Nurses’ experiences on patient safety culture working in Nursing Homes in Singapore: an explanatory sequential mixed-methods study

Research context & significance

Research questions & objectives

• The purpose of this study is to explore and understand registered nurses' experiences of patient safety culture (PSC) from the nursing homes setting in Singapore.

Research approach

1. A · Input / Context

   Patient safety culture in Singapore nursing homes remains underexplored. The study examines registered nurses’ experiences, perceptions, attitudes, roles, and factors influencing patient safety practices.

2. B · Method / Process

   An explanatory sequential mixed-methods design uses the NHSPSC Version 2.0 survey first, followed by semi-structured interviews to explain quantitative findings, guided by the Theory of Planned Behaviour.

3. C · Evaluation / Validation

   Findings are strengthened through mixed-method triangulation, a validated survey, supervisor-reviewed interview questions, pilot interviews, member checking, reflexivity, audit trails, thick description, and supervisory verification.

Expected outcome

Findings will enhance understanding of nursing-home patient safety culture, identify enabling and hindering factors, and inform recommendations for administrators and policymakers to strengthen safety culture and nurses’ commitment.

Progress since last update

• Completion and publication of Integrative Review at the International Journal of Nursing Sciences (Elsevier), Q1 Journal, Impact Factor 4.4
• Completion of Chapter 1 and 2 of the PhD Thesis and halfway completion of Chapter 3 (Methodology)
• Pilot Interview (3 rounds) with PhD Supervisors. Preparing for actual fieldwork and data collection.

Tangible outputs & evidence

• Paper 2 & 3: Reporting the key findings from the qualitative interviews
• Woo, M. W. J., Zhou, H., & Moroney, T. (2026). Patient safety culture in nursing homes: An integrative review of nurses’ and nursing assistants’ experiences. International Journal of Nursing Sciences. https://doi.org/10.1016/j.ijnss.2026.08.012

Key result

• Future qualitative or mixed-methods studies should explore registered nurses’ perceptions and explain how organisational, relational, and systemic conditions influence safety intentions, behaviours, and patient safety culture.

What should we notice?

• Across 21 studies, nursing professionals reported moderately positive patient safety culture, yet important safety areas required improvement, with registered nurses reporting less-positive perceptions than other nursing professionals.
• Positive safety beliefs and intentions did not consistently translate into practice; relational, structural, organisational, and management conditions influenced nursing professionals’ commitment to patient safety.
• Singapore evidence remains limited; one identified cross-sectional study assessed safety culture in only two nursing homes, supporting broader research specifically examining registered nurses’ perceptions.

Next steps

1. 1

   Presentation for Integrative Review at the Sigma Asia Regional Nursing Conference (awarded for oral presentation).

   27 Oct 2026

2. 2

   Continue to write-up Chapter 3 of the thesis (Methodology Chapter) and revise and refine interview questions following pilot interviews

   15 Oct 2026

3. 3

   Draft up revised research proposal and necessary documents for submission to the Curtin Human Research Ethics Committee (HREC) for amendment.

   5 Oct 2026

Success by next forum: Integrative Review, Methodology Chapter, Preliminary Results, Candidature Report

Risks & blockers

• Recruitment of potential participants to take part in the survey and one-to-one interview.
• The quality of interview data (richness) to achieve data saturation.
• The availability of software to facilitate data collection and analysis.

Support needed

• Supervisors’ feedback on the methodology (Chapter 3 of the PhD Thesis), scope boundaries and fieldwork data collection.

Possible Research Grants (Proposed)

• Sigma Nursing Small Grants (Sigma Theta Tau International Honor Society of Nursing)
• Curtin University Higher Degree by Research (HDR) Engagement Grant (Awarded)

Acknowledgement

• Curtin Overseas Postgraduate Research Scholarship (COPRS)
• Curtin University Higher Degree by Research (HDR) Dissemination Grant