una única excepción, tienen capacidad de discriminación. El α de Cronbach es de 0,96 y la información se resume en 15 dimensiones con una adscripción de variables idéntica en 7 de las 12 dimensiones del cuestionario original. Conclusiones El cuestionario de la AHRQ traducido, adaptado, ampliado y validado es, para nuestro medio, un instrumento fiable y útil y debe emplearse para realizar comparaciones internacionales.
PDF
