title: Perceptions of clinical safety climate of the multicultural nursing workforce in Saudi Arabia: a cross-sectional survey.
abstract: OBJECTIVE
  The purpose of this study is to explore the safety climate perceptions of the multicultural nursing workforce, and to investigate the influence of diversity of the multicultural nursing workforce on clinical safety in a large tertiary hospital in Saudi Arabia.
  
  
  BACKGROUND
  Working in a multicultural environment is challenging. Each culture has its own unique characteristics and dimensions that shape the language, lifestyle, beliefs, values, customs, traditions, and patterns of behaviour, which expatriate nurses must come to terms with. However, cultural diversity in the health care environment can potentially affect the quality of care and patient safety.
  
  
  METHODS
  A mixed-method case study (survey, interview and document analysis) was employed. A primary study phase entailed the administration of the Safety Climate Survey (SCS). A population sampling strategy was used and 319 nurses participated, yielding a 76.8% response rate. Descriptive and inferential statistics (Kruskal-Wallis test) were used to analyse survey data.
  
  
  RESULTS
  The data revealed the nurses' perceptions of the clinical safety climate in this multicultural environment was unsafe, with a mean score of 3.9 out of 5. No significant difference was found between the age groups, years of nursing experience and their perceptions of the safety climate in this context. A significant difference was observed between the national background categories of nurses and perceptions of safety climate.
  
  
  CONCLUSIONS
  Cultural diversity within the nursing workforce could have a significant influence on perceptions of clinical safety. These findings have the potential to inform policy and practice related to cultural diversity in Saudi Arabia.
authors.affiliation: School of Nursing, Queensland University of Technology, Brisbane, Australia. almutairiAd1@ngha.med.sa
authors.forename: Adel F
authors.initials: AF
authors.lastname: Almutairi
authors.forename: Glenn
authors.initials: G
authors.lastname: Gardner
authors.forename: Alexandra
authors.initials: A
authors.lastname: McCarthy
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D018864:Cultural Diversity; D054242:Emigrants and Immigrants; D019538:Health Care Surveys; D006801:Humans; D007400:Interprofessional Relations; D008875:Middle Aged; D009741:Nursing Staff, Hospital; D061214:Patient Safety; D012529:Saudi Arabia