Overall Perceptions Of Safety Research Articles

Patient Safety Climate, Burnout, and Safety Outcome Measures among Nurses in Selected Private Hospitals in Davao City, Philippines

Background: Patient harm continues to be an essential concern in healthcare settings. Despite research, education, and collaborative efforts in patient safety, this issue remains a substantial problem and has yet to demonstrate a significant decrease in recent years. Purpose: Seeing as there is a dearth of available studies on this topic locally, the study intended to determine the relationship between patient safety climate (PSC), burnout, and safety outcome measures (SOM) among nurses employed at private tertiary level in Davao City, Philippines. Methods: The objective of this descriptive-correlational study was to establish a correlation between SOM, exhaustion, and PSC among nurses employed in private tertiary hospitals in Davao City. The snowball sampling method was utilized to select 197 respondents who met the following requirements: of legal age and currently employed as staff nurses in the study sites. The data were gathered using the Patient Safety Climate in Healthcare Organizations tool, Copenhagen Burnout Inventory, and Hospital Survey on Patient Safety Culture. Mean, standard deviation, Pearson r, and regression analysis were used in the statistical analysis. Results and Conclusions: The results showed that PSC (M=3.75, SD=0.89), burnout levels (M=3.44, SD=0.30), and SOM (M=3.81, SD=1.19) were high. PSC and SOM were significantly correlated (p=<.001; r=.280), whereas burnout and SOM (p=.843; r=.014) were not correlated. Patient safety climate (p=<.001; β=.280) was a predictor of safety outcome measures. Implications for Practice: Healthcare organizations are encouraged to cultivate a working environment where patient safety is recognized and prioritized. This will increase the frequency of event reporting, overall perceptions of safety, and patient safety grades.

Evaluating perceived safety of autonomous vehicle: The influence of privacy and cybersecurity to cognitive and emotional safety

The autonomous vehicle (AV) is predicted to reduce the number of accidents and fatalities on the roads caused by human-related error and lessen traffic congestion caused by stop-and-go behavior. The susceptibility of autonomous vehicles (AVs) to potential hacking and data exploitation has generated significant concerns regarding cybersecurity and privacy risks within the domain of perceived safety. This study aimed to empirically test a comprehensive model of perceived safety in AVs, incorporating cognitive safety, emotional safety, and privacy cybersecurity. The responses of 466 participants were analyzed using a structural equation modeling (SEM) approach. The findings indicated that a significant majority of the respondents expressed their intention to utilize high-level autonomous vehicles (AVs) in the future. Specifically, 31.1% of the participants expressed an intention to use a level 2 AV, while 8.8% indicated their preference for a level 5 AV. In terms of perceived safety, privacy cybersecurity emerged as the most influential predictor, followed by emotional safety and cognitive safety. The analysis of causal relationships between the variables further revealed that privacy cybersecurity had the greatest impact on both emotional safety and cognitive safety, highlighting its critical role in shaping the overall perception of safety in AVs. Finally, this study can provide insight into how the drivers perceives AVs safety, which can be useful for government organizations, transportation agencies, and AV developers in shaping AV safety.

The Impact of a Patient Participating in Evaluating Patient Safety by Using the Patient Measure of Safety in Saudi Arabia: A Cross-Sectional Study.

Patient safety is an essential element for delivering quality of healthcare. Many studies focus on measuring patient safety from the healthcare provider's perspective to improve patient safety in healthcare facilities. However, patient participation may reduce medical errors and improve patient safety by providing information regarding the safety of their care. This study aimed to evaluate patient safety from the inpatients' perspective and the extent of the influence of the sociodemographic factors on their assessment. A cross-sectional study was conducted at hospitals in different Saudi Arabian regions with 1569 inpatient adults 18 years of older who voluntarily completed an online questionnaire using the Patient Measure of Safety tool (Arabic translated). Two questions were added to assess patient feedback about the overall perception of safety and witnessing patient safety events. COVID-19 patients and those with a mental disorder or incapable of providing informed consent were excluded. The total number of participants was 1569 inpatients from 17 hospitals. Sixty-one percent of the participants were female, and 41.62% were from the 18- to 35-year age group. Less than half (38.69%) of patients stayed at the hospital between 3 and 5 days. Percentages of positive responses were more than 90% observed in dignity and respect, communication and teamworking, and organization and care planning domains. Percentages of negative responses were more than 20% found in organization and care planning, access to resources, and ward type and layout domains. Among the respondents, 57.3% (n = 899) rated the safety of their wards as excellent as opposed to 2.9% (n = 46) who rated it as poor. Approximately 5% (n = 79) have noticed 1 event, and 2.3% (n = 36) have noticed 2 or 3 events. Unemployed participants had a significantly lower rate of positive responses in domains of communication, access to resources, and ward type. In contrast, the no-schooling group had a significantly greater rate of negative responses in care planning and ward-type domains. The patient plays a key role in enhancing the quality of care and has the potential to detect adverse events. The study highlighted the need to focus on better communication processes for patients with low education levels to enhance their engagement in their care. Further steps should be taken to understand the extent of the patient's involvement in the improvement that could be tackled from feedback on the safety of care.

Patient Safety Culture in Bulgarian Hospitals – A Web-Based Survey

Establishing a high culture of patient safety in hospitals is one of the main ways to prevent or reduce errors and improve the overall quality of healthcare. The aim of the study is to assess the perceptions on patient safety culture among healthcare specialists in Bulgarian hospitals. A national cross-sectional survey was conducted among 620 healthcare specialists. The study was conducted using the web-based Bulgarian Version of the Hospital Survey on Patient Safety Culture Questionnaire (B-HSOPSC). The B-HSOPSC includes 42 questions, grouped in 12 different dimensions measuring patient safety culture. No personal identification was possible of the participations in the survey using the e-platform. The data was analyzed with descriptive statistics and non-parametric tests. The results of the study show in general that the respondents demonstrate a positive attitude regarding patient safety culture. The dimensions “Staffing” and “Non-punitive response to error” are most problematic, as their percentage of positive response rates (PRRs) are lowest - 35.16% and 39.62%, respectively. However, “Handoffs and transitions” and “Overall perceptions of safety“ show the highest PRRs – 66.65% and 65.48%, respectively. From all participants, 74.7% have never reported an adverse event or error. Non-parametric tests did not find significant statistical differences in “Patient safety grade” between physicians and other health care specialists. Based on the evidence, the hospital managements need to focus on improving problem areas.

Patient safety culture in Palestine: university hospital nurses’ perspectives

BackgroundUnderstanding the perspectives of healthcare workers toward patient safety-related activities is critical in maintaining a healthy safety climate. The objectives of this research are 1) to examine the perception of Patient Safety Culture (PSC) at a university hospital in Palestine, and to highlight areas in need of improvement, and 2) to assess the relationship between the outcome dimensions (frequency of events reported, and overall perceptions of safety) and the other dimensions of PSC, and 3) to determine the relationship among selected demographic variables (gender, age, hospital tenure, work tenure, profession tenure, and hours worked per week) and nurses’ perceptions of PSC.MethodsA cross-sectional study design was used with a convenience sample of 107 nurses. Nurses were asked by email to complete the Arabic version of the Hospital Survey of Patients’ Safety Culture (HSOPSC) using the SurveyMonkey® online account form within two weeks. The survey data were analyzed using descriptive and inferential statistics. Univariate and multiple regression were used to examine the relationships.ResultsThe dimensions of patient safety with the highest positive response were organizational learning and continuous improvement (87%) and teamwork within units (86%). The dimension with the lowest positive score was the nonpunitive response to error (22%). Multiple regression revealed that the dimension of communication openness was a predictor of the overall perceptions of safety (β = 0.257, p = 0.019). In addition, the dimension of feedback and communication about error was a predictor of the frequency of the reported events (β = 0.334, p = 0.005). Furthermore, age was found to be a predictor of PSC (p < 0.05).ConclusionsThis study provides a general assessment of perceived safety among nurses in a hospital. However, we found that nurses negatively perceive a nonpunitive response to error. Therefore, strenuous efforts are required by hospital management to improve the culture of incident reporting.

The association between experience of hospital accreditation and nurses\u2019 perception of patient safety culture in South Korean general hospitals: a cross-sectional study

BackgroundHospital accreditation programs can positively affect nurses’ perceptions of patient safety culture. However, no previous research has identified the association between experience of hospital accreditation and nurses’ perception of patient safety culture in general hospitals. This study aims to examine 1) the level of perception of each area of patient safety culture in nurses working in general hospitals and 2) the relationship between experience of hospital accreditation and nurses’ overall perceptions of safety in Korean general hospitals.MethodsA cross-sectional survey design was used, with a convenience sample of 310 nurses from six general hospitals. Nurses were asked to complete the self-reported Korean version of the Hospital Survey on Patient Safety Culture and the experience of hospital accreditation. A hierarchical multiple regression analysis was used to examine the associations between hospital accreditation experience and perception of patient safety culture.ResultsThe patient safety composites with the highest positive response were the frequency of events reported (90.6) and supervisor/manager expectations promoting patient safety (69.4%). The composites with the lowest scores were non-punitive responses to errors (22.9%) and organizational learning/continuous improvement (35.5%). Hierarchical multiple regression analysis showed that the experience of hospital accreditation had a very small increase on overall perceptions of safety (β = 0.097, p = 0.023).ConclusionsThis study found that general hospital nurses’ experience of hospital accreditation had very weak relationship with their overall perceptions of patient safety. Therefore, a longitudinal study is needed to confirm the influence of hospital accreditation on nurses’ patient safety culture in general hospitals.

Manager's influence on the registered nurse and nursing assistant relational quality and patient safety culture.

The purpose of this study is to describe the perceptions of relational quality of the registered nurse and nursing assistant and examine how their view of the manager's influence impacts overall patient safety culture of a unit. The primary delivery of nursing care within acute care systems uses teams of registered nurses and nursing assistants. A cross-sectional secondary analysis of data collected in the spring of 2018 using the Agency for Healthcare and Quality Hospital Survey of Patient Safety Culture and a seven-item questionnaire measuring relational quality was conducted. The sample included 1,152 responses. The manager influenced overall perceptions of safety regardless of the relational quality between the registered nurse and nursing assistant. This study found manager behaviours that promote patient safety and also influence overall perceptions of patient safety culture regardless of the relational quality between the registered nurse and nursing assistant. Positive registered nurse and nursing assistant relational quality amplifies perceptions of patient safety culture, yet it is the manager's behaviours regarding safety that make the stronger contribution in building a culture of safety.

Parent Perception of Child Safety following Admission to a Neonatal Unit.

Parent partnership is a key aspect of neonatal hospital care. However, there is a lack of information regarding parents' perception of neonatal safety. This study explores parents' opinions on safety during their child's hospitalization to identify points for improvement. We used a questionnaire, validated by the Spanish National Healthcare Authorities, on perception of safety with respect to hospital health care. Thirty-seven parents of 20 newborns treated in the neonatal intensive care unit (NICU) and 139 parents of newborns in intermediate care (IC) participated in this study. With regard to overall perception of safety, more than 96% of parents felt "very safe" or "fairly safe." In the NICU, an area for improvement detected was to ask parents more often their opinion about the care or treatment provided to their child. In IC, three points for improvement were identified from the group of parents whose child was admitted directly to IC: the consistency of the information received, the request for consent for procedures, and the request for an opinion on their child's care and treatment. Only four parents reported that their child suffered an incident. Regarding incident management, parents were not completely satisfied with the information they received. To the best of our knowledge, this is the first study of parent perception of patient safety in a neonatal unit using a validated questionnaire. Our findings suggest that parents can provide valuable information on neonatal safety, which can then be used to identify areas for improvement. · There is a lack of information regarding parents' perception of neonatal safety.. · This study explores parent's opinion about safety of their child during the hospitalization.. · Our findings suggest that parents can provide valuable information to identify improvement areas..

Evaluation of Patients' Perception of Safety in an Italian Hospital Using the PMOS-30 Questionnaire.

Background: In our study, an Italian version of the PMOS-30 questionnaire was used to evaluate its feasibility and to improve health care quality in an Italian hospital. Methods: A cross-sectional study was conducted with 435 inpatients at a hospital in the Campania Region of Southern Italy using the PMOS-30 questionnaire and two other questions to assess patient feedback about the overall perception of safety. Results: The item “I was always treated with dignity and respect” showed the greatest percentage of agreement (agree/strongly agree = 89.2%; mean = 4.24). The least agreement was associated with the four “Staff Roles and Responsibilities” items (agree/strongly agree ranged from 31.5 to 40.0%; weighted mean = 2.84). All other 25 items had over 55.0% agreement, with 19 items over 70%. Moreover, 94.5% of the patients considered the safety of the ward sufficient/good/very good, and 92.8% did not notice situations that could cause harm to patients. Conclusion: Patient perception of safety was found to be satisfactory. The results were presented to the hospital decision makers for suggesting appropriate interventions. Our experience showed that the use of the PMOS-30 questionnaire may improve safety and health care quality in hospital settings through patient feedback.

Association between nurses' burnout, hospital patient safety climate and quality of nursing care

Aim: To evaluate the associations between nurse burnout, the hospital patient safety climate, the patient safety grade, and adverse events. Design: Cross-sectional. Methods: 117 nurses completed the Copenhagen Burnout Inventory and the Hospital Survey on patient safety culture. Pearson correlation and linear regression analysis was conducted to assess associations between variables. Results: Higher level of burnout significantly met with lower grade of patient safety, overall perception of patient safety, higher frequency of adverse events recorded, and medication errors. The overall perception of safety was positively related to teamwork within hospital units and non-punitive responses to error. The frequency of recorded events was significantly negatively associated with hospital management support and supervisors&#8217; activities, and positively with feedback. Medication errors correlated positively with organizational learning and continuous safety improvement and negatively with staffing. Significant relationships have been identified between management support, non-punitive responses to error, teamwork within hospital units, and selected adverse events. Conclusion: Enhancement of the patient safety climate and nurses&#8217; mental health are important patient safety improvements in healthcare organisations.

Staying ahead of the curve: Navigating changes and maintaining gains in patient safety culture - a mixed-methods study

ObjectivesThis study examines how the results of the Hospital Survey on Patient Safety Culture changed between 2012 and 2019 and identifies organisational factors affecting these changes.DesignThe study combined the use...

The Impact of a National Accreditation Program on Patient Safety Culture in a Tertiary Hospital: Pre- and Post-Evaluation Study.

The objective of this study was to assess the effectiveness of the Saudi national accreditation program on patient safety culture in a secondary-tertiary public hospital in Saudi Arabia. Three hundred health professionals were randomly selected to participate in a survey. The survey was used in three phases: baseline, before accreditation, and after accreditation. Primary and secondary outcome measures were teamwork within hospital units, feedback and communication about errors, hospital handoffs and transitions, overall perceptions of safety, frequency of event reporting, and perception of patient safety grade. The survey response rate was 100%. A statistically significant impact of accreditation was found for teamwork within hospital units, feedback and communication about errors, and hospital handoffs and transitions (p = 0.002, 0.009, and 0.010, respectively). Ordinal logistic regression confirmed that the accreditation program had a significant effect on overall perceptions of safety (odds ratio [OR] [1.42-13.56], p = 0.010), frequency of event reporting (OR [0.91-7.96], p = 0.073), and staff awareness of grading safety culture (OR [0.02-0.70]) and reporting behavior (OR 0.10 [0.03-0.37]). The Saudi national accreditation program had a significant positive impact on some patient safety culture dimensions and outcomes. These findings provide local empirical evidence on the benefits of implementing national accreditation programs. Further research on a larger scale is highly recommended.

Prenatal Cannabinoid Exposure: Emerging Evidence of Physiological and Neuropsychiatric Abnormalities.

Clinical reports of cannabis use prevalence during pregnancy vary widely from 3% to upwards of 35% in North America; this disparity likely owing to underestimates from self-reporting in many cases. The rise in cannabis use is mirrored by increasing global legalization and the overall perceptions of safety, even during pregnancy. These trends are further compounded by a lack of evidence-based policy and guidelines for prenatal cannabis use, which has led to inconsistent messaging by healthcare providers and medically licensed cannabis dispensaries regarding prenatal cannabis use for treatment of symptoms, such as nausea. Additionally, the use of cannabis to self-medicate depression and anxiety during pregnancy is a growing medical concern. This review aims to summarize recent findings of clinical and preclinical data on neonatal outcomes, as well as long-term physiological and neurodevelopmental outcomes of prenatal cannabis exposure. Although many of the outcomes under investigation have produced mixed results, we consider these data in light of the unique challenges facing cannabis research. In particular, the limited longitudinal clinical studies available have not previously accounted for the exponential increase in (-)-Δ9– tetrahydrocannabinol (Δ9–THC; the psychoactive compound in cannabis) concentrations found in cannabis over the past two decades. Polydrug use and the long-term effects of individual cannabis constituents [Δ9–THC vs. cannabidiol (CBD)] are also understudied, along with sex-dependent outcomes. Despite these limitations, prenatal cannabis exposure has been linked to low birth weight, and emerging evidence suggests that prenatal exposure to Δ9–THC, which crosses the placenta and impacts placental development, may have wide-ranging physiological and neurodevelopmental consequences. The long-term effects of these changes require more rigorous investigation, though early reports suggest Δ9–THC increases the risk of cognitive impairment and neuropsychiatric disease, including psychosis, depression, anxiety, and sleep disorders. In light of the current trends in the perception and use of cannabis during pregnancy, we emphasize the social and medical imperative for more rigorous investigation of the long-term effects of prenatal cannabis exposure.

Assessment of patient safety culture in intensive care units and factors affecting it

Abstract Background The intensive care units are a high-risk environments for the occurrence of adverse events with serious consequences. The development of patient safety culture is a strategic focus to prevent these adverse events and improve patient safety and healthcare quality. This study aimed to assess patient safety culture in Tunisian intensive care units and to determine its associated factors. Methods It is a multicenter, descriptive cross-sectional study, among healthcare professionals of the intensive care units in the Tunisian center. The data collection was spread over a period of 2 months (October-November 2017). The measuring instrument used is the validated French version of the Hospital Survey On Patient Safety Culture questionnaire. Data entry and analysis was carried out by the Statistical Package for Social Sciences (SPSS 20.0) and Epi Info 6.04. Chi-square test was used to explore factors associated with patient safety culture. Results A total of 404 professionals participated in the study with a participation rate of 81.94%, spread over 10 hospitals and 18 units. All dimensions were to be improved. The overall perception of safety was 32.35%. The most developed dimension was teamwork within units with a score of 47.87% and the least developed dimension was the non-punitive response to error (18.6%). The patient safety culture was significantly more developed in private hospitals in seven of the 10 dimensions. Participants working in small units had a significantly higher patient safety culture. It has been shown that when workload is reduced the patient safety culture was significantly increased. Conclusions This study has shown that the patient safety culture still needs to be improved and allowed a clearer view of the safety aspects requiring special attention. Thus, improving patient safety culture. by implementing the quality management and error reporting systems could contribute to enhance the quality of healthcare provided to patients. Key messages The culture of culpability is the main weakness in the study. Encouraging event reporting and learning from errors s should be priorities in hospitals to enhance patient safety and healthcare quality.

Culture of Blame-An Ongoing Burden for Doctors and Patient Safety.

Introduction: Every procedure in healthcare carries a certain degree of inherent unsafety resulting from problems in practice, which might lead to a healthcare adverse event (HAE). It is very important, and even mandatory, to report HAE. The point of HAE reporting is not to blame the person, but to learn from the HAE in order to prevent future HAEs. Study question: Our aim was to examine the prevalence and the impact of culture of blame on health workers’ health. Methods: A cross-sectional study on healthcare workers at two Croatian hospitals was conducted using the Hospital Survey on Patient Safety Culture (PSC). Results: The majority of PSC dimensions in both hospitals were high. Among the dimensions, Hospital Handoffs and Transitions and Overall Perceptions of Safety had the highest values. The Nonpunitive Response to Error dimension had low values, indicating the ongoing culture of blame. The Staffing dimension had low values, indicating the ongoing shortage of doctors and nurses. Discussion: We found inconsistencies between a single-item measure and PSC dimensions. It was expected that Frequency of Events Reported (PSC dimension) relates to Number of Events Reported (single-item measure). However, in our study, the relations between these pairs of measures were different between hospitals. Our results indicate the ongoing culture of blame. Healthcare workers do not report HAE because they fear they will be punished by management or by law.

Incorporating a Resident-Driven Quality Improvement Process Change Through a Lean Transformation of Post-Partum Hemorrhage (PPH) Care

PURPOSE: To investigate a resident-driven quality improvement lean event to improve satisfaction in PPH management. BACKGROUND: Interdisciplinary PPH response strategies are recommended as standard of care. OBGYN resident perceptions regarding PPH management prompted an interprofessional quality improvement lean event to create a systems process change on the post-partum unit. METHODS: This was a pre-/post-intervention study evaluating the impact of a lean event that created new hemorrhage protocols (intervention) on postpartum units including: medication safety bundle, assigned/clarified roles for providers, and a streamlined communication process. The survey queried respondents regarding team communication, access to uterotonics and analgesia, and perception of overall patient safety during PPH. It was administered to resident physicians and post-partum nurses prior to the system changes and at 6 and 12-month intervals. These results were compared using nonparametric analyses. RESULTS: Participants included 15 residents and 16 nurses. Pre-intervention, there was a significant difference in the overall perception of safety when comparing resident and nurse response (p=0.0495) with residents perceiving a less safe environment. Post-intervention, overall satisfaction among the 2 groups was improved at the 6 & 12 month intervals (p<0.05) without discrepancy between the groups. Nurse results demonstrated significantly increased satisfaction with team communication and IV access protocols (p<0.05). DISCUSSION: Resident led quality improvement events can result in improved satisfaction of interprofessional team members in PPH care with improvements maintained over 12 months. Reaching a shared perception and mental model between nursing and residents in the care of PPH can further be studied from the patient’s perspective.

Hospital Survey on Patient Safety Culture (HSPSC): a systematic review of the psychometric properties of 62 international studies

ObjectiveTo carry out a systematic review of the psychometric properties of international studies that have used the Hospital Survey on Patient Safety Culture (HSPSC).DesignLiterature review and an analysis framework to...

“I Just Want to Feel Safe”: A Diary Study of Safety Perceptions on Social Media

Social media can increase social capital, provide entertainment, and enable meaningful discourse. However, threats to safety experienced on social media platforms can inhibt users’ ability to gain these benefits. Threats to safety—whether real or perceived—detract from the pleasure people get out of their online interactions and damage the quality of online social spaces. While prior work has individually explored specific threats to safety – privacy, security, harassment – in this work we more broadly capture and characterize the full breadth of day-to-day experiences that influence users’ overall perceptions of safety on social media. We explore these perceptions through a three-week diary study (n=39). We contribute a novel, multidimensional taxonomy of how social media users define ’safety’, centered around security, privacy, and community. We conclude with a discussion of how safety perceptions can be used as a metric for social media quality, and detail the potential for enhancing safety perception through communityenhancing affordances and algorithmic transparency.

457. Relationship Between Healthcare Worker (HCW) Perception of Safety and Rates of Healthcare-Associated Infections (HAI) and Hand Hygiene (HH) Compliance

BackgroundMany facilities complete the Agency for Healthcare Research and Quality (AHRQ) patient safety culture survey. Our goal was to evaluate associations between healthcare worker (HCW) responses to AHRQ patient safety culture survey questions and unit performance on healthcare-associated infections (HAI) and hand hygiene compliance.Methods11,257 HCW across 10 acute care hospitals and four rehabilitation facilities completed the 2016 AHRQ patient safety survey. Unit-level standardized infection ratios (SIRs) were calculated for central line-associated bloodstream infections (CLABSIs) and catheter-associated urinary tract infections (CAUTIs) and standardized utilization ratios (SURs) for Foley catheter use. SIRs and SURs <1 met HAI performance goals. Hand-hygiene compliance was captured via secret-shopper methods and ≥75% used as the cut-off for meeting compliance goals. Unit-aggregated survey responses were compared between units that did vs. did not meet SIR, SUR goals for the year, and HH goals for the quarter, prior to survey distribution, using two-sample t-tests.ResultsFewer HCW on low-HH compliance units (i.e., <75%; n = 179 units) responded positively to questions pertaining to overall perception of safety, frequency of events reported, supervisor/manager expectations/actions promoting safety, organization learning, teamwork within units, communication openness, and nonpunitive response to errors, than HCW on high-compliance units (i.e., >75%; n = 69 units; P < 0.05). More HCW on units with CAUTI SIR <1 (n = 40 units) responded positively to supervisor/manager expectations/actions promoting safety, teamwork across units, and hospital handoffs, compared with HCW on units with SIR ≥1 (n = 20; P < 0.05). Fewer HCW on units with Foley SUR <1 (n = 27 units) responded positively to questions on supervisor/manager expectations/actions promoting safety and teamwork within units, than HCW on units with SUR ≥1 (n = 22; P < 0.05). We observed no associations between CLABSI SIR performance and AHRQ safety survey responses.ConclusionHCW perceptions of unit safety culture can be associated with HAI and HH compliance performance. Unit performance/compliance was most commonly associated with supervisor expectations suggesting a key managerial component to promoting safety culture.Disclosures All authors: No reported disclosures.

Perceptions of Safety Improvement Among Clinicians Before and After Participation in a Multistate Postpartum Hemorrhage Project

ObjectiveTo measure whether implementation of a comprehensive, 18-month, multihospital, multiregion postpartum hemorrhage (PPH) project influenced intrapartum clinicians’ perceptions of patient safety. DesignPre- and post-survey design. SettingSurvey results from eight hospitals in Georgia, New Jersey, and Washington that participated in the Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) PPH Project were included in the final analysis. The number of annual births at the hospitals ranged from 1,290 to 3,567. ParticipantsThere were 473 respondents for the pre-implementation survey: 50.5% (239) were registered nurses, 27.1% (128) were physicians, and 22.4% (106) were other intrapartum clinicians. The post-implementation survey included 426 respondents: 62.9% (268) registered nurses, 18.5% (79) physicians, and 18.6% (79) other intrapartum clinicians. Intervention/MeasurementsA paired t test was used to compare Safety Attitudes Questionnaire (SAQ) domain scores. Pearson’s chi-square test was used to analyze perceptions before and after the intervention. ResultsBaseline SAQ scores were high in all six domains. Improvements were noted in five of the six domains measured; none reached statistical significance. A significant improvement was found in reported perception of the quality of nursing care after implementation of the PPH Project. ConclusionSAQ scores remained high and showed some improvement among participating hospitals. Participation in the PPH Project increased overall perceptions of safety among the clinicians at these hospitals.