How patient safety culture influences nurses' responsibility: a structural equation modeling study

Patient safety culture plays a vital role in shaping nurses' professional responsibility, which is essential for delivering high-quality care. Clarifying this relationship and its variations across demographic factors can help healthcare systems implement more effective improvement strategies. This study aimed to examine how patient safety culture influences nurses' professional responsibility, considering the moderating effects of demographic characteristics.

This descriptive-analytical cross-sectional study was conducted from January to April 2025 among 301 nurses at Samen al-Hojaj Hospital in Sirjan, southern Iran, using a census sampling method. Data were collected using a demographic questionnaire, the Hospital Survey on Patient Safety Culture (HSOPSC), and Hassaniyan's Responsibility Questionnaire based on Carroll's Model. Partial least squares structural equation modeling (PLS-SEM) was used to examine the associations between patient safety culture and nurses' responsibility.

The mean score of patient safety culture was 2.93 out of 5, with 63.5% of responses categorized as positive, indicating an acceptable safety culture. Nurses' responsibility averaged 108.3 out of 175, reflecting a good level overall. Pearson's correlation showed a significant and positive relationship between safety culture and responsibility (r = 0.61, p < 0.001, 95% CI: 0.53-0.68). The SEM analysis confirmed a significant positive effect of patient safety culture on responsibility (β = 0.59, p < 0.001). Age and work experience significantly moderated this relationship, with stronger associations observed among older and more experienced nurses.

This study underscores the association between patient safety culture and nurses' responsibility, emphasizing its potential influence within healthcare settings. Strengthening dimensions such as hospital management support, non-punitive response to error, and overall perceptions of safety may foster higher levels of responsibility among nurses. Moreover, designing interventions tailored to nurses' age and experience can further reinforce responsible behavior and the overall quality of care.

Not applicable.