Safety culture in Slovakian long-term care facilities: a cross-sectional study

To examine the association between components of safety climate and psychosocial hazards with safe work behaviours and test the moderating effects of psychosocial hazards on the safety climate-safety performance relationships. The effects of a strong safety climate on safety performance are well cited, however, the conditions that have an impact on this relationship warrant attention. While the psychosocial hazards commonly reported by nurses are predictors of well-being and job attitudes, evidence suggests that these may also place boundaries on the effects of safety climate on safe work practices. This study used a cross-sectional design to collect data from 146 nurses. Participants were recruited through convenience sampling and snowball sampling methods in 2017. Nurses completed an online questionnaire and received a $5 e-gift card as compensation. SPSS v.23 and PROCESS v3.0 were used to analyse the data. A strong safety climate was positively associated with nurses' safety performance. While psychosocial hazards did not predict safety performance, they did moderate the safety climate-performance relationship. High levels of perceived stressors weakened the association between promoting two-way safety communication, the use and implementation of procedures to promote safe work practices and management's endorsement of health and safety with safe work performance. The positive effects of safety climate on nurses' safety performance are contingent on the levels of psychosocial hazards nurses experience. When aiming to improve safety performance among nurses, it is important for efforts to also focus on the psychosocial conditions of the work environment.

The safety climate in an organization depends on people's understanding of the safety policies and procedures, as well as the value, importance, and priority of safety in the workplace. This study aimed to describe and predict accidents using the path analysis model (PAM) in industrial units though the analysis of the effect of safety performance and climate. This cross-sectional study was conducted on 294 workers in industrial units in Hamadan, a province in the western part of Iran. The data on safety performance and climate was collected using a questionnaire. The first part of the questionnaire was a short version inventory (with 25 items on safety climate) that was used to assess five variables of management commitment, supportive environment, training, personal safety prioritization, and perceived work pressure. Moreover, the safety performance was measured using 10 items on safety rules and participation. The PAM was used to describe the effects of safety climate and performance on accidents. The results showed that the safety climate had the strongest negative impact on work pressure and safety compliance toward accident, followed by safety participation, and quality of training. Moreover, the negative influence of safety climate on accident was mainly mediated by two variables: work pressure and safety participation toward accident. The work pressure had the strongest indirect and total influence on accidents. However, none of the variables had a direct effect on accidents. Training was the most important direct cause of promoting personal safety priority. The safety compliance was more effective than safety participation in reducing accidents rates. Therefore, it seems that perceived work pressure has an indirect effect on accidents which is mediated by other variables, mainly personal safety priority and safety performance.

This study was designed to examine the perceptions of ward quality and safety held by family members and nurses, and investigate its impact on family members' empowerment, and satisfaction with patient hospitalization. A cross-sectional study on two study groups was conducted at a large public hospital in Israel. The first group comprised 86 family members of patients hospitalized for more than 72 hours in acute critical condition in intensive care units (ICU) or general wards (GW). The second group included 101 registered nurses who treated the patients in the ICU or GW. Data were collected by a validated self-administered structured questionnaire. All participants voluntarily signed an informed consent and answered questions related to their demographic characteristics, perceptions, and attitudes toward quality and safety climate, empowerment, and satisfaction with the patients' hospitalization. Pearson correlations coefficient, t-test for independent samples, and a multiple regression model were performed to analyze the data. The mean age of family members was 51.4 ± 14.1 years and of nurses was 40.9 ± 9.9 years. A significant positive association was found between ward quality and safety climate and empowerment of the family member (r = .716; p < .001); empowerment of the family member and family members' satisfaction with the patients' hospitalization (r = .695; p < .001); and ward safety and quality climate and family members' satisfaction with the patients' hospitalization (r = .763; p <.001). Family members ranked ward quality and safety climate (M = 4.20 ± 0.60 vs. M = 3.61 ± 0.40), and their satisfaction with the patients' hospitalization (M = 4.49 ± 0.69 vs. M = 4.07± 0.54), which were significantly (p < .001) higher than the nurses' estimate. The significant predictors for family members' satisfaction with patients' hospitalization were commitment to quality leadership (b = .210; p = .027); implementing a quality improvement (b = .547; p < .001); and hand-off communication (b = .299; p = .001). Positive relationships between quality and safety climate, empowerment, and satisfaction with patients' hospitalization suggest that by improving the ward quality and safety climate, and family empowerment, we may also improve family satisfaction. Although family members reported being satisfied with hospitalization in the ICU and GW, quality leadership and implementing a quality improvement among the nurses and hand-off communication between nurses and patients' families, will be targeted to improve family satisfaction with the patients' hospitalization. Nurses who provide care for patients in a critical condition should maintain high levels of safety and quality care in order to improve the patients' family empowerment and satisfaction. Specifically, their efforts should target a commitment to quality leadership, implementing quality improvement, and hand-off communication.

Healthcare systems are becoming increasingly complex which is helping to promote a ‘culture of safety’ within them based on the best scientific evidence available. Indeed, creating a positive institutional culture of patient safety is reflected in health outcomes. The aim of this present study was to describe the perception of culture of safety by nurses in adult inpatient units in a tertiary hospital and to analyze adverse events reporting. It was a cross-sectional study in which 202 nurses from adult hospitalization units of the Hospital Universitario y Politécnico La Fe in Valencia (Spain) participated. The perception of safety culture was measured using the Hospital Survey on Patient Safety questionnaire version 1.0, which consists of 42 items distributed in 12 dimensions that are considered strengths or weaknesses. In addition, adverse events related to nursing care during the study period and those reported in the official hospital registry were collected. Finally, the association between safety culture and sociodemographic and labor variables was explored. A total of 148 responses to the questionnaire were analyzed (Cronbach’s alpha = 0.94), where seven dimensions and 25 items were identified as weaknesses. Two hundred and fourteen events were identified and none were reported in the official registry. Years of experience were significantly (p < 0.05) associated with safety culture. It is necessary to establish strategies to improve the perception of the safety culture of nurses, as well as to make nurses aware of the importance of notifying adverse events derived from health care.

Objective Patient safety is a fundamental factor in improving the quality of care provided in hospitals. Therefore, it is considered a significant parameter by all healthcare organizations around the world. The present study was conducted to investigate the attitude of nurses toward the patient safety climate during the Coronavirus Disease 2019 (COVID-19) pandemic in the southeast of Iran. Methods This is a cross-sectional descriptive study. Among all the nurses working in one of the hospitals in the southeast of Iran, 171 nurses participated in the study through convenience sampling methods. The survey was conducted between June 1 and July 30, 2020. A 2-part questionnaire including demographic information and an assessment of nurses’ attitudes toward patients’ safety climate was used for data collection in 2021. The content validity of the scale is (0.77) and reliability was re-calculated and confirmed by the present study with Cronbach’s alpha (α = 0.9). Data were analyzed by SPSS 20 (IBM Corporation, Armonk, New York, United States) using descriptive and analytical statistical tests. Results The mean score of safety climates was 3.2 ± 5.20 (out of 5 scores). The results showed that among all dimensions of the safety climate, only the education dimension was statistically significant between males and females (P &lt; 0.001). Also, there was a significant relationship between the overall average of the safety climate and its dimensions according to the people’s position only in the dimension of supervisors’ attitude (P &lt; 0.01) and burnout (P &lt; 0.01). Additionally, a significant correlation between the education level and the overall score of safety climate (P &lt; 0.01), as well as the supervisor’s attitude dimension (P &lt; 0.01), was observed. Conclusions The results showed that the safety climate was at a relatively favorable level. Considering the impact of nurses’ attitudes on the safety climate of patients, its improvement seems necessary. It is recommended to design training courses and educate nurses in order to promote a patients safety climate in hospitals.

Background: Despite a significant amount of attention towards the safety and quality of acute care, little focus has been paid to the residential aged care sector, especially in the Asian region. This research aimed to assess the safety and quality culture within two nursing homes in Singapore. Methods: A cross-sectional study used a validated 42-item Nursing Home Survey on Patient Safety Culture (NHSPSC) tool. Minor linguistic adjustments were made to the tool, and its internal reliability was assessed using Cronbach’s alpha. Results: The Cronbach’s alpha values for the 12 PSC Composites ranged from 0.519 to 0.781, nine PSC Composites were >0.6 (adequate), indicating NHSPSC had acceptable internal reliability in the Singapore context. Of the 12 PSC Composites calculated for the two Singapore nursing homes, six were >90th percentile, four were >75th percentile and two >50th percentile. Conclusion: The NHSPSC tool provided an assessment of residential aged care safety and quality culture of the two nursing homes in Singapore. In general, the staff at the nursing homes in Singapore perceived a higher percentile residential safety culture compared to the US Comparative Database. The findings of this study demonstrated the importance of communication openness in residential safety culture.

The aim was to investigate the interrelationships of nurses' safety climate, quality of care, and adherence to and compliance with standard precautions (SPs). Investigations about nurses' safety climate and quality care and their association with adherence to and compliance with SPs remain remarkably scant across literature, specifically among developing countries like the Philippines. Cross-sectional design and structural equation modeling (SEM) approach while complying with STROBE guidelines. Participant nurses were recruited using convenience sampling (n=870). Four validated self-report instruments were used to collect data from February to August 2022. Spearman rho, SEM, mediation, and path analyses were employed for data analysis. The emerging model showed acceptable model fit parameters. The safety climate positively influenced the quality of care and adherence to and compliance with SPs. Quality of care directly affected adherence to SPs, while adherence to SPs directly affected compliance with SPs. The quality of care mediated the relationship between safety climate and adherence to SPs. Whereas adherence to SPs mediated the relationships between safety climate and compliance with SPs and the quality of care and compliance with SPs. Nurses' safety climate directly affected the quality of care and SPs adherence and compliance. The quality of care mediated the impact of safety climate on SPs adherence. Finally, SPs adherence demonstrated a mediating effect among quality of care, safety climate, and SPs compliance. Nursing policymakers and administrators can use the findings to design strategic policies and sustainable in-service educational courses fostering and maintaining nurses' safety climate, quality of care, and SPs adherence and compliance.

PurposeThis study aims to compare nurses’ authentic leadership and perceptions of the safety climate and concepts association according to different areas of work and types of hospitals.Design/methodology/approachA cross-sectional design was used to conduct this comparative study on 314 Jordanian nurses. The Authentic Leadership Questionnaire (ALQ) and the Safety Climate Survey (SCS) were used.FindingsNurses in private hospitals were more educated. True leadership was mild. Unit nurses had higher ALQ and subscale mean scores. Armed forces hospitals had the highest ALQ subscales, while governmental hospitals had the lowest. The ALQ mean scores favored military hospitals. Governmental hospitals have a negative safety climate. Unit nurses had a higher SCS mean than ward nurses. Military, governmental and private hospitals are rated the safest. Nurses benefited from higher SCS scores in military hospitals. Nurses’ ALQ and safety climate perceptions were moderately positive.Research limitations/implicationsA larger, randomized and equal-sized sample is recommended in future studies to conclude different areas of work and hospitals. It is also recommended to report the confidence interval in further studies using different statistical methods, increasing confidence when interpreting statistical significance variables. Other mediating, moderating and predicting variables could be studied and compared across different areas of work and types of hospitals. Sample characteristics should be handled as confounding variables in the next planned study using various ways to control confounding variables such as randomization, restriction, matching, regression and statistical control. The authors plan to statistically control for the confounding variables by entering them into the regression model. Future studies could investigate safety culture; both safety culture and safety climate are formative and inclusive terms (Experts Insight, 2017).Practical implicationsThis paper fills in the gap in the literature and practice. Authentic leadership is associated with safety climate perceptions and varies across different areas of work and hospitals. Interventions are required to improve safety climate perceptions and promote authentic leadership in all settings and hospitals. Military hospitals ranked the highest in nurses’ perceptions of authentic leadership and safety climate.Social implicationsThe current study’s favorable association between authentic leadership and safety climate measurement would apply to many high-risk institutions, including public and private hospitals. It becomes necessary to include the impacts of authentic leadership on the safe climate within the nursing curriculum and continuing education courses. This may be put into action by executing a hands-on activity, followed by information and reflection conversations that highlight the link between authentic leadership and safety climate measurement. According to the findings of this study, authentic leadership appears to be a basic block in making a difference in nurses’ views of safety climate.Originality/valueAuthentic leadership style is a relatively new concept in the health-care sector, and its link to safety climate security still needs empirical evidence. It is still unclear how leadership resulted in more effective outcomes (Maziero et al., 2020). Few studies investigated both the concepts of authentic leadership and the nursing safety climate (Dirik and Intepeler, 2017; Lee et al., 2019a; Woo and Han, 2018). Aside from the scarcity of studies, no study has compared “working area,” “department” or “hospital type” concepts. Few comparative studies have been conducted using concepts of interest. For example, authentic leadership was linked to empowerment and burnout (Laschinger et al., 2013) and nurses’ satisfaction with safety climates (Vatani et al., 2021). No research has examined authentic leadership in Jordan’s nursing and health-care context. Few studies focused on the safety climate other than authentic leadership (Abualrub et al., 2012) or the safety culture in Jordan rather than the safety climate (Khater et al., 2015).

Safety culture, perceived organizational support, and quality of healthcare: the views of nurses and patients in Saudi Arabia

In Belgium, the federal government launched a national program to support hospitals for implementing quality and patient safety strategies. One of the main objectives in the federal program is the development of a safety culture. The purpose of this study was to examine to what extent the hospitals’ safety culture evolved after participating in the federal program and to explore predictor variables of safety culture. In a cross-sectional follow-up design, safety culture was measured in the Belgian acute, psychiatric and long-term care hospitals using validated translations of the Hospital Survey on Patient Safety Culture in Flemish and French. For both nationwide measurements, hospitals were invited to participate in a benchmark research organized by an academic institution (in 2008 and 2012). Generalized Estimating Equations models were fitted to examine the effect of predictor variables on safety culture perceptions. The Belgian safety culture database contains data from 115 827 respondents from 176 hospitals. For 111 hospitals that participated in both benchmarks it was possible to calculate changes in safety culture. The response rate for the second measurement (52.2%) was comparable to the response rate in the first measurement (51.0%). Improvements were observed for most safety culture dimensions with a major significant improvement for ‘Management support for patient safety’. Although ‘Handoffs and transitions’ and ‘Frequency of events reported’ were key areas within the federal program, a decline was observed for these dimensions. Work area, staff position, language (regional context of hospital), hospital type and hospital statute were found to have important effects on safety culture perceptions. Hospital size and work experience, showed to have less effect on safety culture scores. Large comparative safety culture databases allow identifying patterns and trends. Our findings on variations in safety culture perceptions between types of hospitals, hospital units and professional groups implicate the need for a tailor-made approach for safety culture improvement. Future research should focus on enriching the evidence of the effectiveness of safety culture strategies and linking of safety culture and outcomes of care in order to assess the practical validity of safety culture surveys.

Investigations about the interrelationships of nurses' safety climate, quality of care, and standard precautions (SP) adherence and compliance remain particularly scarce in the literature. Thus, we tested a model of the associations between nurses' safety climate, quality of care, and the factors influencing adherence and compliance with SPs utilizing the structural equation modeling (SEM) approach. Cross-sectional design complying with STROBE guidelines. Using convenience sampling, nurses (n = 730) from the Philippines were recruited. Data were collected between April and September 2022 using four validated self-report measures. Spearman Rho, mediation and path analyses, and SEM were employed for data analysis. Acceptable model fit indices were shown by the emerging model. The safety climate is positively associated with quality of care and factors influencing adherence to and compliance with SPs. Quality of care directly affected factors influencing adherence to SPs. The factors influencing adherence to SPs directly affected SP compliance. Quality of care mediated between safety climate and the factors influencing adherence to SPs. Factors influencing adherence to SPs mediated between safety climate, quality of care, and SP compliance. The study's variables are not distinct but overlapping nursing concepts that must be examined collectively. Nurse administrators can utilize the emerging model to formulate strategies and regulations for evaluating and enhancing nurses' safety climate, quality of care, and SP adherence and compliance. Our findings may impact policymaking, organizational, and individual levels to improve nurses' clinical practice. This study had no patient contribution or public funding.

This study intends to investigate the relationships among leadership behavior, patient safety culture, and safety performance. This study is a cross-sectional study. The questionnaire survey was conducted with the nursing staff. Of the 705 questionnaires 363 were completed and returned, with a response rate of 51.8%. The confirmatory factor analyses (CFA) have been used to test the validity of the constructs, while the structural equation modeling (SEM) has been used in hypotheses testing. The data analysis shows that the model has satisfactory fit, validity and reliability. Additionally, results indicate that the character of health industry leadership significantly affected safety culture and safety culture significantly impacted safety performance. Consideration leadership had significantly positive effects on safety culture, The finding also shows that consideration leadership comparing to the initiating structure leadership have greater positive effects on organizational safety culture; furthermore, through the effect of organizational safety culture, the safety performance was improved. The study suggests that safety culture have directly effect on organizational safety management and individual safety behavior. The individual safety behavior is not only influenced by safety culture, but improved by the safety management as well. Thus, we believe that excellent patient safety culture would be established through the effect of the leadership. Through the establishment of excellent patient safety culture, the organizational safety management system and individual safety behavior performance would be improved.

Preventing occupational injuries remains a significant challenge in Korea. A positive safety climate can contribute to reducing workplace injuries. However, the impact of safety climate on preventing occupational injuries among the Korean workforce has not been adequately explored. Therefore, this study aimed to investigate the relationship between the perceived safety climate and occupational injuries within the Korean working population. This study used baseline data from the Korean Work, Sleep, and Health Study (KWSH). The safety climate was measured using the brief version of the Nordic Safety Climate Questionnaire. Occupational injury was determined by whether injuries or accidents had occurred at workplaces in the past year. Logistic regression analysis was performed to examine the association between the safety climate and occupational injury. Participants who reported an unfavorable workplace safety climate were more likely to experience occupational injuries. Multiple logistic regression analysis revealed that the adjusted odds ratio (OR) for occupational injuries in an unfavorable safety climate was 2.20 (95% confidence interval [CI], 1.38 to 3.51) compared to a favorable safety climate. Specifically, factors such as "not encouraging employees to follow safety rules when on a tight schedule" (OR, 2.02; 95% CI, 1.25 to 3.24) and "not helping each other work safely" (OR, 1.98; 95% CI, 1.17 to 3.25) were significantly associated with occupational injuries. An unfavorable safety climate was associated with increased occupational injuries among Korean workers. Improving the safety climate in the workplace may reduce occupational injuries in Korea.

Background: Radiation safety and radioactive source security constitute an essential part of radiation protection in medicine, and launching them involves cultural interactions.Aim: To explore the current situation of radiation protection in hospitals in order to improve radiation safety and security culture and measures in Ismailia city hospitals.Subjects and Methods: A cross sectional study was conducted at 13 units in four hospitals in Ismailia city. Health care workers (292) with potential exposure to radiation (physicians, technicians, nurses and physicists) were included. Safety culture questionnaire, inspection checklist and thermo scientific model survey meter to assess the radiation levels in different units were used.Results: The results of this study showed moderate radiation safety culture (The mean scores culture was 95.3±12.8). The linear regression analysis showed that working days/week significantly predicts the safety culture of participants. Radiation safety and security measures represented in different departments were insufficient. There was variability among hospitals and departments as regard the level and the efficiency of protection, concerning shields and protection of doors and windows.Conclusion: Different departments/ units in the investigated hospitals showed an overall inadequacy of radiation safety and security measures and most of them showed inefficiency of protection as well as the design of rooms.

BackgroundThe threefold aim of this study was to (1) describe attitudes to patient safety among healthcare providers in home health nursing (HHN), (2) investigate differences in attitudes due to age, education level, years of healthcare work experience, and years at current workplace, and (3) compare attitudes of these HHN healthcare providers with available benchmark data from other healthcare settings.MethodsOne hundred sixty HHN healthcare providers in Mid-Norway answered a survey covering the teamwork climate and safety climate in the Safety Attitudes Questionnaire (SAQ). Data were analyzed by descriptive statistics, t test, and ANOVA.ResultsThe overall mean score was 79.1 for teamwork climate and 72.3 for safety climate. The proportion of positive responses (i.e., scale scores ≥ 75) was 73% on teamwork climate and 53% on safety climate. For teamwork and safety climates, employees with the longest employment at the current workplace had significantly higher mean scores than those with shorter employment. No significant differences were found in mean scores for age, education level, and length of experience in healthcare. Compared to benchmark data from other studies, the mean HHN scores for both safety and teamwork climates were higher than in the vast majority of other healthcare settings and significant differences were found for both dimensions.ConclusionHHN has higher scores for both safety climate and teamwork climate compared to the vast majority of other healthcare settings, but there is room for improvement in the patient safety culture within the Norwegian HHN. Further research on patient safety culture in HHN is needed.