Strong Safety Culture Research Articles

Perception Of Patient Safety Culture At The Primary Care Level: The Case Of The Community Health Centre Ljubljana.

Patient safety is a crucial element of quality healthcare, and endeavours to enhance it are vital for attaining universal health coverage and improving patient outcomes. This study aimed to evaluate the perception of patient safety culture among staff at the Community Health Centre Ljubljana (CHCL). A cross-sectional study was conducted in December 2022. All CHCL staff (N=1,564) from different professional groups were invited to participate in an anonymous electronic survey using the validated Slovenian version of the "Medical Office Survey on Patient Safety Culture" (MOSPSC). Mean percent positive scores for all items in each composite were calculated. The final sample included 377 participants (response rate, 24.1%), most of whom were women (91.5%, N=345) with different professional profiles. The mean age of the participants was 44.5 years (SD 11.1) with a mean work experience of 20.1 years (SD 12.1). The percentage of positive overall MOSPSC composite scores was 59.6%. A strong patient safety culture perception was identified in the following dimensions: Information exchange with other settings (93.5%), Organisational learning (90.2%), List of patient safety and quality issues (88.1%), Patient care tracking/follow-up (76.2 %) and Teamwork (75.0%). Weak patient safety culture was identified in the dimensions of Work pressure and pace (10.7%), Leadership support for patient safety (27.1%), Communication openness (40.9%), Office processes and standardisation (48.2%) and Overall ratings on quality and patient safety (49.4%). CHCL leadership should address weaknesses, redesign processes, and implement strategies to reduce patient safety incidents. Establishing a just culture that encourages employees to report errors fosters transparency and facilitates learning from errors.

Assessment of radiation safety culture among radiological technologists in medical imaging departments in Saudi Arabia

This study aimed to evaluate the perception of radiation safety culture among medical radiological technologists (MRTs) in the Kingdom of Saudi Arabia. The study was performed from June 2022 to February 2023 and involved MRTs from various hospitals and medical centres in Saudi Arabia. A cross-sectional study was conducted using a self-administered and previously validated radiation safety culture survey instrument in medical imaging departments. The survey comprises 11 determinants of radiation safety culture, including personal accountability, teamwork in imaging, teamwork across imaging stakeholders, questioning attitude, feedback loops, organisational learning, leadership actions, non-punitive response, error reporting, radiation policy and overall perception of radiation safety. A total of 496 MRTs participated in this study. Results showed that most of the MRTs were male (75.0%), between 25 and 44 yr old (71.0%), with a bachelor’s degree (53.2%) and had less than 5 yr of experience (41.1%). The highest mean scores were for personal accountability (4.43 ± 0.62) and teamwork in imaging (4.22 ± 0.91), while the lowest mean score was for non-punitive response (2.94 ± 1.01). The majority of the MRTs reported good perception for the personal accountability (71.8%), teamwork in imaging (56.5%) and organisational learning (46%) scales; moderate perception for the teamwork across imaging stakeholders (53.2%), questioning attitude (71%), feedback loops (47.6%), leadership actions (74.2%), error reporting (53.2%), radiation policy (54.8%) and overall perception of radiation safety (62.1%) scales; and poor perception for the non-punitive response scale (45.2%). Individual and organisational interference are warranted to adhere to a strong radiation safety culture with continuing education. Moreover, repeated measures are necessary to assess for categorical improvement associated with the relevant determinants that are also important to support a positive radiation safety culture.

Exploring influential factors on patient safety culture in delirium nursing care within long-term care facilities: a cross-sectional survey

BackgroundElderly residents with physical and cognitive impairments in long-term care facilities are vulnerable to safety risks.PurposeThis study investigated factors that influence patient safety cultures in delirium nursing care in long-term care facilities.MethodsA cross-sectional survey was conducted among 214 nurses working in 12 long-term care facilities using a structured questionnaire from February 15, 2022, to March 14, 2022. Data analysis was performed using Pearson’s correlation coefficients and hierarchical analysis with SPSS/WIN 25.0 software.ResultsSignificant factors associated with patient safety culture were identified. Organizational factors included the availability of delirium care manuals, nursing education and experience in delirium care, and the perceived necessity of delirium education. Individual factors included nurse-to-patient ratios, and nurses marital status.ConclusionTo foster a strong patient safety culture, attention should be given to the availability of delirium care resources, the promotion of specialized and ongoing education and experience, and adequate staffing levels.

SAFETY CONTROL SYSTEMS FOR ETHYLENE PRODUCTION

Ethylene production is a cornerstone of the petrochemical industry, with a global demand that continues to rise. Ensuring efficient, safe, and environmentally responsible ethylene production processes is paramount. Ethylene production control systems, encompassing a range of technologies and strategies, play a pivotal role in achieving these objectives. This abstract provides a concise overview of key aspects of ethylene production control systems, their challenges, and their critical importance. Ethylene production control systems serve as the backbone of modern ethylene plants, orchestrating complex operations to meet production targets while maintaining product quality. These systems integrate advanced technologies such as distributed control systems (DCS), safety instrumented systems (SIS), and process optimization tools to manage variables like temperature, pressure, flow rates, and feedstock composition. Efficiency and yield optimization are central objectives in ethylene production control. Control strategies are designed to maximize product output while minimizing energy consumption and raw material wastage. Additionally, safety control systems are a crucial component, mitigating risks associated with the highly flammable nature of ethylene and ensuring the well-being of personnel and environmental protection. Challenges in ethylene production control systems include managing the variability in feedstock quality, adapting to changing market demands, and adhering to stringent environmental regulations. As feedstock composition can fluctuate, control systems must continually adjust to maintain product quality and consistency. The emergence of Artificial Intelligence (AI) has brought new dimensions to ethylene production control. AI-driven predictive maintenance, anomaly detection, and process optimization are being explored to enhance operational efficiency and reduce downtime. In summary, ethylene production control systems are pivotal in sustaining the global supply of ethylene, a vital chemical compound. Their roles extend beyond production to safety and environmental compliance, making them indispensable components in the petrochemical industry's pursuit of efficiency and sustainability. To meet growing demands and address evolving challenges, the integration of advanced technologies, such as AI, holds promise for the future of ethylene production control systems. A strong safety culture is the backbone of safety control in ethylene production. This involves fostering a work environment where safety is paramount, and all personnel are equipped with the knowledge, awareness, and commitment to safety objectives. Clear communication and continuous training ensure that safety becomes an integral part of the organizational DNA. These systems represent a synergy of hardware, software, and operational protocols meticulously designed to monitor, detect, and respond to anomalous conditions, with a primary objective of averting incidents that could culminate in equipment damage, environmental harm, or harm to personnel. Keywords: Ethylene Production, Control Systems, Petrochemical Industry, Efficiency, Safety, Environmental Responsibility.

What Do We Know About Patient Safety Culture in Saudi Arabia? A Descriptive Study.

Patient safety is described as the prevention and mitigation of medical errors that can result in harm while a patient is receiving care. One important way to improve safety is through improving the patient safety culture in healthcare. The purposes of this study are to evaluate the patient safety culture trend in Saudi Arabia and assess the improvement over time. This study is a descriptive study that used a retrospective analysis of a national data set for 3 cycles from 2019 to 2022. To generate a baseline and allow comparison of the hospital's survey results with the aggregated findings from the database, the 10th, 25th, 50th, 75th, and 90th percentiles were calculated to set the percentage of values. Our results found that one of the barriers to developing a strong patient safety culture in Saudi Arabia is management support of patient safety, which caused a blame culture. This could explain the absence of improvement in the average percentage of reporting patient safety events for all 3 cycles. On the other hand, a decrease was observed in organizational learning/continuous improvement as well as a reduction in the positive percentage of patient safety ratings in the last cycle. Moreover, areas of strength in all 3 cycles did not reach the 75th percentile, whereas staffing and response to error domains remained the lowest-scoring composites in all cycles. Our results have determined the percentile of the positive rate that could guide hospitals to improve their culture survey results. More investigations can focus on change over the years in both patient safety culture and the effectiveness of implementing interventions to measure the impact on quality of care.

Zdravstvena njega i njezin utjecaj na kulturu sigurnosti

Introduction: The World Health Organization defines patient safety as “a framework of organised activities that creates cultures, processes, procedures, behaviours, technologies, and environments in health care”. Patients have a right to expect that every effort is made to ensure their safety as users of all health services. The healthcare system today is facing major challenges, including a lack of human resources, an excessive workload of healthcare professionals, a large number of complex cases, the use of new technologies, and many others. Patient safety is an important component of health care, and it depends on several factors, such as the safety culture, organisation policy, competencies of personnel, and the way care is provided. Safety culture recognises high-risk activities; it is defined as a no-blame culture, and it seeks solutions to problems through an interdisciplinary approach. Objective: To investigate patient safety culture from the perspective of nurses/nursing technicians and the association between nursing care and patient safety in health institutions through a systematic literature review.Methods: A descriptive method was used, a review of scientific and professional literature in the field of nursing care, patient safety culture, patient safety, and adverse events.Results: Results show that patient safety culture characteristics are correlated with nurses’/nursing technicians' intention to report errors. A stronger safety culture along with a developed patient safety competency was found to be significantly associated with a lower incidence of adverse events and surgical site infections, indicating that nurses' competence could reduce the occurrence of adverse events and improve patient safety culture.Conclusion: Improved patient outcomes are associated with a safety culture characterised by shared attitudes among healthcare providers about the importance of patient safety, loyalty, communication transparency, and shared trust in the efficacy of safety measures.

THE ASSESSMENT OF PATIENT SAFETY CULTURE AMONG DOCTORS, NURSES AND PHARMACISTS IN A PUBLIC HOSPITAL IN INDONESIA

Background: Officers who provide health care make it a priority to ensure the safety of their patients. In healthcare, patient safety is a fundamental principle. Understanding the patient safety culture is one step toward improving patient safety. Patient safety culture is the main foundation of patient safety arrangements that aim to improve the quality of service of healthcare facilities by implementing risk management in all service areas.Purpose: This study aimed to determine the cultural picture of patient safety among health workers in a public hospital in East Lombok.Method: This study was observational and cross-sectional using the Hospital Survey of Patient Safety Culture (HSOPSC) questionnaire designed by the Association of Health Care and Research Quality (AHRQ.) The population of this study were healthcare professionals (doctors, pharmacists, pharmaceutical technical personnel, nurses, and midwives) at Dr R. Soedjono Selong Hospital in East Lombok. Descriptive and inferential statistics were used to adjust frequency distribution tables to identify variable relationship differences. The results analysis followed the guidelines from AHRQ, and univariate analysis was carried out.Results: Among the 250 employees invited to participate, 238 (95.2%) completed the surveys. The dimension with the highest percentage of positive responses was organizational learning - continuous improvement (91.3%), and the dimension with the lowest rate of positive responses was staff management (42.5%). Generally, the patient safety culture in health workers at Dr R, Soedjono belongs to the strong category (70.34%).Conclusion: Building a strong patient safety culture is essential to improve service quality.

Proactive safety culture in Nigeria through engineering education: A key to the prevention of catastrophic incidents in the industry

Advances made in promoting a culture of preparedness through disaster risk reduction (DRR) initiatives are strong building blocks to promote more comprehensive changes at the policy level and strengthen resilience in the everyday lives of children, families, schools, and the communities they serve. Proactive safety entails constantly ensuring the safety efficacy of systems, procedures, and people. Process safety entails the identification and understanding of potential hazards, the evaluation of consequences, safeguards, and risks, and the addition of layers of protection to prevent and/or mitigate incidents. The purpose of this study is to review the proactive safety culture in Nigeria through engineering education as a key to the prevention of catastrophic incidents in the industry. A strong safety culture is required to protect employees, but it is especially important for protecting students and developing their skills and awareness of safety. A questionnaire was developed to obtain feedback from industry experts and other stakeholders on the appropriate contents of an undergraduate course on safety that will produce safety-conscious engineering graduates and ultimately a culture of safety in Nigeria. These questions were asked in the following areas: safety assessment in Nigeria, importance of safety education, and safety courses for engineering students. Based on the responses from the 250 questionnaires distributed and 208 responses, a safety course curriculum was suggested with a possible 30 course outlines that could support students at different stages in their development, and as such, it would be expected that students’ safety skills improve as they progress through their degree.

Analyses of Critical Success Factors and Barriers to the Implementation of Indonesian Mining Safety Management System: Case Study of a Nickel Mine & Processing Company

A very high level of work risk makes the implementation of an occupational health and safety management system imperative, particularly for mining businesses. Because it has an impact on the business's performance, sustainability, and reputation, mining safety is an issue of critical importance. The Republic of Indonesia's government has enacted regulations requiring the Mineral and Coal Mining Safety Management System (SMKP MINERBA) to be applied, as detailed in MEMR Regulation No. 26 of 2018 and its derivatives, through the Ministry of Energy and Mineral Resources (MEMR). The implementation of SMKP MINERBA, however, is still insufficient as shown by the rise in mining accidents that result in harm, lost productivity, and even fatalities. The study came to the conclusion that the existing CSFs could be categorized using the seven factors: SMKP good governance; strong organizational safety culture; organizing and resource availability; Specific - Measurable - Attainable - Relevant - Time Bound (SMART) planning and periodic monitoring; management commitment and strategy; effective Occupational Health & Industrial Hygiene (OH-IH) management; and compliance and safety leadership. In the meantime, the barriers may be classified as follows: low SMKP management commitment, inadequate safety leadership, and poor OHS strategy and execution. Rankings of CSFs and Barriers were also established using the Relative Importance Index (RII), and the ratings might be used by Management to enhance the organization further. As a consequence, the findings of this study and the solutions offered are beneficial to the industry since they may increase practitioners' knowledge and support them in expanding their acceptance in organizations

How does management commitment to safety and employee satisfaction impact safety performance in cleaning workers?

Management commitment to safety, which reflects managers' dedication to the physical well-being of workers, is a critical component of the safety climate. It serves as the primary indicator of worker safety behavior and plays a crucial role in reducing injuries across diverse job roles. This study aims to investigate the relationship between safety-committed management and employee satisfaction and how this relationship influences safety performance among cleaning staff at PT WIS Malang. We employed purposive sampling to select 113 respondents who completed online questionnaires. Data collected were analyzed descriptively and using inferential statistical analysis. The results of this study underscore the importance of enhancing the role of management in promoting workplace safety and improving employee job satisfaction. We found that management commitment to safety and employee satisfaction have a positive impact on safety performance These findings hold significant practical implications for companies like PT WIS Malang, aiding in the cultivation of a strong safety culture within the organization.

Status and Factors Affecting Patient Safety Culture at Dilla University Teaching Hospital: A Mixed-Method Cross-Sectional Study.

Patient safety culture is now at the forefront of the global health agenda and has been designated as a human right. Assessing safety culture is seen to be a prerequisite for improving safety culture in health-care organizations. However, no research has been conducted to examine the current study setup. Therefore, this study aims at assessing the status and factors influencing patient safety culture at Dilla University Teaching Hospital. This cross-sectional institutional-based study was conducted from February to March 2022 at Dilla University Hospital. The study used both qualitative and quantitative methods. A total of 272 health professionals were included in the survey. The qualitative data was collected using Key Informant Interviews and In-depth Interviews and 10 health professionals were selected purposively to meet the study objective. The overall composite positive patient safety culture response rate in the current study hospital was 37% (95% CI: 35.3, 38.8). Out of the 12 dimensions, teamwork within hospital units was the highest (75.3%), while frequency of event reporting was the lowest (20.7%) positive percentage response. Only two of the 12 dimensions scored above 50%. Factors affecting patient safety culture majorly at organizational and individual level were poor/low attitude of health professionals, poor documentation practice, and poor cooperation by clients, lack of training and continuous education, lack of standard operating procedure, Staff shortage and high work load. This study revealed that the overall composite positive patient safety culture response rate within the surveyed facility was alarmingly low compared to other hospitals in various countries. The results indicate that there is a need for improvement in areas such as event reporting, documentation, health-care workers' attitude, and staff training. Hospitals must prioritize patient safety by cultivating a strong safety culture through effective leadership, adequate staffing, and education to enhance overall patient care.

Using “CEO-speak” to prioritize a safety culture

PurposeThis paper points to five features that CEO language should have to help enable a robust safety culture.Design/methodology/approachThe paper draws empirical support mainly from the CEO-speak of the CEO of Norfolk Southern Railway in the year prior to the major derailment of a company train and subsequent toxic chemical spill in East Palestine Ohio in February 2023.FindingsCEOs should incorporate the following five features into their CEO-speak. They should actually use the word safety but “in doing so” avoid platitudes about safety. They should exude genuine commitment to safety “cite meaningful safety performance measures” and not ignore operating risks.Originality/valueSafety is a critically important aspect of corporate endeavor. Yet discussion of it is grossly under-represented in the professional and academic literature. This paper offers sound suggestions that reinforce the need for CEOs to write and speak in a way that ensures their company’s commitments to a strong safety culture are not merely platitudinous buzzwords but are genuinely key strategic elements of their company’s business model.

486 Safety Culture in Irish Community Pharmacies: a cross-sectional study using the Community Pharmacy Survey on Patient Safety Culture

Abstract Introduction Safety culture is the product of individual and group values, attitudes, perceptions, competencies, and patterns of behaviour that determine the commitment to, and the style and proficiency of, an organisation’s health and safety management.(1) Community pharmacists play a vital role in ensuring optimum medication safety however the study of patient safety culture in this setting is less developed than in secondary care. Aim The study aim was to measure patient safety culture in Irish community pharmacies using the validated Community Pharmacy Survey on Patient Safety Culture (PSOPSC).(2) Methods The survey consisted of 39 questions based on a 5-point Likert scale, within 11 dimensions. Demographic questions were asked including the pharmacist’s role within the pharmacy. A free-text box allowed respondents to give comments on the survey topic. The online questionnaire, hosted on Microsoft Forms, was emailed to all 3943 community pharmacists registered with the Pharmaceutical Society of Ireland in November 2021. A reminder email was sent 14 days later. Data were analysed in Microsoft Excel. Categorical data were presented as frequencies (%). The positive rate response (PRR) of each survey question and dimension was calculated.(2) The PRR is the mean percentage of positive Likert scale responses to each item and each dimension of the survey. A PRR >75% indicated a strong safety culture, while a PRR <50% indicated a dimension that may be improved upon. Free-text responses were explored by thematic analysis. Results The survey was completed by 173 pharmacists, response rate 4.5%. Of these, 33 (19.1%) were superintendent pharmacist, 65 (37.6%) supervising pharmacist, 53 (30.6%) staff pharmacist and 22 (12.7%) locum pharmacist. The mean %PRR across the 11 survey dimensions was 72.3%. Individual statements with highest PRR were “Our pharmacists tell patients important information about their new prescriptions” (PRR=91.3%) and “Staff are treated fairly when they make mistakes” (PRR=87.3%). Individual statements with lowest PRR were “Interruptions/distractions in this pharmacy (from phone calls, faxes, customers, etc.) make it difficult for staff to work accurately” (PRR=6.4%) and “We feel rushed when processing prescriptions” (PRR=8.1%). The dimension of “Organizational Learning-Continuous Improvement” demonstrated the highest PRR (81.6%), followed by “Response to Mistakes” (PRR=81.2%). The dimension of “Staffing, work pressure and pace” demonstrated the lowest PRR (35.6%). Respondents rated overall patient safety in their pharmacy as excellent/very good/good (88.4%). Differences in perception of patient safety emerged between pharmacists with different levels of responsibility. Patient safety rating was described as fair/poor by 0.0% of superintendent pharmacists, 6.3% of supervising pharmacists, 17.0% of staff pharmacists and 31.8% of locum pharmacists. Fifty-one (29.0%) respondents provided free-text comments. Emergent themes were impact on safety culture of staffing issues; staff training; dispensary workload; and dispensary work pressures. Conclusion The study was limited by low response rate. This may reflect its timing during the COVID-19 pandemic and pharmacists’ prioritisation of clinical roles at that time. Respondents reported a broadly positive patient safety culture in the pharmacy in which they work. Differences in perception of safety culture were observed between those with differing levels of responsibility in community pharmacy practice.

Reducing Falls from Heights through BIM: A Dedicated System for Visualizing Safety Standards

Falls from height (FFH) are common safety hazards on construction sites causing monetary and human loss. Accordingly, ensuring safety at heights is a prerequisite for implementing a strong safety culture in the construction industry. However, despite multiple safety management systems, FFH are still rising, indicating that compliance with safety standards and rules remains low or neglected. Building information modelling (BIM) is used in this study to develop a safety clauses visualization system using Autodesk Revit’s application programming interface (API). The prototype digitally stores and views clauses of safety standards, such as the Operational Health and Safety Rules 2022 and Introduction to Health and Safety in Construction by NEBOSH 2008, in the BIM environment. This facilitates the safety manager’s ability to ensure that the precautionary measures needed to work at different heights are observed. The developed prototype underwent a focus group evaluation involving nine experts to assess its effectiveness in preventing FFH. It successfully created a comprehensive safety clause library that allows safety managers to provide relevant safety equipment to workers before work execution. It also enhances the awareness of construction workers of all safety requirements vis-à-vis heights. Moreover, it creates a database of safety standards that can be viewed and expanded in future by adding more safety standards to ensure wider applicability.

Assessing safety culture in public sector organisations: A cross-national study

An appropriate safety culture helps in enhancing safety performance in organisations. This study aims to investigate safety culture prevalence, assess individual sociodemographic parameters and accident experience effects on this culture and explore ways to enhance this culture in public sector organisations. A specially designed questionnaire was randomly distributed to 805 public sector employees in Dubai and Kuwait. Respondents were asked to rate their agreement with 24 statements representing seven safety culture dimensions. Student t-test and non-parametric tests were used to analyse the responses. Results revealed that employees in both governments reported experiencing a reasonably strong safety culture in their workplaces with safety attitude and teamwork receiving the highest while safety rules and workload receiving the lowest ranks among the seven safety culture dimensions. Moreover, male employees reported experiencing more accidents and scoring higher on most safety culture dimensions than female employees. Finally, employees who experienced accidents in the last five years reported a higher safety culture score than others. Accordingly, recommendations are put forward to enhance safety culture in public sector organisations.

Safety Culture among Transport Companies in Ethiopia: Are They Ready for Emerging Fleet Technologies?

The safety culture and safety climate of transport companies have a significant impact on fleet safety outcomes. Ample research shows that transport companies with a strong safety culture also show lower crash statistics. In spite of modern technologies that help with having a safer fleet, it is difficult to achieve a safer fleet without a proactive safety culture and climate. In Ethiopia, it is assumed that most transport companies have failed to create a distinguishable safety climate in their fleet safety administration and that their heavy vehicle drivers have a poor safety culture. These could be important factors contributing to a higher rate of road traffic crashes involving heavy vehicles. This study aims to assess the existing safety culture among a sample of transport companies in Ethiopia and identify suitable intervention methods to improve the safety culture. Moreover, the study sought to identify the readiness of the transport companies to apply modern technology in their fleets by examining their safety culture and safety climate. In total, 10 fleet managers and 174 heavy vehicle drivers participated in the fleet safety audit survey. A descriptive analysis and a detailed fleet safety audit score were calculated. Based on the scale scoring, ten companies score below best practices, one scores well below best practices, and only one company meets the criteria to be considered achieving best practices. The results from this study show that the safety culture and safety climate in most transport companies are quite limited. In addition, most transport companies implement similar safety measures, including inconsistent driver training and annual maintenance.

INFLUENCE OF SOME SELECTED PERSONAL CHARACTERISTICS AND INFORMATION SOURCES ON FOOD SAFETY PRACTICES OF LOCUST BEAN PROCESSORS IN RURAL COMMUNITIES OF OYO STATE, NIGERIA

As a developing nation, Nigeria struggles with significant challenges related to fostering a strong food safety culture. Shockingly, Nigeria witnesses a staggering annual toll of over 200,000 deaths attributed to foodborne illnesses. Moreover, many rural and suburban areas in the country are severely underserved when it comes to basic facilities and essential awareness or education regarding the critical importance of cultivating a strong food safety culture. The study investigated the influence of selected socioeconomic characteristics and information sources on food safety practices of locust bean processors in selected rural communities of Oyo State, Nigeria. A multistage sampling method was utilized to choose respondents from three LGAs in Oyo State. A random selection of communities known for locust bean processing within each LGA and a total selection of 158 processors was carried out. Data were collected using interview schedule. The result revealed that the mean age of processors was 44 years. The mean years of processing experience were about 17years. The findings revealed a significant relationship between the level of education (p =0.037), frequency of processing (p=0.001), membership of social group (p=0.007), years of processing experience (p=0.002)and food safety practices. Radio (p= 0.011), sanitary officer (p= 0.001), family (p= 0.004), market groups (p= 0.001), and cooperative society (p=0.001) had significant relation with food safety practice respectively. The findings show that personal characteristics like years of processing, education level, and frequency of processing had impacted the unsafe practices of the processors. Likewise, information sources such as family, market groups and cooperative groups were found to influence food safety practices. The findings of the study can therefore be used to provide intervention in training education and provision of up to up to date information, leading to improved food safety practices among Locust bean processors.

CULTURA DE SEGURANÇA NA PRÁTICA CLÍNICA DOS ENFERMEIROS OBSTETRAS

ABSTRACT Objective: to identify the safety culture dimensions that influence obstetric nurses’ clinical practice. Method: an observational, analytical and cross-sectional study, carried out from September 2018 to May 2019 at two maternity hospitals integrated in a hospital center in the Central region of Portugal. A total of 70 obstetric nurses answered the Hospital Survey on Patient Safety Culture. The data were submitted to descriptive and inferential analysis. The dimensions were considered strong when they presented scores ≥ 75.0% of positive answers, and deemed as problematic with scores ≤ 50.0%. Results: the “Teamwork within units” dimension was the one that obtained scores above 75.0%. The “Supervisor expectations”, “Feedback and communication about errors”, “Communication openness”, “Organizational learning” and “Hospital handoffs and transitions” dimensions obtained scores between 50.0% and 65.0%. The “Non-punitive response to error”, “Frequency of events reported”, “Management support for patient safety” and “Staffing” dimensions had scores below 40.0%. Conclusion: the results of this study show that “Teamwork within units” is a strong safety culture dimension in maternity hospitals. However, the prevalence of a punitive culture, underreporting of adverse events, insufficient number of obstetrical nurses and little commitment of the hospital management are considered as problematic dimensions that influence obstetric nurses' practice. This assessment of the safety culture contributes to planning interventions that reduce the incidence of errors and improve the safety of obstetric care.

A generic framework for ensuring safety and efficiency in international engineering projects: Key concepts and strategic approaches

The increasing complexity of international engineering projects demands a structured approach to ensure both safety and efficiency across diverse geographical, regulatory, and operational environments. This paper presents a generic framework for managing these challenges by integrating key concepts and strategic approaches. The framework emphasizes the importance of proactive risk management, regulatory compliance, and cross-cultural collaboration to enhance safety protocols and operational efficiency. It focuses on leveraging project management methodologies such as Agile, Lean, and Six Sigma to streamline processes, reduce waste, and improve decision-making in international contexts. Additionally, the framework advocates for the use of advanced technologies, including digital twins, predictive analytics, and real-time monitoring systems, to ensure timely identification of potential risks and optimize project outcomes. The framework also explores the significance of developing a strong safety culture within multinational teams through consistent training, clear communication, and adherence to international safety standards like ISO 45001. Strategic stakeholder engagement is highlighted as critical to aligning project goals with local regulatory requirements and fostering collaborative problem-solving. The paper reviews case studies of successful international engineering projects, illustrating the application of these concepts in different sectors such as construction, energy, and infrastructure development. By adopting this integrative framework, engineering firms can achieve higher levels of safety and operational efficiency, minimizing delays and cost overruns while ensuring regulatory compliance. The paper concludes by discussing future trends, including the growing role of automation, artificial intelligence, and sustainability considerations in engineering project management. Ultimately, this framework offers a comprehensive guide for professionals aiming to navigate the complexities of international engineering projects while prioritizing safety and efficiency.

Veterinary healthcare needs to talk more about error: For the wellbeing of our patients and medical teams.

Over the past 2 decades, patient safety has become an established priority in human healthcare. There is a large body of research in human medicine on harm caused by healthcare, its impact, and interventions to prevent it. There are also numerous guidelines, policies, and regulations to improve safety. An important realization has been that the same errors that harm patients can also harm members of the healthcare team. Empathetic handling of safety incidents can have positive effects on both the wellbeing of providers and their care of patients. An essential element in patient safety is the creation of a "culture of safety" within the health care team. A strong culture of safety describes a work environment where risk is acknowledged, individuals can report errors without fear of punishment, and the organization has a commitment to collaboratively implementing system changes to prevent future errors. A key element of safety culture is ensuring that healthcare team members are supported and asked to help create solutions for safer care. The principles of safety science and practices to improve safety have not yet been widely adopted in veterinary medicine. We describe a case of a serious medication error and how it was handled to illustrate key components of a culture of safety and a system-based approach to improvement. This case is timely as a recent review of patient safety events in 3 veterinary hospitals found medication-related errors to be the most frequently reported events. Open conversations about safety events and errors that can harm not only our patients but also our healthcare teams will help veterinary professionals learn from their mistakes, support members of the team, and prevent future harm.