Professional environment and patient safety in emergency departments

• Physicians assessed both RPPE and safety with higher ratings.
• The overall rating for the RPPE scale was 2.79 (SD = 0.30) with the physicians (2.84, SD = 0.25) reporting higher score compared to nurses (2.73, SD = 0.33) and a P-value = 0.07.
• The mean score for the Safety Climate Domain of the EMS-SAQ was 3.18 (SD = 0.51) for the total sample with 3.25 (SD = 0.48) among physicians and 3.16 (SD = 0.51) among nurses (P-value = 0.31).
• The factors of the RPPE with the strongest correlation with safety were “leadership” (r = 0.53), followed by “control over practice” (r = 0.48), “staff relations” (r = 0.45) and “cultural sensitivity” (r = 0.44) while the weakest was with “teamwork” (r = 0.26).

The purpose of this study was to examine nurses' and physicians' perceptions of professional environment and its association with patient safety in public emergency departments in Cyprus. A total of 224 professionals (174 nurses and 50 physicians) participated (rr = 81%). Data were collected using the “Revised Professional Practice Environment” (RPPE) instrument and the Safety Climate Domain of the “Emergency Medical Services Safety Attitudes Questionnaire” (EMS-SAQ). The mean overall score of RPPE was 2.79 (SD = 0.30), among physicians 2.84 (SD = 0.25) and nurses 2.73 (SD = 0.33) (P-value = 0.07). Statistically significant differences were observed between the two study groups regarding “staff relationships”, “motivation” and “cultural sensitivity” (P-values < 0.05). No significant differences were observed as regards EMS-SAQ (3.25 vs. 3.16 respectively; P-value = 0.28). All 8 components of the RPPE exhibited significant association with patient safety. Linear and stepwise regression analyses showed that “leadership” explains 28% of the variance of safety. This relationship suggests improvements in professional environment with the ultimate goal of improving patient safety.