Assessment of nurses' patient safety culture in 30 primary health-care centres in Tunisia.

Background: Ensuring patient safety and health-care quality remain priorities and challenges worldwide and the role of nurses is essential to meet these challenges. Developing patient safety culture is a key component to improve patient safety and health-care quality.

Aims: To assess nurses' patient safety culture in primary health-care centres in Tunisia and to determine its associated factors.

Methods: This was a multicentre, cross-sectional descriptive study conducted across 30 primary health-care centres in Tunisia, using the French validated version of the Hospital Survey on Patient Safety Culture questionnaire. All the nurses working in these centres were invited to participate in the study (n = 158).

Results: The response rate for participation in the study was 87.3%. The dimension of "teamwork within units" had the highest score (70.6%). Three safety dimensions had low scores: "frequency of event reporting" (27.6%), "staffing" (34.76%) and "nonpunitive response to errors" (36.5%). Two factors were associated with patient safety culture: participation in risk management committees, and district of the primary care centre.

Conclusions: The level of nurses' patient safety culture needs to be improved in primary health-care centres in Tunisia. Strategies to nurture patient safety culture should focus upon building leadership capacity that supports open communication, blame-free environment, teamwork and continuous organizational learning.