Patient Safety Culture and Competence among Nurses: A Multicenter Cross-Sectional Study in Vietnam

Abstract

Patient safety remains a key issue in developing countries, where limitations in resources and safety systems may compromise the quality of care. Limited evidence exists on nurses’ safety culture and competence in Vietnam. This study examined these aspects, their associated factors, and their interrelationship. A cross-sectional survey was conducted from September to December 2024 in three provincial hospitals in central Vietnam. Five hundred ninety-four registered nurses working in inpatient departments of three Level I provincial hospitals in central Vietnam completed two instruments, namely: “Hospital Survey on Patient Safety Culture” and “Health Professional Education in Patient Safety Survey”. Statistical analyses involved descriptive methods, non-parametric procedures, Spearman’s rank correlation, and generalized linear models.
Findings revealed moderately favorable assessments of safety culture and high competence levels. Strong domains included teamwork, continuous learning, feedback on errors, and communication, whereas the lowest-scoring elements related to blame-oriented responses to mistakes, staffing adequacy, and handoff processes. Education level, department, night-shift frequency, and incident-reporting behavior all showed significant associations with both patient safety culture and competence. These results indicate the importance of developing strategies that concurrently enhance organizational culture and individual competence. Supportive leadership, adequate staffing, and continuous professional development may contribute to improvements in patient safety in hospitals. Future research should explore causal pathways and evaluate interventions that strengthen both safety culture and competence.