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forensic nursing, forensic psychiatry, patient safety, patient safety culture



  1. Kuosmanen, Anssi RN, MSc
  2. Tiihonen, Jari MD, PhD
  3. Repo-Tiihonen, Eila MD, PhD
  4. Eronen, Markku MD, PhD
  5. Turunen, Hannele PhD, RN


ABSTRACT: Safety culture refers to the way patient safety is regarded and implemented within an organization and the structures and procedures in place to support this. The aim of this study was to evaluate patient safety culture, identify areas for improvement, and establish a baseline for improving state hospitals in Finland. Cross-sectional design data were collected from two state-run forensic hospitals in Finland using an anonymous, Web-based survey targeted to hospital staff based on the Hospital Survey on Patient Safety Culture questionnaire. The response rate was 43% (n = 283). The overall patient safety level was rated as excellent or very good by 58% of respondents. The highest positive grade was for "teamwork within units" (72%). The lowest rating was for "nonpunitive response to errors" (26% positive). Good opportunities for supplementary education had a statistically significant (p <= 0.05) effect on 9 of 12 Hospital Survey on Patient Safety Culture dimensions. Statistically significant (p <= 0.05) differences in patient safety culture were also found in the staff's educational background, manager status, and between the two hospitals. These findings suggest there are a number of patient safety problems related to cultural dimensions. Supplementary education was shown to be a highly significant factor in transforming patient safety culture and should therefore be taken into account alongside sufficient resources.