Strong Safety Culture Research Articles

Current Safety Culture among Laboratory Users of the Faculty of Engineering in Universiti Putra Malaysia

Accidents involving higher learning institutes laboratories are no longer a worldwide issue. There is a huge gap between how safety is practiced in industry compared to how it is practiced in research laboratories, especially in an academic setting. For effective implementation of the safety management system, it is necessary to have a strong and positive safety culture throughout the organization. The investigation to the safety culture (SC) practices level and performances among laboratory’s users in the Faculty of Engineering, Universiti Putra Malaysia will be assessed, evaluated and recommended some of the improvement towards SC in UPM. The assessment is done through the distribution of safety culture questionnaire adapted from Hudson’s safety culture element and a publication by American Chemical Society and the results will be based on rating distribution. The safety culture survey resulted in an overall score of µ=3.98 (µ<4.0) which indicates that the level of safety culture among laboratory users are moderate and less proactive. Observation from the audit evaluation suggested that there are still room of improvement for the safety performance. It is deduced from this study that the safety culture and safety performance are inter-related to each other. Therefore, to achieve higher safety performance, one needs to have an improvement in safety culture change in their organization.

Medical Error, Adverse Events, and Complications in Interventional Radiology: Liability or Opportunity?

This review suggests that there is a critical need to renew understanding of adverse events and complications within interventional radiology and to redefine a robust commitment to patient safety a...

Personnel Behavioral Safety Analysis in International Projects of Oil, Gas and Petrochemical Industries (Case Study of Urea and Ammonia Project, Masjed Soleyman Petrochemical Company)

Background: Behavioral safety and behavioral psychology is used to promote safe behavior in industries based on employee participation, and its data collection tool is behavioral checklists that contain safe and unsafe employee behaviors. The purpose of this study was to analyze the behavioral safety of employees in international projects of the oil, gas, and petrochemical industry (Masjed Soleyman Petrochemical Company).
 Materials and Methods: The research method is descriptive and analytical in terms of purpose. The statistical population of this study was 589 Iranian and Chinese employees working in ten different departments of Masjed Soleyman Petrochemical Company. The tool for collecting data in this study was the standard tarantula checklist that was confirmed by Cronbach's alpha. Data were analyzed by SPSS software, version24.
 Results: The results of this study showed that there is a significant difference between Iranian and Chinese groups. The Friedman test also showed that Chinese group is better than Iranian group in behavioral safety.
 Conclusion: The main results of this study are the positive and strong safety of the staff that will prevent many occupational accidents. In other words, a strong positive safety culture among employees will facilitate the organizational drive to achieve higher safety standards

Assessment and Comparison of Patient Safety Culture Among Health-Care Providers in Shenzhen Hospitals.

PurposeTo investigate the health-care providers’ perceptions of patient safety culture in Shenzhen hospitals and to compare 2019 with 2015 data.MethodsThis cross-sectional study adopted a questionnaire survey and targeted hospital staff fitting the sampling criteria (physicians, nurses, technicians, and managers). A total of 5490 staff from 13 Shenzhen hospitals were surveyed using the Hospital Survey on Patient Safety Culture (HSOPSC).ResultsThe average positive response rates of this study were generally higher than the data from the 2018 Agency for Healthcare Research and Quality (AHRQ) survey and the 2015 HSOPSC Shenzhen survey. Bivariate and multivariate regression showed that respondents who had direct contact with patients were less likely to report high overall patient safety grade. The probability of high overall patient safety grade was rated higher by men than by women. Compared with nurses, the probability of high overall patient safety grade was higher for both physicians and technicians.ConclusionThe overall results of the patient safety culture in Shenzhen hospitals were relatively good and have improved significantly in recent years, but some areas of weakness still need improvement. Our recommendations are to develop training programs for various positions, recruit more employees, provide management support, and establish a just culture to promote a strong patient safety culture. Regular assessment is also needed to provide valuable information to hospital leaders on areas requiring improvement and to evaluate the quality improvement plan that has been implemented.

Do drivers differ in their attitudes on speed limit compliance between work and private settings? Results from a group of Nigerian drivers

Existing evidence suggests that drivers, particularly those who work in companies with strong road safety cultures exhibit different sets of speeding attitudes and behaviours in work and private driving. Using Ajzen and Fishbein’s (1980) Theory of Planned behaviour (TPB) and on-road driving experiments, this study examined the self-reported and objective behaviour of driving within posted speed limits for a sample of fleet drivers. The findings show that the TPB explained up to 24% of the variance in intention to comply with speed limits. Drivers’ attitude emerged as the most significant predictor and strongest correlate with intentions to comply with the speed limit in both work and private vehicle.Further analysis revealed participants had a higher intention to comply with speed limits in their work than private vehicle. Also, investigation of the relationship between TPB variables and observed speeding behaviour suggests that participants with higher intention to comply with the speed limit or high perceived behavioural control (PBC), exceeded the speed limit less often than those with lower intention to comply with the speed limit or low PBC. The findings have important theoretical and applied implications for development of better speed limit compliance interventions to improve driving behaviour, and road safety in general.

Psychological and sociological factors impacting on migrant worker contribution to, and adaptation of, workplace safety culture

This paper highlights potential health and safety issues which may emerge in workplaces engaging migrant workers, particularly as effected by social distancing during training prior to employment, such as experienced by international students. There are a number of factors that can contribute to the ways in which a migrant worker applies health and safety in their workplaces, including language and culture, that are commonly addressed through training, socialisation and workplace engagement. With these opportunities limited due to social distancing, migrant workers have less opportunity to contribute to and embrace organisations’ safety culture. This onus then falls onto employers to ensure that safe practices are learned, imbued and correctly and consistently applied with an objective of fostering a strong safety culture where employees go above and beyond what is expected in terms of safety performance that is mutually understood and shared.

Meeting the Challenge

Meeting the Challenge

Creating a Strong Safety Culture in an Undergraduate Engineering Program

In this article, a proven safety concept with documented success is presented. The concept aligns with best safety practices and the international engineering educational framework termed The CDIO ...

Building Strong Cultures with Chemical Safety Education

Developing strong safety cultures in academic institutions requires that students at all levels be educated by faculty in chemical safety. Yet chemical safety education is missing from the chemistr...

608 The Impact of a Nurse Morbidity and Mortality Meeting

Abstract Introduction Physicians have long held Morbidity and Mortality (M&M) conferences to discuss complications and deaths. The format for these conferences is to lay out the case, discuss the care performed, and generate discussion on areas of opportunity. Physician M&M usually focuses on teaching and the presenter may not be the caregiver. There is not much literature on the use of this teaching methodology in nursing. Due to the strong culture of safety on the unit, it was determined that creating a Nurse M&M could prove beneficial for discussion of complications, deaths, errors, and good catches as they related to nursing care. Methods Nurse M&M is held monthly for one hour. All personnel involved in the cases are informed ahead of time what will be discussed. They are given the opportunity to present the individual case or give personal testimony as to the situation from their point of view. Each case is presented in the same format. The initial slides cover background, history of present illness, and the origin of the report. Next is the pertinent review from the electronic medical record and discussions had with those involved in the case. The floor is then open for discussion. If there was a variation in practice, the policy that relates to the error is reviewed. Topics for Nurse M&M are gathered through many venues. The hospital uses an online reporting system for electronic submission of adverse events, variations in care, and good catches. The entire multidisciplinary team have all individually reported something they wanted discussed at Nurse M&M. If clarification is needed on a case, the question is directed to the appropriate decision maker and followed up on. Results Nurse M&M is the most highly attended, non-mandatory, meeting held on the unit. The nursing staff was surveyed to determine their perceptions on how the addition of Nurse M&M had effected them. The results were overwhelmingly positive. All nurses surveyed rated the statement, “I feel that Nurse M&M has had a positive outcome on the unit’s collective practice”, as agree or strongly agree. Over time, the notes taken have evolved from just the discussion to action items created off the case. The staff have will now self-report events before they are entered into the online system. Conclusions The nursing staff are highly engaged Nurse M&M. The staff are open to discussing errors in a way that fosters educational growth and critical thinking development. If the case being discussed is because of a personal error, more often than not, the person responsible will discuss why they made the decision they did and facilitate the discussion as to what could have been done differently. The nurses’ commitment to being present, engaged, and open minded are strong signs of the healthy work environment present on the unit. Applicability of Research to Practice The format of a nursing M&M conference is applicable to all units. Patient safety and nurse engagement are the top factors effected by Nurse M&M.

Food safety culture

Food safety culture

Barriers of Reporting Incident and Suggested Sloutions from the Perspective of Staff Nurses

Abstract Background: Incident reporting in health care is considered a way to monitor, prevent, and reduce the occurrence of patient safety events. “Incident Reporting Systems, (IRS) will continue to be an important influence on improving patient safety and quality of health care. Aim: The aim of this study is to assess barriers of reporting incident report and suggested solutions from the perspective of staff nurses. Material and Methods: Descriptive exploratory study design was utilized to collect data in this study. Convenient sample of staff nurses (N=250) who were working in all inpatient departments at 6 October Health Insurance Hospital in Giza. Two tools were used for data collection: Barriers of reporting incident and suggested solutions questionnaires. Results: Results of the present study revealed that, the highest mean scores regarding barriers of reporting incident was time constrain, while the lowest mean scores was lack of education. While regarding suggested solutions, the highest mean scores was availability of reports pathways, while the lowest mean scores was regarding to valuing reporting. Conclusion: The main barrier for reporting incident barriers was time constrains and the main suggested solutions, was availability of reports pathways. Recommendation: The hospital administrators should introduce reward systems, and improving incident reporting systems by including a variety of reporting channels and ensuring reporter anonymity, and creating a strong safety culture within the hospital.

Improved X-Ray Safety, Quality Control, and Resource Management in Medical Imaging Using QATrack+

Introduction/BackgroundManagement of a quality assurance program in diagnostic imaging involves a variety of machine types, multiple vendors, and a large number of frontline staff who have different specializations. Standardizing tests across multiple platforms in the face of vendor recommendations, regulatory requirements, and professional practice protocols can present challenges to maintain a robust and coherent quality assurance program. The current work presents a unique application of an existing tool that can be used to manage a comprehensive quality assurance program in a diagnostic imaging department. Materials and MethodsQATrack+ is an open source, quality assurance platform originally developed for and currently widely used in radiation therapy departments. The use of QATrack+ for quality assurance program management within a large diagnostic imaging department is a novel use of this tool. Results and DiscussionQATrack+ was successfully implemented in a large, multisite diagnostic imaging department. The progression toward a single platform for the quality assurance program has addressed issues of end of life with previous software packages and has improved the standardization of testing across the institution. The configuration of the software has enabled frontline staff to be directly engaged in the quality control (QC) program, improving the efficiency of resource allocation for QC and promoting a strong safety culture and commitment to quality. Trending tools within QATrack+ allow for simplified review of tests and enable the early identification of potential failures. ConclusionOriginally developed for radiation therapy programs, QATrack+ is well suited to applications within diagnostic imaging. It is versatile and is easily adapted to the individual needs of a department for activities ranging from quality control testing, scheduling, test review, and data trending. It simplifies the standardization of quality control practices across platforms, thereby facilitating training and promoting involvement in the quality assurance program by all staff.

Improving Patient Safety and Reducing Medical Errors in Saudi Healthcare Organizations

هدفت هذه الدراسة إلى تحديد المجالات الحرجة والمهمة في أنظمة الرعاية الصحية والتي تحتاج إلى تحسينات للحد من الأخطاء الطبية وتعزيز سلامة المرضى. وأما المنهجية: فتم إجراء مراجعة علمية منهجية لاستكشاف المشكلة الأخلاقية المتعلقة بالخطأ الطبي وسلامة المرضى في نظام مؤسسات الرعاية الصحية السعودية. أسفر هذا البحث الإلكتروني في قاعدة البيانات عن أكثر من 4000 مقالة مرشحة، تم اختيار 45 منها عشوائياً بعد أن استوفت معايير شمولها في هذه الدراسة. النتائج: كانت نتائج الدراسة البحثية أكثر من 45 مقالة ذات صلة وثيقة بالموضوع قيد التحقيق وتنطبق عليها معايير هذا البحث المنهجي. وقد كان الافتقار إلى المسؤولية الأخلاقية للتحسين المستمر لنظام الرعاية الصحية، وعدم وجود ثقافة سلامة مناسبة ونظام إبلاغ فعال، ونقص وجود الرعاية الصحية التي تركز على المريض من أهم المجالات في نظام مؤسسات الرعاية الصحية السعودية التي تحتاج إلى تحسين لتعزيز سلامة المرضى والحد من الأخطاء الطبية. الآثار العملية: قدم الباحث عدة توصيات على أساس ما تم عمله في نظام الرعاية الصحية في الولايات المتحدة والذي يتناول بشكل منهجي تحسين سلامة المرضى والحد من الأخطاء الطبية. على سبيل المثال، يجب على منظمات الرعاية الصحية التي تسعى لتعزيز سلامة المرضى والحد من الأخطاء الطبية التخلي عن النظام الروتيني الذي يقوم على إلقاء اللوم على الممارس الصحي والتركيز على تحسين نظام الرعاية الصحية بدلا من ذلك. كما أنه لابد أن ينبع التفاني في تعزيز سلامة المرضى من المسؤولية الأخلاقية لمنظمات الرعاية الصحية تجاه المرضى الذين تخدمهم. أيضا، يجب على مؤسسات الرعاية الصحية خلق ثقافة قوية للسلامة. وأخيرًا، يجب أن تهتم مؤسسات الرعاية الصحية بالدور الأساسي والمهم الذي يقوم به إشراك المرضى في العملية الصحية في تحسين السلامة والحد من الأخطاء الطبية.

Impact of Patient Safety Culture on Missed Nursing Care and Adverse Patient Events.

A strong patient safety culture (PSC) may be associated with improved patient outcomes in hospitals. The mechanism that explains this relationship is underexplored; missed nursing care may be an important link. The purpose of this study was to describe relationships among PSC, missed nursing care, and 4 types of adverse patient events. This cross-sectional study employed primary survey data from 311 nurses from 29 units in 5 hospitals and secondary adverse event data from those same units. Analyses include analysis of variance and regression models. Missed nursing care was reported to occur at an occasional level (M = 3.44, SD = 0.24) across all 29 units. The PSC dimensions explained up to 30% of the variance in missed nursing care, 26% of quality of care concerns, and 15% of vascular access device events. Missed care was associated with falls (P < .05). Prioritized actions to enhance PSC should be taken to reduce missed nursing care and adverse patient outcomes.

Building an organizational culture of patient safety

This article shares the experiences of a new institute for patient safety and quality in Asia in building an organization culture of patient safety. Since its launch in June 2017, the SingHealth Duke-NUS Institute for Patient Safety &amp; Quality in Singapore has been active in integrating cluster-wide efforts in patient safety and quality within the SingHealth Duke-NUS Academic Medical Centre. Institute for Patient Safety &amp; Quality focuses on eliminating preventable errors and harm, and improving patient outcomes by building and cultivating a strong patient safety culture. A culture where healthcare professionals strive for implementation of strong safety management systems requires strong leadership, which prioritizes safety above financial and operational goals; encourages the identification, communication and resolution of safety issues and provides appropriate resources, structure and accountability to maintain effective safety systems. A strong patient safety and quality culture requires a virtuous patient safety and quality ecosystem that takes time to develop. We believe that it is necessary when building this ecosystem to promote the various contributing constituent cultures, including Speak Up Culture, Reporting Culture, Learning Culture, Patient Centric Culture and Just Culture. Leadership commitment is paramount for developing this ecosystem. This entails co-creation of organizational strategies and co-development of a professional education framework to enhance capability and capacity for patient safety and quality.

Attending and Resident Physician Engagement of the Radiation Oncology Incident Learning System (RO-ILS)

RO-ILS is designed to improve quality and patient safety in radiation oncology by facilitating shared learning in a non-punitive environment. Higher rates of incident submissions indicate a strong safety culture and support by physicians, who can role model proactive safety culture for team members and trainees. Yet engagement of physicians stands to be improved. We hypothesize that resident versus attending status and select surveyed attitudes predicts RO-ILS utilization. Institutional submissions in RO-ILS between July 1, 2017 and July 1, 2018 were reviewed. In addition, a survey assessing RO-ILS usage, incident reporting to other team members, and attitudes towards submission, was sent to attending and resident physicians in the department. Univariate logistic regression was used to identify if any surveyed attitude’s continuous Likert score predicted direct submission, and if resident versus attending status predicted 1) direct submission, 2) asking another team member to submit incidents (referred submission), or 3) general submission (direct or referred). The multiple testing for attitudes was corrected by Bonferroni method. The association between attitude as a binary categorical variable and direct/general submission was also assessed by chi-squared test. Physicians who self-identified only accounted for 10.7% of all RO-ILS submissions (18/168 total submissions; 5 from residents, 13 from attendings), and these submissions originated from 6 unique physicians (4 attendings, 2 residents) in a department with 13 attendings and 11 residents. The survey was sent to current 12 attendings and 12 residents with a response rate of 83.3% (20/24 physicians); 45% (9/20 respondents) were attendings, 45% (9/20 respondents) reported having ever directly submitted an incident, and 45% (9/20 respondents) reported having ever asked another team member to submit an incident. Of those who referred submissions, 66.7% (6/9 respondents) referred to a therapist or nurse. Avoiding punitive action (OR 0.42, 95% CI 0.14-0.88, p=0.05) and reluctance to submit an incident related to another member of the team (OR 0.51, 95% CI 0.23-0.95, p=0.05) exhibited tendencies for association with submission (Bonferroni threshold p=0.01). Resident status was a borderline significant predictor of less likely to refer submission (OR 0.11, 95% CI 0.01-0.77, p=0.04), and less likely general submission (OR 0.11, 95% CI 0.01-0.73, p=0.03). Attendings are more likely than residents to utilize RO-ILS and ask another team member to submit incidents. The association of RO-ILS use with attitudes of avoiding punitive action and of reluctance to submit incidents related to another team member requires a greater sample size for confirmation.

NCRP Report no.180—management of exposure to ionizing radiation: NCRP radiation protection guidance for the United States

NCRP Report No. 180, ‘Management of Exposure to Ionizing Radiation: Radiation Protection Guidance for the United States (2018)’ was developed by Council Committee 1. The report builds and expands upon previous recommendations of NCRP and ICRP, covering exposure to radiation and radioactive materials for five exposure categories: occupational, public, medical, emergency workers, and nonhuman biota. Actions to add, increase, reduce or remove a source of exposure to humans require justification. Optimisation of protection universally applies, taking into account societal, economic, and environmental factors; addressing all hazards, and striving for continuous improvement when it is reasonable to do so. Numeric protection criteria for management of dose to an individual for a given exposure situation are provided, and differ in some respects from ICRP. A specific numeric criterion is suitable to be designated as a regulatory dose limit only when the source of exposure is stable, characterised, and the responsible organisation has established an appropriate radiation control program in advance of source introduction. Medical exposure includes patients, comforters and caregivers of a patient, and voluntary participants in biomedical research. Emergency workers are a new exposure category; their exposure is treated separately from occupational, public or medical exposure, and numeric criteria are provided for deterministic and stochastic effects. For nonhuman biota, the focus is on population maintenance of the affected species, and a guideline is provided for when additional assessment may be necessary. In addition, the recommendations emphasise that: ethical principles support decision-making; stakeholder engagement is necessary in deciding suitable management of their radiation exposure; and a strong safety culture is intrinsic to effective radiation protection programs.

Industrial lab safety committees and teams — Case study

In order to maintain safe working conditions in their laboratories and establish a strong safety culture, many industrial companies have established safety committees and emergency response teams. These groups involve several lab employees, and everyone participates in regular safety meetings at the department level. In this case study, two research facilities in the same organization have nearly identical committees and teams. There is some variation in how the committees are organized; that variation can influence how a committee carries out its mission and involves employees as active participants in safety programs. Committees keep the research community focused on safety; the teams respond to emergencies and other safety incidents.

Training in food safety culture

Training in food safety culture