Safety climate and attitude toward medication error reporting after hospital accreditation in South Korea

OBJECTIVE: This study compared registered nurses' perceptions of safety climate and attitude toward medication error reporting before and after completing a hospital accreditation program. Medication errors are the most prevalent adverse events threatening patient safety; reducing underreporting of medication errors significantly improves patient safety. Safety climate in hospitals may affect medication error reporting. DESIGN: This study employed a longitudinal, descriptive design. Data were collected using questionnaires. SETTING: A tertiary acute hospital in South Korea undergoing a hospital accreditation program. PARTICIPANTS: Nurses, pre- and post-accreditation (217 and 373); response rate: 58% and 87%, respectively. INTERVENTIONS: Hospital accreditation program. MAIN OUTCOME MEASURES: Perceived safety climate and attitude toward medication error reporting. RESULTS: The level of safety climate and attitude toward medication error reporting increased significantly following accreditation; however, measures of institutional leadership and management did not improve significantly. Participants' perception of safety climate was positively correlated with their attitude toward medication error reporting; this correlation strengthened following completion of the program. CONCLUSIONS: Improving hospitals' safety climate increased nurses' medication error reporting; interventions that help hospital administration and managers to provide more supportive leadership may facilitate safety climate improvement. Hospitals and their units should develop more friendly and intimate working environments that remove nurses' fear of penalties. Administration and managers should support nurses who report their own errors.