Purpose: Patient safety issues pose a great burden worldwide. However, there is still inadequate data on the burden of Patient Safety issues in the Philippines to specifically address institutional and national concerns through directed programs, policies, and interventions. This current study aims to describe the safety culture and attitudes of nurses of the National University Hospital in Manila, Philippines. Design: This study used a non-experimental design that assessed the safety culture and safety attitudes of nurses from the general units of the National University Hospital (NUH) using two assessment tools: the Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture (AHRQ-HSOPS) and the Safety Attitudes Questionnaire- Short Form (SAQ). Ethical approval was granted from both the university and the hospital ethics review boards. Methods: Stratified random sampling was used to ensure representation of staff nurses and nurse administrators. A self-administered survey that included the two tools was translated to Filipino and administered to 200 nurses. Percent of positive responses were obtained to describe the safety culture and attitudes as prescribed by toolkits of AHRQ-HSOPS and SAQ. Findings: The overall survey response rate yielded 86.77%. Nurses from the National University Hospital displayed both positive Safety Culture and Safety Attitudes based on AHRQ-HSOPS and SAQ. Dimensions that garnered the highest positive perceptions in Safety Culture were Organizational Learning and Teamwork while the lowest were Hospital Handoffs and Non-Punitive Response to Error. On the other hand, dimensions on Safety Awareness that received the highest positive perceptions were Teamwork and Safety Climate while the lowest was Stress Recognition. Perceptions of nurses also varied significantly across ranks in position titles and work settings. Conclusions There are identifiable dimensions that can be improved in both Safety Culture and Safety Attitude that can have a positive impact on nurses and potentially impact nurse-patient and hospital-sensitive outcomes through hospital-wide improvement programs.
Patient Safety ; Safety Management ; Nurses ; Working Conditions ; Job Satisfaction ; Philippines

There is limited evidence to substantially describe the state of Patient Safety (PS) in the Philippines.1,2 With most publications reflecting respondent-based assessments of institutional patient safety culture, patient-sensitive and records-based indicators are scarce.3 Despite the Institute of Medicine’s4 call to action to address preventable errors and the publication of patient safety indicators5, there has been slow progress in patient safety in the country.
Patient Safety

Work environment has been described as an important factor in the job satisfaction of nurses and their quality of service provided. However, little is known of the present work environment of Filipino nurses in the country. This study used a cross-sectional design to describe work environment variables affecting Filipino nurses; determine the degree of nurses' job satisfaction;, and determine their intention to remain in their present work environment. A self-administered survey was developed by the study team and was distributed during the PNA national conference   through the Chapter Presidents. This   study discovered   that the lowest positive responses were in the Physiologic  and  Safety  Needs  but  despite  this  result,  nurses  reported  high  job satisfaction and intend to remain in their present work environment.

Human ; Male ; Female ; Aged ; Middle Aged ; Adult ; Job Satisfaction ; Intention ; Workplace ; Safety

BACKGROUND AND OBJECTIVE

Global health highlights the transnational determinants, issues, and possible solutions for improving health outcomes. Addressing global health issues requires population-based approaches coupled with individualized healthcare across settings, including strategies for achieving health equity. Designing and implementing global health solutions requires competent nurse leaders who can facilitate multi-disciplinary collaborations, engage in policy development, and lead advocacies that support the global health agenda. Thus, this paper examined the stakeholder perspectives that informed the development of a leadership program on global health for nurse leaders in the Western Pacific Region (WPR).

METHODS

The study used a descriptive qualitative approach to generate key recommendations for a context-appropriate, multi-country capacity-building program for nurse leaders on global health. The Analysis Design, Development, Implementation, and Evaluation (ADDIE) model and reflexive approach were employed to guide the development of the training design. Twenty-five nurse leaders from World Health Organization Collaborating Centers (WHO-CC) in the Western Pacific participated. Qualitative data were collected from participant feedback and post-activity sessions throughout program implementation.

RESULTS

Thematic analysis of stakeholder data revealed that the program (1) capitalized on equipping nurse leaders with the concepts related to global health and developing competencies in leadership, policy engagement, and advocacy; (2) ensured learning strategies by having participants from varied contexts and experiences; and (3) reflected on the strengths and limitations of the use of the online platform.

CONCLUSION

This paper contributed to the growing literature on global health and programs that support addressing global health issues. The findings underscored the urgent need to capacitate nurses in leadership positions who contribute to addressing emerging issues in global health. The paper recommended improvements in the design and implementation of the Global Health Nursing Leadership Program to engage more nurse leaders across the region and enhance content and delivery.

Global Health

BACKGROUND AND OBJECTIVES

The COVID-19 pandemic has brought additional strain to health workers in the Philippines, leading to a significant proportion of them leaving the workforce. The purpose of this study is to explore the impact of the pandemic on health workers, the support that they received and associated challenges; and identify relevant policies for better workplace conditions.

METHODS

An environmental scanning method was utilized. Particularly, a literature review and policy scan that were validated through key informant interviews with administrators and frontline health workers from selected urban and rural sites in the three main islands in the Philippines. These were framed into a background note to springboard the discussions during a national policy dialogue participated by representatives from key government organizations, professional organizations of physicians, nurses, and midwives, professional regulatory bodies, hospital administrators, frontline health workers, and donor agencies in the Philippines.

RESULTS

Deaths, burn-out, mental health problems, lack of personal protective equipment and poor allocation of vaccines were reported in the early phases of the pandemic. Support varied across settings but included additional allowance, free meals, accomodation, transportation, training and psychosocial services. Furthermore, pre-pandemic issues such as as low salaries and heavy workload continue to be the main reasons for leaving the workforce or the country. The proposed solutions are as follows: (1) creating policies and strategies for appropriate production, recruitment, and retention of human resources for health; (2) allocating regular permanent positions for both the education and health sector; (3) augmenting and continuation of deployment programs; (3) expanding roles of nurses to push for advanced practice nursing; (4) providing fair compensation along with risk allowances, non-financial incentives, and expanded benefits; (5) supporting mental health wellness by providing an appropriate work-rest balance and safe work environment; (6) providing opportunities for professional development and scholarships with accompanying return-service agreement; and (7) strengthening the reintegration programs for returning overseas health workers.

CONCLUSION

The pandemic has affected the well-being of health workers and disparities in support were reported due to longstanding workplace issues and policy implementation gaps. Stakeholder commitments require sustained monitoring while policies that are in place and yet to be developed demand stronger support from the government, members of Congress, the private sector, and other key decision-makers.

Covid-19 ; Health Policy ; Philippines