Factors Influencing Critical Care Nurses’ Attitudes to Patient Safety: A Systematic Review

Abstract

Background: Ensuring patient safety continues to be a key aspect in the health sector. Negligent practices concerning health, hygiene and diet are among the top killers in modern society. The attitudes and practices of critical care nurses concerning patient safety culture are of significant importance. Safety culture refers to the safety beliefs, values and attitudes adopted by health care providers, as well as the processes of practising them and the dedication to creating a riskless health care system. Aim: This systematic review seeks to summarise the attitudes and practices of critical care nurses towards patient safety in ICUs and their adherence to international safety goals, and factors that affect their attitudes and practices towards patient safety practices. Methods: A systematic literature search was conducted in four online databases – CINAHL, MEDLINE, PubMed and Scopus – of publications spanning September 2014 to 2024. The PICo framework was employed in the formulation of the research question. Specific criteria were set for the inclusion of studies. The quality of the included studies was assessed using the Appraisal tool for Cross-Sectional Studies (AXIS). Results: Ten studies were included in this systematic review. These studies employed cross-sectional design to investigate critical care nurses’ attitudes, perceptions and practices about patient safety, compliance with international safety goals, and factors that may influence them in critical care settings. In general, critical care nurses reported significant negativity in safety culture, and the management perception scores were low overall. Organisational commitment and job satisfaction had the highest means of positive scores as did teamwork. Nurses likewise confirmed a perspective of International Patients Safety Goals (IPSGs) as a reliable framework for patient safety; individual factors affecting patient safety culture included fatigue, workload and emotional exhaustion. Nurses aged 31–35 were more knowledgeable about the IPSGs. Conclusion: The current study reveals that critical care nurses had negative perception towards safety culture and poor response on the management support and the implementation of some principles of patient safety. Although 8 nurses’ knowledge of specific goals is strong, a number of implementation challenges remain and thus require focused interventions to enhance safety culture.