Abstract
BackgroundUnderstanding the factors that make it more or less likely that healthcare practitioners (HCPs) will perform certain patient safety behaviors is important in developing effective intervention strategies. A questionnaire to identify determinants of HCP patient safety behaviors does not currently exist. This study reports the development and initial validation of the Influences on Patient Safety Behaviors Questionnaire (IPSBQ) based on the Theoretical Domains Framework.MethodsTwo hundred and thirty-three HCPs from three acute National Health Service Hospital Trusts in the United Kingdom completed the 34-item measure focusing on one specific patient safety behavior (using pH as the first line method for checking the position of a nasogastric tube). Confirmatory factor analysis (CFA) was undertaken to generate the model of best fit.ResultsThe final questionnaire consisted of 11 factors and 23 items, and CFA produced a reasonable fit: χ2 (175) = 345.7, p < 0.001; CMIN/DF = 1.98; GFI = 0.90 and RMSEA = 0.06, as well as adequate levels of discriminant validity, and internal consistency (r = 0.21 to 0.64).ConclusionsA reliable and valid theoretically underpinned measure of determinants of HCP patient safety behavior has been developed. The criterion validity of the measure is still unknown and further work is necessary to confirm the reliability and validity of this measure for other patient safety behaviors.
Highlights
Understanding the factors that make it more or less likely that healthcare practitioners (HCPs) will perform certain patient safety behaviors is important in developing effective intervention strategies
Context Between April 2011 and September 2012, the Yorkshire and the Humber Health Innovation and Education Cluster (HIEC: http://yhhiec.org.uk/themes/patient-safety) Patient Safety Theme worked with three hospitals to support the implementation of a National Patient Safety Agency (NPSA) Alert aimed at ‘reducing the harm caused by misplaced nasogastric (NG) feeding tubes’ [18]
Development of the Influences on Patient Safety Behaviors Questionnaire (IPSBQ) The 34-item IPSBQ was based on the theoretical domains framework (TDF) [9], which specifies 12 domains of behavior change: knowledge, skills, social/professional role and identify, beliefs about capabilities, beliefs about consequences, motivation and goals, memory attention and decision processes, environmental context and resources, social influences, emotion, behavioral regulation, and nature of the behavior.a the current study focuses on establishing the reliability and validity of the IPSBQ in relation to NG tubes behavior, the items were developed in the context of this alert and three additional areas of patient safety to ensure the questionnaire would be applicable for a range of target behaviors
Summary
Understanding the factors that make it more or less likely that healthcare practitioners (HCPs) will perform certain patient safety behaviors is important in developing effective intervention strategies. Understanding the factors that influence those behaviors associated with patient safety is an important first step in the development of strategies to improve care [5]. A questionnaire approach has the potential to be used in practice by HCPs, improvement teams, or others who have been tasked with facilitating behavior change in their organization. For these groups, the knowledge, skills, and time required to use qualitative interviews might be prohibitive
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