The Antecedents of Patient Safety Competency; A Systematic Review

Abstract

The increasing emphasis on safe, high-quality healthcare has made patient safety competency a core requirement for nursing practice and healthcare education. Patient safety competency refers to the knowledge, attitudes, skills, communication behaviors, teamwork abilities, and error-management practices required to prevent avoidable harm and respond effectively to adverse events. Although this competency is widely recognized as essential, its antecedents remain dispersed across educational, clinical, organizational, and individual contexts. Therefore, this systematic review aimed to identify, categorize, and synthesize the antecedents of patient safety competency among nurses, nursing students, and healthcare professionals. A systematic review approach guided by PRISMA 2020 was used to identify and screen relevant studies. Studies focusing on patient safety competency, its determinants, predictors, or related outcomes were included. Data were extracted, organized using a literature review matrix, and synthesized narratively and thematically. A total of 30 studies were included. The findings revealed that patient safety competency is shaped by educational, individual, clinical, organizational, and communication-related antecedents. Key antecedents included patient safety education, curriculum integration, simulation, e-learning, case discussion, adverse event analysis, knowledge, attitudes, self-efficacy, clinical competence, professionalism, systems thinking, compassion competence, experience, safety culture, leadership, teamwork, psychological safety, speaking up, organizational support, and error reporting. The review concludes that patient safety competency is multidimensional, requiring integrated education, clinical learning, leadership support, teamwork, psychological safety, and nonpunitive reporting cultures.