Safety Culture Research Articles

Developing a Culture of Safety for Sustainable Development and Public Health in Manufacturing Companies—A Case Study

One of the most important values in human life is health and safety. This is reflected in the Sustainable Development Goals (SDG3, SDG8), which were presented by the United Nations in 2015. These goals emphasize the importance of ensuring healthy lives, promoting well-being for all, and fostering inclusive and sustainable economic growth through decent work and safe working conditions. Taking into account the importance of issues related to safety, including occupational safety and human health, research was carried out to examine the impact of the development of a safety culture during employees’ work on improving public health. In order to conduct the research, a survey questionnaire was developed, consisting of 20 questions relating to 10 attributes of safety culture. The research surveys were carried out among 363 employees in a production enterprise, and an interview questionnaire was administered to 3 employees of the Occupational Health and Safety Service of this enterprise. The results revealed that the enterprise’s employees rate the level of safety culture very highly. Along with the improvement of working conditions in the enterprise, the level of safety increases, the number of accidents at work decreases, and thus the protection of employee health is higher. Therefore, a high level of safety culture is correlated with a high value attached to the health and life of employees, and this, in turn, affects public health. Moreover, fostering a strong safety culture aligns with the principles of sustainable development, contributing to long-term societal well-being and aligning with global goals for responsible and ethical growth.

Public perceptions of reportable safety events and risks in United States primary care

Introduction: Patients may not feel responsible for reporting safety events, and social norms may prevent patients from questioning health care providers’ judgment. There is a paucity of research regarding public awareness of reportable safety events/risks. Educating the public about reporting is paramount in error prevention. Because more than 70% of errors (e.g., errors in diagnosis, communication errors, unsafe medication practices, and care fragmentation) occur in primary care settings, the purpose of this study was to explore public perceptions of when to report safety events/risks in these settings. Method: System-level primary and outpatient facility safety incident scenarios conducive to safety events/risk reporting were developed and administered via online survey methodology. Following completion of the scenario questions, participants were asked a single open-text item: “As you were reading the scenarios above, what did you think makes an event/risk ‘reportable’?” Results: At least one-third of participants responded incorrectly in 70% of the scenarios. The percentage of incorrect responses ranged from 5.2% to 62.3% with “unwitnessed falls” and “nursing scope of practice” queries incorrectly reported at 44.5% and 53.9%, respectively. Rationales for inappropriate events/risk reporting included “risk prediction at the management/system level,” “legal repercussions/protection (e.g., negligence, legal responsibility to patient),” “violations of scope of practice/professional expectations,” “degree of potential/actual lethality,” and “personnel errors.” Conclusion: This study revealed a gap between understanding why to report an event/risk and when to correctly report (or not report) an actual healthcare issue. Practical applications: Awareness of reasons for correctly reporting incidents and how correct reporting builds a culture of safety needs to be strengthened.

Radiation Hazards, Protection, and Cultivating a Radiologically Safe Environment for Nurses

Medical diagnostics has been revolutionized with the discovery of X-rays. The number of radiological procedures performed globally has increased rapidly during past decades and according to UNSCEAR 2021 report, 4.2 billion medical radiological procedures are performed annually. Ionizing radiations if not used appropriately and carefully can lead to health hazards for health professionals involved in the radiation work as well as patients undergoing the radiological procedure. However, the awareness about the ionising radiation and radiation safety is very limited among the healthcare professionals. This educational paper will provide basic insights in radiation protection training, and key topics to cover during education and training for nurses working in various medical radiological procedures of patients. Nurses need to understand radiation protection principles and ways to minimize their exposure of radiation during radiological procedures. They should be able to practically apply radiation protection principles in healthcare settings with enhanced patient and occupational safety without Radiophobia. Applying radiation safety culture in nursing practice improves quality and safety in patient care.

Radiation Hazards, Protection, and Cultivating a Radiologically Safe Environment for Nurses

Medical diagnostics has been revolutionized with the discovery of X-rays. The number of radiological procedures performed globally has increased rapidly during past decades and according to UNSCEAR 2021 report, 4.2 billion medical radiological procedures are performed annually. Ionizing radiations if not used appropriately and carefully can lead to health hazards for health professionals involved in the radiation work as well as patients undergoing the radiological procedure. However, the awareness about the ionising radiation and radiation safety is very limited among the healthcare professionals. This educational paper will provide basic insights in radiation protection training, and key topics to cover during education and training for nurses working in various medical radiological procedures of patients. Nurses need to understand radiation protection principles and ways to minimize their exposure of radiation during radiological procedures. They should be able to practically apply radiation protection principles in healthcare settings with enhanced patient and occupational safety without Radiophobia. Applying radiation safety culture in nursing practice improves quality and safety in patient care.

Assessment of safety culture in radiotherapy facilities using safety performance indicators.

This paper describes the development of the Safety Performance Indicators (SPIs), the methodology for assessment of the safety culture of radiotherapy institutions using SPIs and common strengths and common areas for improvement. SPIs were categorized into eight sections which all together contain 23 attributes and each attribute has scoring criteria from 0 to 2 (in steps of 0.5). The maximum absolute cumulative score of SPIs was 46. A relative cumulative SPIs score of >80% indicates an institution strong commitment towards safety while score <50% indicates need for additional guidance to enhance safety culture. The assessment using SPIs was conducted for 17 radiotherapy institutions. The methodology of assessment includes interactive discussion, direct observations and document analysis. The relative cumulative SPIs score of seven institutions was found to be >80% while it was found in the range of 67.0% to 80% for the remaining ten institutions. Institutions were communicated about the cumulative SPIs score, areas of strengths, and areas for improvement. SPIs were found to be a good tool for safety culture assessment and can be utilized by the radiotherapy institutes for self-assessment to identify the areas of improvement. Based on SPIs score, regulatory body can grade the institutions from a radiation safety compliance point of view.

Protocol for the development and validation of a trigger tool for antiretroviral ADE detection among adult HIV/AIDS patients: A short communication

Antiretroviral therapy (ART) is a lifelong combination therapy which has been very promising in managing HIV/AIDs but reported to have several adverse events on the recipients, affecting the desired antiretroviral therapeutic goals. Adverse drug event detection and prevention therefore become very important safety culture maintenance tools among patients living with HIV/AIDS. The designed protocol provided step by step approaches to develop and validate a trigger tool for detection of adverse drug events (ADE) among adult HIV/AIDS patients. The approaches involved include a baseline (Pre-trigger tool development) retrospective clinical record review to establish a baseline ADE detection capacity of a conventional non-trigger tool method; the Delphi panel process to develop the trigger tool in question; Face and content validity approach for validation of the developed trigger tool; Pilot test of the trigger tool using small clinical record sample; determining the effectiveness of the developed trigger tool through the retrospective clinical record review of same samples reviewed at the baseline. Finally, the protocol described the process of determining the feasibility of the developed trigger tool through the survey of the clinical record review team members.

Implementing safety standards in radiographic practices: challenges and solutions

Ensuring the safety of patients and healthcare workers in radiographic practices is a critical concern in modern healthcare. The use of ionizing radiation, while invaluable for diagnostic and therapeutic purposes, carries inherent risks that necessitate stringent safety standards. Despite advances in technology and regulatory frameworks, the consistent implementation of these safety standards remains a challenge across various healthcare settings. The discussion addresses the complexities of navigating diverse regulatory environments, where enforcement and adherence to safety guidelines can vary significantly. These inconsistencies are particularly pronounced in low-resource regions, where limited access to modern radiographic equipment and inadequate training further exacerbate the risks of radiation exposure. Technological advancements in radiography, such as digital radiography, dose-reduction software, and advanced imaging modalities, offer significant benefits in terms of diagnostic accuracy and efficiency. However, they also introduce new challenges in maintaining up-to-date safety protocols. The rapid pace of innovation often outstrips the ability of regulatory bodies to update guidelines, leading to gaps in safety practices. Additionally, the effectiveness of these technologies depends heavily on proper usage and understanding by radiographic professionals, highlighting the need for continuous education and training. A strong safety culture within radiographic practices is essential for minimizing radiation risks. Leadership commitment, ongoing education, effective communication, and the empowerment of radiographic professionals are critical components of this culture. When these elements are in place, they foster an environment where safety is prioritized, and all staff members are actively engaged in maintaining and improving safety standards. The multifaceted approach required to enhance radiographic safety underscores the importance of harmonizing regulatory efforts, investing in modern technologies, and cultivating a safety-first mindset among healthcare professionals. These efforts collectively contribute to the safe and effective use of radiographic technology, ultimately protecting both patients and healthcare workers from unnecessary radiation exposure.

FEATURES OF SAFETY CULTURE ASSESSMENT BY USING THE METHOD OF ANALYSIS OF HIERARCHIES BASED ON THE SURVEY OF TEACHERS OF CLINICAL DEPARTMENTS OF THE DENTAL PROFILE

Aim. Determining the features of safety culture, the assessment by using the method of analysis of hierarchies based on the survey of teachers of clinical departments of the dental profile and establishing its main stages. Materials and methods. The research was conducted on the basis of departments of stomatological profile O. O. Bogomolets National Medical University using hygienic, medical sociological and statistical methods, which should be considered a prerequisite for the implementation of the method of analysis of hierarchies (methodology of group examination followed by ranking and pairwise comparison). Results. Based on the application of the method of analysis of hierarchies based on a survey of teachers of clinical departments of the dental profile, the leading components of safety culture were determined, namely: the degree of influence on the level of safety culture and the patient's body of the leading characteristics of dangerous actions of medical personnel related to the operation of equipment, the organization of medical and diagnostic process, use of means of individual and collective protection (component No. 1); the degree of influence on the level of safety culture and the patient’s organism of both strengths and weaknesses in creating the safety of the treatment environment through the culture of awareness, reporting, justice, training (component No. 2), the degree of influence on the level of safety culture and the patient's organism of hygienic and safe working conditions at the workplace of medical personnel (component No. 3), as well as a scientifically based algorithm for assessing the level of safety culture in modern health care institutions. Conclusions. The created algorithm for analytical assessment of the level of safety culture in modern health care institutions provides for the implementation of the following stages: determination of the structural features of the leading components of safety culture and the development of a scoring scale for their evaluation; carrying out an expert assessment of the leading components of the safety culture and establishing the degree of consistency of experts' opinions; calculation of the weighting coefficients of the influence of various components on the formation of a certain level of safety culture; justification of objective statistical approaches to assessing the level of safety culture.

Perioperative Patient Safety Management: The Perspective of Operating Room Nurses

Perioperative patient safety management is a critical aspect of healthcare, requiring a comprehensive understanding of the roles and responsibilities of operating room nurses in ensuring patient safety. This paper emphasizes the significance of nurses' perspectives in enhancing safety protocols during the perioperative phase. It explores the multifaceted responsibilities of operating room nurses, highlighting their pivotal role in patient safety, from preoperative assessment to postoperative care. The challenges faced by nurses in maintaining safety standards are discussed, along with innovative solutions to mitigate these issues. Drawing on insights from contemporary practices, the paper advocates for a proactive approach to safety management, emphasizing continuous education, effective communication, and the implementation of evidence-based guidelines. The conclusions offer a roadmap for future directions in perioperative safety, underscoring the need for collaborative efforts among healthcare professionals to achieve optimal patient outcomes. By integrating the experiences and insights of operating room nurses, this work contributes to a more nuanced understanding of perioperative safety management, aiming to foster a culture of safety in surgical environments.

Medication Errors in Saudi Arabian Hospital Settings: A Systematic Review.

Background and Objectives: Medication errors significantly impact patient safety, potentially causing adverse drug events (ADEs), increasing morbidity and mortality and prolonging hospital stays. This systematic review aimed to identify common medication errors in Saudi hospitals, their contributing factors, and effective prevention strategies. Materials and Methods: Following PRISMA-P guidelines, a comprehensive review of the literature published after 2019 was conducted. Inclusion criteria focused on peer-reviewed articles in English addressing medication errors in Saudi hospitals. Exclusion criteria eliminated reviews, opinion pieces, and non-peer-reviewed sources. A narrative synthesis identified common themes, and a descriptive analysis organized the data. Results: Searches yielded 22 articles from Embase (n = 4), PubMed (n = 10), and Web of Science (n = 8). After removing duplicates and one review article, twelve studies remained. Hand-searching references added 16 more, totaling 28 articles. Of the 28 included studies, 20 (71.4%) reported the types of medication errors observed. Wrong dose and improper dose errors are among the most frequently reported across multiple studies, while prescribing errors remain consistently high, indicating a critical area for intervention. Although less frequent, omission errors still hold significance. Conclusions: This review emphasizes the importance of comprehensive, proactive approaches to preventing medication errors. Integrating evidence-based strategies, fostering a safety culture, and continuously monitoring and evaluating interventions can significantly enhance medication safety and improve patient outcomes in Saudi Arabian hospitals.

Certified Food Safety Management Systems Assessed through the Lenses of Food Safety Culture and Locus of Control: A Pilot Study.

The approach to ensure food safety (FS) has evolved, including the concept of FS culture, which has been shaped by both the legislation and the scientific literature. In this study, two companies that produce foods associated with potential risks of cross-contamination (gluten-free foods and frozen pastry, respectively) and are certified according to international voluntary FS standards, such as the British Retail Council Global Standard (BRC) and the International Featured Standards Food Version (IFS), were investigated to assess: (a) if the assessment of FS culture's pillars can uncover unexpected critical areas; (b) if the scores of the FS culture's pillars are related to personal traits, namely, age, seniority in the company and locus of control orientation, i.e., the beliefs that an event is the result of external factors (luck, destiny or superior beings), or the result of internal factors (human behavior). Questionnaires for the survey and the scoring system applied were selected from the literature. Results showed that all food handlers had an optimistic bias, which paradoxically could be the consequence of the rigorous application of hygienic procedures. The younger food handlers had significantly (p < 0.05) lower commitment than the older ones. Moreover, the segment of food handlers having an external locus orientation demonstrated weaker normative beliefs than those having an internal locus of control orientation. Results showed that the FS culture survey, which is related to the shared FS culture, could disclose unknown weakness in third-party certified companies, even if the well implemented principles of voluntary FS standards are aligned with the FS-culture pillars. Moreover, the segmentation of food handlers according to their age and the locus of control assessment could provide additional information on the individual orientation toward FS behavior. Hence these tools could assist the leaders in the management of the dynamic nature of human capital.

Patient Safety Culture Scale in Medication Administration: A Scale Development Study

Patient Safety Culture Scale in Medication Administration: A Scale Development Study

Safety underreporting during naval operations: Prevalence, associated risk, and several contributing factors

Workplace safety concerns or violations are often underreported, which can result in small issues manifesting into a mishap or accident. Safety underreporting can also be difficult to track since, by definition, workers are knowingly failing to report issues. Unfortunately, underreporting remains pervasive even in high-risk occupations where safety issues may produce exceptionally dangerous and costly outcomes. This study investigated safety underreporting in the context of naval operations using a multi-level, multi-factor approach to evaluate underreporting with three study aims: 1) determine the prevalence of safety underreporting in a naval environment; 2) estimate the link between underreporting and real-world safety incidents; and finally, 3) identify the relative contribution of different factors to underreporting. Analyzes examined a large (N>11,000) sample of active-duty servicemembers who voluntarily participated in a routine online anonymous safety climate survey. Approximately 30% of respondents underreported safety incidents despite the high-risk occupational setting, and Monte Carlo simulations provided estimates for safety underreporting frequency aboard different ship-classes. Additional regression analyses linked safety underreporting aboard ship to actual safety issues (e.g., fire and electrical shock) thereby underscoring the real-world relationship. Finally, hierarchical logistic regression estimated that the most consistent predictor of safety underreporting was making prior reports of safety incidents. For every additional safety event reported, there was a 65 % increase in the likelihood of failing to report safety issues. The next most significant predictors were non-compliance attitudes toward safety regulations at the individual and crew level. Taken together, these results demonstrate the prevalence of underreporting in a naval environment while implicating several key contributing factors, including frequency of safety incidents in the work environment and non-compliance attitudes. This study’s findings highlight the importance of actively leveraging approaches to counter underreporting (e.g., anonymous reporting systems) and promoting positive safety climates to improve safety reporting and reduce negative outcomes (e.g., mishaps and accidents).

Evaluating the Level of Safety Climate and the Prevalence of Work-related Accidents Considering the Mediating Role of Job Satisfaction (Case Study: Shabnam Food Industry)

Background and Objective: The spread of accidents in various industries shows the need to pay more attention to safety factors and try to improve employees' job satisfaction. This research aims to evaluate the safety atmosphere level and the prevalence of work-related accidents by considering the mediating role of job satisfaction in the Shabnam food industry. Materials and methods: This research is an applied and descriptive-non-experimental research, during which a sample of 122 employees of the Shabnam food industry was selected to distribute the questionnaire. To measure the relationship between research variables, a researcher-made questionnaire including 3 variables and 36 items was used, and a structural equation model and SPSS26 and LISREL8.8 software were used to check the hypotheses. Results: The analytical results of the data showed that the evaluation of the level of safety climate and job satisfaction harmed the prevalence of accidents caused by work. Also, the review of the level of safety climate had a positive and significant effect on job satisfaction. Finally, the mediating role of job satisfaction in the relationship between the assessment of the level of safety climate and the prevalence of work-related accidents was confirmed. Conclusion: It was recommended that Shabnam food industry officials improve the safety atmosphere of the work environment by creating a safe work environment by providing safety equipment and relevant training and controlling the statistics of accidents; It was also concluded that paying attention to the needs of employees and getting their satisfaction can increase the speed of this process.

Individual and farm determinants of pesticide safety climate in agriculture: a French nationwide survey

Individual and farm determinants of pesticide safety climate in agriculture: a French nationwide survey

Modeling the Effects of Safety Culture Affecting Safety Performance on Occupational Accidents with System Dynamics

Modeling the Effects of Safety Culture Affecting Safety Performance on Occupational Accidents with System Dynamics

Impact of Pesticide Training on Safety Climate Perception Among French Cereal Farmers.

Background: The training of farmers in pesticide safety is of prime importance for reducing pesticide use and exposure through the implementation of sustainable management practices. This study aimed to assess the impact of compulsory training on the knowledge and perceptions of cereal farmers, with the help of a safety climate scale. Method: We approached cereal farmers throughout France during compulsory training and certification procedures for pesticide-related activities. Trainees were asked to complete a safety climate questionnaire at the start and end of the course. In total, 733 cereal farm managers or workers completed the questionnaire at the start of the study, 131 of whom declined to complete the questionnaire at the end of the training session, leaving 602 subjects available for pre-training/post-training comparisons. Statistical analyses were based on paired t-tests and mixed models for repeated measures. Findings: The mean safety climate score increased from 82.37 to 88.22 after the training course (7.1 %, p < .001) in both univariate and multivariate analyses. Mean increases were also found for each of its seven dimensions (p < .001), ranging from 2.8% for "rules and best practices" to 12.4% for "communication and feedback." Few covariate-by-time interactions were found to be significant. Conclusion/Application to Practice: This study demonstrates that pesticide training is highly effective in increasing safety climate perception among cereal farmers and provides hints for improving the design of educational programs. Promoting the development and facilitation of lifelong learning with continuously updated training programs should be a top priority for minimizing pesticide exposure.

The Art of Speaking Up: Supporting a Culture of Safety in the OR.

Considering the high-risk, stressful, and fast-paced nature of the perioperative environment and vulnerability of surgical patients, the quest for maintaining a safety culture in the OR is ongoing. Speaking up-an interaction between perioperative team members to address a concern-requires team member empowerment to advocate for patient safety when needed. Hierarchical gradients, lack of psychological safety, incivility, and a nonsupportive organizational culture can impede speaking-up behaviors. Strategies to improve speaking up include using multimethod education initiatives, enhancing psychological safety, and managing conflict. Perioperative nurses can experience barriers to speaking up, such as lack of team familiarity, normalization of deviance, and differing perceptions among team members. The logistics of whole-team training initiatives can be challenging; however, such initiatives can help participants improve their understanding of the perspectives and communication goals of all involved personnel. Perioperative nurses and leaders should collaborate to promote speaking up for safety whenwarranted.

Assessing Patient Safety Culture: Insights from a Neurological Institute.

A cross-sectional descriptive study was conducted among healthcare workers exercising at a neurological institution using a validated Hospital Survey of Patient Safety Culture questionnaire containing ten safety care dimensions. A total of 123 responses to the questionnaire were analyzed, accounting for 34.5% of the total (Cronbach's alpha=0.677). Among the participants, 61.8% considered the level of awareness regarding patient safety to be acceptable. The dimensions considered as strengths were "Organizational learning and continuous improvement" with the highest positive response (60.3%) "Relationship patient-staff member" (58.9%) and "Teamwork within units" (58.9%). However, the dimensions considered as weaknesses were "Management support for patient safety" with 28.5% of positive responses and "Communication openness and non-punitive response to error" (40%). Patient safety culture among healthcare professionals is at an average with "Organizational learning and continuous improvement" being a positive aspect. However, improvements should be made in all dimensions to enhance and promote patient safety within the institution.

Assessing the Influence of Safety Culture to Employee Safety Performance Mediated by Safety Communication in Coal-Fired Power Plant

This study analyzes the effect of safety culture on employee safety performance at a Coal Fired Power Plant (CFPP) in Java, as well as the mediating role of safety communication and moderating role of service years. This study aims to investigate the direct and indirect effects between the variables of safety culture, safety communication and employee safety performance. In addition, the study also explored the moderating role of service year in the relationship between safety culture and employee safety performance. Data was obtained from distributing questionnaires to CFPP employees using a stratified sampling method. SmartPLS SEM. The findings reveal that safety culture does not have a significant direct effect on employee safety performance. However, safety communication significantly mediates the relations between safety culture and employee safety performance. The service year does not moderate the relationship between safety culture and employee safety performance This indicates that other factors such as continuous training, reward system, and work environment may be more influential in this context.