Empowered Nurses, Safer Care: A Cross-Sectional Study of Work Environment and Patient Safety Culture
Keywords:
hospitals, indonesia, nurses, patient safety, safety cultureAbstract
Background: Patient safety culture remains a major concern in hospital care, and the nursing work environment may be associated with safer practice, teamwork, and reporting behavior among clinical nurses
Aim: To examine the association between nurses’ work environment and patient safety culture in a regional hospital in Samarinda, Indonesia
Approach: This cross-sectional study included 124 nurses from an accessible population of 140 at Hospital Dirgahayu Samarinda from January 2 to February 4, 2026. Total population sampling was used. Eligible participants were clinical nurses aged 18 years or older who were actively working during data collection. Work environment and patient safety culture were measured using the Indonesian PES-NWI and HSOPSC 2.0. Data were analyzed using descriptive statistics, bivariate tests, and multivariable linear regression in SPSS version 18.0
Results: The mean (SD) age was 31.8 (5.9) years, and 96 participants (77.4%) were women. The mean (SD) patient safety culture score was 3.54 (0.42), and the mean (SD) work environment score was 2.86 (0.39). In the adjusted model, a more favorable work environment was associated with a higher patient safety culture score (β = 0.41; 95% CI, 0.27 to 0.55; P < .001). Greater nursing experience was also associated with a higher score (β = 0.17; 95% CI, 0.05 to 0.29; P = .006), whereas rotating shift work was associated with a lower score (β = −0.19; 95% CI, −0.35 to −0.03; P = .02)
Conclusions: A more favorable nursing work environment was associated with a more positive patient safety culture among nurses in this hospital setting
Implication for Nursing Practice: Nursing practice may benefit from supportive leadership, adequate staffing, structured orientation, and stronger communication systems to reinforce safety culture, especially among less experienced nurses and rotating-shift staff.
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