The study of human error with just culture approach in hospitals wards, in Ardabil

Abstract

Background and Objectives: Just culture is conceptualized as a rational approach to human error and its fallibility. A good evaluation of just culture in an organization is needed to effectively design and implement the preventive measures. This study aimed to evaluate the human error with just culture approach in hospitalswards, in Ardabil city. Methods: In this descriptive-analytical and cross-sectional study the self-report assessment and document-survey method were used for data collection via questionnaire and reporting form. The sample size was calculated 330 persons, which 305 persons were voluntarily involved. The Just Culture Questionnaire (JCQ) was used for the first time in Iranian community. The Persian version of JCQ was prepared by standard method, forward-backward translation. In order to evaluate the content validity, the questionnaire was sent to 28 ergonomists and the content validity index (CVI) and content validity ratio (CVR) were calculated. The reliability of questionnaire was determined based on the results of 221 questionnaires fulfilled by hospital nurses. To evaluate the error rate in hospital wards, a self-designed error reporting form was used. The reported errors to quality improvement unit during last year were gathered. Also, the self –report errors were collected via recorded in selfdesigned error reporting form. The gathered data were inserted in SPSS-16 software and were analyzed via statistical test such as One-way ANOVA, Tukey HSD and Pierson correlation. Results: The content validity of JCQ was confirmed based on CVI and CVR rates. The Cronbach's alpha coefficient for JCQ dimensions was ranged from 0.655 to 0.825. The total coefficient for the JCQ showed that the questionnaire has high internal consistency in all dimensions measured (α = 0.894). 149 errors recorded by quality improvement units during last year, as well as 225 errors reported by employee themselves. The participation rate was 72.5% (n=221). The obtained results showed that the total score of just culture in studied hospitals is acceptable. Also, there is no significant difference between just culture scores in governmental and private hospitals (P value =0.161). The results showed that there is a positive relationship between the error reporting and just culture score (P value < 0.05). Conclusions:This study showed that the validity and reliability of the Persian version of JCQ are acceptable and it is applicable for assessment of just culture in Iranian organizations and workplaces. Also the acceptable just culture level in the health care system can facilitate the human error report and possible the on-time preventive measures.