title: Nurse perceptions of organizational culture and its association with the culture of error reporting: a case of public sector hospitals in Pakistan.
abstract: BACKGROUND
  There is an absence of formal error tracking systems in public sector hospitals of Pakistan and also a lack of literature concerning error reporting culture in the health care sector. Nurse practitioners have front-line knowledge and rich exposure about both the organizational culture and error sharing in hospital settings. The aim of this paper was to investigate the association between organizational culture and the culture of error reporting, as perceived by nurses.
  
  
  METHODS
  The authors used the "Practice Environment Scale-Nurse Work Index Revised" to measure the six dimensions of organizational culture. Seven questions were used from the "Survey to Solicit Information about the Culture of Reporting" to measure error reporting culture in the region. Overall, 309 nurses participated in the survey, including female nurses from all designations such as supervisors, instructors, ward-heads, staff nurses and student nurses. We used SPSS 17.0 to perform a factor analysis. Furthermore, descriptive statistics, mean scores and multivariable logistic regression were used for the analysis.
  
  
  RESULTS
  Three areas were ranked unfavorably by nurse respondents, including: (i) the error reporting culture, (ii) staffing and resource adequacy, and (iii) nurse foundations for quality of care. Multivariable regression results revealed that all six categories of organizational culture, including: (1) nurse manager ability, leadership and support, (2) nurse participation in hospital affairs, (3) nurse participation in governance, (4) nurse foundations of quality care, (5) nurse-coworkers relations, and (6) nurse staffing and resource adequacy, were positively associated with higher odds of error reporting culture. In addition, it was found that married nurses and nurses on permanent contract were more likely to report errors at the workplace.
  
  
  CONCLUSIONS
  Public healthcare services of Pakistan can be improved through the promotion of an error reporting culture, reducing staffing and resource shortages and the development of nursing care plans.
authors.affiliation: Institute of Social and Cultural Studies, Sociology Department, University of the Punjab, Lahore, Pakistan. sararizvijafree@gmail.com.
authors.forename: Sara Rizvi
authors.initials: SR
authors.lastname: Jafree
authors.affiliation: Institute of Social and Cultural Studies, University of the Punjab, New Campus, University of the Punjab, Lahore, Pakistan. rubeena499@hotmail.com.
authors.forename: Rubeena
authors.initials: R
authors.lastname: Zakar
authors.affiliation: Institute of Social and Cultural Studies, Faculty of Behavioral and Social Sciences, New Campus, University of the Punjab, Lahore, Pakistan. mzzakir@yahoo.com.
authors.forename: Muhammad Zakria
authors.initials: MZ
authors.lastname: Zakar
authors.affiliation: Department of Public Health Medicine, School of Public Health, Bielefeld University, P.O. Box 100131, 33501, Bielefeld, Germany. f.fischer@uni-bielefeld.de.
authors.forename: Florian
authors.initials: F
authors.lastname: Fischer
mesh_terms: D000328:Adult; D005163:Factor Analysis, Statistical; D005260:Female; D006779:Hospitals, Public; D006801:Humans; D007857:Leadership; D008297:Male; D019221:Mandatory Reporting; D019300:Medical Errors / Q000523:psychology / Q000706:statistics & numerical data*; D015403:Nursing Evaluation Research; D009741:Nursing Staff, Hospital / Q000458:organization & administration / Q000523:psychology*; D015279:Organizational Culture; D010154:Pakistan; D061214:Patient Safety; D012308:Risk Management; D017751:Safety Management / Q000458:organization & administration; D017132:Workplace / Q000458:organization & administration