Opportunities for improvement in nursing homes: Variance of six patient safety climate factor scores across nursing homes and wards—Assessed by the Safety Attitudes Questionnaire

Background: New scheduling models were needed to adjust to residents’ duty hour reforms while maintaining safe patient care. In interdisciplinary night-float rotations, four to six residents from most residency programs collaborated for after-hours cross-coverage of most adult hospitalised patients as part of a Faculty-led rotation. Residents worked sixteen 12-hour night shifts over a month. Methods: We measured residents’ perception of the patient safety climate during implementation of night-float rotations in five tertiary hospitals. We surveyed 267 residents who had completed the rotation in 2015-2016 with an online version of the Safety Attitudes Questionnaire. First year residents came from most residency programs, second- and third-year residents came from internal medicine.Results: One-hundred-and-thirty residents completed the questionnaire. Scores did not differ across hospitals and residents’ years of training for all six safety-related climate factors: teamwork climate, job satisfaction, perceptions of management, safety climate, working conditions, and stress recognition.Conclusion: Simultaneous implementation in five hospitals of a Faculty-led interdisciplinary night-float rotation for most junior residents proved to be logistically feasible and showed similar and reassuring patient safety climate scores._____Contexte: De nouveaux horaires de garde en établissements hospitaliers étaient nécessaires pour s’adapter aux réformes des heures de travail des résidents tout en maintenant des soins sécuritaires pour les patients. Dans les stages cliniques de nuit interdisciplinaires, quatre à six résidents de la plupart des programmes de résidence ont collaboré pour assurer une couverture croisée, après les heures normales de travail, de la plupart des patients adultes hospitalisés. Les résidents ont travaillé seize nuits de 12 heures durant un mois.Méthodes: Nous avons mesuré la perception des résidents du climat de travail lié à la sécurité des patients lors de la mise en place de stages de nuit dans cinq hôpitaux universitaires. Nous avons interrogé 267 résidents ayant terminé le stage en 2015-2016 avec une version numérique du Safety Attitudes Questionnaire. Les résidents de première année provenaient de la plupart des programmes de résidence, les résidents de deuxième et troisième années provenaient du programme de médecine interne.Résultats: 130 résidents ont complété le questionnaire. Les scores ne différaient pas entre les hôpitaux et les années de formation des résidents pour les six facteurs liés à la sécurité des patients: climat de travail en équipe, satisfaction au travail, perceptions des supérieurs, climat de sécurité, conditions de travail et reconnaissance du stress.Conclusions: La mise en place simultanée, dans cinq hôpitaux, de stages cliniques de nuit réunissant des résidents juniors de la majorité des programmes de résidence fut logistiquement possible et a montré des résultats similaires et rassurants sur le climat de travail lié à la sécurité des patients.

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Factors influencing the patient safety climate in intensive care units: cross-sectional study

BMC Nursing ◽

10.1186/s12912-021-00643-x ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Ranielle de Lima Silva Nunes ◽

Ana Elisa Bauer de Camargo Silva ◽

Juliana Carvalho de Lima ◽

Dayse Edwiges Carvalho ◽

Cristina Alves Bernardes ◽

...

Keyword(s):

Patient Safety ◽

Intensive Care ◽

Intensive Care Units ◽

Safety Climate ◽

Cross Sectional Study ◽

Cross Sectional ◽

Safety Attitudes ◽

Safety Attitudes Questionnaire ◽

Patient Safety Climate ◽

Factors Influencing

Abstract Background Measuring the patient safety climate of a health service provides important information about the safety status at a given time. This study aimed to determine the factors influencing the patient safety climate in Intensive Care Units. Methods An analytical and cross-sectional study conducted in 2017 and 2018 in two adult Intensive Care Units of a Brazilian Teaching Hospital. The Safety Attitudes Questionnaire instrument was applied with the multidisciplinary teams to determine the factors influencing the patient safety climate. Data were double entered into a database and processed using the R (version 3.5.0) statistical software. Position, central tendency and dispersion measures were taken and absolute and relative frequencies, mean and confidence intervals were calculated for the quantitative variables. Linear regression was performed to verify the effect of variables on the SAQ domains. Variables with a p-value of less than 0.25 were selected for multivariate analysis. Results A total of 84 healthcare providers participated in the study. The mean Safety Attitudes Questionnaire score was 59.5, evidencing a negative climate. The following factors influenced the safety climate: time since course completion, professional category, type of employment contract, complementary professional training, and weekly workload. Conclusions The factors identified indicate items for planning improvements in communication, teamwork, work processes, and management involvement, aiming to ensure care safety and construct a supportive safety climate.

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Analyzing Healthcare Safety Climate Through A Collaborative Filtering of Safety Attitudes Questionnaire for A Hospital Case Study

10.1101/2021.02.11.20202440 ◽

2021 ◽

Author(s):

Huiyu Huang ◽

Chun-An Chou ◽

Shao-Jen Weng ◽

Chieh-Liang Wu

Keyword(s):

Patient Safety ◽

Collaborative Filtering ◽

Safety Climate ◽

Personal Information ◽

Safety Attitudes ◽

Hospital Case ◽

Safety Attitudes Questionnaire ◽

Climate Assessment ◽

Research Survey ◽

Patient Safety Climate

ABSTRACTBackgroundPatient safety climate in healthcare is an important element to improve quality of current healthcare system globally. Safety Attitudes Questionnaire (SAQ), one of measurable tools for patient safety climate, is applied as an effective research survey to collect opinions and information from medical workers in a long term.MethodSAQ data in this study consists of medical employee scores to 46 questions in 8 aspects or dimensions and personal information during 2014 to 2017 from a teaching hospital. A quantitative analysis with a core user based collaborative filtering method is conducted to analyze the SAQ data for discovering the latent inter-related pattern among different SAQ aspects of sub-sectors in this hospital for four years.ResultsThere are not interrelationships between these 8 independent aspects for wards at different level (A, B and C) consistently across 4 years. The correlation patterns of aspects are not strong consistent over years for wards.ConclusionObservations in this study can be used to support understanding patient safety climate assessment. They are contributed to further study in this area and understand SAQ aspects dynamically in a real hospital case.

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Factors Influencing the Patient Safety Climate in Intensive Care Units: Cross-sectional Study

10.21203/rs.3.rs-428115/v1 ◽

2021 ◽

Author(s):

Ranielle de Lima Silva Nunes ◽

Ana Elisa Bauer de Camargo Silva ◽

Juliana Carvalho de Lima ◽

Dayse Edwiges Carvalho ◽

Cristina Alves Bernardes ◽

...

Keyword(s):

Patient Safety ◽

Intensive Care ◽

Safety Climate ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Safety Attitudes ◽

Safety Attitudes Questionnaire ◽

Patient Safety Climate ◽

Factors Influencing

Abstract Background:Measuring the patient safety climate of a health service provides important information about the safety status at a given time. This study aimed to determine the factors influencing the patient safety climate in Intensive Care Units.Methods:An analytical and cross-sectional study conducted in 2017 and 2018 in two adult Intensive Care Units of a Brazilian Teaching Hospital. The Safety Attitudes Questionnaire instrument was applied with the multidisciplinary teams to determine the factors influencing the patient safety climate. Data were double entered into a database and processed using the R (version 3.5.0) statistical software. Position, central tendency and dispersion measures were taken and absolute and relative frequencies, mean and confidence intervals were calculated for the quantitative variables. Linear regression was performed to verify the effect of variables on the SAQ domains. Variables with a p-value of less than 0.25 were selected for multivariate analysis.Results:A total of 84 healthcare providers participated in the study. The mean Safety Attitudes Questionnaire score was 59.5, evidencing a negative climate. The following factors influenced the safety climate: time since course completion, professional category, type of employment contract, complementary professional training, and weekly workload. Conclusions:The factors identified indicate items for planning improvements in communication, teamwork, work processes, and management involvement, aiming to ensure care safety and construct a supportive safety climate.

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Measuring Patient Safety Climate in Acute Stroke Therapy

Frontiers in Neurology ◽

10.3389/fneur.2021.686649 ◽

2021 ◽

Vol 12 ◽

Author(s):

Ferdinand O. Bohmann ◽

Joachim Guenther ◽

Katharina Gruber ◽

Tanja Manser ◽

Helmuth Steinmetz ◽

...

Keyword(s):

Patient Safety ◽

Acute Stroke ◽

Safety Climate ◽

Stroke Care ◽

University Hospitals ◽

Acute Stroke Care ◽

Safety Attitudes ◽

Patient Safety Climate ◽

Stroke Team ◽

First Time

Background: Treatment of acute stroke is highly time-dependent and performed by a multiprofessional, interdisciplinary team. Interface problems are expectable and issues relevant to patient safety are omnipresent. The Safety Attitudes Questionnaire (SAQ) is a validated and widely used instrument to measure patient safety climate. The objective of this study was to evaluate the SAQ for the first time in the context of acute stroke care.Methods: A survey was carried out during the STREAM trial (NCT 032282) at seven university hospitals in Germany from October 2017 to October 2018. The anonymous survey included 33 questions (5-point Likert scale, 1 = disagree to 5 = agree) and addressed the entire multiprofessional stroke team. Statistical analyses were used to examine psychometric properties as well as descriptive findings.Results: 164 questionnaires were completed yielding a response rate of 66.4%. 67.7% of respondents were physicians and 25.0% were nurses. Confirmatory Factor Analysis revealed that the original 6-factor structure fits the data adequately. The SAQ for acute stroke care showed strong internal consistency (α = 0.88). Exploratory analysis revealed differences in scores on the SAQ dimensions when comparing physicians to nurses and when comparing physicians according to their duration of professional experience.Conclusion: The SAQ is a helpful and well-applicable tool to measure patient safety in acute stroke care. In comparison to other high-risk fields in medicine, patient safety climate in acute stroke care seems to be on a similar level with the potential for further improvements.Trial registration:www.ClinicalTrials.gov Identifier: NCT032282.

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Simulation-based training improves patient safety climate in acute stroke care (STREAM)

Neurological Research and Practice ◽

10.1186/s42466-021-00132-1 ◽

2021 ◽

Vol 3 (1) ◽

Author(s):

Ferdinand O. Bohmann ◽

Joachim Guenther ◽

Katharina Gruber ◽

Tanja Manser ◽

Helmuth Steinmetz ◽

...

Keyword(s):

Patient Safety ◽

Acute Stroke ◽

Safety Climate ◽

Simulation Training ◽

Stroke Care ◽

Acute Stroke Care ◽

Safety Attitudes ◽

Patient Safety Climate ◽

Simulation Based ◽

Improvement Programs

Abstract Background Treatment of acute stroke performed by a multiprofessional, interdisciplinary team is highly time dependent. Interface problems are preprogrammed and pitfalls relevant to patient safety are omnipresent. The Safety Attitudes Questionnaire (SAQ) is a validated and widely used instrument to measure patient safety. The objective of this study was to evaluate the influence of Simulation-based Training of the Rapid Evaluation and Management of Acute Stroke (STREAM) on patient safety measured by SAQ in the context of acute stroke care. Methods During the STREAM trial at seven university hospitals in Germany from October 2017 to October 2018, an anonymous survey was conducted before and after the STREAM intervention centering around interdisciplinary simulation training. The questionnaire, based on the SAQ, included 33 items (5-point Likert scale, 1 = disagree to 5 = agree) and was addressed at the whole multiprofessional stroke team. Statistical analyses were used to examine psychometric properties as well as descriptive findings. Results In total 167 questionnaires were completed representing an overall response rate of 55.2%, including especially physicians (65.2%) and nurses (26.3%). Safety climate was significantly improved (pre-interventional: 3.34 ± .63 vs. post-interventional: 3.56 ± .69, p = .028). The same applies for teamwork climate among stroke teams (pre-interventional: 3.76 ± .59 vs. post-interventional: 3.84 ± .57, p = .001). The perceived benefit was most relevant among nurses. Conclusions The STREAM intervention centering around interdisciplinary simulation training increases perceived patient safety climate assessed by the SAQ in acute stroke therapy. These results have the potential to be a basis for future quality improvement programs.

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Factors associated with the patient safety climate at a teaching hospital

Revista Latino-Americana de Enfermagem ◽

10.1590/0104-1169.0059.2627 ◽

2015 ◽

Vol 23 (5) ◽

pp. 880-887 ◽

Cited By ~ 10

Author(s):

Raíssa Bianca Luiz ◽

Ana Lúcia de Assis Simões ◽

Elizabeth Barichello ◽

Maria Helena Barbosa

Keyword(s):

Patient Safety ◽

Teaching Hospital ◽

Service Management ◽

Safety Climate ◽

Direct Care ◽

Bivariate Analysis ◽

Graduate Degree ◽

Safety Attitudes ◽

Factors Associated ◽

Patient Safety Climate

Objectives: to investigate the association between the scores of the patient safety climate and socio-demographic and professional variables.Methods: an observational, sectional and quantitative study, conducted at a large public teaching hospital. The Safety Attitudes Questionnaire was used, translated and validated for Brazil. Data analysis used the software Statistical Package for Social Sciences. In the bivariate analysis, we used Student's t-test, analysis of variance and Spearman's correlation of (α=0.05). To identify predictors for the safety climate scores, multiple linear regression was used, having the safety climate domain as the main outcome (α=0.01).Results: most participants were women, nursing staff, who worked in direct care to adult patients in critical areas, without a graduate degree and without any other employment. The average and median total score of the instrument corresponded to 61.8 (SD=13.7) and 63.3, respectively. The variable professional performance was found as a factor associated with the safety environment for the domain perception of service management and hospital management (p=0.01).Conclusion: the identification of factors associated with the safety environment permits the construction of strategies for safe practices in the hospitals.

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Causal Relationship Analysis of the Patient Safety Culture Based on Safety Attitudes Questionnaire in Taiwan

Journal of Healthcare Engineering ◽

10.1155/2018/4268781 ◽

2018 ◽

Vol 2018 ◽

pp. 1-8 ◽

Cited By ~ 4

Author(s):

Yii-Ching Lee ◽

Pei-Shan Zeng ◽

Chih-Hsuan Huang ◽

Hsin-Hung Wu

Keyword(s):

Job Satisfaction ◽

Patient Safety ◽

Safety Culture ◽

Safety Climate ◽

Patient Safety Culture ◽

Laboratory Method ◽

Critical Dimensions ◽

Safety Attitudes ◽

Safety Attitudes Questionnaire ◽

Relationship Analysis

This study uses the decision-making trial and evaluation laboratory method to identify critical dimensions of the safety attitudes questionnaire in Taiwan in order to improve the patient safety culture from experts’ viewpoints. Teamwork climate, stress recognition, and perceptions of management are three causal dimensions, while safety climate, job satisfaction, and working conditions are receiving dimensions. In practice, improvements on effect-based dimensions might receive little effects when a great amount of efforts have been invested. In contrast, improving a causal dimension not only improves itself but also results in better performance of other dimension(s) directly affected by this particular dimension. Teamwork climate and perceptions of management are found to be the most critical dimensions because they are both causal dimensions and have significant influences on four dimensions apiece. It is worth to note that job satisfaction is the only dimension affected by the other dimensions. In order to effectively enhance the patient safety culture for healthcare organizations, teamwork climate, and perceptions of management should be closely monitored.

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Patient safety climate in the hospital cardiology service: instrument for safety management

Revista Brasileira de Enfermagem ◽

10.1590/0034-7167-2019-0549 ◽

2020 ◽

Vol 73 (suppl 5) ◽

Author(s):

Aline Mirema Ferreira Vitorio ◽

Daisy Maria Rizatto Tronchin

Keyword(s):

Public Hospital ◽

Safety Climate ◽

Safety Management ◽

Descriptive Study ◽

Significance Level ◽

Safety Attitudes ◽

Safety Attitudes Questionnaire ◽

Patient Safety Climate ◽

Professional Category ◽

The City

ABSTRACT Objective: To assess the safety climate from the perspective of health professionals in the inpatient and intensive care units of a public hospital specialized in cardiology, in the city of Rio de Janeiro. Methods: Quantitative, exploratory, descriptive study, using the Safety Attitudes Questionnaire. The findings were analyzed according to descriptive and inferential statistics, with a significance level of 5%. Results: The general safety climate had a mean of 66.6; the best score corresponded to the Job satisfaction (80.8) domain and the lowest to Hospital management perception (52.5). The means of the scores were statistically significant regarding the employment relationship, gender and professional category. Conclusion: There are weaknesses in the safety climate related to management and having a state job bond, belonging to the male gender and to the nursing team.

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Cultural adaptation of the Safety Attitudes Questionnaire – Short Form (SAQ-SF) in Poland

PLoS ONE ◽

10.1371/journal.pone.0246340 ◽

2021 ◽

Vol 16 (2) ◽

pp. e0246340

Author(s):

Iwona Malinowska-Lipień ◽

Piotr Brzyski ◽

Teresa Gabryś ◽

Agnieszka Gniadek ◽

Maria Kózka ◽

...

Keyword(s):

Patient Safety ◽

Safety Climate ◽

Short Form ◽

Healthcare Delivery ◽

Patient Safety Culture ◽

Healthcare Services ◽

Good Reliability ◽

Safety Attitudes ◽

Safety Attitudes Questionnaire ◽

Polish Version

Background It is essential to provide safe healthcare in complex, difficult, and quickly changing conditions. The quality of healthcare services directly influences the safety of both the patients and staff. Understanding healthcare staff attitudes toward safety in the healthcare delivery context is foundational for building a culture of safety. Aim of the work To adapt, via a structured translation methodology, the Safety Attitudes Questionnaire–Short Form (SAQ-SF), which assesses how employees of the health care sector perceive the safety climate in their workplace, to the Polish context. Methods Using a content validation approach to structure the translation process, we tested and psychometrically analysed the translated SAQ-SF. The sample comprised 322 employees of a district hospital (second referral level, which ensures 24/7 emergency care services) in Poland. Results The reliability of the sub-scales of the Polish version of the SAQ-SF ranged from 0.66 to 0.95. The discriminatory power of particular SAQ items ranged between 0.02 and 0.90. For 6 out of the 8 scale dimensions, the questions with the highest factor loadings were those measuring the same dimensions of the safety climate, according to the original scale. Conclusions The Polish version of the SAQ-SF (SAQ-SF-PL) meets the criteria of psychometric and functional validation as well as demonstrates good reliability as a measure of patient safety culture in the Polish context. The SAQ-SF-PL is an instrument that enable a valid and reliable assessment of patient safety climate in the Polish healthcare facilities and identify opportunities for improvement. International comparisons will also become easier.

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