Article Text

Download PDFPDF

  1. Jamileh Farokhzadian1,
  2. Batool Poorchangizi2,
  3. Fariba Borhani3
  1. 1Department of Community Health Nursing, School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
  2. 2MSc student of Nursing, School of Nursing and Midwifery and surgical ward nurse in Shahid Bahonar Hospital, Kerman University of Medical Sciences, Kerman, Iran
  3. 3Department of Nursing Ethics, Medical Ethics and Law Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.


Background and aims: At present, modern advances in health care, serious deficiencies have been identified in the quality of care and patients' safety. One way to handle these challenges is the establishment of a clinical risk management (CRM) system. This approach would improve the quality of healthcare and help ensure the safety of patients, visitors, and employees, as well as reduce the costs associated with the healthcare system. The aim of this study was to assess the existence of the requirements of CRM in the hospitals.

Methods: This cross-sectional study was conducted on 200 clinical staff members from three teaching hospitals affiliated with the Kerman University of Medical Sciences in southeast Iran in 2014. The proportionate simple random sampling technique was used. Two tools were used for data collection, i.e., a structured observation checklist and a questionnaire. The data were analyzed using SPSS version 20.

Results: Among the six domains of CRM, the highest mean belonged to domain the monitoring of analysis, evaluation and risk control (3.18±0.72).; the lowest mean belonged to domain the staff's knowledge, recognition and understanding of CRM (2.93±0.66). The findings indicated that implementing and developing domains of CRM ranged from poor to moderate. Almost all of study settings were implementing most measures of CRM. Despite these initiatives, there were no incident report forms in patients' files; electronic systems, such as Patient Safety Information Systems (PSIS); or the Patient Safety Reporting System (PSRS).

Conclusion: Despite the establishment of clinical governance and accreditation approaches, the status of CRM is not appropriate. Health care in southeast Iran is not moving enough towards high quality and safe practice. Health care should move toward quality improvement and safe practice through the effective integration of CRM in organizational process. The organizational leaders must facilitate this process by creating necessary institutional infrastructures and strategic planning, management systems, and reinforcement of teamwork and professional communication to build positive attitudes among care providers towards strategies accreditation and clinical governance.

  • clinical risk
  • clinical risk management
  • patients' safety
  • quality improvement

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.