Evaluation of Approaches to Patient Safety Culture of Nurses Working in Internal Medicine and Surgical Units

INTRODUCTION: This study was conducted to determine the approaches of nurses working in internal medicine and surgical units toward patient safety culture.
METHODS: This descriptive cross-sectional study was conducted with 170 nurses working in internal medicine and surgical clinics of hospitals affiliated with the Ministry of Health between January 2025 and March 2025. Data were collected online through Google Forms using the “Hospital Survey on Patient Safety Culture.” The data were presented using numbers, percentages, means, and standard deviations; the Mann–Whitney U test was used for comparisons between two groups, and the Kruskal–Wallis H test was used for comparisons among three or more groups.
RESULTS: The mean score of the “Overall Perceptions of Safety” subdimension among nurses working in surgical units (72.63±28.73) was higher than that of nurses working in internal units (65.33±29.89). In both units, the lowest positive response rates were found in the “Non-punitive Response to Error” (internal: 25.78±29.29; surgical: 28.42±29.96) and “Staffing” (internal: 30.67±19.53; surgical: 29.74±18.70) subdimensions. Among nurses working in internal units, those with weekly working hours exceeding 49 h had lower teamwork and management support scores (p<0.05). In surgical units, nurses working more than 49 h/week had higher scores in the “Hospital Management Support for Patient Safety” and “Hospital Handoffs and Transitions” subdimensions (p<0.05).
DISCUSSION AND CONCLUSION: The findings indicate that the patient safety culture among nurses working in both medical and surgical units requires further strengthening. Although nurses in surgical units reported more positive perceptions of safety, low scores in the non-punitive response to error and staffing dimensions highlight important areas for improvement across all units. Working hours were found to influence several dimensions of patient safety culture, suggesting that workload and organizational factors play a significant role in shaping safety perceptions. Strengthening managerial support, promoting a non-punitive approach to error reporting, ensuring adequate staffing levels, and improving working conditions may contribute to the development of a stronger patient safety culture and enhance the quality and safety of patient care.

Keywords: Nurses, patient safety culture, teamwork, working conditions