Summary
Purpose
The purpose of this study is to explore the safety climate perceptions of the multicultural
nursing workforce, and to investigate the influence of diversity of the multicultural
nursing workforce on clinical safety in a large tertiary hospital in Saudi Arabia.
Background
Working in a multicultural environment is challenging. Each culture has its own unique
characteristics and dimensions that shape the language, lifestyle, beliefs, values,
customs, traditions, and patterns of behaviour, which expatriate nurses must come
to terms with. However, cultural diversity in the health care environment can potentially
affect the quality of care and patient safety.
Method
A mixed-method case study (survey, interview and document analysis) was employed.
A primary study phase entailed the administration of the Safety Climate Survey (SCS).
A population sampling strategy was used and 319 nurses participated, yielding a 76.8%
response rate. Descriptive and inferential statistics (Kruskal–Wallis test) were used
to analyse survey data.
Results
The data revealed the nurses’ perceptions of the clinical safety climate in this multicultural
environment was unsafe, with a mean score of 3.9 out of 5. No significant difference
was found between the age groups, years of nursing experience and their perceptions
of the safety climate in this context. A significant difference was observed between
the national background categories of nurses and perceptions of safety climate.
Conclusion
Cultural diversity within the nursing workforce could have a significant influence
on perceptions of clinical safety. These findings have the potential to inform policy
and practice related to cultural diversity in Saudi Arabia.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to CollegianAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Health care and nursing in Saudi Arabia.International Nursing Review. 2008; 55: 125-128
- Patient safety: Achieving a new standard for care.The National Academies Press, Washington, DC2004
- Applied statistics: A first course.Prentice-Hall International, New Jersey1988
- Nurses’ experiences in caring for patients from different cultural backgrounds.Nursing Times Research. 2000; 5: 382-389
- Expatriate health care workers and maintenance of standards of practice factors affecting service delivery in Saudi Arabia.International Journal of Health Care Quality Assurance. 2003; 16: 347-353
- Interventions to reduce racial and ethnic disparities in health care.Medical Care Research and Review. 2007; 64: 7S-28S
- Nurses’ experiences of caring for culturally diverse patients in an acute care setting.Contemporary Nurse. 2005; 20: 78-86
- SPSS: Analysis without anguish version 17. 0 for windows.John Wiley & Sons, Milton, Qld2010
- The case for diversity in the health care workforce.Health Affairs. 2002; 21: 90-102
- Are language barriers associated with serious medical events in hospitalized pediatric patients?.Pediatrics. 2005; 118: 575-579
- Racial, cultural, and ethnic factors affecting the quality of end-of-life care in California: Findings and recommendations.California Health Care Foundation, Oakland, CA2007
- Sociology: A global perspective.Cengage Learning, Belmont, CA2008
- Measuring safety culture in healthcare: A case for accurate diagnosis.Safety Science. 2007; 45: 653-667
- Why do workers behave unsafely at work? Determinants of safe work practices in industrial workers.Occupational and Environmental Medicine. 2004; 61: 239-246
- The nature of safety culture: A review of theory and research.Safety Science. 2000; 34: 215-257
- Ethnocultural considerations in family therapy.Journal of the American Psychiatric Nurses Association. 2003; 9: 46-54
- Patient safety climate in primary care: Age matters.Journal of Patient Safety. 2009; 5: 23-28
- Intensive care nurses’ encounters with multicultural families in Norway: An exploratory study.Intensive and Critical Care Nursing. 2008; 24: 338-348
- Safety Climate Survey.Institute for Healthcare Improvement, Austin, Texas2004
- Challenges and successes in reducing health disparities: Workshop summary.The National Academies Press, Washington, DC2008
- Determining sample size.Institute of Food and Agricultural Sciences, Florida1992
- Mixed methods research: A research paradigm whose time has come.Educational Researcher. 2004; 33: 14-26
- Culture, language, and patient safety: Making the link.International Journal for Quality in Health Care. 2006; 18: 383-388
- A strategy to reduce cross-cultural miscommunication and increase the likelihood of improving health outcomes.Academic Medicine. 2003; 78: 577-587
- Safety Climate Survey: Reliability of results from a multicenter ICU survey.Quality and Safety of Health Care. 2005; 14: 273-278
- High- versus low-context culture: A comparison of Chinese, Korean, and American cultures.Psychology and Marketing. 1998; 15: 507-521
- Nurses’ descriptions of caring for culturally diverse clients.Clinical Nursing Research. 1998; 7: 125-146
- Anthropology in the clinic: The problem of cultural competency and how to fix it.PLoS Medicine. 2006; 3: 1673-1676
- Organisational culture, medication administration and the role of nurses.Practice Development in Health Care. 2006; 5: 208-222
- Health statistical year book 2009.Ministry of Health of Saudi Arabia, Riyadh2009
- Health literacy: A prescription to end confusion.National Academy Press, Washington, DC2004
- Leadership style of nurse managers at the Saudi national guard hospitals.George Mason University, Fairfax2005
- SPSS survival manual: A step-by-step guide to data analysis using SPSS for Windows.3rd ed. Allen & Unwin, Sydeny, NSW2007
- Assessing safety culture: Guidelines and recommendations.Quality and Safety of Health Care. 2005; 14: 231-233
- Organizational culture and leadership.3rd ed. Jossey-Bass, San Francisco, CA2004
- Registered nurses, unlicensed assistive personnel, and organizational culture in hospitals.The Journal of Nursing Administration. 2000; 30: 278-286
- The Safety attitudes questionnaire: Psychometric properties, benchmarking data, and emerging research.BMC Health Services Research. 2006; 6: 1-10
- Test retest reliability of the Safety Climate Scale.The University of Texas Center of Excellence for Patient Safety Research and Practice, Houston2005
- Staff nurse perceptions of the work environment: A comparison among ethnic backgrounds.Journal of Nursing Care Quality. 2003; 18: 202-208
Taylor, A. (2004). A patient safety internship program for nurses leaders. Unpublished Master of Arts. British Columbia: Royal Roads University.
- Research methods in physical activity.5th ed. Human Kinetics, Champaign, IL2005
- Strangers in strange lands: A metasynthesis of lived experiences of immigrant Asian nurses working in Western countries.Advances in Nursing Science. 2007; 30: 246-265
- Korean nurses’ adjustment to hospitals in the United States of America.Journal of Advanced Nursing. 2000; 32: 721-729
Article info
Publication history
Published online: September 10, 2012
Accepted:
August 15,
2012
Received in revised form:
August 14,
2012
Received:
May 20,
2012
Identification
Copyright
© 2012 Australian College of Nursing Ltd. Published by Elsevier Inc. All rights reserved.