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Bekele BT, Berhe TT, Wotango BY, Workneh WM, Wendwessen N. Validation study of the Amharic version Safety Attitudes Questionnaire (SAQ) in public hospitals of Addis Ababa, Ethiopia: a cross-sectional study. BMC Health Serv Res 2024; 24:366. [PMID: 38519903 PMCID: PMC10960426 DOI: 10.1186/s12913-024-10865-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 03/13/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND In Ethiopia, there is a growing concern about improving patients' safety in healthcare facilities. However, the lack of a valid and reliable instrument sensitive to the Ethiopian culture for measuring health professional practice environment leads to difficulty in constructing evaluations of safety climate and further linking organizational research to outcomes research. This research study examined the psychometric properties of the Safety Attitude Questionnaire (SAQ) in the Amharic language within an Ethiopian healthcare context. METHOD A hospital-based cross-sectional study design was conducted. The SAQ was meticulously translated into Amharic using forward and backward translation methods. Content validity was evaluated with input from seven patient safety and healthcare quality experts. Face validity was established through feedback from healthcare professionals. Then, the Amharic SAQ (SAQ-A) was distributed to 648 participants working in 11 public hospitals, and a total of 611 valid questionnaires were completed and returned (95.2% response rate). Cronbach's alpha, McDonald's omega, composite reliability, correlation analysis, and average variance estimation were calculated, and confirmatory factor analysis was performed. Descriptive analyses were performed to describe socio-demographic characteristics. A P-value of ≤0.05 was considered statistically significant. Tables, figures, charts, and texts are used for data presentation. RESULT The overall internal consistency (Cronbach's alpha) for the 31-item SAQ-A was 0.903, indicating excellent reliability. Confirmatory factor analyses demonstrated a good model fit for each dimension and the entire construct (χ2=1086.675, df=412, p<0.001, comparative fit index (CFI)=0.923, Tucker Lewis index (TLI)=0.913, and root mean square error of approximation (RMSEA)=0.052). The positive response rate of healthcare workers in hospitals was 32.1%. The positive response rates of the six dimensions were teamwork climate (59.7%), safety climate (41.9%), job satisfaction (57.1%), working conditions (37.5%), perception of management (37.6%), and stress recognition (46.2%). CONCLUSION The Amharic translation of the SAQ showed good psychometric properties, making it a valuable tool for assessing safety attitudes among Amharic-speaking Ethiopian healthcare practitioners.
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Affiliation(s)
- Bisrat Tamene Bekele
- Addis Ababa City Administration Health Bureau, P.O. Box 316, Addis Ababa, Ethiopia.
| | - Trhas Tadesse Berhe
- Public Health Department, Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia
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Olesen AE, Juhl MH, Deilkås ET, Kristensen S. Review: application of the Safety Attitudes Questionnaire (SAQ) in primary care - a systematic synthesis on validity, descriptive and comparative results, and variance across organisational units. BMC PRIMARY CARE 2024; 25:37. [PMID: 38273241 PMCID: PMC10809511 DOI: 10.1186/s12875-024-02273-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 01/11/2024] [Indexed: 01/27/2024]
Abstract
Patient safety research has focused mostly on the hospital and acute care setting whereas assessments of patient safety climate in primary health care settings are warranted. Valid questionnaires as e.g., the Safety Attitudes Questionnaire (SAQ) may capture staff perceptions of patient safety climate but until now, an overview of the use of SAQ in primary care has not been systematically presented. Thus, the aim of this systematic review is to present an overview of SAQ used in primary care.Methods The electronic databases: PubMed, Embase, Cinahl, PsycInfo and Web of Science were used to find studies that used any version of SAQ in primary care. Studies were excluded if only abstract or poster was available, as the information in abstract and posters was deemed insufficient. Commentaries and nonempirical studies (e.g., study protocols) were excluded. Only English manuscripts were included.Results A total of 43 studies were included and 40 of them fell into four categories: 1) validation analysis, 2) descriptive analysis, 3) variance assessment and 4) intervention evaluation and were included in further analyses. Some studies fell into more than one of the four categories. Seventeen studies aimed to validate different versions of SAQ in a variety of settings and providers. Twenty-five studies from fourteen different countries reported descriptive findings of different versions of SAQ in a variety of settings. Most studies were conducted in primary health care centres, out-of-hours clinics, nursing homes and general practice focusing on greatly varying populations. One study was conducted in home care. Three studies investigated variance of SAQ scores. Only five studies used SAQ to assess the effects of interventions/events. These studies evaluated the effect of electronic medical record implementation, a comprehensive Unit-based Safety Program or COVID-19.Conclusion The synthesis demonstrated that SAQ is valid for use in primary care, but it is important to adapt and validate the questionnaire to the specific setting and participants under investigation. Moreover, differences in SAQ factor scores were related to a variety of descriptive factors, that should be considered in future studies More studies, especially variance and intervention studies, are warranted in primary care.Trial registration This systematic review was not registered in any register.
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Affiliation(s)
- Anne Estrup Olesen
- Department of Clinical Pharmacology, Aalborg University Hospital, Mølleparkvej 8a, 9000, Aalborg, Denmark.
- Department of Clinical Medicine, Aalborg University, Selma Lagerløfs Vej 249, 9260, Gistrup, Denmark.
| | - Marie Haase Juhl
- Department of Clinical Pharmacology, Aalborg University Hospital, Mølleparkvej 8a, 9000, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Selma Lagerløfs Vej 249, 9260, Gistrup, Denmark
| | - Ellen Tveter Deilkås
- Health Services Research Unit, Akershus University Hospital, Sykehusveien 25, Oslo, Norway
| | - Solvejg Kristensen
- Aalborg University Hospital, Psychiatry, Mølleparkvej 10, 9000, Aalborg, Denmark
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Świtalski J, Radomska A, Tatara T, Wnuk K, Miazga W, Szpakowski R, Borowska M, Zdęba-Mozoła A, Kozłowski R, Marczak M, Czerw A, Dykowska G. Teamwork and safety climate in Polish long-term care facilities: questionnaire reliability and usability. Sci Rep 2023; 13:21115. [PMID: 38036634 PMCID: PMC10689842 DOI: 10.1038/s41598-023-48415-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 11/26/2023] [Indexed: 12/02/2023] Open
Abstract
The Teamwork and Safety Climate Survey (TSCS) is one of the questionnaires used to measure patient safety. The questionnaire includes two scales: teamwork climate and safety climate. The objective of the study is the linguistic and cultural adaptation of the TSCS to Polish conditions and checking the reliability and usability of the tool in long-term care facilities. Firstly, the TSCS was translated into Polish. Then, a cross-sectional survey was conducted among the medical and auxiliary personnel of long-term care facilities all over Poland. The psychometric properties of the questionnaire were analysed (including Cronbach's alpha coefficient). Correlations between the areas of the questionnaire and individual variables relating to facility parameters were also calculated. Respondents (n = 558) working in 26 different long-term care facilities participated in the study. The analysis has provided four scales instead of two of the original version of the questionnaire (teamwork climate, safety climate, ability to speak up and following the rules, work organisation). Correlation analysis revealed a number of significant correlations between the scales and individual variables corresponding to the parameters of long-term care facilities and respondents themselves. In conclusion, the Polish version of the TSCS may be a useful tool to measure aspects related to patient safety culture in long-term care facilities.
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Affiliation(s)
- Jakub Świtalski
- Department of Health Economics and Medical Law, Faculty of Health Sciences, Medical University of Warsaw, ul. Erazma Ciołka 27, 01-445, Warszawa, Poland.
| | - Agnieszka Radomska
- Department of Health Economics and Medical Law, Faculty of Health Sciences, Medical University of Warsaw, ul. Erazma Ciołka 27, 01-445, Warszawa, Poland
| | - Tomasz Tatara
- Department of Public Health, Faculty of Health Sciences, Medical University of Warsaw, 02-091, Warsaw, Poland
| | - Katarzyna Wnuk
- Department of Health Policy Programs, Faculty of Health Technology Assessment, Agency for Health Technology Assessment and Tariff System, 00-032, Warsaw, Poland
- School of Public Health, Centre of Postgraduate Medical Education of Warsaw, 01-826, Warsaw, Poland
| | - Wojciech Miazga
- Department of Health Policy Programs, Faculty of Health Technology Assessment, Agency for Health Technology Assessment and Tariff System, 00-032, Warsaw, Poland
- School of Public Health, Centre of Postgraduate Medical Education of Warsaw, 01-826, Warsaw, Poland
| | - Rafał Szpakowski
- Department of Development of Nursing, Social and Medical Sciences, Faculty of Health Sciences, Medical University of Warsaw, 01-445, Warsaw, Poland
| | - Mariola Borowska
- Department of Cancer Epidemiology and Prevention, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781, Warsaw, Poland
| | - Agnieszka Zdęba-Mozoła
- Department of Management and Logistics in Healthcare, Medical University of Lodz, 90-131, Lodz, Poland
| | - Remigiusz Kozłowski
- Center for Security Technologies in Logistics, Faculty of Management, University of Lodz, 90-237, Lodz, Poland
| | - Michał Marczak
- Collegium Management, WSB Merito University in Warsaw, 03-204, Warszawa, Poland
| | - Aleksandra Czerw
- Department of Health Economics and Medical Law, Faculty of Health Sciences, Medical University of Warsaw, ul. Erazma Ciołka 27, 01-445, Warszawa, Poland
- Department of Economic and System Analyses, National Institute of Public Health NIH-National Research Institute, 00-791, Warsaw, Poland
| | - Grażyna Dykowska
- Department of Health Economics and Medical Law, Faculty of Health Sciences, Medical University of Warsaw, ul. Erazma Ciołka 27, 01-445, Warszawa, Poland
- Warsaw College of Engineering and Health, 02-366, Warsaw, Poland
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Alanazi NH, Falqi TA. Healthcare Managers' Perception on Patient Safety Culture. GLOBAL JOURNAL ON QUALITY AND SAFETY IN HEALTHCARE 2023; 6:6-14. [PMID: 37260855 PMCID: PMC10229028 DOI: 10.36401/jqsh-22-13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 10/29/2022] [Accepted: 12/28/2022] [Indexed: 06/02/2023]
Abstract
Introduction This paper takes a detailed look at safety culture, different roles, and powers shared by managers, lessons from which can be applied in any form of management. It also focuses on the job of managers in enhancing safety standards in a health institution. The objective of this paper was to examine the managers' perception of patient safety culture. Methods This study followed a quantitative cross-sectional design. The research procedure involved all middle-level managers in Aseer Central Hospital in Abha, Saudi Arabia (N = 52). To assess the status of patient safety culture and the role of healthcare managers in the field study, the researchers constructed a study questionnaire; it included questions adapted and modified from the Safety Attitudes Questionnaire, the Hospital Survey on Patient Safety Culture questionnaire, the 10 Mintzberg managerial roles and the six types of power for healthcare managers. Results Most participants were Saudi nationals (73.1%) aged 31 to 40 years (44.2%). The managerial role practiced frequently was leadership (85%), but the least managerial role was the figurehead (23%). Mangers held positive attitudes toward patient safety culture with 100% positive replies. No significant association was found between sex, nationality, years of experience, and professions concerning patient safety. Additionally, the results indicated that most managers were willing to uphold a safe environment for their patients and ready to involve employees in decision-making strategies to motivate them. Conclusion The managerial choices in Aseer Central Hospital are based on the culture and tradition of the community, which might negatively undermine the capability of other individuals handling the same office based on their educational backgrounds and competency. Such situations also may demoralize the employees, leading to poor employee performance Suboptimal achievement was exhibited primarily by middle-level healthcare managers of all six power types: resource allocator, negotiator, liaison, spokesperson, figurehead, and entrepreneur. Therefore, there is a pressing need to improve managers' attitudes toward patient safety and activate managerial roles to ensure patients' safety is practiced unequivocally.
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Affiliation(s)
- Naif H Alanazi
- Department of Public Health, College of Health Science, Saudi Electronic University, Riyadh, Saudi Arabia
| | - Tariq Ahmed Falqi
- Family Medicine Department, Aseer Central Hospital, Abha, Saudi Arabia
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Ahmed FR, Al-Yateem N, Arsyad Subu M, Alkawaldeh M, Dias JM, Saifan AR, AbuRuz ME. Quality of life as a mediating factor in the relationship between fatigue and perception of safety among critical care nurses in the United Arab Emirates. Intensive Crit Care Nurs 2023; 76:103391. [PMID: 36702032 DOI: 10.1016/j.iccn.2023.103391] [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: 11/15/2022] [Revised: 12/23/2022] [Accepted: 01/16/2023] [Indexed: 01/26/2023]
Abstract
BACKGROUND A scientific understanding of the relationships between intensive care unit nurses' well-being and patient safety will allow nurse managers, administrators, and policymakers to simultaneously manage crucial organisational goals of nurses' health and patient safety. Understanding predictors of fatigue among intensive care unit nurses may help to balance personal and organisational impacts (e.g., turnover intention, sick leave) and provide a way to positively influence their safety perception. OBJECTIVE The aim of this study was to explore the association between work fatigue and perception of patient safety among nurses working in critical care units and determine whether their quality of life levels mediated this relationship. METHODS This study used a cross-sectional correlational comparative design. Participants were a sample of 250 intensive care unit nurses recruited conveniently from three large hospitals in the United Arab Emirates. The self-reported questionnaire included the Nursing Quality of Life Scale, the Fatigue Severity Scale, and the Safety Attitudes Questionnaire (SAQ)-ICU version, as well as sociodemographic characteristics and work-related information. RESULTS Of the 250 participating nurses, 76.8 % reported low QoL. There was a statistically significant correlation between nurses' Quality of Life and fatigue levels (r = 0.234, P = 0.000). Overall, 52.8 % of the sample had high fatigue and 49.6 % had poor safety perception. Multiple regression analysis using the Baron and Kenny approach showed that QoL, marital status, gender, and work environment were predictors of nurses' perception of safety. CONCLUSION Intensive care unit nurses had high levels of fatigue and poor Quality of Life. High Quality of Life and a favourable work environment were independent predictors of good patient safety perception. Efforts should be directed to maximize staffing resources that positively impact patient safety. These findings are comparable with international studies, suggesting that these issues may be ubiquitous. IMPLICATIONS FOR CLINICAL PRACTICE Intensive care practitioners, managers and policymakers should adopt measures to modify intensive care nurses' exhausting working conditions and provide a supportive environment. these interventions might improve nurses' perception of patient safety and consequently prevent safety incidents.
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Affiliation(s)
- Fatma Refaat Ahmed
- Department of Nursing, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates; Critical Care and Emergency Nursing Department, Faculty of Nursing, Alexandria University, Alexandria, Egypt.
| | - Nabeel Al-Yateem
- Department of Nursing, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.
| | - Muhammad Arsyad Subu
- Department of Nursing, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.
| | - Mohammad Alkawaldeh
- Department of Nursing, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.
| | - Jacqueline Maria Dias
- Department of Nursing, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.
| | - Ahmad Rajeh Saifan
- Clinical Nursing Department, Faculty of Nursing, Applied Science Private University, Amman, Jordan
| | - Mohannad Eid AbuRuz
- Clinical Nursing Department, Faculty of Nursing, Applied Science Private University, Amman, Jordan.
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Er ÖS, Altinbaş Y. Nurses' Perceptions of Patient Safety on Patient Safety Climate. J Perianesth Nurs 2023; 38:408-413. [PMID: 36621378 DOI: 10.1016/j.jopan.2022.06.004] [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: 01/01/2022] [Revised: 05/23/2022] [Accepted: 06/05/2022] [Indexed: 01/09/2023]
Abstract
PURPOSE The purpose of this study was to determine the relationship between nurses' perception of patient safety and the safety climate. DESIGN Descriptive study. METHODS The sample consisted of 262 surgical nurses. Data were collected with an online questionnaire system using the Leiden Operating Theatre and Intensive Care Safety (LOTICS) Scale and Patient Safety Climate (PSC) Scale. FINDINGS Intensive care unit (ICU) nurses were found to have higher perceptions of patient safety (106.0 ± 15.2 vs 102.6 ± 17.0) and safety climate (59.2 ± 20.9 vs 50.9 ± 24.3) than Operating Room (OR) nurses. According to ICU nurses, OR nurses stated that teamwork was weak, they did not feel like a part of the team, and teamwork was incompatible. They stated that there was no preliminary information about the operation, that they could not get enough information during the operation, that sufficient materials were not available in the OR in case of need, and that the worn-out materials were not replaced and repaired in a timely manner. CONCLUSION As nurses' perception of patient safety increases; patient safety climate perceptions also increased. Providing both professional and in-service trainings to raise awareness of patient safety, developing strategies that prevent team conflicts, providing preliminary information about the surgery, and eliminating material deficiencies can increase nurses' perception of PSC.
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Affiliation(s)
- Özlem Soyer Er
- Afyonkarahisar Sağlık Bilimleri Üniversitesi, Sağlık Bilimleri Fakültesi, Hemşirelik Bölümü, Afyon, Turkey
| | - Yasemin Altinbaş
- Department of Surgical Nursing, Adıyaman University, Faculty of Health Sciences, Adıyaman, Turkey.
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Indarwati R, Efendi F, Fauziningtyas R, Fauziah A, Sudarsiwi NP. Efforts to Improve the Safety Culture of the Elderly in Nursing Homes: A Qualitative Study. Risk Manag Healthc Policy 2023; 16:393-400. [PMID: 36936883 PMCID: PMC10015942 DOI: 10.2147/rmhp.s399826] [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: 12/13/2022] [Accepted: 02/23/2023] [Indexed: 03/16/2023] Open
Abstract
Introduction The attention to building a safety culture in nursing homes is relatively less when compared to hospitals. Good patient safety will improve the quality of health services and minimize incidents related to patient safety. This study aims to look at efforts that can be made to improve safety culture in nursing homes. Materials and Methods The research design uses phenomenological qualitative with in-depth interviews. Purposive sampling was used with interpretive phenomenological analysis. Participants were 29 staff from four government and private institutions in East Java, Indonesia. Results The sub-themes resulting from the research efforts to improve the safety culture of the elderly in nursing homes are the provision of new staff orientation, training, improvement of infrastructure, and procurement of security staff. Conclusion The analysis shows that efforts to improve safety culture can be carried out with various strategies by paying attention to risk assessment steps, patient risk identification, and management, incident reporting, and analysis, the ability to learn from incidents and their follow-up, as well as implementing solutions to minimize risks and prevent them from occurring injury. Safety culture plays an essential role in improving the quality of care.
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Affiliation(s)
- Retno Indarwati
- Faculty of Nursing, Universitas Airlangga, Campus C Mulyorejo, Surabaya, East Java, 60115, Indonesia
- Correspondence: Retno Indarwati, Email
| | - Ferry Efendi
- Faculty of Nursing, Universitas Airlangga, Campus C Mulyorejo, Surabaya, East Java, 60115, Indonesia
| | - Rista Fauziningtyas
- Faculty of Nursing, Universitas Airlangga, Campus C Mulyorejo, Surabaya, East Java, 60115, Indonesia
| | - Anis Fauziah
- Faculty of Nursing, Universitas Airlangga, Campus C Mulyorejo, Surabaya, East Java, 60115, Indonesia
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Kim KA, Lee J, Kim D, Min D. Patient safety measurement tools used in nursing homes: a systematic literature review. BMC Health Serv Res 2022; 22:1376. [PMCID: PMC9675074 DOI: 10.1186/s12913-022-08814-5] [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: 03/14/2022] [Accepted: 11/08/2022] [Indexed: 11/21/2022] Open
Abstract
Background An increase in the number of older adults has highlighted the important issue of the safety of residents in nursing homes. This review aimed to review previous studies on patient safety of older adults living in nursing homes, analyze the tools used to measure it, and identify factors affecting patient safety of older adult residents in nursing homes. Methods A literature search was conducted using EMBASE, PubMed, CINHAL, and COCHRANE. The main search terms were “nursing home” or “skilled nursing facility” or “long-term care facility” and “patient safety.” In total, 13,586 articles were identified. Two authors independently assessed the quality of each selected study using the Crowe Critical Appraisal Tool. Results Twenty-five studies were included in the analysis. There were a total of seven tools used to measure patient safety in nursing homes: the Nursing Home Survey on Patient Safety Culture (10 studies) and Hospital Survey on Patient Safety Culture (nine studies). Furthermore, the Nursing Home Survey on Patient Safety Culture-China, Safety Attitudes Questionnaire, Safety Attitudes Questionnaire in a Skilled Nursing Facility, Safety Attitudes Questionnaire-Ambulatory Version, and Modified Stanford Patient Safety Culture Survey Instrument were used in one study each. The most used tool among them was the Nursing Home Survey on Patient Safety Culture. Most tools used to measure patient safety in nursing homes were related to patient safety culture and employee attitudes. Conclusion Organizational factors, such as the staff education system and the composition of appropriate personnel, should be strengthened to establish a patient safety culture in nursing homes, for which policy support is crucial.
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Affiliation(s)
- Kyoung-A Kim
- grid.256155.00000 0004 0647 2973Department of Nursing, College of Nursing, Gachon University, 21936 Incheon, Republic of Korea
| | - Jungeun Lee
- grid.448830.30000 0004 7639 4990College of Nursing, Cheju Halla University, Jeju, Republic of Korea
| | - Dahee Kim
- grid.410899.d0000 0004 0533 4755The Graduate School, Wonkwang University, Iksan, Republic of Korea
| | - Deulle Min
- grid.410899.d0000 0004 0533 4755Department of Nursing, College of Medicine, Wonkwang University, 460, Iksandae-ro, 54538 Iksan, Jeonbuk Republic of Korea
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Juhl MH, Soerensen AL, Kristensen JK, Johnsen SP, Olesen AE. Safe Medication of Elderly Through Development and Evaluation of an Intervention (SAME): Protocol for a Fully Integrated Mixed Methods Study with Co-creative Approach (Preprint). JMIR Res Protoc 2022; 12:e43538. [PMID: 37000508 PMCID: PMC10131653 DOI: 10.2196/43538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 01/11/2023] [Accepted: 01/24/2023] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Medication safety is increasingly challenging patient safety in growing aging populations. Developing positive patient safety cultures is acknowledged as a primary goal to improve patient safety, but evidence on the interventions to do so is inconclusive. Nursing home residents are often cognitively and physically impaired and are therefore highly reliant on frontline health care providers. Thus, interventions to improve medication safety of nursing home residents through patient safety culture among providers are needed. Using cocreative partnerships, integrating knowledge of residents and their relatives, and ensuring managerial support could be beneficial. OBJECTIVE The primary aim of the Safe Medication of Nursing Home Residents Through Development and Evaluation of an Intervention (SAME) study is to improve medication safety for nursing home residents through developing an intervention by gaining experiential knowledge of patient safety culture in cocreative partnerships, integrating knowledge of residents and their relatives, and ensuring managerial support. METHODS The fully integrated mixed method study will be conducted using an integrated knowledge translation approach. Patient safety culture within nursing homes will first be explored through qualitative focus groups (stage 1) including nursing home residents, their relatives, and frontline health care providers. This will inform the development of an intervention in a multidisciplinary panel (stage 2) including cocreators representing the medication management process across the health care system. Evaluation of the intervention will be done in a randomized controlled trial set at nursing homes (stage 3). The primary outcome will be changes in the mean scale score of an adapted version of the Danish "Safety Attitudes Questionnaire" (SAQ-DK) for use in nursing homes. Patient safety-related outcomes will be collected through Danish health registers to assess safety issues and effects, including medication, contacts to health care, diagnoses, and mortality. Finally, a mixed methods analysis on patient safety culture in nursing homes will be done (stage 4), integrating qualitative data (stage 1) and quantitative data (stage 3) to comprehensively understand patient safety culture as a key to medication safety. RESULTS The SAME study is ongoing. Focus groups were carried out from April 2021 to September 2021 and the workshop in September 2021. Baseline SAQ-DK data were collected in January 2022 with expected follow-up in January 2023. Final data analysis is expected in spring 2024. CONCLUSIONS The SAME study will help not only to generate evidence on interventions to improve medication safety of nursing home residents through patient safety culture but also to give insight into possible impacts of using cocreativity to guide the development. Thus, findings will address multiple gaps in evidence to guide future patient safety improvement efforts within primary care settings of political and scientific scope. TRIAL REGISTRATION ClinicalTrials.gov NCT04990986; https://clinicaltrials.gov/ct2/show/NCT04990986. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/43538.
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Affiliation(s)
- Marie Haase Juhl
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- Department of Clinical Pharmacology, Aalborg University Hospital, Aalborg, Denmark
| | - Ann Lykkegaard Soerensen
- Department of Clinical Pharmacology, Aalborg University Hospital, Aalborg, Denmark
- University College of Northern Denmark, Aalborg, Denmark
| | | | - Søren Paaske Johnsen
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Anne Estrup Olesen
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- Department of Clinical Pharmacology, Aalborg University Hospital, Aalborg, Denmark
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Exploring safety culture in the Finnish ambulance service with Emergency Medical Services Safety Attitudes Questionnaire. Scand J Trauma Resusc Emerg Med 2021; 29:148. [PMID: 34641925 PMCID: PMC8507218 DOI: 10.1186/s13049-021-00960-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 09/24/2021] [Indexed: 11/28/2022] Open
Abstract
Background Emergency Medical Services (EMS) is, by its nature, a challenging context that may create risks for both patients and employees. It is also known that an organisation’s safety culture has an influence on both patient and employee safety. Finnish EMS organisations lack knowledge of how their safety culture is perceived by their employees. Aim This study aims to test the psychometric properties of the Emergency Medical Services Safety Attitudes Questionnaire (EMS-SAQ) in a Finnish EMS setting. We also explore the connections between individual- and organisation-based characteristics and safety attitudes in the Finnish EMS. Methods A cross-sectional survey study design was used. The EMS-SAQ was used to collect data via social media. The instrument measures six domains of workplace safety culture: safety climate, teamwork climate, perceptions of management, job satisfaction, working conditions and stress recognition. The 5-point Likert scale was converted to a 100-point scale and mean ≥ 75 was dichotomized as a positive. Confirmatory factor analysis (CFA) was carried out to validate the EMS-SAQ in a Finnish setting. Other results were analysed by using non-parametric tests. Results 327 responses were included in the analysis. CFA showed that the total EMS-SAQ model had acceptable goodness-of-fit values in the Finnish EMS setting. Total mean scores for each safety culture domain were identified non-positively (mean score < 75); safety climate 60.12, teamwork climate 60.92, perceptions of management 56.31, stress recognition 64.55, working conditions 53.43 and job satisfaction 70.36. Higher education was connected to lower job satisfaction and the teamwork climate within the individual characteristics. All organisation-based characteristics caused at least one significant variation in the safety culture domain scores. Working area significantly affected (p < 0.05) five out of the six safety culture domain scores. Conclusions The EMS-SAQ is a valid tool to evaluate safety culture among the Finnish EMS organisations; it offers a novel method to evaluate safety and patient safety within the Finnish EMS organisations. According to the findings, the organisation-based characteristics more likely had an impact on safety attitudes than did the individual-based characteristics. Therefore, it is suggested that the Finnish EMS organisations undertake safety culture development at the organisational level. Supplementary Information The online version contains supplementary material available at 10.1186/s13049-021-00960-9.
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Vallières F, Mubiri P, Agyemang SA, Amon S, Gerold J, Martineau T, Nolan A, O'Byrne T, Sanudi L, Sengooba F, Prytherch H. Determinants of safety climate at primary care level in Ghana, Malawi and Uganda: a cross-sectional study across 138 selected primary healthcare facilities. HUMAN RESOURCES FOR HEALTH 2021; 19:73. [PMID: 34098988 PMCID: PMC8186040 DOI: 10.1186/s12960-021-00617-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 05/28/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Safety climate is an essential component of achieving Universal Health Coverage, with several organisational, unit or team-level, and individual health worker factors identified as influencing safety climate. Few studies however, have investigated how these factors contribute to safety climate within health care settings in low- and middle-income countries (LMICs). The current study examines the relationship between key organisational, unit and individual-level factors and safety climate across primary health care centres in Ghana, Malawi and Uganda. METHODS A cross-sectional, self-administered survey was conducted across 138 primary health care facilities in nine districts across Uganda, Ghana and Malawi. In total, 760 primary health workers completed the questionnaire. The relationships between individual (sex, job satisfaction), unit (teamwork climate, supportive supervision), organisational-level (district managerial support) and safety climate were tested using structural equation modelling (SEM) procedures. Post hoc analyses were also carried out to explore these relationships within each country. RESULTS Our model including all countries explained 55% of the variance in safety climate. In this model, safety climate was most strongly associated with teamwork (β = 0.56, p < 0.001), supportive supervision (β = 0.34, p < 0.001), and district managerial support (β = 0.29, p < 0.001). In Ghana, safety climate was positively associated with job satisfaction (β = 0.30, p < 0.05), teamwork (β = 0.46, p < 0.001), and supportive supervision (β = 0.21, p < 0.05), whereby the model explained 43% of the variance in safety climate. In Uganda, the total variance explained by the model was 64%, with teamwork (β = 0.56, p < 0.001), supportive supervision (β = 0.43, p < 0.001), and perceived district managerial support (β = 0.35, p < 0.001) all found to be positively associated with climate. In Malawi, the total variance explained by the model was 63%, with teamwork (β = 0.39, p = 0.005) and supportive supervision (β = 0.27, p = 0.023) significantly and positively associated with safety climate. DISCUSSION/CONCLUSIONS Our findings highlight the importance of unit-level factors-and in specific, teamwork and supportive supervision-as particularly important contributors to perceptions of safety climate among primary health workers in LMICs. Implications for practice are discussed.
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Affiliation(s)
- Frédérique Vallières
- Trinity Centre for Global Health, Trinity College Dublin, 7-9 Leinster Street South, Dublin 2, Ireland
| | - Paul Mubiri
- School of Public Health, Makerere University, Kampala, Uganda
| | - Samuel Agyei Agyemang
- School of Public Health, College of Health Sciences, University of Ghana, Legon, P. O. Box LG13, Accra, Ghana
| | - Samuel Amon
- School of Public Health, College of Health Sciences, University of Ghana, Legon, P. O. Box LG13, Accra, Ghana
| | - Jana Gerold
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4002, Basel, Switzerland.
- University of Basel, 4003, Basel, Switzerland.
| | - Tim Martineau
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Ann Nolan
- Trinity Centre for Global Health, Trinity College Dublin, 7-9 Leinster Street South, Dublin 2, Ireland
| | - Thomasena O'Byrne
- Trinity Centre for Global Health, Trinity College Dublin, 7-9 Leinster Street South, Dublin 2, Ireland
| | - Lifah Sanudi
- Research for Equity and Community Health Trust (REACH Trust), Lilongwe, Malawi
| | | | - Helen Prytherch
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4002, Basel, Switzerland
- University of Basel, 4003, Basel, Switzerland
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Tollefsen S, Førland O, Deilkås ECT, Baste V, Bondevik GT. Patient Safety Culture in Norwegian Home Health Care – a study protocol. TIDSSKRIFT FOR OMSORGSFORSKNING 2020. [DOI: 10.18261/issn.2387-5984-2020-02-11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Huang CH, Wu HH, Lee YC, Van Nieuwenhuyse I, Lin MC, Wu CF. Patient safety in Work Environments: Perceptions of Pediatric Healthcare Providers in Taiwan. J Pediatr Nurs 2020; 53:6-13. [PMID: 32299035 DOI: 10.1016/j.pedn.2020.03.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 03/08/2020] [Accepted: 03/09/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND Extensive research on the link between the organizational characteristics of the work environment and patient safety in a healthcare organization has been conducted; yet, only a few studies have concentrated on care providers in a pediatric unit. OBJECTIVES To determine the correlation between different work environment factors impacting patient safety in a pediatric care unit from the perspective of registered nurses working in these units. DESIGN Cross-sectional design. DATA SOURCES AND METHODS The study was conducted with 155 registered nurses from a pediatric unit in a medical center in Taiwan with the Chinese version of the Safety Attitudes Questionnaire (SAQ) 2014-2017. RESULTS Teamwork climate, higher job satisfaction, and better working conditions are linked to positive perceptions of patient safety culture. Emotional exhaustion is negatively related to most dimensions of patient safety. CONCLUSION Teamwork climate, job satisfaction, working conditions, and emotional exhaustion were identified as critical factors impacting the patient safety climate. IMPLICATIONS FOR NURSING OR HEALTH POLICY Investments to improve teamwork climate, job satisfaction, and working conditions and reduce emotional exhaustion may have a positive effect on patient safety in pediatric care units.
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Affiliation(s)
- Chih-Hsuan Huang
- School of Business Administration, Hubei University of Economics, Wuhan City, China; Institute of Wuhan Studies, Jianghan University, Wuhan City, China; Institute for Development of Cross-Strait Small and Medium Enterprise, Wuhan City, China
| | - Hsin-Hung Wu
- Department of Business Administration, National Changhua University of Education, Changhua City, Taiwan; Department of M-Commerce and Multimedia Applications, Asia University, Taichung City, Taiwan; Faculty of Education, State University of Malang, Malang, East Java, Indonesia
| | - Yii-Ching Lee
- Department of Health Business Administration, Hung Kuang University, Taichung City, Taiwan; School of Health Policy and Management, Chung Shan Medical University, Taichung City, Taiwan
| | | | - Meng-Chen Lin
- School of Business Administration, Hubei University of Economics, Wuhan City, China
| | - Cheng-Feng Wu
- School of Business Administration, Hubei University of Economics, Wuhan City, China; Institute for Development of Cross-Strait Small and Medium Enterprise, Wuhan City, China; Research Center of Hubei Logistics Development, Hubei University of Economics, Wuhan City, China.
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Deilkås ECT, Bondevik GT. Pasientsikkerhetskultur og koronapandemien –nye muligheter for trygghet og samarbeid i norsk helse- og omsorgstjeneste. TIDSSKRIFT FOR OMSORGSFORSKNING 2020. [DOI: 10.18261/issn.2387-5984-2020-01-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
| | - Gunnar Tschudi Bondevik
- Gruppe for helsetjenesteforskning, Institutt for global helse og samfunnsmedisin, Universitetet i Bergen / Nasjonalt kompetansesenter for legevaktmedisin, NORCE Norwegian Research Centre, Bergen
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