Analysis of occupational accidents among nurses working in hospitals based on safety climate and safety performance: a Bayesian network analysis

A Bayesian network model integrating organizational, individual and psychological factors for strengthening construction worker safety behavior

Objectives. Construction worker safety behavior (CWSB) may be affected by a confluence of multilevel and interrelated factors. Cultivating and maintaining CWSB is vital for improving construction safety. Current studies focus on organization-level or individual-level CWSB antecedents. However, few studies have examined the influence of psychological factors on CWSB, thereby reducing the joint effects of multilevel factors on CWSB. Methods. To determine effective strategies for strengthening CWSB, this study adopted the Bayesian network technique to explore the interrelationships between CWSB and its antecedent factors. A Bayesian belief network model was developed and trained with data collected from Chinese construction workers, which connected organizational, individual and psychological factors with CWSB. Results. According to the sensitivity analysis, safety knowledge, safety climate and psychological capital are the three most significant influencing factors for CWSB. A combined strategy that enhances safety knowledge, safety climate and communication competence simultaneously is the most effective option for strengthening CWSB. The validation and robustness of the network showed good accuracy for safety behavior judgment. Conclusion. This study proposes an alternative way to improve safety behavior by identifying its interactive causes and illustrates the importance of initiating systematic safety measures, which may help to mitigate the problem of safety plateau.

Safety climate in Pakistani universities' laboratories: an assessment of individual factors

Objectives. Current research aims to identify factors that affect the occupational safety climate in university laboratories despite their perception as low-risk areas compared to industrial environments. Methods. A safety climate survey was conducted in science laboratories across various engineering universities in Pakistan. The survey questionnaire was administered to 406 personnel, and a quantitative method for analysis was selected to examine the socio-demographic variables. A 5-point Likert scale (1 =  strongly disagree to 5 =  strongly agree) was used to perceive responses from participants. Additionally, a scale reliability test was conducted, and multivariate analysis of variance was performed to determine the relationship between selected dependent and independent variables. Results. The study found an overall safety climate score of 3.16 ± 0.55, indicating a moderate to high perception of safety on a scale of 1-5. Parameters such as role in the laboratory, departments/disciplines, accident experience and safety training significantly affected the safety climate score, while gender, age group, duration in university and accident witnessing did not. Conclusion. Upper management involvement, safety communication and direct supervision are crucial for improving the safety climate of university laboratories. The study recommends the consideration of the identified significant safety climate dimensions in laboratory safety policy-making at academic institutes.

The association between workplace physical environment and nurses' safety compliance: A serial mediation of psychological and behavioral factors

Aim

This study describes Jordanian intensive care unit nurses' satisfaction with their physical environment and investigates the association between workplace physical environment and nurses' safety compliance. Additionally, the study offers serial mediation analyses of psychological and behavioral factors between satisfaction with the workplace physical environment and nurses' safety compliance.

Introduction

Compliance with safety measures is a vital indicator of safety performance, as less compliance directly reflects undesirable safety outcomes among nurses, like occupational accidents, injuries, and fatalities. Social cognitive theory and the safety triad model contribute to understanding safety compliance behaviors to safety procedures. Thus, enhancing safety compliance in healthcare organizations remains a challenge and concern.

Methods

A quantitative research method was used based on cross-sectional and descriptive data from eight governmental hospitals in Jordan. The population included all intensive care unit nurses in the Ministry of Health's hospitals (n = 1104). A cluster sampling technique selected 285 nurses to participate. Empirical results were obtained through structural equation modeling (i.e., Smart PLS-SEM), which has become popular in this kind of research.

Results

The mean of Jordanian ICU nurses' satisfaction with the workplace physical environment was 3.36, which is moderate. Although the Smart PLS findings did not support the direct association between the workplace physical environment and nurses' safety compliance, serial mediation of safety participation in the workplace physical environment and nurses' safety compliance and perceived safety management commitment confirm the indirect association in the study model.

Conclusion

This study fills a gap in available safety and nursing literature, especially when considering the scarce studies that investigated the physical elements in the workplace and both safety compliance and safety participation. The findings are valuable for academicians, health providers, and policymakers and may trigger creative ideas and interventional solutions to improve nurses' safety compliance in healthcare organizations.

A fuzzy Bayesian network DEMATEL model for predicting safety behavior

Objectives. Safety behavior significantly affects safety performance in the workplace. This study aimed to develop a Bayesian network (BN) model for managing and improving safety behavior. Methods. This study was carried out in the chemical industries in Iran. The data were gathered by a questionnaire consisting of 13 variables including organization safety priority, systems design, safety communication, safety education, work strategy, human-system interaction, mental workload, environmental distractions, work pressure, fatigue, sleepiness, safety knowledge and locus of control. The BN structure was created using the fuzzy decision-making trial, evaluation laboratory method and expert opinions. Belief updating was used to determine variables with the strongest effect on safety behavior. Results. Locus of control, organization safety priority and safety knowledge were the best predictors of safety behavior. Moreover, it was found that improving organization safety priority and safety knowledge is the best intervention strategy to improve safety behavior significantly. Conclusions. BN is a powerful tool that can model causal relationships among variables. Improving organization safety priority and safety knowledge can lead to the maximum possible level of safety behavior.

Safety not guaranteed: Investigating employees' safety performance during a global pandemic

The COVID-19 pandemic threatened employees' health and safety more than any event in recent years. Although millions of employees transitioned to working from home to mitigate infectious disease exposure, many worksites re-opened amid the pandemic as high infection rates persisted longer than expected. Safety guidelines were issued by the Centers for Disease Control and Prevention, the World Health Organization, and other national initiatives to improve the health and safety of employees returning to on-site work. The current work addresses predictors of infection control safety behaviors in a general working population that largely lacks infection control training and expertise. Drawing from Neal and Griffin's model of safety behavior, we investigated organizational factors (i.e., perceived safety climate, safety-related organizational constraints, occupational risk of COVID-19 exposure) and individual factors (i.e., infection control safety attitudes, conscientiousness, and risk aversion) associated with employees' infection control safety behaviors shortly after returning to on-site work during the pandemic. Survey results from 89 full-time employees across industries demonstrated that the organizational and individual factors accounted for 51.19 percent of the variance in employees' infection control safety behaviors. Organizational factors accounted for 49.02 percent of the explained variance, and individual factors accounted for 50.98 percent of the explained variance. Conscientiousness, perceived safety climate, safety-related organizational constraints, and infection control safety attitudes explained significant variance in employees' infection control safety behaviors, while the occupational risk of COVID-19 exposure and risk aversion did not. Organizations may benefit from considering employees' conscientiousness and safety attitudes during employee selection as well as enhancing their organization's safety climate and mitigating safety-related organizational constraints.

Problematic internet use and safety behavior: The moderating role of safety climate

Problematic internet use (PIU) can cause mental and physical harm to individuals and may be an emerging factor contributing to unsafe work behavior. In this study, the relationship between PIU and safety behavior was investigated. Moreover, it was hypothesized that safety climate can moderate the relationship between PIU and safety behavior. Participants were employees from a mining industry in Iran. Three validated questionnaires were distributed to gather the required data regarding PIU, safety climate, and safety behavior. Hierarchical regression analysis was used to assess the moderating effect of safety climate on the relationship between PIU and safety behavior. The size of moderation effect was assessed using f2 index. Four hundred eighty-five employees participated in this study. The results demonstrated a negative relationship between PIU and safety behavior. The moderating effect of safety climate on the relationship between PIU and safety behavior was supported. The f2 index was 0.027 which demonstrates a small moderation effect. In conclusion, PIU has a significant negative effect on the safety behavior of employees. Providing a strong safety climate can be a long-term solution for reducing the negative effect of PIU on safety behavior.

Predictors of response rates of safety culture questionnaires in healthcare: a systematic review and analysis

OBJECTIVES

Safety culture questionnaires are widely used in healthcare to understand how staff feel at work, their attitudes and views, and the influence this has on safe and high-quality patient care. A known challenge of safety culture questionnaires is achieving high response rates to enhance reliability and validity. This review examines predictors of response rates, explores reasons provided for low response rates and identifies strategies to improve those rates.

METHODS

Four bibliometric databases were searched for studies assessing safety culture in hospitals from January 2008 to May 2022. Data were extracted from 893 studies that included a safety culture questionnaire conducted in the hospital setting. Regression was used to predict response rate based on recruitment and data collection methods (incentives, reminders, method of survey administration) and country income classification. Reasons for low response were thematically analysed and used to identify strategies to improve response rates.

RESULTS

Of the 893 studies that used a questionnaire to assess safety culture in hospitals, 75.6% reported a response rate. Response rates varied from 4.2% to 100%, with a mean response rate of 66.5% (SD=21.0). Regression analyses showed that safety culture questionnaires conducted in low-income and middle-income countries were significantly more likely to yield a higher response rate compared with high-income countries. Mode of administration, questionnaire length and timing of administration were identified as key factors. Remote methods of questionnaire data collection (electronic and by post) were significantly less likely to result in a higher response rate. Reasons provided for low response included: survey fatigue, time constraints, and lack of resources.

CONCLUSION

This review presents strategies for researchers and hospital staff to implement when conducting safety culture questionnaires: principally, distribute questionnaires in-person, during meetings or team training sessions; use a local champion; and consider the appropriate time of distribution to manage survey fatigue.

FACTORS AFFECTING NURSES' ATTITUDES TOWARDS RISKS IN THE WORK ENVIRONMENT: A CROSS-SECTIONAL STUDY

AIM

This study aimed to examine the factors affecting nurses' attitudes towards risks in the work environment.

BACKGROUND

Nurses' attitudes towards work environment-associated risks affect both risk management and employee health.

METHODS

This descriptive study was conducted with 338 nurses working in a public hospital, university hospital, and private hospital. Data were collected using the Personal Information Form and the Nurses' Attitudes Towards Work Environment Risks Scale.

RESULTS

Nurses were found to have a positive attitude towards risk in the work environment. Regression analysis showed that nurses' attitudes towards risk was affected by institution, gender, access to unit-specific risk management training, past experiences of sharp penetrating tool injuries, acceptance of risks due to the belief that risks are unavoidable, exposure to violence from colleagues, exposure to biological hazards, and neglect to take risk precautions.

CONCLUSIONS

This study's results show that nurses' attitudes towards risk in the work environment is affected by both individual and organizational factors.

IMPLICATIONS FOR NURSING MANAGEMENT

This study's results can help institutions and nurse managers understand the factors affecting nurses' attitudes towards work-related risks, thereby allowing them to determine the primary strategies that may be used to address these factors.

Resilient Safety Culture and Safety Performance: Examining the Effect in Malaysian Paramedic Training Institute through Importance-Performance Map Analysis (IPMA)

An increasing number of studies have shown that safety culture factors have a substantial influence on safety performance in a variety of industrial sectors. These factors’ impact on safety performance are unclear, especially at public service and statutory authorities. On the other hand, the understanding of indicators for safety performance in every working sector in Malaysia is continuing to progress. Hence, this study’s contribution is to explore the influence of safety culture factors (i.e., management commitment and supervision in safety, safety system) and safety competence on safety performance in government paramedic training institutes. Importance-performance map analysis (IPMA) is a technique used in Smart PLS to determine the significance and performance of each of these factors. The study was conducted via an online survey and involved 258 safety and health committee members in the Ministry of Health paramedic training institute. As a matter of relevance, the IPMA’s empirical data study revealed that management commitment and supervision in safety were the predominant factors in determining safety performance. Meanwhile, for performance, the findings showed that worker involvement, safety system, and safety competence perform well in determining safety performance.

Characteristics of Occupational Injuries among Spanish Nursing Workers

Introduction: Nursing professionals face a multitude of daily occupational hazards that can cause occupational accidents. AIM: The objective of this work is to analyze the personal variables included in official accident reports, to evaluate their influence on occupational accidents suffered by nursing and nursing assistant professionals. Methodology: A total of 187,821 occupational accidents recorded in Spain from 2011 to 2019 were analyzed in the sector using contingency tables, chi-square, and corrected standardized residuals. Results: The results showed that the older the professional, the probability that once the accident had occurred, its severity would be more serious. Regarding gender, men are more likely to suffer more serious accidents compared to accidents registered by women. Results about the length of service and nationality did not reach statistical significance in the group of accidents analyzed. Conclusions: The planning of preventive measures must be adapted to the profiles of the workers in the most vulnerable sector.

Research on the influence of job embeddedness on different initiative individuals

"How to improve individual initiative" has become an important subject facing the current researchers and practitioners. This study attempts to answer this question from the perspective of on-the-job embeddedness based on social cognitive theory, organization attachment theory and cognitive neural experiment，we revealed the differences in the effects of three dimensions of on-the-job embeddednesson individuals with different initiative by Event-related Potentials (ERPs) cognitive neural experiment. The experimental results showed that the effect on high-initiative individuals was in the descending order of organization fit, organization link, organization sacrifice; the effect on general-initiative individuals was in the descending order of organization link, organization fit, organization sacrifice; the effect on low-initiative individuals was in the descending order of organization sacrifice, organization link, organization fit. The ultimate goal is to put forward management strategies for different initiative individuals from the three dimensions embedded, promote their initiative level and actively participate in production activities.

Fatigue profile among petrochemical firefighters and its relationship with safety behavior: the moderating and mediating roles of perceived safety climate

The present study aimed to investigate fatigue among firefighters and its relationship with their safety behavior. The moderation and mediation effects of perceived safety climate on this relationship were also investigated. Firefighters from 10 petrochemical companies in Iran were investigated. Moderation analysis was performed based on hierarchical regression analyses and mediation effects were studied using structural equation modeling. A total number of 261 firefighters participated in this study. The mean scores of general fatigue, physical fatigue, reduced activity, reduced motivation and mental fatigue were 10.5, 9.0, 8.2, 7.6 and 8.7, respectively. Fatigue had a negative significant effect on firefighters' safety behavior. Perceived safety climate had a mediation but not moderation effect on the relationship between fatigue and safety behavior of firefighters. Generally, the fatigue level among firefighters was fairly low, but had a significant negative effect on firefighter's safety behavior. Perceived safety climate can mediate such a negative effect.

Prediction of human error probability during the hydrocarbon road tanker loading operation using a hybrid technique of fuzzy sets, Bayesian network and CREAM

Objectives. The hydrocarbon road tanker loading operation is vulnerable to human error. The present study aimed to develop a methodology for predicting human error probabilities (HEPs) in various subtasks of this operation. Methods. First, task analysis was performed using hierarchal task analysis. Then, HEP was calculated using a hybrid technique of fuzzy set theory (FST), Bayesian network (BN) and cognitive reliability and error analysis method (CREAM). FST was used for handling uncertainties regarding common performance conditions (CPCs) and the BN was employed for modeling the interrelationships among CPCs and HEPs. The weighted sum algorithm was used for quantifying conditional probability tables in the network. Results. Twenty-six subtasks were required for completing the road tanker loading operation. Investigating the internal parts of the tanker before the loading operation and attaching the ground rode clamp were the subtasks with highest HEPs. Working conditions and crew collaboration were the CPCs with the highest contribution to these errors. HEP was most sensitive to crew collaboration. Conclusion. Improving collaboration among the driver, site operators and control room operators, as well as increasing the knowledge of the road tanker driver regarding the hazards of incompatible chemicals, are the best practices for reducing HEPs in this operation.