Patient safety attitudes of frontline healthcare workers in Lahore: A multicenter study

Objectives: To evaluate patient safety attitudes of the frontline health workers in hospitals of Lahore, Pakistan.

Methods: A self-administered Safety Attitudes Questionnaire (SAQ) survey was deployed in five hospitals across Lahore, Pakistan (July 2019 to June 2020). A total of 1250 consecutive consenting nurses and postgraduate trainee physicians of under five years working experience were recruited. Assessment for each of the six subdomains (teamwork climate, safety climate, job satisfaction, stress recognition, perception of management, working conditions) was done on a 0-100 scale. Multivariate analyses examined their relationship with job cadre (nurses and physicians), duration of respondents' work experience (< 2 years, 3 - 4 years, > 4 years), and hospital sector (private and public).

Results: The response rate was 97% (1212 individuals; 765 nurses, 447 physicians). Nurses scored less than physicians in teamwork climate (-2.4, 95% CI -4.5 - -0.2, p=0.02) and stress recognition (-10.6, 95% CI -13.5 - -7.7, p<0.001), but more in perception of management (4.2, 95% CI 1.5 - 6.8, p=0.002) and working conditions (3.4, 95% CI 0.66 - 6.2, p=0.01). Increasing work experience was related to greater scores in all subdomains. Private hospitals scored generally higher than public ones.

Conclusion: Duration of job experience was positively correlated with patient safety attitudes of hospital staff. These finding could serve as the baseline to shape staff perceptions by cadre in both public and private sector hospitals.