Attitudes of nurses and midwives toward patient safety in obstetric and gynecological units: the role of fatigue and sleep disturbances - a cross-sectional study

Patient safety constitutes a core dimension of healthcare quality and encompasses actions aimed at preventing errors and minimizing harm occurring during the provision of healthcare services. Chronic fatigue and sleep disturbances, which are common among nursing personnel, may adversely affect professional performance and, consequently, patient safety. To assess the association between fatigue levels (FAS), the severity of insomnia symptoms (AIS), and attitudes toward patient safety (SAQ-SF PL) among nurses and midwives employed in obstetric and gynecological units in the Małopolska region of Poland. This cross-sectional study included 541 nurses and midwives working in obstetric and gynecological units in southern Poland. Data were collected using an anonymous questionnaire comprising the Fatigue Assessment Scale (FAS), the Athens Insomnia Scale (AIS), the Polish version of the Safety Attitudes Questionnaire – Short Form (SAQ-SF PL), and an author-developed survey addressing demographic and occupational characteristics. The highest mean scores were observed in the domains of Job Satisfaction (JS) (M = 72.99; SD = 21.58) and Stress Recognition (SR) (M = 68.23; SD = 24.37), whereas the lowest scores were noted for Working Conditions (WC) (M = 61.16; SD = 21.71) and Teamwork Climate (TC) (M = 62.80; SD = 18.75). Significant negative correlations were identified between fatigue severity and Teamwork Climate ( r = − 0.297), Safety Climate ( r = − 0.291), Job Satisfaction ( r = − 0.383), Perception of Management ( r = − 0.276), and Working Conditions ( r = − 0.218) (all p < 0.001). Similarly, insomnia severity was negatively correlated with Teamwork Climate ( r = − 0.199), Safety Climate ( r = − 0.195), Job Satisfaction ( r = − 0.219), Perception of Management ( r = − 0.273), and Working Conditions ( r = − 0.209) (all p < 0.001), while both fatigue and insomnia were positively associated with Stress Recognition. Fatigue and sleep disturbances were significantly associated with attitudes toward patient safety. Higher levels of these factors corresponded to less favorable evaluations of most safety domains, alongside increased recognition of the impact of stress on professional functioning.