Study Characteristics (n = 9).

Objectives Various psychological concepts have been proposed over time as potential solutions to improving patient safety and quality of care. Psychological safety has been identified as a crucial mechanism of learning and development, and one that can facilitate optimal patient safety in healthcare. We investigated the quantitative evidence on the relationship between psychological safety and objective patient safety outcomes. Methods We searched 8 databases and conducted manual scoping to identify peer reviewed quantitative studies published up to February 2024. Objective patient safety outcomes of any type were eligible. The findings were analysed descriptively and discussed in a narrative synthesis. Results Nine papers were selected for inclusion which reported on heterogeneous patient safety outcomes. Five studies showed a significant relationship between psychological safety and patient safety outcomes (e.g., ventilator associated events, reported medical errors). The majority of studies reported on the experiences of nurses working in healthcare from the USA. Patient safety is consistently characterised as the absence of harm rather than a culture that creates a safe environment. Conclusions No clear conclusions can be extracted regarding the relationship between psychological safety and patient safety. For example, reporting patient safety problems in a team can be an indication of both high and low psychological safety. Patient safety may be contradictory to elements of psychological safety, as the absence of harm is not congruent with a safety environment approach. Systematic review registration: This systematic review is registered with the International Prospective Register of Systematic Reviews (PROSPERO CRD4202347829).研究目的：长期以来，学界已提出多种心理学构想，以期优化患者安全与医疗照护质量。其中，心理安全（psychological safety）被视作学习与发展的核心机制，亦可助力医疗场景达成最优患者安全水平。本研究旨在探究心理安全与客观患者安全结局之间关联的定量实证证据。 研究方法：本研究检索了8个数据库，并通过手动范围综述筛查，识别截至2024年2月发表的同行评议定量研究。任何类型的客观患者安全结局均满足纳入标准。研究结果采用描述性分析方法，并通过叙事性综合展开讨论。 研究结果：最终纳入9篇文献，均报道了异质性的患者安全结局。其中5项研究表明，心理安全与患者安全结局之间存在显著关联（例如呼吸机相关事件、上报的医疗差错）。大部分研究聚焦于美国医疗系统内注册护士的工作体验。学界对患者安全的一贯界定为「无伤害发生」，而非「构建安全环境的文化」。 研究结论：目前尚无法就心理安全与患者安全之间的关联得出明确定论。例如，在团队中上报患者安全问题，既可能体现较高的心理安全水平，也可能反映较低的心理安全水平。患者安全或与心理安全的部分要素存在冲突，因为「无伤害发生」的界定与「安全环境」的研究路径并不契合。本系统综述已在国际系统综述前瞻性注册平台（International Prospective Register of Systematic Reviews, PROSPERO CRD4202347829）完成注册。