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Hooven K, Altmiller G. Creating a Just Culture in the Perioperative Setting. AORN J 2024; 119:152-160. [PMID: 38275261 DOI: 10.1002/aorn.14074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 01/28/2023] [Accepted: 02/26/2023] [Indexed: 01/27/2024]
Abstract
There has been an increased perioperative focus on avoiding adverse events and providing safe patient care since To Err Is Human: Building a Safer Health System published in 2000. Adverse events continue to occur in perioperative areas and are likely underreported. The interdisciplinary nature and high cost of perioperative care may discourage personnel from speaking up for fear of retribution and punishment when reporting. Organization leaders can implement a just culture that focuses on improving patient care processes and safety rather than placing blame after an adverse event. A tenet of just culture is achieving balanced accountability between systems and individuals. Strategies for just culture implementation include leader support, policies and procedures for reporting, accessibility of reporting systems, provision of information for staff members, identification of support champions, and creation of a good catch program. Leaders also should measure and track progress associated with the just culture in their facility.
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Factors influencing patient safety culture in operating room in a teaching hospital in Jordan: a qualitative descriptive study. TQM JOURNAL 2022. [DOI: 10.1108/tqm-04-2022-0133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeTo explore the perceptions of surgical team members in a tertiary hospital in Jordan toward the factors influencing patient safety culture (PSC).Design/methodology/approachThis was a qualitative descriptive study intended to characterize the factors that influence PSC. Interviews were conducted with health-care providers in the operation room (OR) in a tertiary Jordanian hospital. Participants included surgeons, anesthetists, nurses and senior surgical residents who had worked for three years minimum in the OR. Thematic analysis was used to analyze the data.FindingsA total of 33 interviews were conducted. Thematic analysis of the content yielded four major themes: (1) operational factors, (2) organizational factors, (3) health-care professionals factors and (4) patient factors. The respondents emphasized the role of the physical layout of the OR, implementing new techniques and new equipment, and management support to establish a safety culture in the operating room setting.Originality/valueThe present research study will have implications for hospitals and health-care providers in Jordan for developing organizational strategies to eliminate or decrease the occurrence of adverse events and improve patient safety in the OR.
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Jahangiri M, Zinat-Motlagh K, Ghaem H, Zinat-Motlagh F, Kamalinia M, Banaee S. Safety culture maturity and resilience engineering in an oil drilling industry: A comparison study among government-owned and private companies. Work 2021; 70:443-453. [PMID: 34633346 DOI: 10.3233/wor-213583] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Organizational factors including a proper safety culture are among the important contributors of major accidents in process industriesOBJECTIVE: This study evaluates and compares the dimensions of safety culture maturity (SCM) and resilience engineering (RE) among 423 employees of government-owned drilling companies (GODC) and private drilling companies (PDC) located in Azar oilfield, Ilam province, southwest of Iran. METHODS The maturity of safety culture was measured using the modified version of Hudson safety culture maturity questionnaire and RE performance was studied using the resilience analysis gird (RAG). The relationship between RE and the SCM was discussed according to Hollnagel conceptual model. RESULTS The results showed that lowest and highest levels of SCM in all dimensions were observed in the pathological (11.75%) and reactive (28%) levels, respectively. However, high levels of SCM have not been established in any of the studied drilling companies. The status of SCM dimensions and levels as well as RE performance was better in PDC compared to GODC which is consistent with their safety performance lagging indicators. CONCLUSION This study showed that RE abilities could be improved by establishment of high levels of safety culture maturity.
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Affiliation(s)
- Mehdi Jahangiri
- Research Center for Health Science, Department of Occupational Health Engineering and Safety, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kiarash Zinat-Motlagh
- Student Research Committee, Department of Occupational Health Engineering, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Haleh Ghaem
- Epidemiology Department, School of Health, Shiraz University of Medical Sciences, Iran
| | - Fazel Zinat-Motlagh
- Social Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Mojtaba Kamalinia
- Department of Occupational Health Engineering and Safety, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sean Banaee
- College of Health Sciences, Old Dominion University, Norfolk, Virginia, USA
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Pimentel MPT, Choi S, Fiumara K, Kachalia A, Urman RD. Safety Culture in the Operating Room: Variability Among Perioperative Healthcare Workers. J Patient Saf 2021; 17:412-416. [PMID: 28574955 DOI: 10.1097/pts.0000000000000385] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Safety culture is defined as the product of individual and group values, attitudes, perceptions, competencies, and patterns of behavior that determine an organization's health and safety management. There is a lack of studies assessing patient safety culture in the perioperative setting. OBJECTIVES We examined safety culture at a single tertiary care hospital, across all types of surgery, using previously collected data from a validated survey tool. We aim to understand how safety culture varies among perioperative staff. METHODS The Hospital Survey on Patient Safety Culture was administered at a single tertiary care hospital in 2014. We identified 431 respondents as perioperative healthcare workers: surgery attending physician, surgery trainee physician, anesthesia attending physician, anesthesia trainee physician, nurse, and technician. We calculated percent positive scores for each dimension of safety culture, as well as a composite score. Pairwise comparisons were calculated via analysis of variance. RESULTS The average response rate was 67%. The dimensions with the highest average percent positive scores were teamwork within hospital units (69%) and organizational learning and continuous improvement (57%). The dimensions with the lowest scores were feedback and communication about error (34%) and hospital handoffs and transitions (30%). Surgery attending physicians perceived the strongest safety climate overall, whereas nurses and surgical technicians perceived significantly worse safety climate. CONCLUSIONS We observed significant variability in perioperative safety culture, across dimensions of safety climate, professional roles, and levels of training. These variations in safety culture should be addressed when implementing culture change programs in the perioperative setting.
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Grailey KE, Murray E, Reader T, Brett SJ. The presence and potential impact of psychological safety in the healthcare setting: an evidence synthesis. BMC Health Serv Res 2021; 21:773. [PMID: 34353319 PMCID: PMC8344175 DOI: 10.1186/s12913-021-06740-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 07/12/2021] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Psychological safety is the shared belief that the team is safe for interpersonal risk taking. Its presence improves innovation and error prevention. This evidence synthesis had 3 objectives: explore the current literature regarding psychological safety, identify methods used in its assessment and investigate for evidence of consequences of a psychologically safe environment. METHODS We searched multiple trial registries through December 2018. All studies addressing psychological safety within healthcare workers were included and reviewed for methodological limitations. A thematic analysis approach explored the presence of psychological safety. Content analysis was utilised to evaluate potential consequences. RESULTS We included 62 papers from 19 countries. The thematic analysis demonstrated high and low levels of psychological safety both at the individual level in study participants and across the studies themselves. There was heterogeneity in responses across all studies, limiting generalisable conclusions about the overall presence of psychological safety. A wide range of methods were used. Twenty-five used qualitative methodology, predominantly semi-structured interviews. Thirty quantitative or mixed method studies used surveys. Ten studies inferred that low psychological safety negatively impacted patient safety. Nine demonstrated a significant relationship between psychological safety and team outcomes. The thematic analysis allowed the development of concepts beyond the content of the original studies. This analytical process provided a wealth of information regarding facilitators and barriers to psychological safety and the development of a model demonstrating the influence of situational context. DISCUSSION This evidence synthesis highlights that whilst there is a positive and demonstrable presence of psychological safety within healthcare workers worldwide, there is room for improvement. The variability in methods used demonstrates scope to harmonise this. We draw attention to potential consequences of both high and low psychological safety. We provide novel information about the influence of situational context on an individual's psychological safety and offer more detail about the facilitators and barriers to psychological safety than seen in previous reviews. There is a risk of participation bias - centres involved in safety research may be more aligned to these ideals. The data in this synthesis are useful for institutions looking to improve psychological safety by providing a framework from which modifiable factors can be identified.
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Affiliation(s)
- K. E. Grailey
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - E. Murray
- Said Business School, University of Oxford, Oxford, UK
| | - T. Reader
- Department of Psychological and Behavioural Science, London School of Economics and Political Science, London, UK
| | - S. J. Brett
- Department of Surgery and Cancer, Imperial College London, London, UK
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Abstract
OBJECTIVES Patient safety climate is associated with patient outcomes in hospitals around the world. A better understanding of how safety climate varies within and across hospitals will help identify improvement opportunities. We examined variations in safety climate by work area and job category in Chinese hospitals. METHODS We administered the Chinese Hospital Survey on Patient Safety Climate in 2011 to workers in 6 hospitals in China, with completed surveys from 1464 (86% response). We calculated the percent positive response for survey items and dimensions among hospitals and compared this across work areas and job categories using general linear models. RESULTS Overall, 68% of responses suggested the presence of a positive safety climate. The percent positive responses were highest for organizational learning (86.1%) and unit management support for safety (84.5%) and lowest for staffing (30.6%) and error reporting (44.5%). Workers in surgical units, intensive care units, operating rooms, and emergency departments were slightly more negative regarding overall safety climate than those in medical and ancillary units. Physicians reported worse perceptions than nurses or other hospital workers on all dimensions except for unit management support for safety and communication and peer support. CONCLUSIONS The perceived problem with staffing in Chinese hospitals was consistent with other studies. The lack of positive responses for error reporting may indicate a lack of awareness of the importance of learning from and reporting minor events and near misses. Variations within and across hospitals in safety climate suggest that improvement interventions should be tailored to individual units and professional groups.
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Affiliation(s)
- Junya Zhu
- From the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Liping Li
- School of Nursing, Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
| | - Zehui Zhou
- Columbian College of Arts & Sciences, The George Washington University, Washington, DC
| | - Qingqing Lou
- Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, People's Republic of China
| | - Albert W Wu
- From the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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Kuhn CM, Newton RC, Damewood MD, Zaidan JR, Wagner R, Koh NJ, Weiss KB. New CLER Insights Into the Operative and Procedural Areas of Clinical Learning Environments. J Grad Med Educ 2021; 13:301-302. [PMID: 33897970 PMCID: PMC8054587 DOI: 10.4300/jgme-d-21-00210.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Catherine M. Kuhn
- Catherine M. Kuhn, MD, is Director, Graduate Medical Education, and Designated Institutional Official, Duke University Hospital and Health System, and Associate Dean, Graduate Medical Education and Professor of Anesthesiology, Duke University School of Medicine
| | - Robin C. Newton
- Robin C. Newton, MD, is Vice President, CLER Field Operations, Accreditation Council for Graduate Medical Education (ACGME)
| | | | - James R. Zaidan
- James R. Zaidan, MD, is Field Representative, CLER Program, ACGME
| | - Robin Wagner
- Robin Wagner, RN, MHSA, is Senior Vice President, CLER, ACGME
| | - Nancy J. Koh
- Nancy J. Koh, PhD, is Senior Director of Program Evaluation, CLER, ACGME
| | - Kevin B. Weiss
- Kevin B. Weiss, MD, MPH, is Chief Sponsoring Institutions and Clinical Learning Environment Officer, ACGME; on behalf of the CLER Evaluation Committee, the CLER Operative and Procedural Subprotocol National Advisory Group, and the CLER Program
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McMullan SP, Raju D, Patrician P. The Psychometric Analysis of an Instrument to Measure the Perceived Workload for Certified Registered Nurse Anesthetists. J Nurs Meas 2020; 28:503-520. [PMID: 33199484 DOI: 10.1891/jnm-d-19-00028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE In a previous study, the CRNA Workload Perception Scale (CWPS) was developed. The purpose of this study was to investigate the psychometrics of the CWPS. METHODS The CWPS was tested in a population of CRNAs. This study was conducted in two phases. Phase I consisted of classical psychometrics; the 12-item instrument was piloted in a sample of 265 CRNAs. Phase II consisted of qualitative analysis to provide feedback on items that did not perform well. RESULTS Phase I: Instrument demonstrated good reliability (r = .77). Parametric and nonparametric analysis indicated 6 of 12 items were good fit to measure perception of workload. PHASE II Qualitative analysis resulted in refinement of four items, addition of one item, and elimination of two items. CONCLUSIONS A revised 11-item CWPS was developed.
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Affiliation(s)
- Susan P McMullan
- Department of Acute, Chronic and Continuing Care, University of Alabama at Birmingham School of Nursing, Birmingham, Alabama
| | - Dheeraj Raju
- Cancer Treatment Centers of America, Boca Raton, Florida University of Alabama at Birmingham School of Nursing, Birmingham, Alabama
| | - Patricia Patrician
- University of Alabama at Birmingham School of Nursing, Birmingham, Alabama
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Yoo J, Chung SE, Oh J. Safety Climate and Organizational Communication Satisfaction Among Korean Perianesthesia Care Unit Nurses. J Perianesth Nurs 2020; 36:24-29. [PMID: 32912708 DOI: 10.1016/j.jopan.2020.04.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 04/21/2020] [Accepted: 04/25/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE This study investigated organizational communication satisfaction and safety climate among perianesthesia care unit (PACU) nurses and factors affecting safety climate. DESIGN A cross-sectional study of 103 registered nurses currently working in PACUs in Korea. METHODS Organizational communication satisfaction was measured using the Communication Satisfaction Questionnaire, and safety climate was assessed using the Safety Attitudes Questionnaire-Korean version 2. Additional questions covered the demographics of the respondents and the characteristics of the hospital where they worked. FINDINGS Factors affecting teamwork climate included communication climate and horizontal informal communication. Safety climate was affected by media quality and organizational integration; job satisfaction by working in secondary hospitals, communication climate, and media quality; perception of management by working in public hospitals, media quality, and personal feedback; and working conditions by working in public hospitals, media quality, and personal feedback. CONCLUSIONS The results show that Korean PACU nurses experience poorer safety climate compared with other countries. One suggestion is to enhance nurses' satisfaction using organizational communication (eg, by developing effective communication media that satisfy users) and to promote communication at an organizational level so that individual health care professionals are aware of their organizations' vision and policies.
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Affiliation(s)
- Jebog Yoo
- Department of Nursing, Gyeongnam National University of Science and Technology, JinJu, South Korea
| | - Seung Eun Chung
- Department of Nursing, Korea National University of Transportation, Jeungpyeong, South Korea
| | - Juyeon Oh
- College of Nursing, Dankook University, Cheonan, South Korea.
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Tavirani MR, Beigvand HH. A Review of Various Methods of Management of Risk in the Field of Emergency Medicine. Open Access Maced J Med Sci 2019; 7:4179-4187. [PMID: 32165973 PMCID: PMC7061389 DOI: 10.3889/oamjms.2019.616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Revised: 11/23/2019] [Accepted: 11/24/2019] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND: The main concept of risk management in the emergency department (ED) contains a broader meaning, so that; it’s known as a sudden event or situation which would happen at an uncertain future that has some negative or positive impacts which could be called threat or opportunity respectively. However, the knowledge of risk management could cover the overall procedures involved with administering the planning of risk management, identification, investigation, monitoring and also step by step clinical examination. One of the main tools for preventing adversities is evaluating and management of possible risks. AIM: One of the main objectives of the present study is recognising the most frequent types of the risk happening in the EDs. Moreover, the present study is trying to evaluate the possible risks which could happen among various ED sections. METHODS: Six databases of EMBASE, HubMed, Cochrane Library, MEDLINE, PubMed, CHBD and Goggle scholar were chosen for discovering much-related articles from the year 2005 to 2019. A total number of 68 were chosen finally to be reviewed more precisely based on the main objective of the present study. RESULTS: Precise planning, preparing sufficiently and conducting the process of continuous monitoring are needed for ensuring the fact that any possible risks could be managed through these planned strategies. On the other hand, by modifying the patients’ beliefs, anticipations and the available social culture about the importance of risk management issue, the overall objective of the present study could be achieved at higher rates. CONCLUSION: Moreover, because the potential of occurrence of risk in EDs is high and approximately more than half of them are fatal, more precise adequate systematic plans for management of them should result.
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Affiliation(s)
- Majid Rezaei Tavirani
- Faculty of Medicine, Iran University of Medical Sciences, Firoozabadi Research Development Center, Tehran, Iran
| | - Hazhir Heidari Beigvand
- Faculty of Medicine, Iran University of Medical Sciences, Firoozabadi Research Development Center, Tehran, Iran
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Nekoei-Moghadam M, Raadabadi M, Heidarijamebozorgi M. Patient safety culture in university hospital's emergency departments: A case study. Int J Health Plann Manage 2019; 35:852-858. [PMID: 31808587 DOI: 10.1002/hpm.2948] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 10/15/2019] [Accepted: 10/16/2019] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Improving patient safety culture in healthcare organization is the first step in reducing medical errors and improving patient safety. The aim of the study was to determine and to compare patient safety culture dimensions in emergency departments of selected educational hospitals of Kerman University of Medical Sciences. METHODS This descriptive-analytical study was conducted in 2018 in the emergency departments Shahid Bahonar, Afzalipour, Shahid Beheshti, and Shafa hospitals. Data collection was carried using the Hospital Survey of Patient Safety Culture questionnaire which includes 42 questions and 12 dimensions. Data were analyzed using descriptive and analytical statistics. RESULTS The highest and lowest mean related to the organizational learning (3.96 ± 0.34) and handoffs and transitions (2.27 ± 0.55). According to independent t test, there was a significant relationship between nurse's gender and patient safety culture. Also, according to analysis of variance test, there was a significant relationship between work experience and patient safety culture. CONCLUSIONS The situation of patient safety culture was average at a moderate level. Development of reporting system and encouraging staff to report errors and adjusting nursing number and workload is suggested.
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Affiliation(s)
- Mahmood Nekoei-Moghadam
- Department of Health Management, Economics and Policy, Kerman University of Medical Sciences, Kerman, Iran
| | - Mehdi Raadabadi
- Students Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Majid Heidarijamebozorgi
- Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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Abstract
A positive safety culture is essential to patient safety because it improves quality of care. The aim of this study was to assess staff and student perceptions of the patient safety culture in the clinics of the College of Dentistry at King Saud University in Saudi Arabia.A cross-sectional study was conducted in the College of Dentistry at King Saud University in Saudi Arabia. It included 4th and 5th year students, interns, general practitioners, and dental assistants. The data were collected by using paper-based questionnaire of modified version of the Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture. Data were entered into SPSS Version 20. Score on a particular safety culture dimension was calculated.The overall response rate was 72.8% (390/536). Team work dimension had the highest average percent positive dimension score (72.3%) while staffing had the lowest score (10%). Dental assistant had high agreement in Teamwork dimension (87.8%); Supervisor/Manager Expectations and Actions Promoting Patient Safety dimension (66.9%); Organizational Learning-Continuous Improvement dimension (79.1%); Management Support for Patient Safety dimension (84.5%); Feedback and Communication About Error dimension (58.3%); Frequency of Events Reported dimension (54.0%); Teamwork Across Units dimension (73.2%). Most of areas perceived that there is no event reported (76.1-85.3%) in the past 12 months.Overall patient safety grade is more than moderate in the clinic. Teamwork within Units and Organizational Learning-Continuous Improvement dimension had the highest score while staffing had the lowest score. Dental assistants perceived positive score in most dimensions while students perceived slight negative score in most dimensions.
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Affiliation(s)
| | | | - Omar Abdullah Al Dayel
- Department of Dental Clinics, Prince Abdulrahman Advanced Dental Institute, Riyadh, Kingdom of Saudi Arabia
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How Does Patient Safety Culture in the Surgical Departments Compare to the Rest of the County Hospitals in Xiaogan City of China? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14101123. [PMID: 28954427 PMCID: PMC5664624 DOI: 10.3390/ijerph14101123] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 09/16/2017] [Accepted: 09/22/2017] [Indexed: 11/17/2022]
Abstract
Objectives: Patient safety culture affects patient safety and the performance of hospitals. The Hospital Survey on Patient Safety Culture (HSOPSC) is generally used to assess the safety culture in hospitals and unit levels. However, only a few studies in China have measured surgical settings compared with other units in county hospitals using the HSOPSC. This study aims to assess the strengths and weaknesses of surgical departments compared with all other departments in county hospitals in China with HSOPSC. Design: This research is a cross-sectional study. Methods: In 2015, a Chinese translation of HSOPSC was administered to 1379 staff from sampled departments from 19 county hospitals in Xiaogan City (Hubei Province, China) using a simple random and cluster sampling method. Outcome Measures: The HSOPSC was completed by 1379 participants. The percent positive ratings (PPRs) of 12 dimensions (i.e., teamwork within units, organizational learning and continuous improvement, staffing, non-punitive response to errors, supervisor/ manager expectations and actions promoting patient safety, feedback and communication about errors, communication openness, hospital handoffs and transitions, teamwork across hospital units, hospital management support for patient safety, overall perception of safety, as well as frequency of events reported) and the positive proportion of outcome variables (patient safety grade and number of events reported) between surgical departments and other departments were compared with t-tests and X2 tests, respectively. A multiple regression analysis was conducted, with the outcome dimensions serving as dependent variables and basic characteristics and other dimensions serving as independent variables. Similarly, ordinal logistic regression was used to explore the influencing factors of two categorical outcomes. Results: A total of 56.49% of respondents were from surgical departments. The PPRs for “teamwork within units” and “organizational learning and continuous improvement” were ≥75%, which denoted strengths, and the PPRs for “staffing” and “non-punitive response to errors” were ≤50%, which denoted weaknesses in surgical units and other units. Three dimensions for surgical departments were weaker than those for other departments (p < 0.05). The staff from surgical units reported more events compared with the other units, but only a few respondents in surgical settings evaluated patient safety grade as good/excellent. Four dimensions influenced patient safety grade, and three dimensions influenced event reporting in surgical units. Conclusions: Strategies including recruiting workers, using the reporting system, and building a non-punitive culture should be adopted in the surgical units of county hospitals in China to improve safety culture. Supervisors should also prioritise patient safety.
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Zhao P, Li Y, Li Z, Jia P, Zhang L, Zhang M. Use of patient safety culture instruments in operating rooms: A systematic literature review. J Evid Based Med 2017; 10:145-151. [PMID: 28471047 DOI: 10.1111/jebm.12255] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Revised: 03/01/2017] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To identify and qualitatively describe, in a literature review, how the instruments were used to evaluate patient safety culture in the operating rooms of published studies. METHODS Systematic searches of the literature were conducted using the major database including MEDLINE, EMbase, The Cochrane Library, and four Chinese databases including Chinese Biomedical Literature Database (CBM), Wanfang Data, Chinese Scientific Journal Database (VIP), and Chinese Journals Full-text Database (CNKI) for studies published up to March 2016. We summarized and analyzed the country scope, the instrument utilized in the study, the year when the instrument was used, and fields of operating rooms. Study populations, study settings, and the time span between baseline and follow-up phase were evaluated according to the study design. RESULTS We identified 1025 references, of which 99 were obtained for full-text assessment; 47 of these studies were deemed relevant and included in the literature review. Most of the studies were from the USA. The most commonly used patient safety culture instrument was Safety Attitude Questionnaire. All identified instruments were used after 2002 and across many fields. Most included studies on patient safety culture were conducted in teaching hospitals or university hospitals. The study population in the cross-sectional studies was much more than that in the before-after studies. The time span between baseline and follow-up phase of before-after studies were almost over three months. CONCLUSION Although patient safety culture is considered important in health care and patient safety, the number of studies in which patient safety culture has been estimated using the instruments in operating rooms, is fairly small.
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Affiliation(s)
- Pujng Zhao
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yaqin Li
- West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Zhi Li
- West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Pengli Jia
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China
| | - Longhao Zhang
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China
| | - Mingming Zhang
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China
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Rizalar S, Topcu SY. The patient safety culture perception of Turkish nurses who work in operating room and intensive care unit. Pak J Med Sci 2017; 33:374-379. [PMID: 28523040 PMCID: PMC5432707 DOI: 10.12669/pjms.332.11727] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2016] [Accepted: 02/08/2017] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To determine the patient safety culture perception of operating room and intensive care nurses and the factors affecting this perception. METHODS This descriptive study was conducted on 232 nurses working in a Turkish city hospitals. The data obtained from the nurses were collected using personal information form and Patient Safety Culture Scale (PSCS) from June to July 2015. RESULTS The total score average of the nurses on the PSCS was 2.58±0.39. The nurses obtained the highest score on the employee behavior subscale, and the lowest score on the the adverse event reporting system subscale. No significant difference was found between the total score averages of the PSCS of the operating room and intensive care nurses (p>0.05). CONCLUSION The patient safety culture score average of the operating room and intensive care nurses was at medium level. In addition, being able to choose the unit in which they worked, working day or night shifts, and being educated on patient safety were found to affect the patients safety cultures of the nurses (P<0.05).
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Affiliation(s)
- Selda Rizalar
- Selda Rizalar, PhD, RN. School of Health Science, Istanbul Medipol University, Istanbul, Turkey
| | - Sacide Yildizeli Topcu
- Sacide Yildizeli Topcu, PhD, RN. Faculty of of Health Science, Trakya University, Edirne, Turkey
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Mallouli M, Tlili MA, Aouicha W, Ben Rejeb M, Zedini C, Salwa A, Mtiraoui A, Ben Dhiab M, Ajmi T. Assessing patient safety culture in Tunisian operating rooms: A multicenter study. Int J Qual Health Care 2017; 29:176-182. [DOI: 10.1093/intqhc/mzw157] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Accepted: 12/24/2016] [Indexed: 12/25/2022] Open
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McMullan SP, Thomas-Hawkins C, Shirey MR. Certified Registered Nurse Anesthetist Perceptions of Factors Impacting Patient Safety. Nurs Adm Q 2017; 41:56-69. [PMID: 27918405 DOI: 10.1097/naq.0000000000000204] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Certified registered nurse anesthetists (CRNAs) provide more than 40 million anesthetics each year in the United States. This article describes a study that investigates relationships among CRNA organizational structures (CRNA practice models, work setting, workload, level of education, work experience), CRNA ratings of patient safety culture, and CRNA adverse anesthesia-related event (ARE) reporting. This is a cross-sectional survey study of 336 CRNAs randomly selected from American Association of Nurse Anesthetists database. Workload was measured using NASA Task-Load Index and the Revised Individual Workload Perception Scale. Agency for Healthcare Research and Quality (AHRQ) Hospital Survey on Patient Safety Overall Perceptions of Safety Scale and Hospital Survey on Patient Safety Patient Safety Grade Scale were utilized to measure safety culture. Dependent variables (ARE) included difficult intubation/extubation, inadequate ventilation/oxygenation, and pulmonary aspiration. The Revised Individual Workload Perception Scale workload was significantly associated with ARE. Years' experience and Patient Safety Grade Scale were inversely associated with ARE. Overall Perceptions of Safety Scale was significantly and inversely associated with ARE. Practice model, education, and work setting were not associated with ARE. Based on findings, CRNA workload, years' experience, and patient safety culture may be important markers for ARE. Administrative interventions designed to upgrade patient safety culture and ensure manageable CRNA workload may foster quality patient care.
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Affiliation(s)
- Susan P McMullan
- Acute, Chronic & Continuing Care, University of Alabama at Birmingham School of Nursing, Birmingham (Drs McMullan and Shirey); and Center for Healthcare Quality, Rutgers School of Nursing, Newark, New Jersey (Dr Thomas-Hawkins)
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Taleghani YM, Rezaei F, Sheikhbardsiri H. Risk assessment of the emergency processes: Healthcare failure mode and effect analysis. World J Emerg Med 2016; 7:97-105. [PMID: 27313803 DOI: 10.5847/wjem.j.1920-8642.2016.02.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Ensuring about the patient's safety is the first vital step in improving the quality of care and the emergency ward is known as a high-risk area in treatment health care. The present study was conducted to evaluate the selected risk processes of emergency surgery department of a treatment-educational Qaem center in Mashhad by using analysis method of the conditions and failure effects in health care. METHODS In this study, in combination (qualitative action research and quantitative cross-sectional), failure modes and effects of 5 high-risk procedures of the emergency surgery department were identified and analyzed according to Healthcare Failure Mode and Effects Analysis (HFMEA). To classify the failure modes from the "nursing errors in clinical management model (NECM)", the classification of the effective causes of error from "Eindhoven model" and determination of the strategies to improve from the "theory of solving problem by an inventive method" were used. To analyze the quantitative data of descriptive statistics (total points) and to analyze the qualitative data, content analysis and agreement of comments of the members were used. RESULTS In 5 selected processes by "voting method using rating", 23 steps, 61 sub-processes and 217 potential failure modes were identified by HFMEA. 25 (11.5%) failure modes as the high risk errors were detected and transferred to the decision tree. The most and the least failure modes were placed in the categories of care errors (54.7%) and knowledge and skill (9.5%), respectively. Also, 29.4% of preventive measures were in the category of human resource management strategy. CONCLUSION "Revision and re-engineering of processes", "continuous monitoring of the works", "preparation and revision of operating procedures and policies", "developing the criteria for evaluating the performance of the personnel", "designing a suitable educational content for needs of employee", "training patients", "reducing the workload and power shortage", "improving team communication" and "preventive management of equipment's" were on the agenda as the guidelines.
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Affiliation(s)
- Yasamin Molavi Taleghani
- Health Management and Economics Research Center, School of Management and Medical Information, Isfahan University of Medical Science, Isfahan, Iran
| | - Fatemeh Rezaei
- Health Management and Economics Research Center, School of Management and Medical Information, Isfahan University of Medical Science, Isfahan, Iran
| | - Hojat Sheikhbardsiri
- Department of Disaster and Emergency Medical Management Center, Kerman University of Medical Science, Kerman, Iran
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Choi UE, Kim HY. The Impact of Safety Climate and Fatigue on Safety Performance of Operating Room Nurses. ACTA ACUST UNITED AC 2016. [DOI: 10.11111/jkana.2016.22.5.471] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- U-Eun Choi
- Graduate School of Advanced Practice Nursing, Eulji University, Korea
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Park KO, Kim JK, Kim MS. [Operating Room Nurses' Experiences of Securing for Patient Safety]. J Korean Acad Nurs 2015; 45:761-72. [PMID: 26582121 DOI: 10.4040/jkan.2015.45.5.761] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Revised: 11/24/2014] [Accepted: 07/07/2015] [Indexed: 11/09/2022]
Abstract
PURPOSE This study was done to evaluate the experience of securing patient safety in hospital operating rooms. METHODS Experiential data were collected from 15 operating room nurses through in-depth interviews. The main question was "Could you describe your experience with patient safety in the operating room?". Qualitative data from the field and transcribed notes were analyzed using Strauss and Corbin's grounded theory methodology. RESULTS The core category of experience with patient safety in the operating room was 'trying to maintain principles of patient safety during high-risk surgical procedures'. The participants used two interactional strategies: 'attempt continuous improvement', 'immersion in operation with sharing issues of patient safety'. CONCLUSION The results indicate that the important factors for ensuring the safety of patients in the operating room are manpower, education, and a system for patient safety. Successful and safe surgery requires communication, teamwork and recognition of the importance of patient safety by the surgical team.
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Affiliation(s)
- Kwang Ok Park
- College of Life Science and Natural Resources Department of Nursing, Sunchon National University, Sunchon, Korea
| | - Jong Kyung Kim
- Department of Nursing, Dankook University, Cheonan, Korea.
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Shu Q, Cai M, Tao HB, Cheng ZH, Chen J, Hu YH, Li G. What Does a Hospital Survey on Patient Safety Reveal About Patient Safety Culture of Surgical Units Compared With That of Other Units? Medicine (Baltimore) 2015; 94:e1074. [PMID: 26166083 PMCID: PMC4504589 DOI: 10.1097/md.0000000000001074] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The objective of this study was to examine the strengths and weaknesses of surgical units as compared with other units, and to provide an opportunity to improve patient safety culture in surgical settings by suggesting targeted actions using Hospital Survey on Patient Safety Culture (HSOPSC) investigation.A Hospital Survey on Patient Safety questionnaire was conducted to physicians and nurses in a tertiary hospital in Shandong China. 12 patient safety culture dimensions and 2 outcome variables were measured.A total of 23.5% of respondents came from surgical units, and 76.5% worked in other units. The "overall perceptions of safety" (48.1% vs 40.4%, P < 0.001) and "frequency of events reported" (63.7% vs 60.7%, P = 0.001) of surgical units were higher than those of other units. However, the communication openness (38.7% vs 42.5%, P < 0.001) of surgical units was lower than in other units. Medical workers in surgical units reported more events than those in other units, and more respondents in the surgical units assess "patient safety grade" to be good/excellent. Three dimensions were considered as strengths, whereas 5 other dimensions were considered to be weaknesses in surgical units. Six dimensions have potential to aid in improving events reporting and patient safety grade. Appropriate working times will also contribute to ensuring patient safety. Medical staff with longer years of experience reported more events.Surgical units outperform the nonsurgical ones in overall perception of safety and the number of events reported but underperform in the openness of communication. Four strategies, namely deepening the understanding about patient safety of supervisors, narrowing the communication gap within and across clinical units, recruiting more workers, and employing the event reporting system and building a nonpunitive culture, are recommended to improve patient safety in surgical units in the context of 1 hospital.
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Affiliation(s)
- Qin Shu
- From the Department of Health Administration (QS, MC, HT, ZC, JC, YH), School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology; and Tongji Hospital (GL), Tongji Medical college, Huazhong University of Science and Technology, Wuhan, Hubei Province, P.R. China
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Vlayen A, Hellings J, Barrado LG, Haelterman M, Peleman H, Schrooten W, Claes N. Evolution of patient safety culture in Belgian acute, psychiatric and long-term care hospitals. ACTA ACUST UNITED AC 2015. [DOI: 10.1186/2056-5917-1-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Kadzielski J, McCormick F, Herndon JH, Rubash H, Ring D. Surgeons' attitudes are associated with reoperation and readmission rates. Clin Orthop Relat Res 2015; 473:1544-51. [PMID: 24874115 PMCID: PMC4385371 DOI: 10.1007/s11999-014-3687-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Attitudes influence how people make decisions. In an effort to decrease pilot judgment-related accidents, the Federal Aviation Administration teaches new pilots about hazardous attitudes that are believed to be incompatible with safe flight: macho, impulsive, worry, resignation, self-confidence, and antiauthority. If these attitudes are hazardous for pilots and their passengers, they may also be incompatible with the reliable and safe delivery of surgical care. QUESTIONS/PURPOSES The purposes of this study were (1) to ascertain to what extent surgeons harbor hazardous attitudes; and (2) to determine their relationship, if any, to reoperation and readmission rates. METHODS We selected validated aviation psychology tools that are used to measure these attitudes in pilots. We converted the aviation scenarios to analogous situations for surgeons and invited all surgeons from one academic program to participate in this study. A total of 41 surgeons were eligible to participate; 37 (90%) completed the attitude prevalence protocol and 31 (76%) had complete reoperation and readmission data for the correlation and regression analysis. Attending orthopaedic surgeons completed the Modified Surgeon Hazardous Attitude Scale as well as a series of additional instruments. RESULTS Levels of macho thought to be hazardous in pilots were present in nine (24%) surgeons. Similar, elevated levels of self-confidence were found in three (8%) surgeons. High levels of impulsivity were found in 5% (two surgeons) and high levels of antiauthority were found in 3% (one surgeon). Only one (3%) surgeon reported elevated levels of worry and no surgeon reported hazardous levels of resignation. Thirty percent (11 surgeons) of surgeons harbored at least one elevated attitude level. In a regression model, macho attitude levels predicted 19% of the variation in surgeons' rate of readmissions and reoperations. CONCLUSIONS High levels of hazardous attitudes may not be consistent with the routine delivery of safe surgical care in a teamwork setting where human factors and safe systems are the key to success. Further research is needed to determine if abnormally high levels of these hazardous attitudes impact patient care. LEVEL OF EVIDENCE Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.
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Affiliation(s)
- John Kadzielski
- />Hand and Upper Extremity Surgery, South Shore Orthopedics, 2 Pond Park Road, Suite 102, Hingham, MA 02043 USA
| | | | - James H. Herndon
- />Hand and Upper Extremity Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA USA
| | - Harry Rubash
- />Arthroplasty Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA USA
| | - David Ring
- />Hand and Upper Extremity Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA USA
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Bahrami MA, Chalak M, Montazeralfaraj R, Dehghani Tafti A. Iranian nurses' perception of patient safety culture. IRANIAN RED CRESCENT MEDICAL JOURNAL 2014; 16:e11894. [PMID: 24910783 PMCID: PMC4028756 DOI: 10.5812/ircmj.11894] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/04/2013] [Revised: 07/27/2013] [Accepted: 08/19/2013] [Indexed: 12/03/2022]
Abstract
Background: In recent decades, patient safety has become a high priority health system issue, due to the high potential of occurring adverse events in health facilities. Objectives: This study was aimed to survey patient safety culture in 2 Iranian educational hospitals. Materials and Methods: In a descriptive, cross-sectional survey, a hospital survey on patient safety culture, was used in two teaching hospitals in Yazd, Iran during 2012. Study population was comprised of the same hospitals' nurses. Stratified-random sampling method was used and distributed among a total of 340 randomly-selected nurses from different units. From all distributed questionnaires, 302 ones were answered completely and afterwards analyzed using SPSS 17. Dimensional- and item-level positive scores were used for results reporting. Additionally descriptive statistics (mean and standard deviation), independent sample t-test and ANOVA were sued for data analyzing. Results: Research findings demonstrated that both hospitals had low to average scores in all dimensions of patient safety culture. Non-punitive response to error, staffing and frequency of events reported had the lowest positive scores of patient safety dimensions with scores 15.26, 19.26, 16.65, 30 and 32.87, 31.10 respectively in Shahid Sadoughi and Shahid Rahnemoon Hospitals. Also only 29.20 and 28.80 percent of nurses in Shahid Sadoughi and Shahid Rahnemoon Hospitals, respectively, evaluated the patient safety grade of their hospital as “excellent” and “very good”. Indeed, the studied hospitals had a statistical difference in 3 dimensions of patient safety culture (frequency of events reported, organizational learning and staffing). (P ≤ 0.05) Conclusions: Our study results were indicating of the challenge of weak patient safety culture, in educational hospitals. Therefore, the issue should be integrated to all policy makers and managerial initiatives in our health system, as a top priority.
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Affiliation(s)
- Mohammad Amin Bahrami
- Department of Healthcare Management, Shahid Sadoughi University of Medical Sciences, Yazd, IR Iran
- Hospital Management Research Center, Shahid Sadoughi Hospital, Yazd, IR Iran
| | - Mahjabin Chalak
- Shahid Sadoughi University of Medical Sciences, Yazd, IR Iran
| | - Razieh Montazeralfaraj
- Hospital Management Research Center, Shahid Sadoughi Hospital, Yazd, IR Iran
- Corresponding Author: Razieh Montazeralfaraj, Hospital Management Research Center, Shahid Sadoughi Hospital, Yazd, IR Iran. Tel: +98-9132564206, E-mail:
| | - Arefeh Dehghani Tafti
- Department of Epidemiology and Biostatistics, Shahid Sadoughi University of Medical Sciences, Yazd, IR Iran
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Kadzielski J, McCormick F, Zurakowski D, Herndon JH. Patient safety climate among orthopaedic surgery residents. J Bone Joint Surg Am 2011; 93:e62. [PMID: 21655881 DOI: 10.2106/jbjs.j.01478] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- John Kadzielski
- Harvard Combined Orthopaedic Surgery Residency Program, Department of Orthopaedic Surgery, Massachusetts General Hospital, 55 Fruit Street, White 535, Boston, MA 02114, USA.
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Haugen AS, Søfteland E, Eide GE, Nortvedt MW, Aase K, Harthug S. Patient safety in surgical environments: cross-countries comparison of psychometric properties and results of the Norwegian version of the Hospital Survey on Patient Safety. BMC Health Serv Res 2010; 10:279. [PMID: 20860787 PMCID: PMC2955019 DOI: 10.1186/1472-6963-10-279] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2010] [Accepted: 09/22/2010] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND How hospital health care personnel perceive safety climate has been assessed in several countries by using the Hospital Survey on Patient Safety (HSOPS). Few studies have examined safety climate factors in surgical departments per se. This study examined the psychometric properties of a Norwegian translation of the HSOPS and also compared safety climate factors from a surgical setting to hospitals in the United States, the Netherlands and Norway. METHODS This survey included 575 surgical personnel in Haukeland University Hospital in Bergen, an 1100-bed tertiary hospital in western Norway: surgeons, operating theatre nurses, anaesthesiologists, nurse anaesthetists and ancillary personnel. Of these, 358 returned the HSOPS, resulting in a 62% response rate. We used factor analysis to examine the applicability of the HSOPS factor structure in operating theatre settings. We also performed psychometric analysis for internal consistency and construct validity. In addition, we compared the percent of average positive responds of the patient safety climate factors with results of the US HSOPS 2010 comparative data base report. RESULTS The professions differed in their perception of patient safety climate, with anaesthesia personnel having the highest mean scores. Factor analysis using the original 12-factor model of the HSOPS resulted in low reliability scores (r = 0.6) for two factors: "adequate staffing" and "organizational learning and continuous improvement". For the remaining factors, reliability was ≥ 0.7. Reliability scores improved to r = 0.8 by combining the factors "organizational learning and continuous improvement" and "feedback and communication about error" into one six-item factor, supporting an 11-factor model. The inter-item correlations were found satisfactory. CONCLUSIONS The psychometric properties of the questionnaire need further investigations to be regarded as reliable in surgical environments. The operating theatre personnel perceived their hospital's patient safety climate far more negatively than the health care personnel in hospitals in the United States and with perceptions more comparable to those of health care personnel in hospitals in the Netherlands. In fact, the surgical personnel in our hospital may perceive that patient safety climate is less focused in our hospital, at least compared with the results from hospitals in the United States.
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Affiliation(s)
- Arvid S Haugen
- Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Jonas Lies vei 65, N-5021 Bergen, Norway
| | - Eirik Søfteland
- Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Jonas Lies vei 65, N-5021 Bergen, Norway
| | - Geir E Eide
- Centre for Clinical Research, Haukeland University Hospital, Jonas Lies vei 65, N-5021 Bergen, Norway
- Department of Public Health and Primary Health Care, University of Bergen, Kalfarveien 31, N-5018 Bergen, Norway
| | - Monica W Nortvedt
- Centre for Evidence Based Practice, Bergen University College, P.O. Box 7030, N-5020 Bergen, Norway
| | - Karina Aase
- Faculty of Social Sciences, University of Stavanger, N-4036 Stavanger, Norway
| | - Stig Harthug
- Department of Medicine, University of Bergen, P.O. Box 7804, N-5020 Bergen, Norway
- Department of Research and Development, Haukeland University Hospital, Jonas Lies vei 65, N-5021 Bergen, Norway
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Allen G. Evidence for Practice. AORN J 2010. [DOI: 10.1016/j.aorn.2009.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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