The Relationship between Hospital-Based Healthcare Personnel Perceptions of Safety Culture and the Occurrence of Sharps Injuries

Abstract

BACKGROUND/OBJECTIVES: Hospital-based healthcare personnel (HCP) sustain an estimated 385,000 sharps injuries (SI) each year in the United States. Sharps injury prevention efforts have been primarily focused on providing safer needle devices and reducing unsafe work practices. However, HCP perceptions of institutional safety culture have been associated with adherence to universal precautions and the risk of sustaining blood and body fluid exposures (BBFE). We examined perceptions of safety culture among HCP at a large multi-facility medical center to assess the relationship between HCP attitudes and the risk of SI. METHODS: A 33-item survey was mailed to the home addresses of 13,700 employees of Detroit Medical Center from June-July 2005. Data obtained included occupational demographics, perceptions of safety culture, knowledge of SI/BBFE reporting procedures, SI incident history, reasons for not reporting SI/BBFE, and post-BBFE care experiences. A 13-item safety culture construct measured perceptions of safety culture using a 5-point Likert scale; a total safety culture score was created for each respondent by adding the scores for each question. Associations between perceptions of safety culture and SI occurrence were assessed using bivariate associations and simple logistic regression. RESULTS: Of the 13,700 surveys mailed, 3,043 (22%) were returned. One-third of all respondents were employed in patient care services (nursing). Most (87%) respondents were familiar with hospital protocols for reporting SI/BBFE; 109 (3.6%) recalled sustaining an SI in the past 12 months. The average safety culture score was 49.4 (range 4-65; highest possible score=65); 568 (19%) gave positive responses (agreed or strongly agreed) to all questions. After adjusting for occupation, work shift, and knowledge of hospital reporting procedures, respondents with positive perceptions of safety culture (higher total safety culture score) were less likely (OR = 0.97, 95% CI=0.95, 0.99) to have sustained an SI in the previous 12 months. CONCLUSIONS: These results suggest that HCP perceptions of safety culture may influence the risk of sustaining an SI. Perceptions of safety culture should be measured when designing an SI prevention program in hospitals.