Razavi Journal of Medicine

Razavi Journal of Medicine

Unveiling the roadblocks: Explaining the Threatening Factors to Patient Safety in Hospitals Receiving COVID-19 Patients: A Qualitative Study

Articles in Press

Document Type : Original Article

Authors
Javad Moghri 1, 2
Rasoul Raesi 3
Razieh Jafari 4
Fatemeh Kokabi saghi 1, 2
Mehrsadat Mahdizadeh 5
Abdollah Reihany yassavoli 6
Seyed Saeed Tabatabaee 1, 2
1 Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
2 Department of Management Sciences and Health Economics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
3 Department of Public Health, school of Health, Torbat Jam Faculty of Medical Sciences, Torbat Jam, Iran
4 School of Health, Student research committee, Mashhad University of Medical Sciences, Mashhad, Iran
5 Department of public Health, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
6 Director of Akbar Educational, Research and Superspecialty Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
10.30483/rjm.2026.254669.1439
Abstract
Background: With the COVID-19 outbreak, patient safety in hospitals has become a serious challenge. Identifying the factors threatening patient safety in this critical situation is crucial for improving the quality of healthcare services and reducing adverse outcomes.

Objectives: To determine the factors threatening patient safety in hospitals that admit COVID-19 patients

Methods: This qualitative study was conducted in hospitals in Iran that were receiving COVID-19 patients in 2023. 26 participants, including deputies, patient safety experts, nurses, head nurses, and nursing managers, were selected by purposive sampling until data saturation. The data were collected using a semi-structured, in-depth, face-to-face interview. A conventional content analysis approach was used for data analysis, and MAXQDA 2020 was used for data management.

Results: The findings from the conventional content analysis showed that the factors threatening the safety of COVID-19 patients include four categories (factors related to the patient and disease, task-related factors, management factors, and organizational-infrastructural factors), 11 subcategories (factors related to the patient, factors related to the disease, communication factors with the patient, non-communication factors with the patient, medications and medical equipment, human resources, physical resources, planning and decision-making, supervision, maintaining human resources, processes and protocols), and 33 sub-subcategories.

Discussion: The findings indicate the complexity of patient safety challenges during the COVID-19 pandemic and the need for comprehensive approaches to improve safety conditions in healthcare systems.

Conclusion: These factors directly impact the quality of healthcare services and patient safety. Therefore, reforming policies and improving infrastructure are essential to promoting patient safety in critical care settings.
Keywords
Patient safety
COVID-19
treatment
disease

Acknowledgements: The authors thank Mashhad University of Medical Sciences for the financial support of this research project and all the patients who participated this study.

Availability of data and materials: The data supporting this study's findings are available from the corresponding author upon reasonable request.

Conflicts of interests: The authors declare no conflicts of interest.

Consent for publication: Not applicable.

Ethics approval and consent to participate: The study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki. This study was conducted after ethical clearance from Mashhad University of Medical Sciences IR.MUMS.REC.1399.020: Written informed consent was obtained, and each participant was provided with an explanation of the study's purpose.

Financial disclosure: This study was financially supported by Mashhad University of Medical Sciences, Iran. This paper demonstrates the results of a thesis submitted as necessary to obtain a Master’s degree in Health Services Management.

Author contributions: Conceptualization: A.A., Methodology and Formal analysis: A.M., Study design: JM, SST Data gathering: RJ, AR Data analysis: SST, MM Preparing the initial manuscript: FK, JM, RR Finalizing the manuscript: SST, RR, RJ, JM, FK, MM, AR.

Open Access Policy: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/

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Razavi Journal of Medicine

Articles in Press, Accepted Manuscript
Available Online from 15 April 2026