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Patient Involvement in Patient Safety

A Qualitative Study of Nursing Staff and Patient Perceptions

Bishop, Andrea C. PhD*; Macdonald, Marilyn RN, PhD

doi: 10.1097/PTS.0000000000000123
Original Articles

Objectives The risk associated with receiving health care has called for an increased focus on the role of patients in helping to improve safety. Recent research has highlighted that patient involvement in patient safety practices may be influenced by patient perceptions of patient safety practices and the perceptions of their health care providers. The objective of this research was to describe patient involvement in patient safety practices by exploring patient and nursing staff perceptions of safety.

Methods Qualitative focus groups were conducted with a convenience sample of nursing staff and patients who had previously completed a patient safety survey in 2 tertiary hospital sites in Eastern Canada. Six focus groups (June 2011 to January 2012) were conducted and analyzed using inductive thematic analysis.

Findings Four themes were identified: (1) wanting control, (2) feeling connected, (3) encountering roadblocks, and (4) sharing responsibility for safety. Both patient and nursing staff participants highlighted the importance of building a personal connection as a precursor to ensuring that patients are involved in their care and safety. However, perceptions of provider stress and nursing staff workload often reduced the ability of the nursing staff and patient participants to connect with one another and promote involvement.

Conclusions Current strategies aimed at increasing patient awareness of patient safety may not be enough. The findings suggest that providing the context for interaction to occur between nursing staff and patients as well as targeted interventions aimed at increasing patient control may be needed to ensure patient involvement in patient safety.

From the *Department of Psychology, Saint Mary’s University; and †School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada.

Correspondence: Andrea C. Bishop, Department of Psychology, Saint Mary’s University, 923 Robie St, Halifax, Nova Scotia, Canada B3H 3C3 (e-mail:

The authors disclose no conflict of interest.

Supported by Eli Lilly Canada, Ltd. The first author’s stipend during this research was provided through a Canadian Institutes for Health Research (CIHR) Doctoral Research Award.

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