Safety attitudes among general practice nurses: A cross-sectional mixed-methods study

Background Safety is a critical element within general practice as it is a unique environment with limited resources, diverse patients' needs, and varied healthcare environments. Within this landscape, general practice is a complex clinical environment with General Practice Nurses making up 45 % of the clinical workforce. Understanding the factors that influence general practice nurses' safety attitudes is important to improving patient care and organisational safety culture. This study aimed to explore factors associated with general practice nurses' safety attitudes, including demographics, safety perceptions, and experiences in practice. Methods A cross-sectional mixed methods study was conducted with survey comprising Likert scale and open-ended questions. A total of 302 fully completed responses were obtained from general practice nurses. Quantitative data were analysed to examine associations between safety attitudes and demographic characteristics. Qualitative data were thematically analysed to provide contextual insights into safety-related challenges. Results The length of work as a General Practice Nurse, regular operational briefings and smaller working teams are positively associated with the General Practice Nurses' safety attitudes. Participants expressed their preference towards regular and systematic communication. High workload, time pressures, inadequate communication, and unsupportive teamwork appeared as barriers of effective functioning within general practice. Conclusion Work experience and team size significantly impact safety attitudes, with experienced nurses and smaller teams showing better understanding and accountability. Regular operational briefings enhance collaboration and preparedness, while inconsistent communication leads to frustration. Positive perceptions of teamwork and communication are strongly linked to favourable safety attitudes, while excessive workload and limited autonomy pose challenges. Practical applications To improve safety within general practice, it is essential to address these issues through organisational support, systematic communication systems, and targeted training programmes.