title: Safety Culture in Neonatal Intensive Care Units in the Gaza Strip, Palestine: A Need for Policy Change.
abstract: BACKGROUND
  Assessment of the prevailing safety culture within the Gazan health care system can be used to identify problem areas. Specifically, the need for improvements, raising awareness about patient safety, the identification and evaluation of existing safety programs and interventions for improving the safety culture. This study aims to assess the safety culture in the neonatal intensive care units (NICUs) in Gaza Strip hospitals and to assess the safety culture in regards to caregivers' characteristics.
  
  
  METHODS
  In a cross-sectional study using a census sample, we surveyed all nurses and physicians working in at all the NICUs in the Gaza Strip, Palestine. The Safety Attitudes Questionnaire (SAQ) which includes six scales was used to assess participants' attitudes towards safety culture.
  
  
  RESULTS
  The overall score for SAQ was 63.9. Domains' scores ranged between 55.5 (perception of management) and 71.8 (stress recognition). The scores reported by our participants fell below the 75 out of a possible score of 100, which was considered as a cut-off point for a positive score. Moreover, our results revealed substantial variation in safety culture domain scores among participating NICUs.
  
  
  CONCLUSIONS
  These results should be an indicator to our health care policy makers to modify current or adopt new health care policies to improve safety culture. It should also be a call to design customized programs for improving the safety culture in NICUs in the Gaza Strip.
authors.affiliation: College of Nursing, Islamic University of Gaza, P.O. Box 108, Gaza, Gaza Strip, Palestine. Electronic address: naselnoor@iugaza.edu.ps.
authors.forename: Nasser Ibrahim
authors.initials: NI
authors.lastname: Abu-El-Noor
authors.affiliation: School of Public Health, Al-Quds University, Abu Dis, P.O. Box 89, Palestine. Electronic address: mhamdan@staff.alquds.edu.
authors.forename: Motasem Abduallah
authors.initials: MA
authors.lastname: Hamdan
authors.affiliation: College of Nursing, Islamic University of Gaza, P.O. Box 108, Gaza, Gaza Strip, Palestine. Electronic address: maziz@iugaza.edu.ps.
authors.forename: Mysoon Khalil
authors.initials: MK
authors.lastname: Abu-El-Noor
authors.affiliation: College of Nursing, Islamic University of Gaza, P.O. Box 108, Gaza, Gaza Strip, Palestine. Electronic address: arodwan@iugaza.edu.ps.
authors.forename: Abdal-Karim Said
authors.initials: AS
authors.lastname: Radwan
authors.affiliation: College of Nursing, Islamic University of Gaza, P.O. Box 108, Gaza, Gaza Strip, Palestine. Electronic address: aashaer@iugaza.edu.ps.
authors.forename: Ahmed Ali
authors.initials: AA
authors.lastname: Alshaer
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003422:Critical Care / Q000458:organization & administration; D003430:Cross-Sectional Studies; D005260:Female; D019538:Health Care Surveys; D006291:Health Policy; D006301:Health Services Needs and Demand; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000458:organization & administration*; D008297:Male; D008877:Middle East; D015279:Organizational Culture; D017063:Outcome Assessment, Health Care; D010348:Patient Care Team / Q000458:organization & administration*; D061214:Patient Safety; D017751:Safety Management / Q000458:organization & administration*
keywords: Adverse events; Gaza strip; Neonatal intensive care units (NICU); Patient safety; Safety culture