Psychometric properties and nursing students’ perceptions of patient safety using the Health Professional Education in Patient Safety Survey: a cross-sectional validation study

Introduction: Despite increasing emphasis on patient safety in nursing education, valid culturally adapted instruments in Central Europe remain scarce. Nursing students' perceptions of safety competencies is essential for enhancing patient-centred care.

Aim: The study aimed to evaluate the psychometric properties of the Czech version of the Health Professional Education in Patient Safety Survey (H-PEPSS) and to assess nursing students' self-reported competencies in patient safety.

Methods: A purposive sample of 496 nursing students participated. Psychometric properties included face and content validity, confirmatory factor analysis, and internal consistency. Descriptive and inferential statistical methods were applied to examine differences across settings and sociodemographic variables.

Results: After ensuring face and content validity, the six-factor structure of H-PEPSS demonstrated good model fit (CMIN/df < 2.0; CFI, TLI, NFI > 0.90; RMSEA < 0.10). Internal consistency was high (α = 0.939 academic; α = 0.935 clinical). The highest-rated competencies were in "Effective Communication" (≥80%), while the lowest-rated were in "Safety Risk Management" (70.9%) in the academic setting and in "Teamwork" (72.67%) in the clinical setting. Significant differences between individual settings were mainly associated with variables related to education (p ≤ 0.01).

Conclusion: The Czech version of the H-PEPSS is a valid and reliable instrument for assessing patient safety competencies in nursing education. The results highlight persistent challenges in sociocultural safety domains and call for stronger support for students' learning in both academic and clinical settings. These findings contribute to the ongoing international challenges on fostering a culture of safety and accountability in patient-centred nursing care.