Nurses' Perceptions of Safety Attitudes in Emergency Departments of West Bank Hospitals: A Cross-sectional Study

Background: The attitude towards patient safety has been recognized as a critical factor in hospital safety performance. An important part of safety attitude management is understanding workforce perceptions of the patient safety climate, particularly in high-risk settings like emergency departments. Objective: To assess nurses' perceptions of safety attitudes in emergency departments of West Bank hospitals and identify factors associated with these perceptions. Method: A cross-sectional study was conducted with 349 nurses working in emergency departments of governmental and private hospitals in the West Bank, Palestine. Data were collected using the validated Safety Attitudes Questionnaire (SAQ). Multiple linear regression was performed to identify predictors of safety attitudes. Results: The overall mean score for safety attitudes was 51.87 (SD=12.5), with only 20.3% of nurses demonstrating positive safety attitudes (scores >75/100, the standard threshold for positive SAQ benchmarks). The domains with the highest mean scores were job satisfaction (59.86, SD=3.19, 47.0% positive), teamwork climate (59.1, SD=1.58, 45.3% positive), and safety climate (47.43, SD=2.82, 34.1% positive). Work conditions received the lowest positive ratings (20.3%). Multiple regression analysis revealed that age was a significant predictor of safety attitudes (β=-0.501, p=0.001), accounting for 32.5% of the variance, while gender, years of experience, job position, and education level were not significant predictors. Conclusion: Safety attitudes among emergency department nurses in West Bank hospitals are suboptimal compared to international benchmarks. These results underscore the urgency of addressing systemic gaps, particularly poor work conditions and leadership engagement. Targeted interventions should prioritize resource allocation, team-based training, and regular safety climate assessments to foster a robust safety culture in Palestinian emergency care settings.