Exploring Normalization of Deviance and Examining Factors that Predict Negative Patient Safety Outcomes in the Ivory Coast Public Hospitals

Objectives: The main objective of this study is to determine the relationship between organizational, individual, and cultural factors with the deviant practices on patient safety in healthcare settings. The study also provides recommendations and strategies to address normalizations of the identified deviances and mitigate factors contributing to adverse patient safety outcomes.
Study design: The study design follows a qualitative approach, utilizing content analysis to analyse textual data from interviews, documents, and relevant literature. Through purpose sampling, a diverse group of 25 participants was selected including nurses, doctors, midwives, healthcare assistants and technicians. Semi-structured interviews were conducted to gather rich qualitative data regarding the normalizations of deviance and their implications for patient safety. A comprehensive literature review was conducted to establish the existing knowledge on patient safety, normalizations of deviance, and factors influencing patient safety outcomes. This review serves as the foundation for the research, highlighting the relevance and significance of the study in the context of Ivory Coast public hospitals.
Findings: The findings reveal the existence of deviant practices such as corruption, absenteeism, briberies, excessive medication prescriptions, theft of medications and resources, and disregarding established protocols for safety guidelines, which have become normalized over time. The analysis identifies organizational, individual, and cultural factors that contribute to the normalization of deviance, including resource constraints, lack of accountability, cultural acceptance of corruption, staffing shortage, communication challenges, non-adherence to protocols, and systemic challenges.
Conclusion: In conclusion, this study sheds light on the normalization of deviance and its impact on patient safety in Ivory Coast public hospitals. The findings emphasize the need for a comprehensive approach to tackle deviant practices and improve patient safety outcomes. By implementing the recommended strategies, healthcare organizations can work towards creating a culture of safety, preventing the normalisation of deviance, and ensuring better patient outcomes.