English abstract
Background: Clinical Adverse Events are major causes of mortality in hospitals and
significantly influence patient safety, causing an economic burden on the healthcare system.
Most hospital adverse events are linked to attitudes of healthcare professionals towards
safety.
Purpose: The aim of this study was to assess the relationship between nurses' attitudes
toward patient safety and their reporting of clinical adverse events and adverse patient events.
Methods: A descriptive, cross-sectional design was used to conduct the study in Sultan
Qaboos Hospital, Salalah and Royal Hospital, Muscat, with participants recruited from the
inpatient units. Data to evaluate nurses' attitudes towards patient safety was collected using
the Safety Attitude Questionnaires (SAQ), while the data for attitude towards reporting
clinical adverse events were collected using Reporting of Clinical Adverse Events Scale
(RoCAES). The data on the type of adverse events (AEs) was collected using the Adverse
Patient Events Scale (APES).
Results: Hundred and eighty-four questionnaires were administered from February to April
2022, with a response rate of 96.8%. The results showed nurses had an overall low positive
perception of patient safety and reporting of adverse clinical events. Recognition of stress
(M=3.102, SD=0.944) and clarity of reporting adverse events (M= 4.40, SD=1.640) attracted
the lowest safety score. Patient and family complaints (M=1.96, SD=1.846) had the highest
AEs reporting over the past year. There was no significant association between nurses'
patient safety perception and their attitude towards RoCAE. Linear regression analysis
showed nurses' attitude towards patient safety (β= -0.176±0.146; p = 0.026), and their
attitude toward RoCAE (β= 0.185±0.01; p = 0.016) and nurses-patient staffing ratio (β=0.228
±0.024; p=0.016) were predictors of AEs in clinical areas.
Conclusion: There was a low positive safety culture among nurses, and nurses' attitude
towards reporting clinical adverse events was generally negative. Patient and family
complaints were the commonest adverse events, followed by patient and family verbal abuse,
nosocomial infection, medication errors, and patient fall, respectively. The study also found
that complaints were occurring more frequently than in previous studies conducted in Oman.
Furthermore, there was no significant relationship between nurses' attitudes toward patient
safety and their attitude towards reporting clinical adverse events. Finally, the nurses'
attitudes towards patient safety and their attitudes toward reporting clinical adverse events
and nurse-patient staffing ratio were predictors contributing to the occurrence of adverse
patient events. These findings provide key insights about patient safety status in Oman that
key stakeholders in the hospitals and the ministry of health could use to improve safety
culture, including raising patient safety awareness.
