Relationship Between the Nurse's Working Environment and Patients Quality of Care and Patient Safety Culture inAccredited and Non-Accredited Hospitals in Palestine a National Study رسالة دكتوراة

Abstract

Background: The Study Examines How The Nursing Work Environment And Patient Safety Culture Impact Patient Care Quality In Accredited Versus Non-Accredited Hospitals In Palestine. Purpose: To determine how various factors, including work environment, safety culture, education, experience, income, age, workload, and working hours, predict patient care quality in both hospital types. Methods: A predictive correlational design was used with a convenience sample of 412 full time nurses from seven hospitals. Data were collected from December 2023 to March 2024 using the Practice Environment Scale (PES), the Hospital Survey on Patient Safety Culture (HSOPS), and the Caring Behaviors Inventory-24 (CBI24). Results: In accredited hospitals, the work environment positively correlated with care quality (r = 0.58, p = 0.003) and patient safety culture (r = 0.61, p = 0.001), and had a significant relationship to reported safety events (r = 0.57, p = 0.023). Non-accredited hospitals showed weaker correlations with safety culture and events reporting (r = 0.19, p = 0.023 and r = 0.33, p = 0.011 respectively). Both hospital types had moderate work environment scores (accredited: M = 68.62, SD = 17.92; non-accredited: M = 71.65, SD = 14.99) and patient care quality (accredited: M = 92.44, SD = 12.10; non-accredited: M = 90.21, SD = 13.09). Accredited hospitals reported better caring behaviors (M = 92.44, SD = 12.10) and higher safety culture perceptions (M = 2.23, SD = 0.87) compared to non-accredited hospitals (caring behaviors: M = 90.21, SD = 13.09; safety culture: M = 1.10, SD = 0.89). The regression model explained 53.0% of the variance in care quality. Conclusion: This study underscores the complex interplay between the nursing work environment, patient safety culture, and patient care quality. The findings indicate that accredited hospitals generally achieve better outcomes regarding caring behaviors and safety culture. These insights highlight the need for targeted interventions to enhance the working environment and patient safety culture, especially in non-accredited hospitals, to improve patient care quality across both institutions.