• Dewa Ayu Dyah Widya
  • Adang Bachtiar
  • Dumilah Ayuningtyas
  • Vetty Yulianty Permanasari


Background: Patient safety is one of the most important dimensions in quality of healthcare. Nurses are the key in care delivery, their compliance toward Patient Safety policy cannot be overlooked. Studies evaluating determinants of nurse’s compliance to Patient Safety policy is still lacking.
Aims: To evaluate nurse’s attitude toward Patient Safety policy using Health Belief Model (HBM). Methods: An analytical cross-sectional study was carried on in Bali Royal Hospital, Indonesia, on December 2016. An anonymous, self-administered questionnaire was used to collect the data on socio demographics, knowledge, and attitude toward Patient Safety policy. Attitudes are specifically assessed using HBM.

Results: A total of 124 nurses are included in this study. Mean age of the study population was 29.7±6.7 years. Mean score for knowledge about Patient Safety policy was 12.68±3.40 from 18.0- point scale. Nurses perceived a low risk of non-compliance (mean perceived risk 8.07±1.89) and a low barrier to comply with Patient Safety policy (mean perceived barrier 8.66±1.78). Knowledge and attitudes toward Patient Safety policy did not differ by sex and educational background but it did differ according to unit of workplace. Age and length of work correlated positively to knowledge (Spearman’s r=0.439, p-value 0.000; and r=0.400, p-value <0.001, respectively). A positive and moderate correlation was observed between knowledge vs. perceived severity (r= 0.394, p-value <0.001) and knowledge vs. perceived benefit (r=0.422, p-value < 0.001). There was a strong and positive correlation between perceived severity and perceived benefit (r= 0.725, p-value <0.001). Conclusion: Nurse’s attitudes toward Patient Safety policy were generally good and correlate positively with knowledge. The use of HBM provides an increased understanding of how individual perceptions can be influenced to improve nurse’s engagement in promoting safer health care. 


Azami-Aghdash S, Mohammadi R. Using Tracer Methodology in Clinical Setting and Research to Measure and Improve Quality. J Clin Res Gov 2013;2 39-40.

Azami-Aghdash S, Ghaffari S, Sadeghi- Bazargani H, Tabrizi JS, Yagoubi A, Naghavi-Behzad M. Developing Indicators of Service Quality Provided for Cardiovascular Patients Hospitalized in Cardiac Care Unit. JCTR 2013;5(1):23-8.

Tabrizi J, Gholipoor K, Asghari jafarabadi M, Farahbakhsh M, Mohammadzedeh M. Customer quality and maternity care in Tabriz urban health centers and health posts. J Clin Res Gov 2012;1:12-5.

Farahbakhsh M, Sadeghi-Bazargani H, Nikniaz AR, Tabrizi JS, Zakeri A, Azami-Aghdash S. Iran's Experience of Health Cooperatives as a Public- Private Partnership Model in Primary Health Care: A Comparative Study in East Azerbaijan HPP 2012;2(2):287-98.

Tabrizchi N, Sedaghat M. The first study of patient safety culture in Iranian primary health centers. Acta Med Iran. 2012;50(7):505-10.

Ebadi Fardazar F, Safari H, Habibi F, Akbari Haghighi F, Rezapour A. Hospitals' readiness to implement clinical governance. Int J Health Policy Manag 2014;4(2):69-74.

Arab M, Akbari Sari A, Movahed Kor E, Hos¬seini M, Toloui Rakhshan S, Ezati M. Patient Safety in Tehran University of Medical Sciences? General Hospitals, Iran. Iran J Public Health 2013;42(3):306-13.

Sheikhtaheri A. Near Misses and Their Importance for Improving Patient Safety. Iran J Public Health 2014;43(6):853-4.

Baker GR, Norton PG, Flintoft V et al. The Canadian adverse events study: the incidence of adverse events among hospital patients in

Canada. Canadian Medical Association Journal, 2004; 170:1678–1686.