BACKGROUND : The Nursing Act 33 of 2005 holds nurse practitioners responsible for all acts and
omissions in the delivery of quality patient care. But quality patient care is influenced by a
number of factors beyond the control of nurse practitioners. Patient safety culture is one such
factor and is seldom explored in hospitals in developing countries. This article describes the
patient safety culture of a district hospital in South Africa.
Objectives: The study identified and analysed the factors that influence the patient safety
culture by using the Manchester Patient Safety Framework at the National District Hospital,
Bloemfontein, Free State Province.
METHOD : A descriptive cross-sectional study was conducted and included the total population
of permanent staff; community service health professionals; temporarily employed
health professionals and volunteers. The standard Manchester Patient Safety Framework
questionnaire was distributed with a response rate of 61%.
RESULTS : Less than half of the respondents (42.4%; n = 61) graded their units as acceptable.
Several quality dimensions were statistically significant for the employment profile: overall
commitment to quality (p = 0.001); investigating patient incidents (p = 0.031); organisational
learning following incidents (p < 0.001); communication around safety issues (p = 0.001); and
team working around safety issues (p = 0.005). These same quality dimensions were also
statistically significant for the professional profiles. Medical doctors had negative perceptions
of all the safety dimensions.
CONCLUSION : The research measured and described patient safety culture (PSC) amongst
the staff at the National District Hospital (NDH). This research has identified the perceived
inadequacies with PSC and gives nurse managers a clear mandate to implement change to
ensure a PSC that fosters quality patient care.