A survey on patient safety culture in primary healthcare services in Turkey

Int J Qual Health Care. 2009 Oct;21(5):348-55. doi: 10.1093/intqhc/mzp035. Epub 2009 Aug 22.


Objective: To evaluate the patient safety culture in primary healthcare units.

Design: A cross-sectional study, utilizing the Turkish version of the Hospital Survey on Patient Safety Culture developed by the Agency for Healthcare Research and Quality and a demographic questionnaire.

Setting: Twelve primary healthcare centers in the center of the city of Konya, Turkey.

Participants: One hundred and eighty healthcare staff, including general practitioners (GPs), nurses, midwives and health officers.

Intervention: None.

Main outcome measure(s): The patient safety culture score including subscores on 12 dimensions and 42 items; patient safety grade and number of events reported.

Results: Fifty-four (30%) of the participants were GPs, 48 (27%) were nurses, 51 (28%) were midwives and 27 (15%) were health officers. The mean overall score for positive perception of patient safety culture in primary healthcare units was 46 +/- 20 (43-49 CI). No differences were found by staff members' profession. Among the dimensions of patient safety, those with the highest percentage of positive ratings were teamwork within units (76%) and overall perceptions of safety (59%), whereas those with the lowest percentage of positive ratings were the frequency of event reporting (12%) and non-punitive response to error (18%). Reporting of errors was infrequent with 87% of GPs, 92% of nurses and 91% of other health staff indicating that they did not report or provide feedback about errors.

Conclusions: Improving patient safety culture should be a priority among health center administrators. Healthcare staff should be encouraged to report errors without fear of punitive action.

MeSH terms

  • Adult
  • Attitude of Health Personnel*
  • Female
  • Health Care Surveys
  • Humans
  • Male
  • Medical Errors / prevention & control
  • Medical Errors / psychology
  • Medical Errors / statistics & numerical data
  • Middle Aged
  • Organizational Culture
  • Patient Care Team / organization & administration
  • Patient Care Team / standards
  • Primary Health Care / methods*
  • Primary Health Care / organization & administration
  • Primary Health Care / standards
  • Safety Management / methods*
  • Safety Management / organization & administration
  • Safety Management / standards
  • Turkey
  • Young Adult