The moderating role of just culture between nursing practice environment and oncology nurses' silent behaviors toward patient safety: A multicentered study.

BACKGROUND: Patient safety is a critical part of healthcare delivery that must be prioritized to guarantee optimal patient outcomes. Oncology nursing is a specialized area of nursing that demands great focus on patient safety because of the high-risk nature of this patient group. Nurses play an important role in ensuring that patients receive safe and effective care. However, the nursing practice environment can have a substantial impact on how nurses respond to patient safety problems. A just culture can promote open communication and identify potential safety issues, whereas a culture of silence can have a negative impact on patient outcomes. OBJECTIVE: Firstly, assess the relationship between the nursing practice environment and oncology nurses' silent behavior towards patient safety. Secondly, the interaction effect of just culture as a moderator in this relationship. METHOD: A cross-sectional, correctional research design was employed. Data was collected from 303 nurses working at the oncology departments of five hospitals in Egypt using three questionnaires. Data was analyzed using SPSS-PROCESS Macro (v4.2). RESULTS: There was a moderate, negative, and significant correlation between the nurse practice environment and silent behavior of nurses towards patient safety. The interaction effect of just culture with nurse practice environment strengthens this relationship, thus enhancing errors reporting. CONCLUSIONS: This study emphasized on the importance of creating a just culture that facilitates open communication and eliminating the potential hazards result from nurses' silence. Thus, oncology nurses must be encouraged to report issues related to patient safety.

Enhancing the Occurrence Variance Reporting System Implementation at one of the Hospitals of the Egyptian Universal Health Insurance.

Background: Identifying, reporting, measuring, and tracking events provide an opportunity to study system issues, motivate learning, measure the frequency and severity of events, and manage high-risk ones which refer to a safety culture that is focused on valuing the input of working staff and improving the quality of care. Aim: Enhance the implementation of the occurrence variance reporting (OVR) system at the Obstetrics and Gynecological Hospital in Port Said Governorate, Egypt. Design: A quasi-experimental research design for one group (pre-posttest) and a mixed-methods approach was conducted in this study. Method: This study was carried out at an Obstetrics and Gynecological Hospital in Port Said Governorate, Egypt. Study subjects included a convenient sample of 100 doctors and nurses. The study used three tools: OVR Knowledge, Attitude, and Practice (KAP) questionnaire, the OVR trend analysis clinical audit checklist, and barriers that hinder staff to report patient safety events through two open-ended questions. Results: Significant improvements were detected in the OVR system post-program implementation than pre-program implementation phase. A statistically significant increase in nurses' and doctors' total knowledge score from 0.74 to 3.39 and a statistically significant decrease in nurses' and doctors' total negative attitude score from 3.87 to 3.27. Also, a statistically significant increase in total practice score from 2.35 to 2.45. Conclusion: There were significant improvements in the hospital OVR system postprogram implementation than preprogram implementation. Relevance to clinical practice: To maintain performance and make sure that the original result is not lost, the health care facilities should emphasize the ongoing monthly and quarterly monitoring and analysis of data. Meetings, lectures, and training sessions are used for ongoing education.