Analysis of the relationship between patient safety and resistance to change: assessment of perceptions of nurses' working i̇n university hospital

To foster a patient safety culture in hospitals, the existing systems need to be redesigned. The implementation of each new system brings along change processes. During these processes, the health care personnel are obliged to change their practices and working conditions. The evaluation of the healthcare personnel?s perception of patient security and the determination of the importance levels of the factors involved in the creation of a patient safety culture help hospital administrations realize the important points, which they need to consider in determining health safety policies. Additionally, the determination of the attitudes of the healthcare personnel towards change is crucial for the planning of patient safety policies and their mode of implementation.The aim of the study: To evaluate nurses? perception of patient safety, determine their attitudes towards change and analyze the relation between their perception of patient safety and their resistance to change.The method: The sample of the city consists of 493 (44.81%) nurses working at the university hospitals of Izmir. The data collection tool was the patient safety questionnaire for health enterprises developed by Sexton JB and Thomas EJ of Texas University, which was used in their study titled ?Error, stress and teamwork in medicine and aviation: cross-sectional surveys". As for the organizational change aspect, we used the ?The Proactive Supervisor-Subordinate, Two-Way Communicative Processes (PSSTWCP)? scale, which was developed by Barret and used by a telecommunication enterprise in 2007. This scale is based on the Leader Member Exchange (LMX) theory. The nurses? perception of patient safety and organizational change was assessed by a 5-point Likert scale. The first step in the analysis of the data was the validity and reliability analyses. Then the descriptive statistics were calculated and the T-test, the ANOVA test and the correlation and regression analyses were performed.Results: The nurses included in the study ranked the factors associated with perfect medical safety as follows: the viewpoint of the administration about patient safety, the patient safety system and the attitude of the healthcare workers towards patient safety. The factors affecting change management, on the other hand, were ranked according to order of importance as follows: institutional change, leadership change, individual response to novelty and resistance to change. It was determined that the nurses? perception of patient safety and organizational change varied according to their demographic characteristics.Conclusion: According to the nurses working at university hospitals, in order to improve patient safety, the issue must primarily be addressed by the senior management. In order for the organizational change to take place in a healthy way, the leaders must take the greater responsibility. The participation of healthcare workers must be increased and communication must be ensured to guarantee that change does not face resistance. Thus, the planning should be made by taking the demographic differences into consideration.