The effect of nurse empowerment educational program on patient safety culture: a randomized controlled trial

Background: The complexity of patients' condition and treatment processes in intensive care units (ICUs) predisposes patients to more hazardous events. Effective patient safety culture is related to lowering the rate of patients' complications and fewer adverse events. The present study aimed to determine the effect of empowering nurses and supervisors through an educational program on patient safety culture in adult ICUs. Methods: A randomized controlled trial was conducted during April-September 2015 in 6 adult ICUs at Namazi Hospital, Shiraz, Iran. A total of 60 nurses and 20 supervisors were selected through proportional stratified sampling and census, respectively, and randomly assigned to the experimental and control groups. The intervention consisted of a two-day workshop, hanging posters, and distributing pamphlets that covered topics such as patient safety, patient safety culture, speak up about safety issues, and the skills of Team Strategies and Tools to Enhance Performance and Patient Safety. Data were collected through a hospital survey on patient safety culture. Eventually, 61 participants completed the study. Data were analyzed using descriptive statistics, independent-samples t-test, paired-samples t-test, and Chi-square test. P < 0.05 was considered statistically significant. Results: In the experimental group, the total post-test mean scores of the patient safety culture (3.46 +/- 0.26) was significantly higher than that of the control group (2.84 +/- 0.37, P < 0.001). It was also higher than that of the pretest (2.91 +/- 0.4, P < 0.001). Additionally, significant improvements were observed in 5 out of 12 dimensions in the experimental group. However, dimensions such as non-punitive response to errors and the events reported did not improve significantly. Conclusion: Empowering nurses and supervisors could improve the overall patient safety culture. Nonetheless, additional actions are required to improve areas such as reporting the events and non-punitive response to errors.