Objective This study aimed to assess nurses’ perceptions of patient safety culture (PSC) and its relationship with adverse events in Hail City, Saudi Arabia. Design A cross-sectional study was conducted between 1 August 2023 and the end of November 2023 at 4 governmental hospitals and 28 primary healthcare centres. Setting Hail City, Saudi Arabia. Participants Data were collected from 336 nurses using 3 instruments: demographic and work-related questions, PSC and adverse events. Results Nurses had positive responses in the dimensions of ‘teamwork within units’ (76.86%) and ‘frequency of events reported’ (77.87%) but negative responses in the dimensions of ‘handoffs and transitions’ (18.75%), ‘staffing’ (20.90%), ‘non-punitive response to errors’ (31.83%), ‘teamwork across units’ (34.15%), ‘supervisor/manager expectations’ (43.22%) and ‘overall perception of patient safety’ (43.23%). Significant associations were found between nationality, experience, current position and total safety culture, with p values of 0.015, 0.046 and 0.027, respectively. Nurses with high-ranking perceptions of PSC in ‘handoffs and transitions,’ ‘staffing’ and ‘teamwork across hospital units’ reported a lower incidence of adverse events than those with low-ranking perceptions, particularly in reporting pressure ulcers (OR 0.86, 95% CI 0.78 to 0.94, OR 0.82, 95% CI 0.71 to 0.94 and OR 0.83, 95% CI 0.70 to 0.99, respectively) (p<0.05). Nurses with high-ranking perceptions of PSC in UK ‘handoffs and transitions’ reported a lower incidence of patient falls. Similarly, those with high-ranking perceptions in both ‘handoffs and transitions’ and ‘overall perception of patient safety reported a lower incidence of adverse events compared with those with low-ranking perceptions, especially in reporting adverse drug events (OR 0.83, 95% CI 0.76 to 0.91 and OR 0.75, 95% CI 0.61 to 0.92, respectively) (p<0.05). Conclusion From a nursing perspective, hospital PSCs have both strengths and weaknesses. Examples include low trust in leadership, staffing, error-reporting and handoffs. Therefore, to improve staffing, communication, handoffs, teamwork, and leadership, interventions should focus on weak areas of low confidence and high rates of adverse events.

Emergency nurses face high demands that potentially lead to burnout, compassion fatigue, and moral distress. This study aimed to identify and assess the predictive factors of burnout, compassion fatigue, and moral distress among Emergency Nurses. A cross-sectional predictive design was employed. Data collected from 290 emergency nurses via Google Forms using convenience sampling from four government hospitals in Hail City, Saudi Arabia. Data collection was conducted between May and June 2024. The findings revealed that socio-demographic factors significantly predict these outcomes, with the regression model explaining 67.9% of the variance. Older age and being female (β = -6.532 for burnout) were consistently associated with lower levels of all three negative outcomes. While nurses with 6–10 years of experience reported lower levels (β = -5.071 for burnout), this benefit didn’t extend to the most experienced group. Shift patterns had a strong impact, with the 3 PM − 11 PM shift being most protective (β = -6.377 for burnout), while the 11 PM − 7 AM night shift correlated with significantly higher distress (β = 3.151 for burnout). Counterintuitively, higher education levels (e.g., Master’s β = 16.437 for burnout) were linked to increased negative outcomes, and the absence of social support (β = -8.726 for burnout) was surprisingly associated with lower levels of these outcomes. Younger nurses, male, and less experienced emergency nurses who are highly educated are more susceptible to burnout, compassion fatigue, and moral distress. These phenomena reveal the need for integrated organizational and educational restructuring, emphasizing the intersection of sociodemographic and occupational characteristics. Strikingly, postgraduate-educated nurses display greater compassion fatigue and moral distress which paradoxically suggests that higher training may subject them to more frequent and heightened ethical dilemmas.

Studying the public perception of nurses among nursing students is vital in establishing strategic solutions to recruit and retain more students in nursing programs and to contain nurses in the health care system. This study aimed to determine the mediating role of self-concept in the relationship between sociocultural and perceived public image of nurses. This study employed a correlational approach using convenience sampling of 1390 participants. This study was conducted at six large universities in three regions of Saudi Arabia (central, northern, and eastern). Student nurses in their second to fourth years of study were included as participants, with an 89.7% response rate. Data were collected from January to April 2023. A significant positive relationship was observed between sociocultural factors and self-concept (r = .685, p = .0001). In addition, there was a significant positive relationship between self-concept and public image (PI) (r = .352, p value = 0.0001). Furthermore, there was a significant positive relationship between sociocultural and public image (r = .456, p = .0001); sociocultural had a direct effect on self-concept (β = 0.324, SE = 0.098, t = 9.429, p < .0001) and public image (β = 0.605, SE = 0.038, t = 22.617, p < .0001). Furthermore, sociocultural had an indirect effect on public image through self-concept (H6) (β = 0.389, SE = 0.123, t = 12.766, p < .0001). The study findings suggest that nursing school programs should take measures to foster a supportive environment that promotes self-concept and public image, while also being mindful of the sociocultural background. This would also open the scope for further research on the matter involving multiple centers. This study suggests the need for programs to boost self-concept and public image that consider sociocultural influences. These ’findings have crucial implications for student nurses’ social and psychological wellbeing as they improve the understanding of how sociocultural affects self-concept and public image.