Patient satisfaction with nursing care quality and patient safety culture in the medical-surgical unit

Keywords: culture, patient, safety, satisfaction


The objective of the study was to determine a significant relationship between patient safety culture as perceived by the nurses. The study was done in the medical-surgical units of a private hospital in Cebu City. The respondents were 131 regular nurses assigned in the medical surgical units and patients admitted in the medical-surgical units. Quota/purposive sampling technique was used. Research tools used were the Modified Hospital Survey on Patient Safety Culture developed by the Agency of Healthcare Research and Quality and the Modified Patient Satisfaction with Nursing Care Questionnaire developed by Laschinger, Hall, Pedersen & Almost. Results showed that majority (52.475%) of the regular nurses assigned in the medical-surgical units of a private hospital in Cebu City have positive assessments with regards to the perceptions, values, attitudes and patterns of behavior that determine the dedication to, manner and mastery of an institutions management of health and safety indicating a positive patient safety culture. 55% of the patient respondents rated the nursing care quality in medical-surgical units as “Excellent” or “Very Good” indicating a positive patient satisfaction rating. Spearman’s Rho revealed that there is no significant relationship between patient safety culture as perceived by nurses and patient satisfaction to nursing care quality. Mann-Whitney Test and Kruskall-Wallis Test for Difference revealed no significant difference in perception in patient safety culture based on the demographic profiles of nurses and no significant difference in patient satisfaction to nursing care quality based on the demographic profiles of the patients. Some dimensions of patient safety culture had less than 50% of the nurse respondents giving a positive assessment which indicated that these were areas needing of improvement. Continuous evaluation of patient safety in the hospital is needed to assess strengths and areas needing improvement. Continuous re-evaluation of policies is needed to ensure its effectiveness in the attainment of the patient safety culture of the organization.


1. Arcenal, L. (2015). South general hospital employees’ level of safety culture and work attitude: proposed program design for organizational setting enhancement towards patient safety. Graduate School Journal: Cebu Doctors' University, 33.

2. Blegen, M. (2006). Patient safety in hospital acute care units. Annual Review of Nursing Research, 24, 103-125

3. Cannon-Bowers, J., Tannenbaum, S., Salas, E., & Volpe, C. (1995). Defining competencies and establishing team training requirements. In R. Guzzo, & E. Salas (Eds.). Team effectiveness and decision making in organizations (pp. 333–80). San Francisco: Jossey-Bass.

4. Edmondson, A. (1999). Psychological safety and learning behavior in work teams. Administrative Science Quarterly, 44(2), 350-383.

5. Famolaro, T., Yount, N., Willow, B., Elizabeth, F., Liu, H., &Sorra, J. (2016). Hospital survey on patient safety culture: 2016 user comparative database report. Retrieved October 16, 2015, from safety/patientsafetyculture/hospital/2016/2016_hospitalsops_report_pt1.pdf

6. Farley, D., Haviland, A., Champagne, S., Jain, A., Battles, J., Munier, W., & Loeb, J. (2008). Adverse-event-reporting practices by US Hospitals: Results of a national survey. Quality and Safety in Health Care, 17(6),416-423. doi: 10/1136/qshc.2007.024638

7. Fitzpatrick, R. (1991). Surveys of patient satisfaction: Important general consideration.British Medical General, 302(6781). Retrieved July 20, 2016, from

8. Force, M., Deering, L., & Hubbe, J. (2006). Effective strategies to increase reporting of medication errors in hospitals. Journal of Nursing Academy, 36(1), 34–41

9. Gandhi, T. (2005). Fumbled handoffs: One dropped ball after another. Annals of Internal Medicine, 142(5), 352–358

10. Hart, P. (2003). Patient to nurse staffing ratios: Perspectives from hospital nurses. Retrieved July 3, 2016, from

11. Heidari, S., Nayeri, N. D., Ravari, A., & Sabzevari, S. (2016). How organizational learning is associated with patient rights: A qualitative content analysis. Global Health Action, 9. doi: 10.3402/gha.v9.30939.

12. Hellings, J., Schrooten, W., Klazinga, N., & Vleugels, A. (2007 ). Challenging patient safety culture: Survey results. International Journal of Health Care Quality Assurance,20(7), 620-632. doi: 10.1108/09526860710822752

13. Hickam, D., Severance, S., Feldstien, A., Ray, L., & Gorman, P. (2003). The effect of healthcare working conditions on patient safety. Retrieved July 29, 2016, from

14. Hofmann, D., Morgeson, F., & Gerras, S. (2003). Climate as a moderator of the relationship between LMX and content-specific citizenship behavior: Safety climate as an exemplar. Journal of Applied Psychology, 88(1), 170–178. doi: 10.1037/0021-9010.88.1.170

15. Hupcey, J. (2000). Feeling safe: Psychosocial needs of ICU patients. Journal of Nursing Scholarship, 32(4), 36-367

16. Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st century. Retrieved August 1, 2016, from

17. Jones, K., Skinner, A., Xu, L., Sun, J. & Mueller, K. (2008). The AHRQ hospital survey on patient safety culture: A tool to plan and evaluate patient safety programs. Retrieved October 15, 2015, from

18. Karsh, B., Escoto, K., Beasley, J., & Holden, R. (2006). Toward a theoretical approach to medical error reporting system research and design. Applied Ergon, 37(3), 283-95

19. Kozlowski, S., & Doherty, M. (1989). Integration of climate and leadership: Examination of a neglected issue. Journal of Applied Psychology,74(4), 546–553.

20. Laschinger, H., Hall, L., Pedersen, C., & Almost, J. (2005). A psychometric analysis of the patient satisfaction with nursing care quality questionnaire: An actionable approach to measuring patient satisfaction. Journal of Nursing Care Quality, 20(3),220-230

21. Leonard, M., Graham, S., & Bonacum, D. (2004). The human factor: The critical importance of effective teamwork and communication in providing safe care. Quality Safety Health Care, 13(Suppl 1), 85-90.doi: 10.1136/qshc.2004.010033

22. Mardon, R., Khanna, K., Sorra, J., Dyer, N., & Famolaro, T. (2010). Exploring relationships between hospital patient safety culture and adverse events. Journal of Patient Safety,6(4), 226-32. doi: 10.1097/PTS.0b013e3181fd1a00

23. Marx, D. (2001). Patient safety and the “just culture”: A primer for health care executives. Retrieved July 15, 2016, from

24. Parand, A., Dopson, S., Renz, A., & Vincent, C. (2014). The role of hospital managers in quality and patient safety: A systematic review. BMJ Open, (4). doi:10.1136/bmjopen-2014-005-055.

25. Petersen, L. A., Brennan, T. A., O’Neil, A. C., Cook, E. F., & Lee, T. H. (1994). Does housestaff discontinuity of care increase the risk for preventable adverse events? Annals of Internal Medicine, 121(11), 866–872

26. Salas, E. & Cannon-Bowers, J. (2001). The science of training: A decade of progress. Annual Review of Psychology, 52(1), 471-99

27. Stefanini, C. (2003). H. 1282 safe staffing levels and quality care: A critical combination whose time has come. Massachusetts Nurse, 74(2), 4.

28. Wolosin, R. J. (2008, June). Safety and satisfaction: Where are the connections?.Patient Safety and Quality Healthcare. Retrieved February 3, 2016, from

29. World Health Organization. (2000). The World Health report 2000: Health systems: improving performance. Retrieved August 28, 2016, from

30. World Health Organization. (2015). Regional Strategy for patient safety in the WHO Southeast Asia region (2016-2025). Retrieved August 4, 2016, from

31. Wu, T. C., Chen, C. H., & Li, C. C. (2008). A correlation among safety leadership, safety climate and safety performance. Journal of Loss Prevention in the Process Industries, 21(3), 307-318. Retrieved September 20, 2016, from
How to Cite
Pepito, J. A. T. (2016). Patient satisfaction with nursing care quality and patient safety culture in the medical-surgical unit. University of the Visayas - Journal of Research, 10(1), 39-48. Retrieved from