Clinical risk and patient safety: a multicenter cross-sectional study to explore knowledge, attitudes and practice of hospital nurses

Objectives: To investigate knowledge, attitudes, and behavior of nurses working in acute care hospitals regarding clinical risk and patient safety, and to identify predisposing factors. Design: Cross-sectional multicenter study. Methods: The study was conducted in thirteen non-teaching acute public and private hospitals of a region of southern Italy from September through December 2015. A structured self-report questionnaire was administered to clinical nurses working in the hospitals involved. Three multivariate linear and logistic regression models have been constructed: knowledge of the definition of an adverse event; attitude towards risk of making an error while working; and nurses who reported at least one error in the past 12 months. Results: The sample consisted of 484 respondents out of 670 (72.2%) nurses approached. The final multivariable model showed that educational courses about patient safety play a significant role in nurses gaining knowledge of adverse events. In the absence of organization-wide patient safety programs, nurses with low knowledge levels showed a significantly higher perceived risk. Nurses (n=96) who made errors over the past 12 months had discussed them with head nurses (75%) and colleagues (41.7%). Anonymous reporting to the organization was very low, with only 8.3% of nurses who had made an error submitting an anonymous report. Conclusions: Managers should implement multimodal improvement strategies aimed at enabling nurses' to recognize the critical issues of the system and to increase their reporting, in order to make the organizations safer.