Impact of COVID-19 on professional nursing practice environments and patient safety culture

J Nurs Manag. 2022 Jul;30(5):1105-1114. doi: 10.1111/jonm.13617. Epub 2022 Apr 25.


Aim: To analyse the impact of COVID-19 on professional nursing practice environments and patient safety culture.

Background: The relationship between work environments and patient safety has been internationally recognized. In 2020, the pandemic imposed enormous challenges, yet the impact on these variables remains unknown.

Method: This is a quantitative observational study, conducted in a Portuguese hospital, with 403 registered nurses. A self-completion questionnaire was used.

Results: The impact on the Structure and Outcome components of nursing professional practice environments was positive. Although the Process component remained favourable to quality of care, a negative trend was confirmed in almost all dimensions. The results regarding safety culture showed weaknesses; 'teamwork within units' was the only dimension that maintained a positive culture.

Conclusion: Positive responses regarding patient safety were significantly associated with the quality of the nursing professional practice environment. The need to invest in all dimensions of safety culture emerges to promote positive professional environments.

Implications for nursing management: Improving professional nursing practice environments can be achieved through managers' investment in the participation and involvement of nurses in the policies and functioning of institutions, as well as promoting an open, fair and participatory safety culture that encourages reporting events and provides adequate support for professionals.

Keywords: coronavirus infection; hospitals; pandemic; patient safety; work environment.

Publication types

  • Observational Study

MeSH terms

  • COVID-19* / epidemiology
  • Humans
  • Nurses*
  • Nursing Staff, Hospital*
  • Patient Safety
  • Safety Management
  • Surveys and Questionnaires
  • Workplace