Positive Safety Climate Research Articles

Safe patient handling behaviors and lift use among hospital nurses: A cross-sectional study

PurposePatient handling is well known for the risk of musculoskeletal injury. Safe work practices are important to reduce risk of injury while performing patient handling tasks. This study investigated factors associated with safe patient handling behaviors and lift use among hospital nurses in the United States. MethodsThis study analyzed cross-sectional survey data from a statewide random sample of 221 hospital nurses in California who had patient handling duties. Safe patient handling behaviors and lift use were examined for the relationships with demographic characteristics, organizational safety practices, physical and psychosocial job factors, musculoskeletal symptoms, and perceptions about lift use and risk of injury. ResultsIn multivariable logistic regression, high safe patient handling behaviors were significantly associated with a positive organizational safety climate (Odds Ratio [OR]=2.76, 95% Confidence Interval [CI] 1.51–5.03), people-oriented culture (OR=2.59, 95% CI 1.45–4.62), and ergonomic practices (OR=1.67, 95% CI 1.04–2.67). High lift use (>50% of the time when needed) were significantly associated with high lift availability (OR=3.1, 95% CI 1.06–9.01) and positive perceptions about lift use (OR=3.48, 95% CI 1.63–7.44). In bivariate analysis, high safe patient handling behaviors were associated with shorter height, non-White race, lower physical workload, lower job strain, higher job satisfaction, and less musculoskeletal symptoms. ConclusionsThe study findings underscore the importance of organizational safety practices and culture to promote safe work practices for patient handling injury prevention. Also, making lift equipment readily available and improving positive perceptions and experiences about lifts can be crucial to ensure the use of lift equipment.

Effects of organizational safety practices and perceived safety climate on PPE usage, engineering controls, and adverse events involving liquid antineoplastic drugs among nurses

ABSTRACTAntineoplastic drugs pose risks to the healthcare workers who handle them. This fact notwithstanding, adherence to safe handling guidelines remains inconsistent and often poor. This study examined the effects of pertinent organizational safety practices and perceived safety climate on the use of personal protective equipment, engineering controls, and adverse events (spill/leak or skin contact) involving liquid antineoplastic drugs.Data for this study came from the 2011 National Institute for Occupational Safety and Health (NIOSH) Health and Safety Practices Survey of Healthcare Workers which included a sample of approximately 1,800 nurses who had administered liquid antineoplastic drugs during the past seven days. Regression modeling was used to examine predictors of personal protective equipment use, engineering controls, and adverse events involving antineoplastic drugs.Approximately 14% of nurses reported experiencing an adverse event while administering antineoplastic drugs during the previous week. Usage of recommended engineering controls and personal protective equipment was quite variable. Usage of both was better in non-profit and government settings, when workers were more familiar with safe handling guidelines, and when perceived management commitment to safety was higher. Usage was poorer in the absence of specific safety handling procedures. The odds of adverse events increased with number of antineoplastic drugs treatments and when antineoplastic drugs were administered more days of the week. The odds of such events were significantly lower when the use of engineering controls and personal protective equipment was greater and when more precautionary measures were in place. Greater levels of management commitment to safety and perceived risk were also related to lower odds of adverse events.These results point to the value of implementing a comprehensive health and safety program that utilizes available hazard controls and effectively communicates and demonstrates the importance of safe handling practices. Such actions also contribute to creating a positive safety climate.

Impact of individual resilience and safety climate on safety performance and psychological stress of construction workers: A case study of the Ontario construction industry

IntroductionThe construction industry has hit a plateau in terms of safety performance. Safety climate is regarded as a leading indicator of safety performance; however, relatively little safety climate research has been done in the Canadian construction industry. Safety climate may be geographically sensitive, thus it is necessary to examine how the construct of safety climate is defined and used to improve safety performance in different regions. On the other hand, more and more attention has been paid to job related stress in the construction industry. Previous research proposed that individual resilience may be associated with a better safety performance and may help employees manage stress. Unfortunately, few empirical research studies have examined this hypothesis. This paper aims to examine the role of safety climate and individual resilience in safety performance and job stress in the Canadian construction industry. MethodThe research was based on 837 surveys collected in Ontario between June 2015 and June 2016. Structural equation modeling (SEM) techniques were used to explore the impact of individual resilience and safety climate on physical safety outcomes and on psychological stress among construction workers. ResultsThe results show that safety climate not only affected construction workers' safety performance but also indirectly affected their psychological stress. In addition, it was found that individual resilience had a direct negative impact on psychological stress but had no impact on physical safety outcomes. ConclusionsThese findings highlight the roles of both organizational and individual factors in individual safety performance and in psychological well-being. Practical applicationsConstruction organizations need to not only monitor employees' safety performance, but also to assess their employees' psychological well-being. Promoting a positive safety climate together with developing training programs focusing on improving employees' psychological health — especially post-trauma psychological health — can improve the safety performance of an organization.

The role of communication in managing the safety climate of construction site environments

ABSTRACTManagers in the construction sector are met with a critical charge: they are responsible for the safety of employees in one of the most notoriously dangerous industries in the world. In terms of managing the safety climate of construction site environments, no recommendations have been made in the literature that truly elucidate the role of organisational communication therein. The aim of this research was to fill this void by enriching the seminal work of Mohamed (2002) which focusses on the nature of the safety climate in construction organisations, and the factors it is comprised of. To this end, the research comprised a data-triangulated qualitative and quantitative empirical study undertaken at nine different construction sites in South Africa, which allowed for the reformulation of the model for safety climate management in construction environments, with an added understanding of the role of communication therein. The findings indicated that communication is conducive to a positive safety climate when it is managed to be strategic, holistic, relational and symmetrical. The model put forward in this article offers an empirical application of the four identified constructs of communication, which gives way to data-driven recommendations for use in construction organisation settings.

Disentangling the roles of safety climate and safety culture: Multi-level effects on the relationship between supervisor enforcement and safety compliance

Despite increasing attention to contextual effects on the relationship between supervisor enforcement and employee safety compliance, no study has yet explored the conjoint influence exerted simultaneously by organizational safety climate and safety culture. The present study seeks to address this literature shortcoming. We first begin by briefly discussing the theoretical distinctions between safety climate and culture and the rationale for examining these together. Next, using survey data collected from 1342 employees in 32 Italian organizations, we found that employee-level supervisor enforcement, organizational-level safety climate, and autocratic, bureaucratic, and technocratic safety culture dimensions all predicted individual-level safety compliance behaviors. However, the cross-level moderating effect of safety climate was bounded by certain safety culture dimensions, such that safety climate moderated the supervisor enforcement-compliance relationship only under the clan-patronage culture dimension. Additionally, the autocratic and bureaucratic culture dimensions attenuated the relationship between supervisor enforcement and compliance. Finally, when testing the effects of technocratic safety culture and cooperative safety culture, neither safety culture nor climate moderated the relationship between supervisor enforcement and safety compliance. The results suggest a complex relationship between organizational safety culture and safety climate, indicating that organizations with particular safety cultures may be more likely to develop more (or less) positive safety climates. Moreover, employee safety compliance is a function of supervisor safety leadership, as well as the safety climate and safety culture dimensions prevalent within the organization.

Effect of Awareness about Health, Safety and Environment Management System on Safety Climate and Risk Perception in Oil Refinery Employees

Abstract Aims: Health, safety and environment is an integrated and convergence system and also a synergistic arrangement of human resources, facilities and equipment. This study aimed to determine the relationship of safety climate and perception of risk with the awareness level of HSE management system among oil refineries employees. Instrument & Methods: This cross-sectional study was performed at 2016 in all Kermanshah Oil Refinery employees. “Demographic characteristic”, “safety climate”, “perception of risk” and “awareness of the HSE management system” questionnaires were used for data collection. Data was analyzed in SPSS 22 statistical software using Pearson correlation and ANOVA tests. Findings: The average of total awareness of HSE was 20.85±4.82. The average of safety climate was 157.04±22.42. The average of perception of risk was 3.45±0.84. There was a significant relationship between awareness of HSE management system and safety climate (r=0.219; p=0.001), but there was no significant relationship between awareness of HSE management system and perception of risk (r=0.137; p=0.128). The relationship between perception of risk and safety climate was significant (r=0.651; p=0.001). Conclusion: Oil refinery's employees have the moderate awareness of HSE management system, high perception of risk and positive safety climate. By increasing the perception of risk and safety climate, the safety performance of the refinery staffs increase.

Variations in Patient Safety Climate in Chinese Hospitals.

Patient safety climate is associated with patient outcomes in hospitals around the world. A better understanding of how safety climate varies within and across hospitals will help identify improvement opportunities. We examined variations in safety climate by work area and job category in Chinese hospitals. We administered the Chinese Hospital Survey on Patient Safety Climate in 2011 to workers in 6 hospitals in China, with completed surveys from 1464 (86% response). We calculated the percent positive response for survey items and dimensions among hospitals and compared this across work areas and job categories using general linear models. Overall, 68% of responses suggested the presence of a positive safety climate. The percent positive responses were highest for organizational learning (86.1%) and unit management support for safety (84.5%) and lowest for staffing (30.6%) and error reporting (44.5%). Workers in surgical units, intensive care units, operating rooms, and emergency departments were slightly more negative regarding overall safety climate than those in medical and ancillary units. Physicians reported worse perceptions than nurses or other hospital workers on all dimensions except for unit management support for safety and communication and peer support. The perceived problem with staffing in Chinese hospitals was consistent with other studies. The lack of positive responses for error reporting may indicate a lack of awareness of the importance of learning from and reporting minor events and near misses. Variations within and across hospitals in safety climate suggest that improvement interventions should be tailored to individual units and professional groups.

5S impact on safety climate of manufacturing workers

Purpose – 5S is a commonly used Lean tool that focusses on creating an organized work environment, but the effects of 5S on safety climate are not as well studied. The purpose of this paper is to determine the impact of a 5S event on safety climate. Design/methodology/approach – This pre-test post-test study examines the effect of implementing 5S on safety climate of the packaging area of a manufacturing plant. Two groups of employees (case and control groups) completed a safety climate questionnaire (Safety Climate Assessment Toolkit) prior to the 5S event, one month after, and two months after. Findings – Total safety climate significantly improved for the case group but remained unchanged for the control group over the study period. Specifically, management commitment and involvement dimensions of safety climate improved for the case group. Practical implications – These results show that two important aspects of safety climate (management commitment and involvement) can be significantly, positively influenced by successful 5S events, which may translate to improved safety overall. Originality/value – Prior literature on 5S speculates a positive impact of 5S on safety and safety climate, but this assertion is not well supported with empirical evidence. This study provides quantitative measurement of positive safety climate changes that resulted from a successful 5S event. The results provide additional incentive for management to continue 5S and other Lean activities with the possibility of also improving safety.

Safety climate and increased risk: The role of deadlines in design work

Although much research indicates positive safety climate is associated with reduced safety risk, we argue this association is not universal and may even be reversed in some contexts. Specifically, we argue that positive safety climate can be associated with increased safety risk when there is pressure to prioritize production over safety and where workers have some detachment from the consequences of their actions, such as found in engineering design work. We used two indicators of safety risk: use of heuristics at the individual level and design complexity at the design team level. Using experience sampling data ( N = 165, 42 design teams, k = 5752 observations), we found design engineers’ perceptions of team positive safety climate were associated with less use of heuristics when engineers were not working to deadlines, but more use of heuristics when engineers were working to deadlines. Independent ratings were obtained of 31 teams’ designs of offshore oil and gas platforms ( N = 121). For teams that worked infrequently to deadlines, positive team safety climate was associated with less design complexity. For teams that worked frequently to deadlines, positive team safety climate was associated with more design complexity.

Effect of STOP technique on safety climate in a construction company.

Safety programs are a core part of safety management in workplaces that can reduce incidents and injuries. The aim of this study was to investigate the influence of Safety Training Observation Program (STOP) technique as a behavior modification program on safety climate in a construction company. This cross-sectional study was carried out on workers of the Petrochemical Construction Company, western Iran. In order to improve safety climate, an unsafe behavior modification program entitled STOP was launched among workers of project during 12 months from April 2013 and April 2014. The STOP technique effectiveness in creating a positive safety climate was evaluated using the Safety Climate Assessment Toolkit. 76.78% of total behaviors were unsafe. 54.76% of total unsafe acts/ at-risk behaviors were related to the fall hazard. The most cause of unsafe behaviors was associated with habit and unavailability of safety equipment. After 12 month of continuous implementation the STOP technique, 55.8% of unsafe behaviors reduced among workers. The average score of safety climate evaluated using of the Toolkit, before and after the implementation of the STOP technique was 5.77 and 7.24, respectively. The STOP technique can be considered as effective approach for eliminating at-risk behavior, reinforcing safe work practices, and creating a positive safety climate in order to reduction incidents/injuries.

Safety Culture in Cardiac Surgical Teams: Data From Five Programs and National Surgical Comparison

Little is known about safety culture in the area of cardiac surgery as compared with other types of surgery. The unique features of cardiac surgical teams may result in different perceptions of patient safety and patient safety culture. We measured and described safety culture in five cardiovascular surgical centers using the Hospital Survey on Patient Safety Culture, and compared the data with the Agency for Healthcare Research and Quality (AHRQ) 2010 comparative database in surgery and anesthesiology (all types). We reported mean scores, standard deviations, and percent positive responses for the two single-item measures and 12 patient safety climate dimensions in the Hospital Survey on Patient Safety Culture. In the five cardiac surgical programs, the dimension of teamwork within hospital units had the highest positive score (74% positive responses), and the dimension of nonpunitive response to error had the lowest score (38% positive responses). Surgeons and support staff perceived better safety climate than nurses, perfusionists, and anesthesia practitioners. The cardiac surgery cohort reported more positive safety climate than the AHRQ all-type surgery cohort in four dimensions but lower frequency of reporting mistakes. The cardiac anesthesiology cohort scored lower on two dimensions compared with the AHRQ all-type anesthesiology cohort. This study identifies patient safety areas for improvement in cardiac surgical teams in comparison with all-type surgical teams. We also found that different professional disciplines in cardiac surgical teams perceive patient safety differently.

Proactive occupational safety and health management: Promoting good health and good business

This research assessed the impact of organisational approaches to occupational safety and health (OSH) management on organisational performance, safety climate, employee attitudes, health and well-being. Interviews with health and safety personnel, company directors and worker representatives were used to categorise the organisations according to their approaches to OSH management, using the Continuous Improvement Cycle model (Budworth and Khan, 2003). A cross-sectional survey of 2067 employees from these organisations examined the impact of company size, industrial sector and approach to OSH management on indicators of organisational performance and employee outcomes. A structured questionnaire assessed demographic characteristics, organisation and job tenure, job satisfaction, organisational commitment, intention to quit and job motivation, safety climate, self-reported absence, performance and work-related ill-health. Organisations were also asked to provide data on profit, performance, accidents and absence indices. Organisations adopting a proactive approach to OSH management reported higher profit margins and lower accident rates, however these differences were not statistically significant. Organisations classified as ‘very good’ were found to show significantly more positive safety climate perceptions across eight out of the nine safety climate dimensions. Employees in proactive organisations were significantly more committed to their organisations and showed greater job satisfaction than employees in organisations categorised as ‘yet to be fully engaged/complier’. Positive safety climate perceptions and organisational attitudes were associated with better self-reported physical and mental health. The findings add to the validation of the CIC model as an assessment and learning tool which may support the transition of organisations from reactive to proactive safety culture.

Investigation of Safety Climate in an Oil Industry in Summer of 2014

Background: Safety Climate is an issue that has received much attention in recent years. Evaluation of safety climate in a workplace gives us good information about the safety organization situation. Safety climate is a leading indicator in preventing accidents. Objectives: The aim of this study was to evaluate safety climate and investigate of association between safety climate and demographic factors in an oil industry in summer of 2014. Materials and Methods: This cross-sectional descriptive-analytical research was conducted in an oil industry during summer of 2014. Sample size was 97 and used the Loughborough University Safety Climate Assessment Toolkit, which assesses safety climate in nine areas. Scoring in each area was done in Likert scale. Data analyzing was done after data collection. Results: Final scoring was done on a scale of one through ten. The highest scores were achieved in personal values (mean score, 8.7 ± 1.36) and lowest scores were achieved on the personal perception of risk (mean score, 5.4 ± 1.26). The mean safety climate score were 6.8. Significant associations were found between safety climate and age (P = 0.01), between age and management's commitment to safety (P = 0.02), and between marital status and regulations and guidelines (P = 0.04). The association of other domains with the age, education, and marital status were not significant (P > 0.05). Conclusions: Based on of this study, management has an important role in creating a positive safety climate. Individual characteristics can influence thee safety climate. Management commitment to safety is an important factor in the success of safety programs.

The relationship between safety–production conflict and employee safety outcomes: Testing the impact of multiple organizational climates

Safety research is understandably dominated by studies examining the impact of organizational safety climate. Yet, other climates (e.g. service climate; productivity climate) that may also influence safety-related outcomes are rarely concurrently studied. Consequently, questions regarding how different organizational climates simultaneously affect employee safety attitudes and behaviours largely remain unanswered. Multilevel data collected from public transit employees indicated that safety–production conflict (SPC) was negatively related to accident-reporting attitudes and behavioural safety compliance. As expected, among employees in workgroups exhibiting a positive safety climate, the negative effect of SPC on behavioural safety compliance was attenuated. Moreover, a positive customer service climate reduced the negative effects of SPC on reporting attitudes; on the other hand, this relationship was exacerbated among workgroups with a high-productivity climate (i.e. those emphasizing on-time performance). The need for considering multiple aspects of an organizational climate is discussed in light of these results.

Survey on patient safety climate in public hospitals in China.

BackgroundPatient safety climate has been recognized as a core determinant for improving safety in hospitals. Describing workforce perceptions of patient safety climate is an important part of safety climate management. This study aimed to describe staff’s perceptions of patient safety climate in public hospitals in Shanghai, China and to determine how perceptions of patient safety climate differ between different types of workers in the U.S. and China.MethodsSurvey of employees of 6 secondary, general public hospitals in Shanghai conducted during 2013 using a modified version of the U.S. Patient Safety Climate in Health Care Organizations (PSCHO) tool. The percentage of “problematic responses” (PPRs) was used to measure safety climate, and the PPRs were compared among employees with different job types, using χ2 tests and multivariate regression models.ResultsPerceptions of patient safety climate were relatively positive among hospital employees and similar to those of employees in U.S. hospitals along most dimensions. For workers in Chinese hospitals, the scales of “fear of blame” and “fear of shame” had the highest PPRs, whereas in the United States the scale of “fear of shame” had among the lowest PPRs. As in the United States, hospital managers in China perceived a more positive patient safety climate overall than other types of personnel.Conclusions“Fear of shame” and “fear of blame” may be important barriers to improvement of patient safety in Chinese hospitals. Research on the effect of patient safety climate on outcomes is necessary to implement effective polices to improve patient safety and quality outcomes in China.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-015-0710-x) contains supplementary material, which is available to authorized users.

Safety climate in Swiss hospital units: Swiss version of the Safety Climate Survey.

Rationale, aims and objectivesSafety climate measurements are a broadly used element of improvement initiatives. In order to provide a sound and easy‐to‐administer instrument for the use in Swiss hospitals, we translated the Safety Climate Survey into German and French.MethodsAfter translating the Safety Climate Survey into French and German, a cross‐sectional survey study was conducted with health care professionals (HCPs) in operating room (OR) teams and on OR‐related wards in 10 Swiss hospitals. Validity of the instrument was examined by means of Cronbach's alpha and missing rates of the single items. Item‐descriptive statistics group differences and percentage of ‘problematic responses’ (PPR) were calculated.Results3153 HCPs completed the survey (response rate: 63.4%). 1308 individuals were excluded from the analyses because of a profession other than doctor or nurse or invalid answers (n = 1845; nurses = 1321, doctors = 523). Internal consistency of the translated Safety Climate Survey was good (Cronbach's alpha G erman = 0.86; Cronbach's alpha F rench = 0.84). Missing rates at item level were rather low (0.23–4.3%). We found significant group differences in safety climate values regarding profession, managerial function, work area and time spent in direct patient care. At item level, 14 out of 21 items showed a PPR higher than 10%.ConclusionsResults indicate that the French and German translations of the Safety Climate Survey might be a useful measurement instrument for safety climate in Swiss hospital units. Analyses at item level allow for differentiating facets of safety climate into more positive and critical safety climate aspects.

Organizational safety climate and supervisor safety enforcement: Multilevel explorations of the causes of accident underreporting.

According to national surveillance statistics, over 3 million employees are injured each year; yet, research indicates that these may be substantial underestimates of the true prevalence. The purpose of the current project was to empirically test the hypothesis that organizational safety climate and transactional supervisor safety leadership would predict the extent to which accidents go unreported by employees. Using hierarchical linear modeling and survey data collected from 1,238 employees in 33 organizations, employee-level supervisor safety enforcement behaviors (and to a less consistent extent, organizational-level safety climate) predicted employee accident underreporting. There was also a significant cross-level interaction, such that the effect of supervisor enforcement on underreporting was attenuated in organizations with a positive safety climate. These results may benefit human resources and safety professionals by pinpointing methods of increasing the accuracy of accident reporting, reducing actual safety incidents, and reducing the costs to individuals and organizations that result from underreporting.

Leadership and turnover intentions of Taiwan TV reporters: the moderating role of safety climate

TV reporters in Taiwan often encounter accidents during regular assignment runs, which may be a significant factor that increases their intentions to leave their job. Occupational hazard has always been ignored by news media organizations. Recent research has shown that a positive organizational safety climate may improve safety-related issues. To build on previous research conducted, this study investigates the moderating effect of safety climate between safety leadership and turnover intentions. This research collected 268 valid samples with an 89% response rate. Using the hierarchical linear model, results show that the transformational leadership style is negatively related to turnover intentions and the passive leadership style is positively related. Moreover, the moderation tests found a negative relationship between the interaction of passive leadership and safety and employees' turnover intentions. This implies that when reporters are working in a positive safety climate environment, their turnover intentions will be significantly lower. On the contrary, the positive moderating effect of safety climate on the relationship between transformational leadership and turnover intention is not significant.

The relationship between communication and construction safety climate in China

Cultivating a good safety climate is critical to the improvement of safety performance in construction. Previous research has demonstrated that communication is important in strengthening the safety climate. However, few studies have addressed the role of jobsite communication in safety or investigated its relationship with the safety climate. Attempts to optimize communication to improve the safety climate appear to lack both adequate theoretical and empirical bases, as well as consensus on its importance. Therefore, this study identifies the relationship between communication and construction safety climate. The authors surveyed four subcontractors employed on two construction projects, which were administered by different Chinese state-owned enterprises. Models of the safety communication structure and safety climate were developed through social network analysis. Interviews were conducted to confirm and summarize the findings. The results indicate that a positive safety climate could be associated with higher communication density and degree centrality, as well as with lower betweenness centrality. To enhance the jobsite safety climate, this study recommends the following best practices: (1) Construction safety leaders (e.g., site managers) should communicate more frequently with construction workers when high organizational centrality is detected. (2) Additional communication channels should be established to bridge communication gaps among individuals. The findings validate the importance of communication as a way to manage the safety climate of Chinese construction projects.

Safety climate, safety behaviors and line-of-duty injuries in the fire service

Purpose– The purpose of this paper is to test an initial model of safety climate for firefighting. Relationships between safety climate, safety behaviors and firefighter injuries were examined.Design/methodology/approach– Data were collected from 398 professional firefighters in the southeastern USA. Structural equation modeling, using a zero-inflated Poisson regression method, was used to complete the analyses.Findings– Safety climate, as a higher order factor, was comprised of four factors including management commitment to safety, supervisor support for safety, safety programs/policies and safety communication. Both safety compliance behaviors and safety participation behaviors were significantly, positively associated with safety climate. Both behaviors were deemed protective and were associated with reductions in injury. Safety climate relations to injury were interesting, but somewhat ambiguous. Safety climate significantly predicted membership in the “always zero” injury group. For those not in the “always zero” group, the relationship between safety climate and injury was positive, which was not completely surprising as direct relationships between safety climate and injury have been insignificant and opposite to predictions in studies using retrospective data and may be attributed to reverse causation.Originality/value– This novel study illustrates the importance of both organizational and work unit factors in helping shape safety climate perceptions among firefighters. The results also support the safety climate – behavior – injury model and show that a positive safety climate encourages safer behaviors among firefighters. Lastly, the findings confirm that both safety compliance behaviors and safety participation behaviors are important to reducing individual firefighter injury experience.