Date of Award


Document Type


Degree Name

Master of Science in Nursing (MSN)

Committee Chair

Cindy Miller


Preventable errors in healthcare are a significant problem in today’s society, contributing to numerous adverse patient outcomes and even deaths on a daily basis. Identifying adverse outcomes is an imperative first step in creating a safer healthcare system, which can be followed by cause analyses and action plans to address systematic issues and improve process reliability. Despite the widespread use of voluntary reporting systems to identify adverse events, recent literature has found extreme limitations and severe underreporting with its use in healthcare facilities. A frequent theme in the literature implies that identifying reportable events and discouraging hesitation in reporting begins with a strong safety culture. However, limited evidence was found in current literature to establish a clear link between various dimensions of safety culture with event reporting and overall safety perceptions. The purpose of this MSN thesis was to investigate the relationships between the Agency for Healthcare Research and Quality’s (AHRQ) 10 safety culture dimensions and four outcome measures, as categorized in the Hospital Survey on Patient Safety Culture (HSOPSC), among direct care nurses. The primary methodology of this research involved secondary analysis of existing data in which survey results from the AHRQ’s HSOPSC were obtained from a large teaching hospital in the southeastern United Sates. Statistical correlational analyses were calculated using SPSS and Excel for a sample of 433 direct care nurses. All results were found to be statistically significant, in which a medium effect was seen in the correlations between overall dimensions of safety culture and patient safety grade (r = .476, p < .001), as well as between safety culture dimensions and overall perception of safety (r = .391, p < .001). A small effect was seen in the relationship between overall dimensions of safety culture and frequency of event reporting (r = .275, p < .001). A negative, but minimal relationship was found between dimensions of safety culture and number of events reported (r = -.042, p < .001). The results of this study are consistent with previous themes throughout the literature, in which leadership and communication were found to influence safety culture and frequency of event reporting. Due to the limitations of this MSN thesis, such as estimated frequency of event reporting on a survey item as opposed to an actual frequency, further research is needed to strengthen the relationships that were observed.

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Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.