Award Date


Degree Type


Degree Name

Doctor of Philosophy (PhD)



First Committee Member

Lori Candela

Second Committee Member

Carolyn Yucha

Third Committee Member

Alona Angosta

Fourth Committee Member

Richard Tandy

Number of Pages



Patient safety has always been a central focus of nursing practice. Current research makes it increasingly clear that what occurs in the surrounding health care environment impacts patient safety. The protracted nursing shortage and nurse turnover may adversely affect patient outcomes and are exacerbated by an environment of disruptive behavior, conflict, and poor communication in the nursing workplace. The Joint Commission has identified these behaviors as key elements that jeopardize the "culture of safety" necessary to assure safe, quality patient outcomes. A culture of safety includes the attributes of teamwork, communication openness, collaboration, and a manager's positive focus on prevention of errors (AHRQ, 2010). There is currently no consensus on the best and practical method of patient safety culture educational interventions for practicing nurses. The purpose of this quasi-experimental, two group pretest/posttest study was to explore the influence of an online educational intervention on nursing staff perceptions of a culture of safety. The study utilized the Department of Defense "Professional Conduct" (2010) online toolkit, and the Hospital Survey on Patient Safety (HSOPS) to measure changes in nurse perception. The framework for the study is guided by Donabedian's Structure-Process-Outcome (SPO) model. Data were analyzed with independent and paired sample t-tests on the mean total safety scores, as well as repeated measures ANOVA on the mean scores of selected safety dimensions, with within and between groups' variables and exploratory analysis statistics. The final chapter discusses the findings with implications for further research. Recommendations are provided for future research on staff perceptions of their work environment and how to improve that environment. Further research will provide evidence that can help foster continued growth in a culture of safety.


Communication in nursing – Study and teaching; Communication openness; Culture of safety; Handoffs; Horizontal violence; Hospitals – Safety measures; Just culture; Nursing errors – Prevention; Patients – Safety measures; Safety education; Work environment


Health and Medical Administration | Medical Sciences | Medicine and Health Sciences | Nursing

File Format


Degree Grantor

University of Nevada, Las Vegas




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