Hospital safety: perceptual paradox

Abstract

Objective

This purpose of this case study was to assess how a medicine/surgery unit patients and nursing staff in the southeast United States perceived patient safety in comparison with US federal patient safety goals.

Method

Researchers verbally administered 3 rating scales (0–10) and 21 open-ended questions to 45 patients. Their responses were recorded verbatim and inductively analysed. Ten unit RNs filled out a survey with 18 open-ended questions with 1 rating scale (0-10).

Results

Using a 10-point scale, patients rated the average degree of control over their care as 7.29 and facility safety as 8.74 while nurses rated their degree of control as 6.6 and facility safety at 7.2. 80% of patients but only 20% of nurses described their response time to call lights in a specific number of minutes with 20% of patients reporting a wait time of greater than 30 minutes. Patient themes included medical errors, concerns about not being heard, lack of knowledge regarding safety, and passivity. Nursing staff themes included reporting errors, call light response, and expectations for patient participation.

Conclusions

This exploratory study supports previous research and depicts how hospital patients and nurses perceive care and safety differently. Of importance, patients possess little understanding of hospital safety creating a paradox of patient dependency.

Keywords:

• Hospital
• Safety
• Adverse events
• Medical errors
• Patient care

Additional information

Notes on contributors

Carol Isaac

Carol A Isaac, PhD, PT is a researcher at the Center for Women's Health Research at the University of Wisconsin-Madison and former hospital department manager. Her areas of interest are gender, power, and leadership, and she authored Women Deans: Patterns of Power (University Press of America, 2007).

Linda S Behar-Horenstein

Linda Behar-Horenstein is a Distinguished Teaching Scholar and Professor in the Department of Educational Administration and Policy at the University of Florida. Her research focuses on instructional practices that encompass: critical thinking, curriculum development, faculty development, postsecondary education, professional education, qualitative research, and program evaluation. To a lesser degree, her lines of inquiry incorporate learning styles, mentorship, science education, organizational change, and complementary therapies. She is nationally recognized for her research and teaching healthcare faculty about critical thinking skills.

Craig A Davis

Craig A Davis, PhD is Vice Principal at St Augustine High School in St Augustine, Florida.

Randy Graff

Randy Graff, PhD, is the Assistant Director of Training in Instructional Technology at the Health Science Center at the University of Florida.