Safety Management has lately been considered by some Nuclear Regulatory agencies as the tool on which to concentrate their efforts to implement modern regulation structures, because Safety Culture was said to be difficult to monitor. However, Safety Culture can be assessed and monitored even if it is problematical to make Safety Culture the object of regulation. This paper stresses the feasibility and importance of Safety Culture Assessment based on self-assessment applications performed in several nuclear organizations in Latin America. Reasons and ownership for assessing Safety Culture are discussed, and relevant aspects considered for setting up and programming such an assessment are shown. Basic principles that were taken into account, as well as financial and human resources used in actual self-assessments are reviewed, including the importance of adequate statistical analyses and the necessity of proper feed-back of results. The setting up of action plans to enhance Safety Culture is the final step of the assessment program that once implemented will enable to establish a Safety Culture monitoring process within the organization.
Han, Kiyoon; Jae, Moosung [Hanyang Univ., Seoul (Korea, Republic of)
The purpose of this study is to develop methodology for assessing safety culture impact on nuclear power plants. A new methodology for assessing safety culture impact index has been developed and applied for the reference nuclear power plants. The developed SCII model might contribute to comparing the level of safety culture among nuclear power plants as well as to improving the safety of nuclear power plants. Safety culture is defined to be fundamental attitudes and behaviors of the plant staff which demonstrate that nuclear safety is the most important consideration in all activities conducted in nuclear power operation. Through several accidents of nuclear power plant including the Fukusima Daiichi in 2011 and Chernovyl accidents in 1986, the safety of nuclear power plant is emerging into a matter of interest. From the accident review report, it can be easily found out that safety culture is important and one of dominant contributors to accidents. However, the impact methodology for assessing safety culture has not been established analytically yet. It is difficult to develop the methodology for assessing safety culture impact quantitatively.
Al-Mandhari, Ahmed; Al-Zakwani, Ibrahim; Al-Kindi, Moosa; Tawilah, Jihane; Dorvlo, Atsu S.S.; Al-Adawi, Samir
Objective To illustrate the patient safety culture in Oman as gleaned via 12 indices of patient safety culture derived from the Hospital Survey on Patient Safety Culture (HSPSC) and to compare the average positive response rates in patient safety culture between Oman and the USA, Taiwan, and Lebanon. Methods This was a cross-sectional research study employed to gauge the performance of HSPSC safety indices among health workers representing five secondary and tertiary care hospitals in the northern region of Oman. The participants (n=398) represented different professional designations of hospital staff. Analyses were performed using univariate statistics. Results The overall average positive response rate for the 12 patient safety culture dimensions of the HSPSC survey in Oman was 58%. The indices from HSPSC that were endorsed the highest included ‘organizational learning and continuous improvement’ while conversely, ‘non-punitive response to errors’ was ranked the least. There were no significant differences in average positive response rates between Oman and the United States (58% vs. 61%; p=0.666), Taiwan (58% vs. 64%; p=0.386), and Lebanon (58% vs. 61%; p=0.666). Conclusion This study provides the first empirical study on patient safety culture in Oman which is similar to those rates reported elsewhere. It highlights the specific strengths and weaknesses which may stem from the specific milieu prevailing in Oman. PMID:25170407
Park, Jung Hwan; Kim, Jong Hyun [KEPCO, Ulsan (Korea, Republic of)
This paper aims at developing the requirements for a method to evaluate the operational safety culture, evaluating currently available methods based on the requirements, and suggesting a method to evaluate and improve the operational safety culture for Korean nuclear power plants. This paper reviews the widely-used methods to assess safety culture for NPPs and their basis. Then, this paper develops the requirements for the method to evaluate operational safety culture for Korean NPPs. Based on these requirements, Korean Safety Culture Indicators (KSCI) and evaluation measures are also suggested. Finally this paper proposes the guidelines to develop improvements to safety culture from the evaluation results.
Zwijnenberg, N.C.; Hendriks, M.; Hoogervorst-Schilp, J.; Wagner, C.
Background: By assessing patient safety culture, healthcare providers can identify areas for improvement in patient safety culture. To achieve this, these assessment outcomes have to be relevant and presented clearly. The aim of our study was to explore healthcare professionals’ views on the
Han, Kiyoon; Jae, Moosung [Hanyang Univ., Seoul (Korea, Republic of)
Through several accidents of NPP including the Fukushima Daiichi in 2011 and Chernobyl accidents in 1986, a lack of safety culture was pointed out as one of the root cause of these accidents. Due to its latent influences on safety performance, safety culture has become an important issue in safety researches. Most of the researches describe how to evaluate the state of the safety culture of the organization. However, they did not include a possibility that the accident occurs due to the lack of safety culture. Because of that, a methodology for evaluating the impact of the safety culture on NPP's safety is required. In this study, the methodology for assessing safety culture impact is suggested and a computer program is developed for its application. SCII model which is the new methodology for assessing safety culture impact quantitatively by using PSA model. The computer program is developed for its application. This program visualizes the SCIs and the SCIIs. It might contribute to comparing the level of the safety culture among NPPs as well as improving the management safety of NPP.
The paper assessed the health and safety culture perceptions of management and field personnel of eight (8) construction firms located in Asokoro district of Abuja. Data on the perceptions of management and field personnel on construction health and safety culture were collated to test the hypothesis which states that ...
Leduc, C; De Blay, F; Kessler, R; Quoix, E; Kuteifan, K
Improvement in treatment safety is a major issue in Western healthcare systems, with the aim of reducing the number of treatment associated undesirable events. The safety culture, defined as an integrated and coherent collection of individual and organizational behavior that seeks continuously to reduce harm to patients, possibly related to treatment, could fulfill this aim. We have used an adaption of the American "Hospital Survey on Patient Safety" questionnaire (HSOPSC), which examines professionals' perception of treatment safety, to assess the safety culture in our respiratory medicine service in the Strasbourg University Hospital. Of the 110 questionnaires distributed to the service personnel, 93 were returned (85 %). The level of treatment safety was judged "acceptable" for 56 % of the personnel, "very good" for 32 %, against "weak" or "failing" for 10 %. Of the 10 dimensions explored, 8 were considered to need improvement and 2 had a level of positive responses greater than 50 %. Treatment safety culture seems to be an area to develop in our service. A strong safety culture should allow health care professionals to adhere better to treatment safety mechanisms. Copyright © 2015 SPLF. Published by Elsevier Masson SAS. All rights reserved.
Nascimento, C.S. do, E-mail: firstname.lastname@example.org [Centro Tecnológico da Marinha em São Paulo (CTMSP), Av. Professor Lineu Prestes 2468, 05508-000 São Paulo, SP (Brazil); Andrade, D.A., E-mail: email@example.com [Instituto de Pesquisas Energéticas e Nucleares (IPEN/CNEN – SP), Av. Professor Lineu Prestes 2242, 05508-000 São Paulo, SP (Brazil); Mesquita, R.N. de, E-mail: firstname.lastname@example.org [Instituto de Pesquisas Energéticas e Nucleares (IPEN/CNEN – SP), Av. Professor Lineu Prestes 2242, 05508-000 São Paulo, SP (Brazil)
Highlights: • A psychometric model to evaluate ‘safety climate’ at nuclear research facilities. • The model presented evidences of good psychometric qualities. • The model was applied to nuclear research facilities in Brazil. • Some ‘safety culture’ weaknesses were detected in the assessed organization. • A potential tool to develop safety management programs in nuclear facilities. - Abstract: A safe and reliable operation of nuclear power plants depends not only on technical performance, but also on the people and on the organization. Organizational factors have been recognized as the main causal mechanisms of accidents by research organizations through USA, Europe and Japan. Deficiencies related with these factors reveal weaknesses in the organization’s safety culture. A significant number of instruments to assess the safety culture based on psychometric models that evaluate safety climate through questionnaires, and which are based on reliability and validity evidences, have been published in health and ‘safety at work’ areas. However, there are few safety culture assessment instruments with these characteristics (reliability and validity) available on nuclear literature. Therefore, this work proposes an instrument to evaluate, with valid and reliable measures, the safety climate of nuclear research facilities. The instrument was developed based on methodological principles applied to research modeling and its psychometric properties were evaluated by a reliability analysis and validation of content, face and construct. The instrument was applied to an important nuclear research organization in Brazil. This organization comprises 4 research reactors and many nuclear laboratories. The survey results made possible a demographic characterization and the identification of some possible safety culture weaknesses and pointing out potential areas to be improved in the assessed organization. Good evidence of reliability with Cronbach's alpha
Park, Sunghyun; Kim, Namyeong; Jae, Moosung [Hanyang University, Seoul (Korea, Republic of)
In order to incorporate organizational factors into PSA, a methodology needs to be developed. Using the AHP to weigh organizational factors as well as the SLIM to rate those factors, a methodology is introduced in this study. The safety issues related to nuclear safety culture have occurred increasingly. The quantification tool has to be developed in order to include the organizational factor into Probabilistic Safety Assessments. In this study, the state-of-the-art for the organizational evaluation methodologies has been surveyed. This study includes the research for organizational factors, maintenance process, maintenance process analysis models, a quantitative methodology using Analytic Hierarchy Process, Success Likelihood Index Methodology. The purpose of this study is to develop a methodology to incorporate the safety culture into PSA for obtaining more objective risk than before. The organizational factor considered in nuclear safety culture might affect the potential risk of human error and hardware-failure. The safety culture impact index to monitor the plant safety culture can be assessed by applying the developed methodology into a nuclear power plant.
Ford, Eric W; Silvera, Geoffrey A; Kazley, Abby S; Diana, Mark L; Huerta, Timothy R
Purpose - The purpose of this paper is to explore the relationship between hospitals' electronic health record (EHR) adoption characteristics and their patient safety cultures. The "Meaningful Use" (MU) program is designed to increase hospitals' adoption of EHR, which will lead to better care quality, reduce medical errors, avoid unnecessary cost, and promote a patient safety culture. To reduce medical errors, hospital leaders have been encouraged to promote safety cultures common to high-reliability organizations. Expecting a positive relationship between EHR adoption and improved patient safety cultures appears sound in theory, but it has yet to be empirically demonstrated. Design/methodology/approach - Providers' perceptions of patient safety culture and counts of patient safety incidents are explored in relationship to hospital EHR adoption patterns. Multi-level modeling is employed to data drawn from the Agency for Healthcare Research and Quality's surveys on patient safety culture (level 1) and the American Hospital Association's survey and healthcare information technology supplement (level 2). Findings - The findings suggest that the early adoption of EHR capabilities hold a negative association to the number of patient safety events reported. However, this relationship was not present in providers' perceptions of overall patient safety cultures. These mixed results suggest that the understanding of the EHR-patient safety culture relationship needs further research. Originality/value - Relating EHR MU and providers' care quality attitudes is an important leading indicator for improved patient safety cultures. For healthcare facility managers and providers, the ability to effectively quantify the impact of new technologies on efforts to change organizational cultures is important for pinpointing clinical areas for process improvements.
Han, Sang Min; Seong, Poong Hyun [KAIST, Daejeon (Korea, Republic of)
This study is conducted to suggest a new safety culture assessment method in nuclear power plants. Criteria with various existing safety culture analysis methods are united, and reliability analysis methods are applied. The concept of the most representative methods, Fault Tree Analysis (FTA) and Failure Mode and Effect Analysis (FMEA), are adopted to assess safety culture. Through this application, it is expected that the suggested method will bring results with convenience and objectiveness.
The Center for Health and Safety Culture at Montana State University developed a survey to investigate the traffic safety culture related to engagement in traffic safety citizenship behaviors. The development of the survey was based on an augmented f...
Ashcroft, D M; Morecroft, C; Parker, D; Noyce, P R
To develop a framework that could be used by community pharmacies to self-assess their current level of safety culture maturity, which has high face validity and is both acceptable and feasible for use in this setting...
.Conclusion: Strong and positive safety culture among laboratory personnel would prevent incidence of many occupational accidents. In another word, it would help organizations to facilitate access to higher standards.
Mohammad Zakaria Kiaei
Full Text Available Introduction: Patient safety culture is an important part of improvement in the safety of health care. Knowing its present status is required for development of safety culture. The present study aimed to evaluate the current status of Patient safety culture in hospitals of three central provinces of Iran. Method: The present cross-sectional study was performed in teaching hospitals of Tehran, Alborz, and Qazvin provinces. The standard HSOPSC questionnaire was used for evaluation of the patient safety culture from the viewpoint of 522(Qazvin: 200, Tehran: 312, Alborz: 40 individuals who were randomly selected as workers of the hospitals. The collected data were analyzed using Chi-square and ANOVA tests. Results:The mean positive response to 12 aspects of the patient safety was 62.9%. “Organizational learning” had the highest proportion of positive response (71.18% and “Handoffs & Transitions” had the lowest (54.49%. There was a statistically significant difference in scores of “Teamwork within Units”(p=0.006(,”Manager Expectations & actions promoting”(p=0.014,”organizational learning and continuous improvement”(p=0.001, “Management support”(p=0.007, “Feedback and communication”(p=0.012, and “Communication openness”(p=0.003 among the provinces, respectively. Conclusion: We performed a full assessment of the patient safety culture in the studied provinces. Organizational learning was satisfactory in the hospitals. The studied hospitals need arrangement of safety-based programs and supports of senior administrators to perform more sophisticated efforts and improve the patient safety culture.
M. Shekari; G. A. Shirali; T. Hosseinzadeh
Introduction: Investigation of accidents have shown that more than 90% of industrial accidents are related to human aspects. What is more, safe behaviors can not be institutionalized in industries by only using technical-engineering measures and enacting safety rules. Building a positive and effective safety culture can make individuals aware of hazards and consequently reduce accidents in the workplace. .Material and Method: In this analytical-descriptive study, a standardized safety cul...
Wagner, C; Smits, M; Sorra, J; Huang, C C
It is believed that in order to reduce the number of adverse events, hospitals have to stimulate a more open culture and reflective attitude towards errors and patient safety. The objective is to examine similarities and differences in hospital patient safety culture in three countries: the Netherlands, the USA and Taiwan. This is a cross-sectional survey study across three countries. A questionnaire, the Hospital Survey on Patient Safety Culture (Hospital SOPS), was disseminated nationwide in the Netherlands, the USA and Taiwan. The study was conducted in 45 hospitals in the Netherlands, 622 in the USA and 74 in Taiwan. A total of 3779 professionals from the participating hospitals in the Netherlands, 196 462 from the USA and 10 146 from Taiwan participated in the study. The main outcome measures of the study were 12 dimensions of patient safety culture, e.g. Teamwork, Organizational learning, Communication openness. Most hospitals in all three countries have high scores on teamwork within units. The area with a high potential for improvement in all three countries is Handoffs and transitions. Differences between countries exist on the following dimensions: Non-punitive response to error, Feedback and communication about error, Communication openness, Management support for patient safety and Organizational learning--continuous improvement. On the whole, US respondents were more positive about the safety culture in their hospitals than Dutch and Taiwanese respondents. Nevertheless, there are even larger differences between hospitals within a country. Comparison of patient safety culture data has shown similarities and differences within and between countries. All three countries can improve areas of their patient safety culture. Countries can identify and share best practices and learn from each other.
Rodney, George A.
The development of a culture of safety and NASA since the Challenger accident is reviewed. The technical elements of the strengthened NASA safety program are described, including problem reporting, risk/assessment/risk management, operational safety, and safety assurance are addressed. Future directions in the development of safety are considered.
Walala, Micah S.
The researcher applied a mixed methods approach to conduct a cross-sectional assessment of the safety culture, safety climate, and SMS at a regional airline in the United States. Data collection techniques were comprised of interview, on-line-survey, and a focus group activity. Participants in the current study were maintenance technicians, flight attendants, dispatchers, pilots, and managers. Results indicated significant differences of perception of safety climate, safety culture, and Safet...
Zwijnenberg, Nicolien C; Hendriks, Michelle; Hoogervorst-Schilp, Janneke; Wagner, Cordula
By assessing patient safety culture, healthcare providers can identify areas for improvement in patient safety culture. To achieve this, these assessment outcomes have to be relevant and presented clearly. The aim of our study was to explore healthcare professionals' views on the feedback of a patient safety culture assessment. Twenty four hospitals participated in a patient safety culture assessment in 2012. Hospital departments received feedback in a report and on a website. In a survey, we evaluated healthcare professionals' views on this feedback and the effect of additional information about patient safety culture improvement strategies on the appraisal of the feedback. 20 hospitals participated in part I (evaluation of the report), 13 hospitals participated in part II (evaluation of the website). Healthcare professionals (e.g. members of staff and department heads/managers) rated the feedback in the report and on the website positively (average mean on different aspects = 7.2 on a scale from 1 to 10). Interpreting results was sometimes difficult, and information was sometimes lacking, like specific recommendations and improvement strategies. The provision of additional general information on patient safety culture improvement strategies resulted only in a higher appraisal of the attractiveness (lay-out) of the report and the understandability of the feedback report. The majority (84 %) of the healthcare professionals agreed or partly agreed that the feedback on patient safety culture stimulated actions to improve patient safety culture. However, a quarter also stated that although the feedback report provided insight into the patient safety culture, they did not know how to improve patient safety culture in their hospital. Healthcare professionals seem to be positive about the feedback on patient safety culture and its effect on stimulating patient safety culture improvement. To optimally tune feedback on patient safety culture towards healthcare
Patient safety is highly prioritised in the Danish health care system, never the less, patients are still exposed to risk and harmed every day. Implementation of a patient safety culture has been suggested an effective mean to protect patients against adverse events. Working strategically...... with assessment and development of the patient safety culture is in early days in Denmark. It depends upon valid, reliable and effective methods. The patient safety culture represents a wide range of social phenomena permeating the way of life in a health care. In essence, the safety culture is an aggregation...... of health care professional’s behaviour, habits, norms, values, and basic assumptions related to patient care; it is the way things are done. The patient safety culture guides the motivation, commitment to and know-how of the safety management, and how all members of a work place interact. This thesis...
Hoffmann, B; Müller, V; Rochon, J
practices. Conclusions Applied as a team-based instrument to assess safety culture, FraTrix did not lead to measurable improvements in error management. Comparable studies with more positive results had less robust study designs. In future research, validated combined methods to measure safety culture...
Lawson, Chad; Predella, Megan; Rowden, Allison; Goldstein, Jamie; Sistino, Joseph J; Fitzgerald, David C
The Hospital Survey on Patient Safety Culture was developed by the Agency for Healthcare Research and Quality (AHRQ) to assess the culture of safety in hospitals. The purpose of this study was to identify specific domains of perfusion that are indicators of a high quality culture of safety. Perfusionists were recruited to participate in the survey through email invitation through Perflist, Perfmail and LinkedIn. The survey consisted of 37 questions across six safety domains. Questions were developed using the AHRQ Hospital Survey on Patient Safety Culture. 'Positive scores' were defined as a response that either agreed or strongly agreed with a safety standard. Survey responses that resulted in a 75 percent or higher positive response rate were identified as vital components of a high culture of safety. Logistic regression analysis was used to determine importance components of perceived safety. Four responses were found to have a significant predictive level of a positive safety environment in the work unit: (1) in this unit, we discuss ways to prevent errors from happening again; OR=3.09, (2) in this unit, we treat others with respect; OR=1.09 (3) my supervisor/manager seriously considers staff suggestions for improving patient safety; OR=1.89 and (4) there is good cooperation among hospital units that need to work together; OR=1.77. There were two predictors of a negative work unit safety environment: (1) staff are afraid to ask questions when something does not seem right; OR=0.62 and (2) it is just by chance that more serious mistakes don't happen around here; OR=0.55. The results from this survey indicate that effective communication secondary to both incident and near-miss reporting is associated with a higher perceived culture of safety. A positive safety environment is associated with being able to speak up regarding safety issues without fear of negative repercussions.
Desmedt, Melissa; Bergs, Jochen; Vertriest, Sonja; Vlayen, Annemie; Schrooten, Ward; Hellings, Johan; Vandijck, Dominique
To give an overview of empirical studies using self-reported instruments to assess patient safety culture in primary care and to synthesize psychometric properties of these instruments. A key condition for improving patient safety is creating a supportive safety culture to identify weaknesses and to develop improvement strategies so recurrence of incidents can be minimized. However, most tools to measure and strengthen safety culture have been developed and tested in hospitals. Nevertheless, primary care is facing greater risks and a greater likelihood of causing unintentional harm to patients. A systematic literature review of research evidence and psychometric properties of self-reported instruments to assess patient safety culture in primary care. Three databases until November 2016. The review was carried out according to the protocol for systematic reviews of measurement properties recommended by the COSMIN panel and the PRISMA reporting guidelines. In total, 1.229 records were retrieved from multiple database searches (Medline = 865, Web of Science = 362 and Embase = 2). Resulting from an in-depth literature search, 14 published studies were identified, mostly originated from Western high-income countries. As these studies come with great diversity in tools used and outcomes reported, comparability of the results is compromised. Based on the psychometric review, the SCOPE-Primary Care survey was chosen as the most appropriate instrument to measure patient safety culture in primary care as the instrument had excellent internal consistency with Cronbach's alphas ranging from 0.70-0.90 and item factor loadings ranging from 0.40-0.96, indicating a good structural validity. The findings of the present review suggest that the SCOPE-Primary Care survey is the most appropriate tool to assess patient safety culture in primary care. Further psychometric techniques are now essential to ensure that the instrument provides meaningful information regarding safety
Webair, Hana H; Al-Assani, Salwa S; Al-Haddad, Reema H; Al-Shaeeb, Wafa H; Bin Selm, Manal A; Alyamani, Abdulla S
Patient safety culture in primary care is the first step to achieve high quality health care. This study aims to provide a baseline assessment of patient safety culture in primary care settings in Al-Mukala, Yemen as a first published study from a least developed country. A survey was conducted in primary healthcare centres and units in Al-Mukala District, Yemen. A comprehensive sample from the available 16 centres was included. An Arabic version of the Medical Office Survey on Patient Safety Culture was distributed to all health workers (110). Participants were physicians, nurses and administrative staff. The response rate from the participating centres was 71 %. (N = 78). The percent positive responses of the items is equal to the percentage of participants who answered positively. Composite scores were calculated by averaging the percent positive response on the items within a dimension. Positive safety culture was defined as 60 % or more positive responses on items or dimensions. Patient safety culture was perceived to be generally positive with the exception of the dimensions of 'Communication openness', 'Work pressure and pace' and 'Patient care tracking/follow-up', as the percent positive response of these dimensions were 58, 57, and 52 % respectively. Overall, positive rating on quality and patient safety were low (49 and 46 % respectively). Although patient safety culture in Al-Mukala primary care setting is generally positive, patient safety and quality rating were fairly low. Implementation of a safety and quality management system in Al-Mukala primary care setting are paramount. Further research is needed to confirm the applicability of the Medical Office Survey on Patient Safety Culture (MOSPSC) for Al-Mukala primary care.
Samsuri, Srima Elina; Pei Lin, Lua; Fahrni, Mathumalar Loganathan
Objective To assess the safety attitudes of pharmacists, provide a profile of their domains of safety attitude and correlate their attitudes with self-reported rates of medication errors. Design A cross-sectional study utilising the Safety Attitudes Questionnaire (SAQ). Setting 3 public hospitals and 27 health clinics. Participants 117 pharmacists. Main outcome measure(s) Safety culture mean scores, variation in scores across working units and between hospitals versus health clinics, predictors of safety culture, and medication errors and their correlation. Results Response rate was 83.6% (117 valid questionnaires returned). Stress recognition (73.0±20.4) and working condition (54.8±17.4) received the highest and lowest mean scores, respectively. Pharmacists exhibited positive attitudes towards: stress recognition (58.1%), job satisfaction (46.2%), teamwork climate (38.5%), safety climate (33.3%), perception of management (29.9%) and working condition (15.4%). With the exception of stress recognition, those who worked in health clinics scored higher than those in hospitals (psafety culture. As perceptions improved, the number of medication errors reported decreased. Group-specific interventions that target specific domains are necessary to improve the safety culture. PMID:26610761
Samsuri, Srima Elina; Pei Lin, Lua; Fahrni, Mathumalar Loganathan
To assess the safety attitudes of pharmacists, provide a profile of their domains of safety attitude and correlate their attitudes with self-reported rates of medication errors. A cross-sectional study utilising the Safety Attitudes Questionnaire (SAQ). 3 public hospitals and 27 health clinics. 117 pharmacists. Safety culture mean scores, variation in scores across working units and between hospitals versus health clinics, predictors of safety culture, and medication errors and their correlation. Response rate was 83.6% (117 valid questionnaires returned). Stress recognition (73.0±20.4) and working condition (54.8±17.4) received the highest and lowest mean scores, respectively. Pharmacists exhibited positive attitudes towards: stress recognition (58.1%), job satisfaction (46.2%), teamwork climate (38.5%), safety climate (33.3%), perception of management (29.9%) and working condition (15.4%). With the exception of stress recognition, those who worked in health clinics scored higher than those in hospitals (pculture. As perceptions improved, the number of medication errors reported decreased. Group-specific interventions that target specific domains are necessary to improve the safety culture. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Listyowardojo, Tita Alissa; Yan, Xiaoling; Leyshon, Stephen; Ray-Sannerud, Bobbie; Yu, Xin Yan; Zheng, Kai; Duan, Tao
Objective To assess safety culture at a public maternity hospital in Shanghai, China, using a sequential mixed methods approach. The study was part of a bigger study looking at the application of the mixed methods approach to assess safety culture in health care in different organizations and countries. Methodology A mixed methods approach was utilized by first distributing the Safety Attitudes Questionnaire measuring six safety culture dimensions and five independent items to all hospital staff (n=1482) working in 18 departments at a single hospital. Afterward, semistructured interviews were conducted using convenience sampling, where 48 hospital staff from nine departments at the same hospital were individually interviewed. Results The survey received a response rate of 96%. The survey findings show significant differences between the hospital departments in almost all safety culture dimensions and independent items. Similarly, the interview findings revealed that there were different, competing priorities between departments perceived to result in a reduced quality of collaboration and bottlenecks in care delivery. Another major finding was that staff who worked more hours per week would perceive working conditions significantly more negatively. Issues related to working conditions were also the most common concerns discussed in the interviews, especially the issue on high workload. High workload was also reflected in the fact that 91.45% of survey respondents reported that they worked 40 hours or longer per week. Finally, interview findings complemented survey findings, thus providing a more complete and accurate picture of safety culture. Conclusion Hospital leaders need to prioritize interventions focused on improving the quality of cross-department collaboration and reducing workload. A mixed methods assessment of safety culture provides more meaningful, targeted results, enabling leaders to prioritize and tailor improvement efforts to increase the impact of
Giménez-Marín, Angeles; Rivas-Ruiz, Francisco; García-Raja, Ana M; Venta-Obaya, Rafael; Fusté-Ventosa, Margarita; Caballé-Martín, Inmaculada; Benítez-Estevez, Alfonso; Quinteiro-García, Ana I; Bedini, José Luis; León-Justel, Antonio; Torra-Puig, Montserrat
There is increasing awareness of the importance of transforming organisational culture in order to raise safety standards. This paper describes the results obtained from an evaluation of patient safety culture in a sample of clinical laboratories in public hospitals in the Spanish National Health System. A descriptive cross-sectional study was conducted among health workers employed in the clinical laboratories of 27 public hospitals in 2012. The participants were recruited by the heads of service at each of the participating centers. Stratified analyses were performed to assess the mean score, standardized to a base of 100, of the six survey factors, together with the overall patient safety score. 740 completed questionnaires were received (88% of the 840 issued). The highest standardized scores were obtained in Area 1 (individual, social and cultural) with a mean value of 77 (95%CI: 76-78), and the lowest ones, in Area 3 (equipment and resources), with a mean value of 58 (95%CI: 57-59). In all areas, a greater perception of patient safety was reported by the heads of service than by other staff. We present the first multicentre study to evaluate the culture of clinical safety in public hospital laboratories in Spain. The results obtained evidence a culture in which high regard is paid to safety, probably due to the pattern of continuous quality improvement. Nevertheless, much remains to be done, as reflected by the weaknesses detected, which identify areas and strategies for improvement.
Kenneth Milne, J; Bendaly, Nicole; Bendaly, Leslie; Worsley, Jill; FitzGerald, John; Nisker, Jeff
Clinical error in acute care hospitals can only be addressed by developing a culture of safety. We sought to develop a cultural assessment survey (CAS) to assess patient safety culture change in obstetrical units. Interview prompts and a preliminary questionnaire were developed through a literature review of patient safety and "high reliability organizations," followed by interviews with members of the Managing Obstetrical Risk Efficiently (MOREOB) Program of the Society of Obstetricians and Gynaecologists of Canada. Three hundred preliminary questionnaires were mailed, and 21 interviews and 9 focus groups were conducted with the staff of 11 hospital sites participating in the program. To pilot test the CAS, 350 surveys were mailed to staff in participating hospitals, and interviews were conducted with seven nurses and five physicians who had completed the survey. Reliability analysis was conducted on four units that completed the CAS prior to and following the implementation of the first MOREOB module. Nineteen values and 105 behaviours, practices, and perceptions relating to patient safety were identified and included in the preliminary questionnaire, of which 143 of 300 (47.4%) were returned. Among the 220 cultural assessment surveys returned (62.9%), six cultural scales emerged: (1) patient safety as everyone's priority; (2) teamwork; (3) valuing individuals; (4) open communication; (5) learning; and (6) empowering individuals. The reliability analysis found all six scales to have internal reliability (Cronbach alpha), ranging from 0.72 (open communication) to 0.84 (valuing individuals). The CAS developed for this study may enable obstetrical units to assess change in patient safety culture.
Full Text Available Introduction: Annually, many accidents and preventable events happen for the patients hospitalized in treatment centers. Therefore, the related causing factors should be recognized in order to reduce the medical errors. Accordingly, the present study aimed to assess the relationship between patient’s safety culture elements and medical errors and also the ways to tackle them. Material and Method: This cross-sectional study was conducted among 380 employees working in the education and treatment centers affiliated with Kermanshah University of Medical Sciences in 2015. The hospital version of patient safety culture questionnaire was used for data collection. Data were analyzed by SPSS software, version 19 using different statistical tests including multivariate analysis of variance and Pearson’s correlation. Result: The patient safety culture was at an undesirable level in the study centers. Of the elements related to safety culture, the lowest positive scores belonged to ‘issues related to employees’, and ‘reporting’ with scores of 23% and 26%, respectively. On the other hand, ‘team working in the organizations’ (59% and ‘organizational learning’ (57% obtained the highest positive scores. Fifty-eight percent of the respondents did not report any errors. Conclusion: The results of present study emphasize on creating a desirable organizational atmosphere, the need for staff participation in various levels of decision making, and creating the culture of reporting errors in order to recognize the causing factors and to promote patient safety culture.
Full Text Available Tita Alissa Listyowardojo,1 Xiaoling Yan,2,3 Stephen Leyshon,1 Bobbie Ray-Sannerud,1 Xin Yan Yu,4 Kai Zheng,4 Tao Duan2,3 1Life Sciences Program, Group Technology and Research, DNV GL, Hovik, Norway; 2Quality and Safety Department, Shanghai First Maternity and Infant Hospital, 3Tongji University School of Medicine, Shanghai, 4Healthcare Department, Business Assurance, DNV GL, Beijing, China Objective: To assess safety culture at a public maternity hospital in Shanghai, China, using a sequential mixed methods approach. The study was part of a bigger study looking at the application of the mixed methods approach to assess safety culture in health care in different organizations and countries.Methodology: A mixed methods approach was utilized by first distributing the Safety Attitudes Questionnaire measuring six safety culture dimensions and five independent items to all hospital staff (n=1482 working in 18 departments at a single hospital. Afterward, semistructured interviews were conducted using convenience sampling, where 48 hospital staff from nine departments at the same hospital were individually interviewed.Results: The survey received a response rate of 96%. The survey findings show significant differences between the hospital departments in almost all safety culture dimensions and independent items. Similarly, the interview findings revealed that there were different, competing priorities between departments perceived to result in a reduced quality of collaboration and bottlenecks in care delivery. Another major finding was that staff who worked more hours per week would perceive working conditions significantly more negatively. Issues related to working conditions were also the most common concerns discussed in the interviews, especially the issue on high workload. High workload was also reflected in the fact that 91.45% of survey respondents reported that they worked 40 hours or longer per week. Finally, interview findings complemented
Hellings, Johan; Schrooten, Ward; Klazinga, Niek S.; Vleugels, Arthur
PURPOSE: Improving hospital patient safety means an open and stimulating culture is needed. This article aims to describe a patient safety culture improvement approach in five Belgian hospitals. DESIGN/METHODOLOGY/APPROACH: Patient safety culture was measured using a validated Belgian adaptation of
Maha Mohamed Ghobashi
Full Text Available Background Patient safety is critical component of health care quality. We aimed to assess the awareness of primary healthcare staff members about patient safety culture and explore the areas of deficiency and opportunities for improvement concerning this issue.Methods: This descriptive cross sectional study surveyed 369 staff members in four primary healthcare centers in Kuwait using self-administered “Hospital Survey on Patient Safety Culture” adopted questionnaire. The total number of respondents was 276 participants (response rate = 74.79%.Results: Five safety dimensions with lowest positivity (less than 50% were identified and these are; the non – punitive response to errors, frequency of event reporting, staffing, communication openness, center handoffs and transitions with the following percentages of positivity 24%, 32%, 41%, 45% and 47% respectively. The dimensions of highest positivity were teamwork within the center’s units (82% and organizational learning (75%.Conclusion: Patient safety culture in primary healthcare settings in Kuwait is not as strong as improvements for the provision of safe health care. Well-designed patient safety initiatives are needed to be integrated with organizational policies, particularly the pressing need to address the bioethical component of medical errors and their disclosure, communication openness and emotional issues related to them and investing the bright areas of skillful organizational learning and strong team working attitudes.
Khasawneh, Khalid; Park, Yun Woon [KAIST, Daejeon (Korea, Republic of)
For countries initiating or considering to start their nuclear power programs; developing a successful safety culture is of a great challenge, owing to lack of experience and the sensitive nature of the nuclear industry in general. The Jordanian case was chosen since Jordan is in the early stages of its nuclear program and the establishment of an effective safety culture is crucial to guarantee the safe operation of its future nuclear facilities. It also should be noted that Fukushima accident has adversely affected the progress of the Jordanian nuclear program driven by the negative public opinion. The government shifts the policies toward enhancing the nuclear safety by enforcing the communication between the engaged parties and openness and transparency with public. In the wake of Fukushima accident the Jordanian government reassured the appropriate siting criteria and siting review, the leadership and the organizations commitment to nuclear safety by adopting advanced reactor technology, the consideration of modern operator accident mitigation strategies and the increased and close cooperation with IAEA and adherence to evolving international safety standards. The progress in the Jordanian nuclear power project in order to satisfy the IAEA requirements was quantified and ranked. A good progress was shown in some aspects, for example in the multicultural and multi-national elements and the establishment of an independent and effective regulatory body. However, some elements, concerning the understanding of the safety culture, management system of the regulatory body and the cultural assessment was not satisfied and an urgent need to focus on and enhance those aspects are required by the Jordanian government. Some elements, for example the leadership, communication and competence, have partial fulfillment of the IAEA requirements. However enhancing those aspects is required in the short and the mid-term in order to guarantee a well-established nuclear power
Sorra, Joann; Khanna, Kabir; Dyer, Naomi; Mardon, Russ; Famolaro, Theresa
The purpose of this study was to examine relationships among 2 Agency for Healthcare Research and Quality measures of hospital patient safety and quality, which reflect different perspectives on hospital performance: the Hospital Survey on Patient Safety Culture (Hospital SOPS)--a hospital employee patient safety culture survey--and the Consumer Assessment of Healthcare Providers and Systems Hospital Survey (CAHPS Hospital Survey)--a survey of the experiences of adult inpatients with hospital care and services. Our hypothesis was that these 2 measures would be positively related. We performed multiple regressions to examine the relationships between the Hospital SOPS measures and CAHPS Hospital Survey measures, controlling for hospital bed size and ownership. Analyses were conducted at the hospital level with each survey's measures using data from 73 hospitals that administered both surveys during similar periods. Higher overall Hospital SOPS composite average scores were associated with higher overall CAHPS Hospital Survey composite average scores (r = 0.41, P G 0.01). Twelve of 15 Hospital SOPS measures were positively related to the CAHPS Hospital Survey composite average score after controlling for bed size and ownership, with significant standardized regression coefficients ranging from 0.25 to 0.38. None of the Hospital SOPS measures were significantly correlated with either of the two single-item CAHPS Hospital Survey measures (hospital rating and willingness to recommend). This study found that hospitals where staff have more positive perceptions of patient safety culture tend to have more positive assessments of care from patients. This finding helps validate both surveys and suggests that improvements in patient safety culture may lead to improved patient experience with care. Further research is needed to determine the generalizability of these results to larger sets of hospitals, to hospital units, and to other settings of care.
Moussavi, Fatemeh; MOGHRI, Javad; Gholizadeh, Yavar; Karami, Atiyeh; Najjari, Sedigheh; Mehmandust, Reza; ASGHARI, Mehdi; Asghari, Habib
Background: Patient safety is an essential element in the quality of healthcare, and a clear knowledge of its culture in healthcare organizations will lead to both improved healthcare and patient safety. The aim of this study was to assess the patient safety culture at Islamic Azad University hospitals in Tehran, Iran, in 2013. Methods: This cross-sectional study was conducted on clinical and diagnostic staff in all Islamic Azad University hospitals in Tehran in June 2013. The international ?...
Conclusion: According to the results of this study, commitment of healthcare authorities to patient safety culture is the most important factor in the promotion of organizational patient safety. Considering that the lowest score of patient safety culture belonged to the dimension of “overall perceptions of patient safety”,it is recommended that related training interventions be implemented for healthcare staff in order to establish and promote the patient safety culture in pharmacies.
Ammouri, A A; Tailakh, A K; Muliira, J K; Geethakrishnan, R; Al Kindi, S N
Patient safety is considered to be crucial to healthcare quality and is one of the major parameters monitored by all healthcare organizations around the world. Nurses play a vital role in maintaining and promoting patient safety due to the nature of their work. The purpose of this study was to investigate nurses' perceptions about patient safety culture and to identify the factors that need to be emphasized in order to develop and maintain the culture of safety among nurses in Oman. A descriptive and cross-sectional design was used. Patient safety culture was assessed by using the Hospital Survey on Patient Safety Culture among 414 registered nurses working in four major governmental hospitals in Oman. Descriptive statistics and general linear regression were employed to assess the association between patient safety culture and demographic variables. Nurses who perceived more supervisor or manager expectations, feedback and communications about errors, teamwork across hospital units, and hospital handoffs and transitions had more overall perception of patient safety. Nurses who perceived more teamwork within units and more feedback and communications about errors had more frequency of events reported. Furthermore, nurses who had more years of experience and were working in teaching hospitals had more perception of patient safety culture. Learning and continuous improvement, hospital management support, supervisor/manager expectations, feedback and communications about error, teamwork, hospital handoffs and transitions were found to be major patient safety culture predictors. Investing in practices and systems that focus on improving these aspects is likely to enhance the culture of patient safety in Omani hospitals and others like them. Strategies to nurture patient safety culture in Omani hospitals should focus upon building leadership capacity that support open communication, blame free, team work and continuous organizational learning. © 2014 International
Jung, Su Jin; Oh, Jang Jin; Choi, Young Sung [Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of)
The oversight of licensee's safety culture becomes an important issue that attracts great public and political concerns recently in Korea. Beginning from the intended violation of rules, a series of corruptions, documents forgery and disclosure of wrong-doings made the public think that the whole mindset of nuclear workers has been inadequate. Thus, they are demanding that safety culture shall be improved and that regulatory body shall play more roles and responsibilities for the improvements and oversight for them. This paper introduces, as an effort of regulatory side, recent changes in the role of regulators in safety culture, regulatory expectations on the desired status of licensee's safety culture, the pilot inspection program for safety culture and research activity for the development of oversight system. After the Fukushima accident in Japan 2011, many critics has searched for cultural factors that caused the unacceptable negligence pervaded in Japan nuclear society and the renewed emphasis has been placed on rebuilding safety culture by operators, regulators, and relevant institutions globally. Significant progress has been made in how to approach safety culture and led to a new perspective different from the existing normative assessment method both in operators and regulatory side. Regulatory expectations and oversight of them are based on such a new holistic concept for human, organizational and cultural elements to maintain and strengthen the integrity of defense in depth and consequently nuclear safety.
Mallouli, Manel; Tlili, Mohamed Ayoub; Aouicha, Wiem; Ben Rejeb, Mohamed; Zedini, Chekib; Salwa, Amrani; Mtiraoui, Ali; Ben Dhiab, Mohamed; Ajmi, Thouraya
To assess the patient safety culture (PSC) in operating rooms (ORs) and to determine influencing factors. A cross-sectional descriptive multicenter study which was conducted over a period of 7 months (October 2014-April 2015) using the French validated version of the Hospital Survey On Patient Safety Culture questionnaire. Of the note, 15 ORs of public and private healthcare institutions. In total, there were 368 participants including surgeons, anesthesiologists, surgical and anesthesia technicians, nurses and caregivers, divided into 316 professionals exercising in public sector and 52 working in private one. A self-administrated questionnaire investigating 10 dimensions of PSC (including 45 items), two items examining the staff perception of patient safety quality and reporting events, and five items regarding demographic characteristics of respondents. The participation rate in the study was 70.8%. All 10 dimensions were to be improved. The overall perception of patient safety had a score of 34.9%. The dimension that had the lowest score (20.5%) was the non-punitive response to error, and the one that had the highest score (41.67%) was teamwork in the ORs. Three dimensions were developed in private sector, and none in public hospitals. This study showed that the level of the PSC needs to be improved not only in public hospitals but also in private ones. The obtained results highlight the importance of implementing quality management systems and developing PSC.
Full Text Available Introduction: Safety culture is considered as the core of an organization’s safety management system. Safety culture is an organization ability to achieve higher standards of safety. The aim of this study was to investigate safety culture and its influencing factors and relation to the accident in a dam construction project. .Material and Method: This cross-sectional study was conducted among 130 workers at a dam construction project. A standardized questionnaire included 59 questions was used to determine the level of safety culture. The accidents occurred in the project during the year were collected based on demographic characteristics. The collected data were analyzed using SPSS version 19. .Result: The mean age of the subjects, their work experience and score of safety culture were 35.05, 7.5 Years and 183.2, respectively. Twenty seven accidents were recorded during the year in project. The most common cause of the accidents was indiscretions (33.3%. There was a statistically significant correlation between safety culture to occurred accidents and history of accident (P<0.05. The percentage of a positive safety culture of workers with an experience of accident (71.8% was more than that of those with no experience of accident (45.1%. There was not a statistically significant correlation between safety culture and age, work experience, education, and marital status. .Conclusion: It seems that safety culture on the project is influenced by the experience of accident and also it was strongly significant with the occurred accidents. Consequently, in order to create a positive safety culture in the workplace many factors including safety education program, work experience and accidents analysis should be considered.
Oxtoby, C; Mossop, L; White, K; Ferguson, E
Safety culture is a vital concept in human healthcare because of its influence on staff behaviours in relation to patient safety. Understanding safety culture is essential to ensure the acceptance and sustainability of changes, such as the introduction of safe surgery checklists. While widely studied and assessed in human medicine, there is no tool for its assessment in veterinary medicine. This paper therefore presents initial data on such an assessment: the Nottingham Veterinary Safety Culture Survey (NVSCS). 350 pilot surveys were distributed to practising vets and nurses. The survey was also available online. 229 surveys were returned (65 per cent response rate) and 183 completed online, resulting in 412 surveys for analysis. Four domains were identified: (1) organisational safety systems and behaviours, (2) staff perceptions of management, (3) risk perceptions and (4) teamwork and communication. Initial indications of the reliability and the validity of the final survey are presented. Although early in development, the resulting 29-item NVSCS is presented as a tool for measuring safety culture in veterinary practices with implications for benchmarking, safety culture assessment and teamwork training. British Veterinary Association.
Conclusion: The comparison between the two petrochemical plants of the group Sonatrach confirms these results in which Company A, the managers of which are English and Norwegian, distinguishes itself by the maturity of their safety culture has significantly higher evaluations than the company B, who is constituted of Algerian staff, in terms of safety management practices and safety performance.
Full Text Available This paper examines differences between formal safety and real safety in Estonian small and medium-sized enterprises. The results reveal key issues in safety culture assessment. Statistical analysis of safety culture questionnaires showed many organisations with an outstanding safety culture and positive safety attitudes. However, qualitative data indicated some important safety weaknesses and aspects that should be included in the process of evaluation of safety culture in organisations.
Torijano-Casalengua, María Luisa; Olivera-Cañadas, Guadalupe; Astier-Peña, María Pilar; Maderuelo-Fernández, José Ángel; Silvestre-Busto, Carmen
[corrected] To validate a tool to measure patient safety culture in Spanish primary care professionals. Medical Office Survey on Patient Safety Culture (MOSPSC), from the Agency for Healthcare and Research in Quality (AHRQ). The process has been performed in five steps: original version traslation, conceptual equivalence evaluation, acceptability and viability assessment, content validity and questionnaire test and response analysis and psichometric properties assessment. Primary care. 185 Primary care professionals from different Spanish regions represented the sample test. Frecuency, response pattern and discrimination power of each item. Cronbach's alpha coefficient and dimensions obtained through factor analysis. 17, 8% of respondents answered all the items and 28, 7% of them did not answer, or answered the option "Don't know/Does not apply", to one to four items. All the sentences, with only one exception, present discrimination capacity. Cronbach's alpha coefficient results 0,96 and information is sumarized in 15 factors obtaining the same items in 7 of the total 12 factors in the original questionnaire. Traslated, adapted, extended and validated AHRQ questionnaire is, in this setting, a reliable and useful instrument and it must be used for international comparisons. Copyright © 2012 Elsevier España, S.L. All rights reserved.
Pumar-Méndez, María J; Attree, Moira; Wakefield, Ann
A thematic literature review was undertaken to identify methodological aspects in the assessment of safety culture and critically examine how these have been addressed in hospital-based studies of safety culture, for the period 1999-2012. The literature search included an electronic database search (BNI, CINAHL, EMBASE, MEDLINE and PsycINFO), access to websites of organizations dedicated to the enhancement of patient safety, and a manual search of reference lists of the papers included. The analysis of the 43 records included in the review revealed that discussion regarding the measurement of safety culture in the hospital setting revolves around three methodological areas, namely: research approaches; survey tools for data collection; and levels of data aggregation. To advance these discussions, robust research is needed to clarify what dimensions belong to the core of safety culture and what the main sources of safety culture variability are. Studies using a mixed methods approach to assess safety culture would be useful, since they permit the in-depth research necessary to depict the multiple components of this construct. © 2014.
Boughaba, Assia; Hassane, Chabane; Roukia, Ouddai
To elucidate the relationship between safety culture maturity and safety performance of a particular company. To identify the factors that contribute to a safety culture, a survey questionnaire was created based mainly on the studies of Fernández-Muñiz et al. The survey was randomly distributed to 1000 employees of two oil companies and realized a rate of valid answer of 51%. Minitab 16 software was used and diverse tests, including the descriptive statistical analysis, factor analysis, reliability analysis, mean analysis, and correlation, were used for the analysis of data. Ten factors were extracted using the analysis of factor to represent safety culture and safety performance. The results of this study showed that the managers' commitment, training, incentives, communication, and employee involvement are the priority domains on which it is necessary to stress the effort of improvement, where they had all the descriptive average values lower than 3.0 at the level of Company B. Furthermore, the results also showed that the safety culture influences the safety performance of the company. Therefore, Company A with a good safety culture (the descriptive average values more than 4.0), is more successful than Company B in terms of accident rates. The comparison between the two petrochemical plants of the group Sonatrach confirms these results in which Company A, the managers of which are English and Norwegian, distinguishes itself by the maturity of their safety culture has significantly higher evaluations than the company B, who is constituted of Algerian staff, in terms of safety management practices and safety performance.
Boughaba, Assia; Hassane, Chabane; Roukia, Ouddai
Background To elucidate the relationship between safety culture maturity and safety performance of a particular company. Methods To identify the factors that contribute to a safety culture, a survey questionnaire was created based mainly on the studies of Fernández-Muñiz et al. The survey was randomly distributed to 1000 employees of two oil companies and realized a rate of valid answer of 51%. Minitab 16 software was used and diverse tests, including the descriptive statistical analysis, factor analysis, reliability analysis, mean analysis, and correlation, were used for the analysis of data. Ten factors were extracted using the analysis of factor to represent safety culture and safety performance. Results The results of this study showed that the managers' commitment, training, incentives, communication, and employee involvement are the priority domains on which it is necessary to stress the effort of improvement, where they had all the descriptive average values lower than 3.0 at the level of Company B. Furthermore, the results also showed that the safety culture influences the safety performance of the company. Therefore, Company A with a good safety culture (the descriptive average values more than 4.0), is more successful than Company B in terms of accident rates. Conclusion The comparison between the two petrochemical plants of the group Sonatrach confirms these results in which Company A, the managers of which are English and Norwegian, distinguishes itself by the maturity of their safety culture has significantly higher evaluations than the company B, who is constituted of Algerian staff, in terms of safety management practices and safety performance. PMID:25180135
Monaca, Clara; Bestmann, Beate; Kattein, Martina; Langner, Daria; Müller, Hardy; Manser, Tanja
Both, patient satisfaction and hospital safety culture have been recognized as key characteristics of healthcare quality and patient safety. Thus, both characteristics are measured widely to support quality and safety improvement efforts. However, because safety culture surveys focus exclusively on the perspective of hospital staff, the complimentary information to be gained from patients' perceptions of safety culture has received little research attention so far. We aimed to develop a measure explicitly focusing on patients' perceptions of safety culture in the hospital setting and perform an initial evaluation of its measurement properties. We employed a multistep development approach including (a) literature review of survey instruments for patient experience and safety culture and (b) item categorization and selection. We evaluated the measurement properties of the final item set focusing on factor structure, internal consistency, item difficulty, and discrimination. Data were collected from June to December 2015 via an online patient survey conducted routinely by a health insurer. Overall, 112,814 insured persons participated in the online survey (response rate = 19.7%). The final 11-item set formed a single scale that was named Patients' Perceptions of Safety Culture scale. Its measurement properties were deemed satisfactory based on this initial evaluation. The Patients' Perceptions of Safety Culture scale contributes to both a more comprehensive view of patients' experience of healthcare and a more balanced approach to safety culture measurement in healthcare. It contributes to an increased recognition of patients' views on safety-relevant aspects of their care that provide important inputs to patient safety improvement.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The
Owen, Edward L.
The need to identify the factors that influence the overall safety environment and compliance with safety procedures within airline operations is substantial. This study examines the relationships between job satisfaction, the overall perception of the safety culture, and compliance with safety rules and regulations of airline employees working in flight operations. A survey questionnaire administered via the internet gathered responses which were converted to numerical values for quantitative analysis. The results were grouped to provide indications of overall average levels in each of the three categories, satisfaction, perceptions, and compliance. Correlations between data in the three sets were tested for statistical significance using two-sample t-tests assuming equal variances. Strong statistical significance was found between job satisfaction and compliance with safety rules and between perceptions of the safety environment and safety compliance. The relationship between job satisfaction and safety perceptions did not show strong statistical significance.
Mohammad Reza Sharif
Full Text Available Patient safety, i.e. prevention of any hurt to the patient, is one of the main factors of health care quality. Improving patient safety culture through the implementation of systems and processes necessary to work can play an important role in preventing errors and improving the quality. For this purpose, the status of patient safety culture in Kashsn hospitals was examined. This cross - sectional study was performed in five hospitals of Kashan University of Medical Sciences and one Social Security Hospital, by a 42-item standard patient safety questionnaire with a random sampling of 200 nurses available in 2016. Mean age, experience, experience in the last unit of work, experience in nursing profession, work hours per week were obtained 34.28 ± 6.89, 7.72 ± 5.1, 5.87 ± 4.2, 10.42±7.93years and 62.8±26.8hours, respectively. Average of safety culture and its dimensions including teamwork within the units, in line with expectations and the head of patient safety, patient safety management support, organizational learning and continuous improvement, the general perception of patient safety, communication and feedback about errors were obtained 2.88±0.56, 3.04±069, 2.87±0.79, 3.08±0.88, 2.96±0.54, 2.87±0.98, 2.81±0.59, 2.52±0.98, 2.91±0.43, 3.14±1.04, 2.99±0.54, respectively. According to the obtained results, the status of safety culture in hospitals was deemed unfavorable and seemed to need development by training and proper guidelines in order to establish a culture of patient safety and prevention of hurt to patients in order to assure their safety at the hospitals.
Nyarugwe, Shingai P.; Linnemann, Anita; Nyanga, Loveness K.; Fogliano, Vincenzo; Luning, Pieternel A.
Food safety challenges are a global concern especially in emerging economies, which are in the midst of developmental changes. The challenges are directly or indirectly related to the behaviour and decision-making of personnel, and to an organisation's food safety culture. This study evaluated the
Taylor, T.N.; Eeckeleaert, L.; Starren, A.; Scheppingen, A. van; Fox, D.; Bruck, C.
Occupational safety and health culture, or more briefly 'OSH culture', can be seen as a concept for exploring how informal organisational aspects influence OSH in a positive or negative way. The aim is to convey up-to-date information on this complex topic in a straightforward, condensed way, trying
Adams, Catherine A.
'..only a fool perseveres in error.' Cicero. Humans will break the most advanced technological devices and override safety and security systems if they are given the latitude. Within the workplace, the operator may be just one of several factors in causing accidents or making risky decisions. Other variables considered for their involvement in the negative and often catastrophic outcomes include the organizational context and culture. Many organizations have constructed and implemented safety programs to be assimilated into their culture to assure employee commitment and understanding of the importance of everyday safety. The purpose of this paper is to examine literature on organizational safety cultures and programs that attempt to combat vulnerability, risk taking behavior and decisions and identify the role of training in attempting to mitigate unsafe acts.
Carvalho, Rhanna Emanuela Fontenele Lima de; Arruda, Lidyane Parente; Nascimento, Nayanne Karen Pinheiro do; Sampaio, Renata Lopes; Cavalcante, Maria Lígia Silva Nunes; Costa, Ana Carolina Pinto
to assess the culture of safety in three public hospitals. transversal study undertaken in three Brazilian public hospitals, with health professionals through applying the Safety Attitudes Questionnaire (SAQ). Scores greater than or equal to 75 were considered positive. a total of 573 professionals participated in the study, including nurse technicians and auxiliary nurses 292 (51%), nurses 105 (18.3%), physicians 59 (10.3%), and other professionals 117 (20.4%). The mean of the SAQ varied between 65 and 69 in the three hospitals. Among the domains, however, 'Job satisfaction' presented a higher score, and the opposite was observed for the domain 'Perceptions of management'. The outsourced professionals presented a better perception of the culture of safety than did the statutory professionals. The professionals with higher education presented a better perception of the stressing factors than did the professionals educated to senior high school level. the level of the culture of safety found is below the ideal. The managerial actions are considered the main contributing factor to the culture's weakness; however, the professionals demonstrated themselves to be satisfied with the work. evaluar la cultura de seguridad en tres hospitales públicos. estudio transversal realizado en tres hospitales públicos brasileños, desarrollado con profesionales de la salud aplicando el Safety Attitudes Questionnaire (SAQ). Fueron considerados positivos puntajes mayores o iguales a 75. participaron del estudio 573 profesionales, incluyendo técnicos y auxiliares de enfermería 292 (51%), enfermeros 105 (18,3%), médicos 59 (10,3%), y otros profesionales 117 (20,4%). El promedio del SAQ varió entre 65 a 69 en los tres hospitales. Sin embargo, en los dominios, Satisfacción en el Trabajo presentó mayor puntaje y lo opuesto fue observado en el dominio Percepción de la Administración. Los profesionales tercerizados presentaron mejor percepción de la cultura de seguridad que los
Cole, Kerstan Suzanne; Stevens-Adams, Susan Marie; Wenner, Caren A.
Workplace safety has been historically neglected by organizations in order to enhance profitability. Over the past 30 years, safety concerns and attention to safety have increased due to a series of disastrous events occurring across many different industries (e.g., Chernobyl, Upper Big-Branch Mine, Davis-Besse etc.). Many organizations have focused on promoting a healthy safety culture as a way to understand past incidents, and to prevent future disasters. There is an extensive academic literature devoted to safety culture, and the Department of Energy has also published a significant number of documents related to safety culture. The purpose of the current endeavor was to conduct a review of the safety culture literature in order to understand definitions, methodologies, models, and successful interventions for improving safety culture. After reviewing the literature, we observed four emerging themes. First, it was apparent that although safety culture is a valuable construct, it has some inherent weaknesses. For example, there is no common definition of safety culture and no standard way for assessing the construct. Second, it is apparent that researchers know how to measure particular components of safety culture, with specific focus on individual and organizational factors. Such existing methodologies can be leveraged for future assessments. Third, based on the published literature, the relationship between safety culture and performance is tenuous at best. There are few empirical studies that examine the relationship between safety culture and safety performance metrics. Further, most of these studies do not include a description of the implementation of interventions to improve safety culture, or do not measure the effect of these interventions on safety culture or performance. Fourth, safety culture is best viewed as a dynamic, multi-faceted overall system composed of individual, engineered and organizational models. By addressing all three components of
Kim, Younggab; Hur, Nam Young; Jeong, Hyeon Jong [KHNP Central Research Institute, Daejeon (Korea, Republic of)
In order to eliminate the vague fears of the people about the nuclear power and operate continuously NPPs, a strong safety culture of NPPs should be demonstrated. Strong safety culture awareness of workers can overcome social distrust about NPPs. KHNP has been a variety efforts to improve and establish safety culture of NPPs. Safety culture framework applying global standards was set up and safety culture assessment has been carried out periodically to enhance safety culture of workers. In addition, KHNP developed various safety culture contents and they are being used in NPPs by workers. As a result of these efforts, safety culture awareness of workers is changed positively and the safety environment of NPPs is expected to be improved. KHNP makes an effort to solve areas for improvement derived from safety culture assessment. However, there are some areas to take a long time in completing the work. Therefore, these actions are necessary to be carried out consistently and continuously. KHNP also developed recently safety culture enhancement system based on web. All information related to safety culture in KHNP will be shared through this web system and this system will be used to safety culture assessment. In addition to, KHNP plans to develop safety culture indicators for monitoring the symptoms of safety culture weakening.
Zenere, Alessandra; Zanolin, M Elisabetta; Negri, Roberta; Moretti, Francesca; Grassi, Mario; Tardivo, Stefano
Neonatal intensive care units (NICUs) are a high-risk setting. The Safety Attitude Questionnaire (SAQ) is a widely used tool to measure safety culture. The aims of the study are to verify the psychometric properties of the Italian version of SAQ, to evaluate safety culture in the NICUs and to identify improvement interventions. A cross-sectional study was conducted in 6 level III NICUs. The SAQ was translated into Italian and adapted to the context, a confirmatory factor analysis (CFA) was performed to validate the questionnaire. 193 questionnaires were collected. The mean response rate was 59.7% (range 44.5%-95.7%). The answers were analysed according to six factors: f1 - teamwork climate, f2 - safety climate, f3 - job satisfaction, f4 - stress recognition, f5 - perception of management, f6 - working conditions. The CFA indexes were adequate (McDonald's omega indexes varied from 0.74 to 0.94, the SRMR index was equal to 0.79 and the RMSEA index was 0.070, 95% CI = 0.063-0.078). The mean composite score was 57.6 (SD 17.9), ranging between 42.3 and 69.7 on a standardized 100-point scale. We highlighted significant differences among units and professions (P safety culture in the NICUs. The obtained scores significantly varied both within and among the NICUs. The organizational and structural characteristics of the involved hospitals probably affect the safety culture perception by the staff. © 2015 John Wiley & Sons, Ltd.
Pozo Muñoz, F; Padilla Marín, V
1) To describe the frequency of positive attitudes and behaviours, in terms of patient safety, among the healthcare providers working in a healthcare district; 2) to determine whether the level of safety-related culture differs from other studies; and 3) to analyse negatively valued dimensions, and to establish areas for their improvement. A descriptive, cross-sectional study based on the results of an evaluation of the safety-related culture was conducted on a randomly selected sample of 247 healthcare providers, by using the Spanish adaptation of the Hospital Survey on Patient Safety Culture (HSOPSC) designed by the Agency for Healthcare Research and Quality (AHRQ), as the evaluation tool. Positive and negative responses were analysed, as well as the global score. Results were compared with international and national results. A total of 176 completed survey questionnaires were analysed (response rate: 71.26%); 50% of responders described the safety climate as very good, 37% as acceptable, and 7% as excellent. Strong points were: «Teamwork within the units» (80.82%) and «Supervisor/manager expectations and actions» (80.54%). Dimensions identified for potential improvement included: «Staffing» (37.93%), «Non-punitive response to error» (41.67%), and «Frequency of event reporting» (49.05%). Strong and weak points were identified in the safety-related culture of the healthcare district studied, together with potential improvement areas. Benchmarking at the international level showed that our safety-related culture was within the average of hospitals, while at the national level, our results were above the average of hospitals. Copyright © 2013 SECA. Published by Elsevier Espana. All rights reserved.
The purpose of this project was to develop a better understanding of the traffic safety culture (i.e., shared values, beliefs, and : attitudes) of driving under the influence of cannabis (DUIC). A survey was developed based on an augmented integrated...
Singer, Sara J; Falwell, Alyson; Gaba, David M; Meterko, Mark; Rosen, Amy; Hartmann, Christine W; Baker, Laurence
Safety climate refers to shared perceptions of what an organization is like with regard to safety, whereas safety culture refers to employees' fundamental ideology and orientation and explains why safety is pursued in the manner exhibited within a particular organization. Although research has sought to identify opportunities for improving safety outcomes by studying patterns of variation in safety climate, few empirical studies have examined the impact of organizational characteristics such as culture on hospital safety climate. This study explored how aspects of general organizational culture relate to hospital patient safety climate. In a stratified sample of 92 U.S. hospitals, we sampled 100% of senior managers and physicians and 10% of other hospital workers. The Patient Safety Climate in Healthcare Organizations and the Zammuto and Krakower organizational culture surveys measured safety climate and group, entrepreneurial, hierarchical, and production orientation of hospitals' culture, respectively. We administered safety climate surveys to 18,361 personnel and organizational culture surveys to a 5,894 random subsample between March 2004 and May 2005. Secondary data came from the 2004 American Hospital Association Annual Hospital Survey and Dun & Bradstreet. Hierarchical linear regressions assessed relationships between organizational culture and safety climate measures. Aspects of general organizational culture were strongly related to safety climate. A higher level of group culture correlated with a higher level of safety climate, but more hierarchical culture was associated with lower safety climate. Aspects of organizational culture accounted for more than threefold improvement in measures of model fit compared with models with controls alone. A mix of culture types, emphasizing group culture, seemed optimal for safety climate. Safety climate and organizational culture are positively related. Results support strategies that promote group orientation and
Background In light of the immense attention given to patient safety, this paper details the findings of a baseline assessment of the patient safety culture in a large hospital in Riyadh and compares results with regional and international studies that utilized the Hospital Survey on Patient Safety Culture. This study also aims to explore the association between patient safety culture predictors and outcomes, considering respondent characteristics and facility size. Methods This cross sectional study adopted a customized version of the HSOPSC and targeted hospital staff fitting sampling criteria (physicians, nurses, clinical and non-clinical staff, pharmacy and laboratory staff, dietary and radiology staff, supervisors, and hospital managers). Results 3000 questionnaires were sent and 2572 were returned (response rate of 85.7%). Areas of strength were Organizational Learning and Continuous Improvement and Teamwork within units whereas areas requiring improvement were hospital non-punitive response to error, staffing, and Communication Openness. The comparative analysis noted several areas requiring improvement when results on survey composites were compared with results from Lebanon, and the United States. Regression analysis showed associations between higher patient safety aggregate score and greater age (46 years and above), longer work experience, having a Baccalaureate degree, and being a physician or other health professional. Conclusions Patient safety practices are crucial toward improving overall performance and quality of services in healthcare organizations. Much can be done in the sampled organizations and in the context of KSA in general to improve areas of weakness and further enhance areas of strength. PMID:24621339
Lee, Yong Hee; Lee, Yong Hee [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)
The Fukushima I nuclear accident following the Tohoku earthquake and tsunami on 11 March 2011 occurred after twelve years had passed since the JCO accident which was caused as a result of an error made by JCO employees. These accidents, along with the Chernobyl accident, associated with characteristic problems of various organizations caused severe social and economic disruptions and have had significant environmental and health impact. The cultural problems with human errors occur for various reasons, and different actions are needed to prevent different errors. Unfortunately, much of the research on organization and human error has shown widely various or different results which call for different approaches. In other words, we have to find more practical solutions from various researches for nuclear safety and lead a systematic approach to organizational deficiency causing human error. This paper reviews Hofstede's criteria, IAEA safety culture, safety areas of periodic safety review (PSR), teamwork and performance, and an evaluation of HANARO safety culture to verify the measures used to assess the organizational safety
... death in the United States. 2013 Traffic Safety Culture Index January 2014 607 14th Street, NW, Suite ... org | 202-638-5944 Title 2013 Traffic Safety Culture Index (January 2014) About the Sponsor AAA Foundation ...
Ek, Åsa; Olsson, Ulf; Akselsson, Roland
A project focusing on identifying and describing maritime risks is being conducted in the heavily trafficked water area of the Sound, situated in northern Europe between Sweden and Denmark. This paper reports of a test of a first version of a questionnaire constructed for measuring safety culture onboard vessels.48 crew members on a Swedish registered passenger/cargo ship completed and returned the questionnaire. The crew members were able to complete the questionnaire with few unanswered que...
Full Text Available Introduction: Occupational injuries and accidents as one of the problems have always been considered important in occupational environments. Domino model that Heinrich was formed to pursue the idea of the cause of the accident is the man. Thus one of the effective way to reduce accidents will be control by the unsafe behaviors among workers by promoting safety culture. .Material and Method: In this descriptive - analytical study, the reliability and exploratory factor analysis was used to evaluate the reliability of the questionnaire. In total 303 questionnaires were analyzed using SPSS 17 software. . Result: The alpha crumbed, coefficient was 0/86. Structural factor of the questionnaire was evaluated using factor analysis. KMO and Bartlett’s sphericity test coefficient were 0/909 and 9785/057, respectively. The varimax rotation showed that all test questions are based on factors. .Conclusion: The results indicated favorable validity of this questionnaire for use in detergents and cleaners industries within the country. Considering the load factor safety culture in detergents and cleaners industries, contained 5 factors including “management commitment”, “education and information exchange,” “supportive environment”, “barriers” and “priority to safety”. The obtained the correlations, the highest positive correlation was belong to the “management commitment” (r=0/952, as the strongest correlation with the safety culture.
Woodhouse, Kristina D; Volz, Edna; Bellerive, Marc; Bergendahl, Howard W; Gabriel, Peter E; Maity, Amit; Hahn, Stephen M; Vapiwala, Neha
In 2010, the American Society for Radiation Oncology launched a national campaign to improve patient safety in radiation therapy. One recommendation included the expansion of educational programs dedicated to quality and safety. We subsequently implemented a quality and safety culture education program (Q-SCEP) in our large radiation oncology department. The purpose of this study is to describe the design, implementation, and impact of this Q-SCEP. In 2010, we instituted a comprehensive Q-SCEP, consisting of a longitudinal series of lectures, meetings, and interactive workshops. Participation was mandatory for all department members across all network locations. Electronic surveys were administered to assess employee engagement, knowledge retention, preferred learning styles, and the program's overall impact. The Agency for Healthcare Research and Quality (AHRQ) Survey on Patient Safety Culture was administered. Analysis of variance was used for statistical analysis. Between 2010 and 2015, 100% of targeted staff participated in Q-SCEP. Thirty-three percent (132 of 400) and 30% (136 of 450) responded to surveys in 2012 and 2014, respectively. Mean scores improved from 73% to 89% (P safety culture education was critical to performing their jobs well. Full course compliance was achieved despite the sizable number of personnel and treatment centers. Periodic assessments demonstrated high knowledge retention, which significantly improved over time in nearly all department divisions. Additionally, our AHRQ patient safety grade remains high and continues to improve. These results will be used to further enhance ongoing internal safety initiatives and to inform future innovative efforts. Copyright © 2016 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.
Ibrahim, Sabariah Kader [KAIST, Daejeon (Korea, Republic of); Lee, Y. E. [Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of)
This paper presents preliminary study on safety culture and its implementation in Malaysian nuclear industries by realizing the importance of safety culture; identification of important safety culture attributes; safety culture assessment and the practices to incorporate the identified safety culture attributes in organization. The first section of this paper explains the terms and definitions related to safety culture. Second, for the realization of importance of safety culture in organization, the international operational experiences emphasizing the importance of safety culture are described. Third, important safety culture attributes which are frequently cited in literature are provided. Fourth, methods to assess safety culture in operating organization are described. Finally, the practices to enhance the safety culture in an organization are discussed.
Full Text Available Background and aims As a Development of Industrial process, human, environment, equipment, material and validity of system has been exposed to hazardous conditions. Regards of 32.3 percent of occupations in industries, this study focused on risk assessment of foundry unit by energy trace and barrier analysis (ETBA method and presented approaches to control of accident. Methods the recent study is as a case study one to risk assessment in a foundry unit in Qazvin industrial city in1387. In this study risks were founded by ETBA method and evaluated by MILSTD- 882B. Data were collected by direct observations, interview with workers and supervisor and engineers, walking-talking through method, documents investigation of operational processors, preventive maintenances, equipment technical properties, accidental and medical documents. Finally ETBA worksheets completed. Results totally 154 risks has been found. 40 from total are been unacceptable risk, 68 unfavorable and also 46 acceptable but with remediation action. Casting workshop had risks more than other workshops (with 74 identified risks.Potential and heat energies were founded as most hazardous energies, with respectively 51 and 38 risk cases. Conclusion This study recommended to be done actions for identification and control risk, such as: safety training, occupation training, preventive maintenance, contract safety, safety communication and safety audit group.
Smits, M.; Wagner, C.; Spreeuwenberg, P.; Wal, G. van der; Groenewegen, P.P.
Objectives: To test the claim that the Hospital Survey on Patient Safety Culture (HSOPS) measures patient safety culture instead of mere individual attitudes and to determine the most appropriate level (individual, unit or hospital level) for interventions aimed at improving the culture of patient
Hinde, Theresa; Gale, Thomas; Anderson, Ian; Roberts, Martin; Sice, Paul
Interprofessional point of care or in situ simulation is used as a training tool in our operating theatre directorate with the aim of improving crisis behaviours. This study aimed to assess the impact of interprofessional point of care simulation on the safety culture of operating theatres. A validated Safety Attitude Questionnaire was administered to staff members before each simulation scenario and then re-administered to the same staff members after 6-12 months. Pre- and post-training Safety Attitude Questionnaire-Operating Room (SAQ-OR) scores were compared using paired sample t-tests. Analysis revealed a statistically significant perceived improvement in both safety (p safety culture) 6-12 months after interprofessional simulation training. A growing body of literature suggests that a positive safety culture is associated with improved patient outcomes. Our study supports the implementation of point of care simulation as a useful intervention to improve safety culture in theatres.
An organizations safety culture can influence safety outcomes. Research and experience show that when safety culture is strong, accidents are less frequent and less severe. As a result, building and maintaining strong safety cultures should be a t...
Han, Kiyoon; Jae, Moosung [Hanyang Univ., Seoul (Korea, Republic of). Dept. of Nuclear Engineering
The present study developed a Safety Culture Impact Assessment Model (SCIAM) which consists of a safety culture assessment methodology and a safety culture impact quantification methodology. The SCIAM uses a safety culture impact index (SCII) to monitor the status of safety culture of NPPs periodically and it uses relative core damage frequency (RCDF) to present the impact of safety culture on the safety of NPPs. As a result of applying the SCIAM to the reference plant (Kori 3), the standard for the healthy safety culture of the reference plant is suggested. SCIAM might contribute to improve the safety of NPPs (Nuclear Power Plants) by monitoring the status of safety culture periodically and presenting the standard of healthy safety culture.
Full Text Available The increased use of food cultures to ferment perishable raw materials has potentiated the need for regulations to assess and assure the safety of food cultures and their uses. These regulations differ from country to country, all aimed at assuring the safe use of food cultures which has to be guaranteed by the food culture supplier. Here we highlight national differences in regulations and review a list of methods and methodologies to assess the safety of food cultures at strain level, at production, and in the final product.
Bentley, Tim; Tappin, David
This paper conceptualises organisational safety culture and considers its relevance to ergonomics practice. Issues discussed in the paper include the modest contribution that ergonomists and ergonomics as a discipline have made to this burgeoning field of study and the significance of safety culture to a systems approach. The relevance of safety culture to ergonomics work with regard to the analysis, design, implementation and evaluation process, and implications for participatory ergonomics approaches, are also discussed. A potential user-friendly, qualitative approach to assessing safety culture as part of ergonomics work is presented, based on a recently published conceptual framework that recognises the dynamic and multi-dimensional nature of safety culture. The paper concludes by considering the use of such an approach, where an understanding of different aspects of safety culture within an organisation is seen as important to the success of ergonomics projects. STATEMENT OF RELEVANCE: The relevance of safety culture to ergonomics practice is a key focus of this paper, including its relationship with the systems approach, participatory ergonomics and the ergonomics analysis, design, implementation and evaluation process. An approach to assessing safety culture as part of ergonomics work is presented.
Radiation safety and protection of people are shared goals of the Health Physics Society (HPS) and the U.S. Nuclear Regulatory Commission (NRC). A positive safety culture contributes to achieving radiation safety and protection of people, which are important to both the HPS and the NRC. Through unprecedented collaboration and engagement with diverse stakeholders, the NRC and the stakeholders developed a Safety Culture Policy Statement. The policy statement defines safety culture and describes the traits of a positive safety culture. Consideration of both safety and security issues and the interface of safety and security are underlying principles that support the policy. Examination of significant events, both within the nuclear industry and in society at large, illustrates how weaknesses in these traits can contribute to the occurrence and consequences of safety incidents, including serious injury and loss of life. With the policy statement in place, the NRC is moving forward with outreach and education about safety culture. Health physicists and other radiation safety specialists play an essential role in enhancing safety culture.
Han, Kiyoon; Jae, Moosung [Hanyang University, Seoul (Korea, Republic of)
Through several accidents of NPPs including the Fukushima Daiichi in 2011 and Chernobyl accidents in 1986, nuclear safety culture has been emphasized in reactor safety world-widely. In Korea, KHNP evaluates the safety culture of NPP itself. KHNP developed the principles of the safety culture in consideration of the international standards. A questionnaire and interview questions are also developed based on these principles and it is used for evaluating the safety culture. However, existing methodology to evaluate the safety culture has some disadvantages. First, it is difficult to maintain the consistency of the assessment. Second, the period of safety culture assessment is too long (every two years) so it has limitations in preventing accidents occurred by a lack of safety culture. Third, it is not possible to measure the change in the risk of NPPs by weak safety culture since it is not clearly explains the effect of safety culture on the safety of NPPs. In this study, Safety Culture Impact Assessment Model (SCIAM) is developed overcoming these disadvantages. In this study, SCIAM which overcoming disadvantages of exiting safety culture assessment method is developed. SCIAM uses SCII to monitor the statues of the safety culture periodically and also uses RCDF to quantify the safety culture impact on NPP's safety. It is significant that SCIAM represents the standard of the healthy nuclear safety culture, while the exiting safety culture assessment presented only vulnerability of the safety culture of organization. SCIAM might contribute to monitoring the level of safety culture periodically and, to improving the safety of NPP.
Embrey, David [Human Reliability Associates Ltd., Lancashire (United Kingdom)
In this paper, an approach will be described, called IDEAS (Influence Diagram Evaluation and Assessment System) that can achieve this objective. This approach has been applied to a number of industrial domains including chemical processing, railways, nuclear power generation, aviation and marine transport. IDEAS has a number of important applications in improving the safety and reliability of operations and maintenance. Firstly, it provides an explicit and easily understandable model of both the direct and indirect factors that influence the reliability of task performance. This model is based upon a combination of information from all available sources, including research studies, incident reports and the insights of personnel actually engaged in maintenance operations at the 'harp end' This provides comprehensive and practical insights into the factors that influence maintenance reliability. (author)
Afzal, Muhammad [Pakistan Nuclear Regulatory Authority, Islamabad (Pakistan); Choi, Kwang Sik [Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of)
The objective of this study is to assess the SC of the Pakistan Nuclear Regulatory Authority (PNRA) by developing a performance indicator-based questionnaire. Aspects that potentially play important roles in developing perceptions of SC, including age, type of job, gender and duty hours of regulatory staff, are given due importance in this study. The study also identifies the strengths and weaknesses in the SC of the PNRA and can be used as a model study to assess the SC of other RBs. The questionnaire, developed to assess the SC of the PNRA, was in line with the PNRA's own defined attributes for SC. In the past, significant efforts have been made to ensure the safe operation of NPPs by improving designs and operating procedures; however, the nuclear accident at the Fukushima NPP in Japan in March 2011 revealed that the currently allotted hardware safety margins are not sufficient, and much work is needed to improve safety management in terms of SC. Initially, the concept of SC was introduced for operating organizations to ensure safe operation of NPPs; nonetheless, more recent investigations of nuclear events and accidents, especially Fukushima, and at Davis-Besse, in the US, have revealed that a strong focus is required to address and improve the SC of Regulatory Bodies (RBs). Strong SC is considered a vital tool for RBs to achieve their objectives and discharge their responsibilities in an effective and efficient manner. Though the relationship between the SC of RBs and that of operating organizations is not straight forward, it is believed that the former has a strong influence over the latter. The questionnaire was consistent in terms of the credible nature of its questions, and the response group covered different levels of PNRA staff, from managers to lower level staff. The results show that the PNRA staff have a very good understanding of the nature and significance of attributes of SC and are doing their best to exercise the same within the
This final report summarizes the methods, results, conclusions, and recommendations derived from a survey conducted to understand values, beliefs, and attitudes regarding engagement in behaviors that impact the traffic safety of others. Results of th...
Raeissi, Pouran; Reisi, Nahid; Nasiripour, Amir Ashkan
In the relevant literature, the establishment of a patient safety culture (PSC) is a vital step in providing quality service to patients. The goal of this study was to establish a baseline for PSC in Iranian academic hospitals and to determine its strength and weaknesses. A survey was distributed in 26 academic hospitals linked to the Iran and Tehran Universities of Medical Sciences, of which 18 participated. The questionnaire, the Hospital Survey on Patient Safety Culture (HSOPSC), was used to collect the data. The questionnaire contained 14 dimensions and 43 items, and the questions were scored using a 5-point Likert scale in which 1 = strongly disagree and 5 = strongly agree.The results were expressed in the percentage of positive responses (%), or the percentage of positive responses (e.g., agree, strongly agree) to positively worded items (e.g., "Hospital units work well together to provide the best care for patients") in relation to the percentage of negative responses (e.g., disagree, strongly disagree) to negatively worded items (e.g., "When an event is reported, it feels like the person is being written up, not the problem"). To score each item, the following formula was applied: % of Positive Responses = [(No. of Agree + No. of Totally Agree) / Total No. of Subjects Responding to the Question)] × 100). For the negatively worded items, the answers were reversed. To score each dimension, a composite mean score of positive responses were estimated. The same methodology was applied to the scoring of the PSC of each hospital. (i.e., the composite mean score of positive responses on 12 dimensions was obtained). Note that the data reported in the tables of this manuscript represent percentages, and for ease of communication, (%) are omitted from the stated tables. In the text, however, we have used percent wherever needed.To categorize the hospitals' safety culture from very weak to very strong, a range of 0.0% to 100% positive responses on the PSC
Sharpanskykh, O.; Stroeve, S.
Safety culture is broadly recognized as important for operational safety in various fields, including air traffic management, power plant control and health care. Previous studies addressed characterization and assessment of safety culture extensively. Nevertheless, relations between safety culture
Pfaff, Holger; Hammer, Antje; Ernstmann, Nicole; Kowalski, Christoph; Ommen, Oliver
Safety culture is a multi-dimensional phenomenon. Safety culture of a healthcare organization is high if it has a common stock in knowledge, values and symbols in regard to patients' safety. The article intends to define safety culture in the first step and, in the second step, demonstrate the effects of safety culture. We present the model of safety behaviour and show how safety culture can affect behaviour and produce safe behaviour. In the third step we will look at the causes of safety culture and present the safety-culture-model. The main hypothesis of this model is that the safety culture of a healthcare organization strongly depends on its communication culture and its social capital. Finally, we will investigate how the safety culture of a healthcare organization can be improved. Based on the safety culture model six measures to improve safety culture will be presented.
Fischer, Erwin; Nithack, Eckhard [PreussenElektra GmbH, Hannover (Germany)
The meaning of leadership for safety in the nuclear industry is pointed out. This topic has became an increasing rank since the German ''Energiewende''. Despite the phase-out of the German NPP's nuclear safety and the belonging safety culture needs to be well maintained. A challenge for the whole organisation. Following the challenge to operate nuclear power plants towards Operational Excellence a highly skilled and motivated organisation is needed. Therefore Leadership is a valuable success factor.
Nordén-Hägg, Annika; Sexton, J Bryan; Kälvemark-Sporrong, Sofia; Ring, Lena; Kettis-Lindblad, Åsa
Safety culture assessment is increasingly recognized as an important component in healthcare quality improvement, also in pharmacies. One of the most commonly used and rigorously validated tools to measure safety culture is the Safety Attitudes Questionnaire; SAQ. This study presents the validation of the SAQ for use in Swedish pharmacies. The psychometric properties of the translated questionnaire are presented The original English language version of the SAQ was translated and adapted to the Swedish context and distributed by e-mail. The survey was carried out on a national basis, covering all 870 Swedish community pharmacies. In total, 7,244 questionnaires were distributed. Scale psychometrics were analysed using Cronbach alphas and intercorrelations among the scales. Multiple group confirmatory factor analysis (CFA) was conducted. SAQ data from 828 community pharmacies in Sweden, including 4,090 (60.22%) pharmacy personnel out of 6,683 eligible respondents, were received. There were 252 (28.97%) pharmacies that met the inclusion criteria of having at least 5 respondents and a minimum response rate of 60% within that pharmacy.The coefficient alpha value for each of the SAQ scales ranged from .72 to .89. The internal consistency results, in conjunction with the confirmatory factor analysis results, demonstrate that the Swedish translation of the SAQ has acceptable to good psychometric properties. Perceptions of the pharmacy (Teamwork Climate, Job Satisfaction, Perceptions of Management, Safety Climate, and Working Conditions) were moderately to highly correlated with one another whereas attitudes about stress (Stress Recognition) had only low correlations with other factors. Perceptions of management showed the most variability across pharmacies (SD = 26.66), whereas Stress Recognition showed the least (SD = 18.58). There was substantial variability ranging from 0% to 100% in the percent of positive scores for each of the factors across the 252 pharmacies. The
Xuanyue, Mao; Yanli, Nie; Hao, Cui; Pengli, Jia; Mingming, Zhang
Quite a number of articles on patient safety culture have been published in recent 10 years to assess the safety culture in hospitals using the Hospital Survey on Patient Safety Culture in many countries. However, until now there have been no relevant studies to investigate the quality of these, and their contribution to present-day thinking. The aim of this study was to explore the areas of theme, and the study design of published research on patient safety culture in literature published in English and Chinese language journals. We searched the major databases, including MEDLINE, EMbase, Chinese Biomedical Literature Database, Chinese Journals Full-text Database, and to analyze the publication years, research themes, authors' affiliations and methodologies of articles published from January 2001 to December 2011. Quality and statistical method were only appraised by classification of study designs. The annual number of published articles on patient safety culture was increasing in the last decade, and the number of articles published in 2010 and 2011 reached its peak with 86 articles accounting for 44.6% of the decade's publication; patient safety culture scale dominated the included literature, accounting for 67.8% of all studies. Cross-sectional studies and commentary reviews were the most popular study designs which took up approximately 95.9% of the included studies with 66.9% (129 articles) and 29.0% (56 articles), respectively. All the included studies on patient safety culture were conducted in the following four institutions: hospitals, geracomium, Veterans Health Administration hospitals, and medical schools. There is a growing change trend in the number of articles on patient safety culture research in recent 10 years, most of which are non-comparative studies. More methodologically rigorous designs are needed to improve research quality on patient safety culture. © 2013 Wiley Publishing Asia Pty Ltd and Chinese Cochrane Center, West China Hospital of
Madsen, Marlene Dyrløv
Patient safety - the prevention of medical error and adverse events - and the initiative of developing safety cultures to assure patients from harm have become one of the central concerns in quality improvement in healthcare both nationally andinternationally. This subject raises numerous challenging issues of systemic, organisational, cultural and ethical relevance, which this dissertation seeks to address through the application of different disciplinary approaches. The main focus of resear...
Madsen, Marlene Dyrløv
Patient safety - the prevention of medical error and adverse events - and the initiative of developing safety cultures to assure patients from harm have become one of the central concerns in quality improvement in healthcare both nationally andinternationally. This subject raises numerous...... the problems, and suggest possible solutions for improving patient safety through the promotion of safety culture and ethics. I seek to illuminate theissues of patient safety from several perspectives; the organizational healthcare system, in particular the healthcare workers perspectives and experiences......, and those of patients who experience the physical effect of poor patient safety. The dissertationconsists of nine papers and an appendix. Paper 1 describes the results of doctors and nurses attitudes towards reporting and the handling of adverse events. Paper 2 is a study and “review” of the international...
Bondevik, Gunnar Tschudi; Hofoss, Dag; Husebø, Bettina Sandgathe; Deilkås, Ellen Catharina Tveter
Patient safety culture concerns leader and staff interaction, attitudes, routines, awareness and practices that impinge on the risk of patient-adverse events. Due to their complex multiple diseases, nursing home patients are at particularly high risk of adverse events. Studies have found an association between patient safety culture and the risk of adverse events. This study aimed to investigate safety attitudes among healthcare providers in Norwegian nursing homes, using the Safety Attitudes Questionnaire - Ambulatory Version (SAQ-AV). We studied whether variations in safety attitudes were related to professional background, age, work experience and mother tongue. In February 2016, 463 healthcare providers working in five nursing homes in Tønsberg, Norway, were invited to answer the SAQ-AV, translated and adapted to the Norwegian nursing home setting. Previous validation of the Norwegian SAQ-AV for nursing homes identified five patient safety factors: teamwork climate, safety climate, job satisfaction, working conditions and stress recognition. SPSS v.22 was used for statistical analysis, which included estimations of mean values, standard deviations and multiple linear regressions. P-values patient safety factors teamwork climate, safety climate, job satisfaction and working conditions. Not being a Norwegian native speaker was associated with a significantly higher mean score for job satisfaction and a significantly lower mean score for stress recognition. Neither professional background nor work experience were significantly associated with mean scores for any patient safety factor. Patient safety factor scores in nursing homes were poorer than previously found in Norwegian general practices, but similar to findings in out-of-hours primary care clinics. Patient safety culture assessment may help nursing home leaders to initiate targeted quality improvement interventions. Further research should investigate associations between patient safety culture and the
Itoh, Kenji; Omata, N.; Andersen, Henning Boje
The present paper reports on a human error taxonomy system developed for healthcare risk management and on its application to evaluating safety performance and reporting culture. The taxonomy comprises dimensions for classifying errors, for performance-shaping factors, and for the maturity...... of reporting culture contained in incident reports. Applying several dimensions in the taxonomy, we propose on the one hand two safety performance measures, i.e., the rate of near-miss reporting and the rate of near-miss detection by safety procedure, and on the other, measures for diagnosing reporting culture...... including average descriptive depth in reports. We applied the taxonomy to a total of 3749 incident cases collected from two Japanese hospitals, which were at different stages of patient safety activities: Hospital A initiated organisation-wide initiatives several years before the survey period, while...
Full Text Available Abstract Background Patient safety is a critical component to the quality of health care. As health care organizations endeavour to improve their quality of care, there is a growing recognition of the importance of establishing a culture of patient safety. In this research, the authors use the Hospital Survey on Patient Safety Culture (HSOPSC questionnaire to assess the culture of patient safety in Taiwan and attempt to provide an explanation for some of the phenomena that are unique in Taiwan. Methods The authors used HSOPSC to measure the 12 dimensions of the patient safety culture from 42 hospitals in Taiwan. The survey received 788 respondents including physicians, nurses, and non-clinical staff. This study used SPSS 15.0 for Windows and Amos 7 software tools to perform the statistical analysis on the survey data, including descriptive statistics and confirmatory factor analysis of the structural equation model. Results The overall average positive response rate for the 12 patient safety culture dimensions of the HSOPSC survey was 64%, slightly higher than the average positive response rate for the AHRQ data (61%. The results showed that hospital staff in Taiwan feel positively toward patient safety culture in their organization. The dimension that received the highest positive response rate was "Teamwork within units", similar to the results reported in the US. The dimension with the lowest percentage of positive responses was "Staffing". Statistical analysis showed discrepancies between Taiwan and the US in three dimensions, including "Feedback and communication about error", "Communication openness", and "Frequency of event reporting". Conclusions The HSOPSC measurement provides evidence for assessing patient safety culture in Taiwan. The results show that in general, hospital staffs in Taiwan feel positively toward patient safety culture within their organization. The existence of discrepancies between the US data and the Taiwanese data
Weaver, Sallie J.; Lubomksi, Lisa H.; Wilson, Renee F.; Pfoh, Elizabeth R.; Martinez, Kathryn A.; Dy, Sydney M.
Developing a culture of safety is a core element of many efforts to improve patient safety and care quality. This systematic review identifies and assesses interventions used to promote safety culture or climate in acute care settings. The authors searched MEDLINE, CINAHL, PsycINFO, Cochrane, and EMBASE to identify relevant English-language studies published from January 2000 to October 2012. They selected studies that targeted health care workers practicing in inpatient settings and included data about change in patient safety culture or climate after a targeted intervention. Two raters independently screened 3679 abstracts (which yielded 33 eligible studies in 35 articles), extracted study data, and rated study quality and strength of evidence. Eight studies included executive walk rounds or interdisciplinary rounds; 8 evaluated multicomponent, unit-based interventions; and 20 included team training or communication initiatives. Twenty-nine studies reported some improvement in safety culture or patient outcomes, but measured outcomes were highly heterogeneous. Strength of evidence was low, and most studies were pre–post evaluations of low to moderate quality. Within these limits, evidence suggests that interventions can improve perceptions of safety culture and potentially reduce patient harm. PMID:23460092
Bagnasco, Annamaria; Tibaldi, Laura; Chirone, Paola; Chiaranda, Clara; Panzone, Maria Stella; Tangolo, Domenico; Aleo, Giuseppe; Lazzarino, Luciana; Sasso, Loredana
To understand what level of awareness health professionals working in a hospital of Northern Italy had of the patient safety culture by using the Italian version of the Hospital Survey on Patient Safety Culture questionnaire and also validate its use in this setting. The Hospital Survey on Patient Safety Culture questionnaire was developed by the Agency for Health Research and Quality in 2008 and validated by several studies. Therefore, we decided to test the Italian version of this tool to see if it could be used effectively to measure and appraise patient safety culture also in Italy. Survey. To check the validity of the questionnaire, we applied the continued comparison and the global data treatment methods. Of the 1008 questionnaires we administered, 724 (71%) were returned. The majority of the questions were answered (mean 98, SD 3·4%). From a Chi-square test on the consistency of the answers, we found that six of the 12 perspectives we explored had a high level of significance, whereas in the other six, the differences in the answers were just casual. The Italian version of the Hospital Survey on Patient Safety Culture questionnaire allowed us to assess health professionals' awareness of patient safety culture and thus validate the effectiveness of this tool. The findings of our survey could be useful to design an objective tool that would allow the five health professional groups involved in the study (directors/coordinators, physicians, nurses/midwives, physiotherapists and technicians) gain a better knowledge of the patient safety culture and thus improve the quality of clinical practice. © 2011 Blackwell Publishing Ltd.
Nolte, Kurt D.; Sanchez, Charles A.; Fonseca, Jorge M.
The 2006 "Escherichia coli" outbreak in spinach prompted the implementation of unprecedented production strategies (Arizona Leafy Green Products Shipper Marketing Agreement) to minimize microbial risk in leafy greens. As the new procedures require assessments of physical intrusion and excrement in fields, outreach was initiated to…
Richter, Jason P; McAlearney, Ann Scheck
Approximately 250,000 central line-associated bloodstream infections (CLABSIs) occur annually in the United States, with 30,000 related deaths. CLABSIs are largely preventable, and the Comprehensive Unit-Based Safety Program (CUSP) is a proven sustainable model that can be used to reduce CLABSIs. CUSP is a resource intensive program that, although widely used, has not been universally adopted. The purpose of this study is to identify the significant factors of safety culture prior to CUSP implementation associated with a reduction or elimination of CLABSIs. By identifying these factors, hospitals can target CUSP to those units expected to have the greatest odds of reducing CLABSIs. Using logistic and negative binomial regressions, we analyzed 649 hospital units that completed the national On the CUSP: Stop BSI study between May 2009 and June 2012. Hospital units provided CLABSI rates and staff survey responses on perceptions of factors of safety culture prior to CUSP implementation and CLABSI rates for six quarters thereafter. We found that hospital units reduced infection rates in the six quarters following CUSP implementation from 1.95 to 1.04 CLABSIs per 1,000 central line days. Most of the improvement occurred within the first two quarters following implementation. Hospitals with a stronger preimplementation safety culture had lower CLABSI rates at conclusion of the study. We found communication openness, staffing, organizational learning, and teamwork to be significantly associated with zero or reduced CLABSI rates. CUSP appears to have a greater impact on CLABSI rates when implemented by units with a strong existing safety culture. Targeted implementation allows hospitals to optimize success, maximize scarce resources, and alleviate some of the CUSP program's cost concerns if CUSP cannot be implemented in all units. To enhance the impact of CUSP, hospitals should improve safety culture prior to implementation in units that poorly exhibit it.
The match between safety and culture was made around 1986, when the INSAG delivered its initial report on the Chernobyl accident. Whether the marriage is a happy one is still a matter of debate, but it is most definitely a fruitful one. In the past twenty years, many researchers have devoted much
Hellings, Johan; Schrooten, Ward; Klazinga, Niek; Vleugels, Arthur
PURPOSE: The purpose of this paper is to measure patient safety culture in five Belgian general hospitals. Safety culture plays an important role in the approach towards greater patient safety in hospitals. DESIGN/METHODOLOGY/APPROACH: The Patient Safety Culture Hospital questionnaire was
Marshall, Martin; Cruickshank, Lesley; Shand, Jenny; Perry, Sarah; Anderson, James; Wei, Li; Parker, Dianne; de Silva, Debra
Understanding the cultural characteristics of healthcare organisations is widely recognised to be an important component of patient safety. A growing number of vulnerable older people are living in care homes but little attention has been paid to safety culture in this sector. In this study, we aimed to adapt the Manchester Patient Safety Framework (MaPSaF), a commonly used tool in the health sector, for use in care homes and then to test its face validity and preliminary feasibility as a tool for developing a better understanding of safety culture in the sector. As part of a wider improvement programme to reduce the prevalence of common safety incidents among residents in 90 care homes in England, we adapted MaPSaF and carried out a multimethod participatory evaluation of its face validity and feasibility for care home staff. Data were collected using participant observation, interviews, documentary analysis and a survey, and were analysed thematically. MaPSaF required considerable adaptation in terms of its length, language and content in order for it to be perceived to be acceptable and useful to care home staff. The changes made reflected differences between the health and care home sectors in terms of the local context and wider policy environment, and the expectations, capacity and capabilities of the staff. Based on this preliminary study, the adapted tool, renamed 'Culture is Key', appears to have reasonable face validity and, with adequate facilitation, it is usable by front-line staff and useful in raising their awareness about safety issues. 'Culture is Key' is a new tool which appears to have acceptable face validity and feasibility to be used by care home staff to deepen their understanding of the safety culture of their organisations and therefore has potential to contribute to improving care for vulnerable older people. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Ayres, R.A. [Transnuclear West Inc, California (United States); Reiss, R.E. [Performance Improvement International, San Clemente, Ca (United States)
A strong and improving safety culture provides the foundation for building long term success for a company. It is a cultural change for most organizations and requires years not months to achieve. Short term successes are typically achieved and the smart companies build upon and communicate those successes. For long term success, these companies never deviate or become complacent about maintaining a strong safety culture. There are several lessons learned from the nuclear industry that support the need to maintain a strong safety culture: (1)prevention of human errors costs less than dealing with the consequences (2)poorly designed processes cause the majority of human errors (3)quality supervision is a powerful tool in human error reduction (4)performance monitoring/trending and technology based root cause analysis are essential to human error reduction (5)human errors caused by misjudgment need special attention (6)procedural non-compliance needs a focused solution based on organizational psychology (7)the benefits of a well designed accountability system are very significant (8)knowledge and skills, more rules, are the last line of defense against problems. (authors)
Verbakel, Natasha J; Van Melle, Marije; Langelaan, Maaike; Verheij, Theo J M; Wagner, Cordula; Zwart, Dorien L M
To explore perceptions of safety culture in nine different types of primary care professions and to study possible differences. Cross-sectional survey. Three hundred and thirteen practices from nine types of primary care profession groups in the Netherlands. Professional staff from primary care practices. Nine professions participated: dental care, dietetics, exercise therapy, physiotherapy, occupational therapy, midwifery, anticoagulation clinics, skin therapy and speech therapy. Perceptions of seven patient safety culture dimensions were measured: 'open communication and learning from error', 'handover and teamwork', 'adequate procedures and working conditions', 'patient safety management', 'support and fellowship', 'intention to report events' and 'organizational learning'. Dimension means per profession were presented, and multilevel analyses were used to assess differences between professions. Also the so-called patient safety grade was self-reported. Five hundred and nineteen practices responded (response rate: 24%) of which 313 (625 individual questionnaires) were included for analysis. Overall, patient safety culture was perceived as being positive. Occupational therapy and anticoagulation therapy deviated most from other professions in a negative way, whereas physiotherapy deviated the most in a positive way. In addition, most professions graded their patient safety as positive (mean = 4.03 on a five-point scale). This study showed that patient safety culture in Dutch primary care professions on average is perceived positively. Also, it revealed variety between professions, indicating that a customized approach per profession group might contribute to successful implementation of safety strategies. © The Author 2014. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.
Enhancing the quality and safety of dairy food is critical to maintaining the competitiveness of dairy products in the food and beverage market and in reinforcing consumer confidence in the dairy industry. Raw milk quality has a significant effect on finished product quality. Several microbial groups found in raw milk have been shown to adversely affect the shelf life of pasteurized milk. Current microbiological criteria used to define milk quality are based primarily on culture-dependent methods, some of which are perceived to lack the desired sensitivity and specificity. To supplement traditional methods, culture-independent methods are increasingly being used to identify specific species or microbial groups, and to detect indicator genes or proteins in raw milk or dairy products. Some molecular subtyping techniques have been developed to track the transmission of microbes in dairy environments. The burgeoning "-omics" technologies offer new and exciting opportunities to enhance our understanding of food quality and safety in relation to microbes. Metagenomics has the potential to characterize microbial diversity, detect nonculturable microbes, and identify unique sequences or other factors associated with dairy product quality and safety. In this review, fluid milk will be used as the primary example to examine the adequacy and validity of conventional methods, the current trend of culture-independent methods, and the potential applications of metagenomics in dairy food research. Copyright © 2012 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.
Allen, Suellen; Chiarella, Mary; Homer, Caroline S E
. Undertaking research in this way requires local engagement, commitment and capacity from the study site. The absence of these factors is likely to limit the practicality of this approach in the clinical setting. the use of safety culture surveys as the only method of assessing safety culture is of limited value in identifying strategies to potentially improve the safety culture. Copyright © 2010 Elsevier Ltd. All rights reserved.
Weaver, Matthew D; Wang, Henry E; Fairbanks, Rollin J; Patterson, Daniel
Prior studies have highlighted wide variation in emergency medical services (EMS) workplace safety culture across agencies. To determine the association between EMS workplace safety culture scores and patient or provider safety outcomes. We administered a cross-sectional survey to EMS workers affiliated with a convenience sample of agencies. We recruited these agencies from a national EMS management organization. We used the EMS Safety Attitudes Questionnaire (EMS-SAQ) to measure workplace safety culture and the EMS Safety Inventory (EMS-SI), a tool developed to capture self-reported safety outcomes from EMS workers. The EMS-SAQ provides reliable and valid measures of six domains: safety climate, teamwork climate, perceptions of management, working conditions, stress recognition, and job satisfaction. A panel of medical directors, emergency medical technicians and paramedics, and occupational epidemiologists developed the EMS-SI to measure self-reported injury, medical errors and adverse events, and safety-compromising behaviors. We used hierarchical linear models to evaluate the association between EMS-SAQ scores and EMS-SI safety outcome measures. Sixteen percent of all respondents reported experiencing an injury in the past three months, four of every 10 respondents reported an error or adverse event (AE), and 89% reported safety-compromising behaviors. Respondents reporting injury scored lower on five of the six domains of safety culture. Respondents reporting an error or AE scored lower for four of the six domains, while respondents reporting safety-compromising behavior had lower safety culture scores for five of the six domains. Individual EMS worker perceptions of workplace safety culture are associated with composite measures of patient and provider safety outcomes. This study is preliminary evidence of the association between safety culture and patient or provider safety outcomes.
Background Developing a patient safety culture was one of the recommendations made by the Institute of Medicine to assist hospitals in improving patient safety. In recent years, a multitude of evidence, mostly originating from developed countries, has been published on patient safety culture. One of the first efforts to assess the culture of safety in the Eastern Mediterranean Region was by El-Jardali et al. (2010) in Lebanon. The study entitled "The Current State of Patient Safety Culture: a study at baseline" assessed the culture of safety in Lebanese hospitals. Based on study findings, the objective of this paper is to explore the association between patient safety culture predictors and outcomes, taking into consideration respondent and hospital characteristics. In addition, it will examine the correlation between patient safety culture composites. Methods Sixty-eight hospitals and 6,807 respondents participated in the study. The study which adopted a cross sectional research design utilized an Arabic-translated version of the Hospital Survey on Patient Safety Culture (HSOPSC). The HSOPSC measures 12 patient safety composites. Two of the composites, in addition to a patient safety grade and the number of events reported, represented the four outcome variables. Bivariate and mixed model regression analyses were used to examine the association between the patient safety culture predictors and outcomes. Results Significant correlations were observed among all patient safety culture composites but with differences in the strength of the correlation. Generalized Estimating Equations for the patient safety composite scores and respondent and hospital characteristics against the patient safety grade and the number of events reported revealed significant correlations. Significant correlations were also observed by linear mixed models of the same variables against the frequency of events reported and the overall perception of safety. Conclusion Event reporting
Full Text Available Abstract Background Developing a patient safety culture was one of the recommendations made by the Institute of Medicine to assist hospitals in improving patient safety. In recent years, a multitude of evidence, mostly originating from developed countries, has been published on patient safety culture. One of the first efforts to assess the culture of safety in the Eastern Mediterranean Region was by El-Jardali et al. (2010 in Lebanon. The study entitled "The Current State of Patient Safety Culture: a study at baseline" assessed the culture of safety in Lebanese hospitals. Based on study findings, the objective of this paper is to explore the association between patient safety culture predictors and outcomes, taking into consideration respondent and hospital characteristics. In addition, it will examine the correlation between patient safety culture composites. Methods Sixty-eight hospitals and 6,807 respondents participated in the study. The study which adopted a cross sectional research design utilized an Arabic-translated version of the Hospital Survey on Patient Safety Culture (HSOPSC. The HSOPSC measures 12 patient safety composites. Two of the composites, in addition to a patient safety grade and the number of events reported, represented the four outcome variables. Bivariate and mixed model regression analyses were used to examine the association between the patient safety culture predictors and outcomes. Results Significant correlations were observed among all patient safety culture composites but with differences in the strength of the correlation. Generalized Estimating Equations for the patient safety composite scores and respondent and hospital characteristics against the patient safety grade and the number of events reported revealed significant correlations. Significant correlations were also observed by linear mixed models of the same variables against the frequency of events reported and the overall perception of safety
Background A constructive patient safety culture is a main prerequisite for patient safety and improvement initiatives. Until now, patient safety culture (PSC) research was mainly focused on hospital care, however, it is of equal importance in primary care. Measuring PSC informs practices on their
Nyarugwe, Shingai P.; Linnemann, Anita; Hofstede, Gert Jan; Fogliano, Vincenzo; Luning, Pieternel A.
Background Foodborne outbreaks continue to occur regardless of existing food safety measures indicating the shortcomings of these measures to assure food safety. This has led to the recognition of food safety culture as a key contributory factor to the food safety performance of food
Lowe, Andrew; Hayward, Brent (Dedale Asia Pacific, Albert Park VIC 3206 (Australia))
results of the Safety Culture Perceptions Questionnaire conducted with site managers to access their opinions about the adequacy of the local safety culture; - a framework of safety-related competencies for managers, representing desirable actions for leading and promoting a positive safety culture; - results of an evaluation survey completed by participants at the conclusion of the Management Workshops to assess the utility of this activity. Section 4 of the report, Recommendations for Future Action, highlights nine proposed activities that could be undertaken to build on the outcomes from this project, to support the enhancement of safety culture within the Swedish nuclear industry in the longer term. Specifically, these recommendations propose actions to: 1. Introduce formal processes to ensure the ongoing development of safety related competencies amongst industry managers. 2. Strengthen the resources, contribution, value and profile of Man Technology Organisation (MTO) expertise within nuclear industry sites, in order to promote a better understanding of human performance issues, enhance error management and accident prevention capabilities. 3. Identify ways to embed existing positive safety culture attributes, in an environment of considerable workforce changes resulting from increasing use of contractors and (expected) retirements amongst an ageing industry employee population. 4. Standardise and improve aspects of incident and accident investigation processes and analysis methodologies currently used, to improve information sharing and optimise learning. 5. Implement harmonised MTO / human factors awareness training programs at appropriate levels for all nuclear industry personnel. 6. Formalise the application of applied teamwork training (as per the principles of Crew Resource Management training in aviation) for NPP Control Room Operators, Maintenance workers and other employees working in safety-critical teams. 7. Increase the use of simulation training to
Efforts to reduce construction accidents can be initiated by building good safety culture. Researches concerning safety culture, however, are still limited. This research aims to empirically gauge workerâs perception toward safety culture in construction projects. Data were obtained through questionnaire survey to three large construction projects in Surabaya. Two hundreds and seven sets of questionnaires were gathered and used for subsequent analyses. Results show that in general workersâ pe...
Dyhrberg, Mette Bang
Safety culture is a major issue in accident research. A recently finished ph.d.-study has evaluated the symbolic safety culture approach and found four advantages and two disadvantages. These are presented and discussed in this contribution. It is concluded that the approach can be useful...... in the planning of accident prevention activities if focus is maintained on prevention of accidents and not on changing of the safety culture....
Lee, Yii-Ching; Wu, Hsin-Hung; Hsieh, Wan-Lin; Weng, Shao-Jen; Hsieh, Liang-Po; Huang, Chih-Hsuan
The Sexton et al.'s (2006) safety attitudes questionnaire (SAQ) has been widely used to assess staff's attitudes towards patient safety in healthcare organizations. However, to date there have been few studies that discuss the perceptions of patient safety both from hospital staff and upper management. The purpose of this paper is to improve and to develop better strategies regarding patient safety in healthcare organizations. The Chinese version of SAQ based on the Taiwan Joint Commission on Hospital Accreditation is used to evaluate the perceptions of hospital staff. The current study then lies in applying importance-performance analysis technique to identify the major strengths and weaknesses of the safety culture. The results show that teamwork climate, safety climate, job satisfaction, stress recognition and working conditions are major strengths and should be maintained in order to provide a better patient safety culture. On the contrary, perceptions of management and hospital handoffs and transitions are important weaknesses and should be improved immediately. Research limitations/implications - The research is restricted in generalizability. The assessment of hospital staff in patient safety culture is physicians and registered nurses. It would be interesting to further evaluate other staff's (e.g. technicians, pharmacists and others) opinions regarding patient safety culture in the hospital. Few studies have clearly evaluated the perceptions of healthcare organization management regarding patient safety culture. Healthcare managers enable to take more effective actions to improve the level of patient safety by investigating key characteristics (either strengths or weaknesses) that healthcare organizations should focus on.
Robertson, Mike Fuller
Safety Management Systems (SMS) are becoming the industry standard for safety management throughout the aviation industry. As the Federal Aviation Administration (FAA) continues to mandate SMS for different segments, the assessment of an organization's safety culture becomes more important. An SMS can facilitate the development of a strong…
Khater, W A; Akhu-Zaheya, L M; Al-Mahasneh, S I; Khater, R
Patients' safety culture is a key aspect in determining healthcare organizations' ability to address and reduce risks of patients. Nurses play a major role in patients' safety because they are accountable for direct and continuous patient care. There is little known information about patients' safety culture in Jordanian hospitals, particularly from the perspective of healthcare providers. The study aimed to assess patient safety culture in Jordanian hospitals from nurses' perspective. A cross-sectional, descriptive design was utilized. A total number of 658 nurses participated in the current study. Data were collected using an Arabic version of the hospital survey of patients' safety culture. Teamwork within unit dimensions had a high positive response, and was perceived by nurses to be the only strong suit in Jordanian hospitals. Areas that required improvement, as perceived by nurses, are as follows: communication openness, staffing, handoff and transition, non-punitive responses to errors, and teamwork across units. Regression analysis revealed factors, from nurses' perspectives, that influenced patients' safety culture in Jordanian hospital. Factors included age, total years of experience, working in university hospitals, utilizing evidence-based practice and working in hospitals that consider patient safety to be a priority. Participants in this study were limited to nurses. Therefore, there is a need to assess patient safety culture from other healthcare providers' perspectives. Moreover, the use of a self-reported questionnaire introduced the social desirability biases. The current study provides insight into how nurses perceive patient safety culture. Results of this study have revealed that there is a need to replace the traditional culture of shame/blame with a non-punitive culture. Study results implied that improving patient safety culture requires a fundamental transformation of nurses' work environment. New policies to improve collaboration between
Bozorgzad, Parisa; Negarandeh, Reza; Raiesifar, Afsaneh; Poortaghi, Sarieh
Healing occurs in a safe milieu, and patients feel safe when service providers view them as whole persons, recognizing the multiple underlying factors that cause illness. Cultural safety can lead to service delivery in this way, but most nurses have no clear understanding of this concept. This study aimed to clarify cultural safety on the basis of Rodgers' evolutionary concept analysis. Cultural sensitivity and cultural awareness are the antecedents of cultural safety. These concepts include a nurse's flexibility toward his or her patients with different perspectives, creating an atmosphere free from intimidation and judgment of the patients, with an overall promotion of health in multicultural communities.
Full Text Available Efforts to reduce construction accidents can be initiated by building good safety culture. Researches concerning safety culture, however, are still limited. This research aims to empirically gauge workerâs perception toward safety culture in construction projects. Data were obtained through questionnaire survey to three large construction projects in Surabaya. Two hundreds and seven sets of questionnaires were gathered and used for subsequent analyses. Results show that in general workersâ perception toward safety culture are quite good. Further analysis indicates that workers in the three projects have different safety culture perceptions, especially on factors of top management commitment, safety rules and procedures, communication, and workerâs competency.
Profit, Jochen; Etchegaray, Jason; Petersen, Laura A; Sexton, J Bryan; Hysong, Sylvia J; Mei, Minghua; Thomas, Eric J
background Variation in health care delivery and outcomes in NICUs may be partly explained by differences in safety culture. objective To describe NICU caregiver assessments of safety culture, explore the variability within and between NICUs on safety culture domains, and test for association with caregiver characteristics. methods We surveyed NICU caregivers in a convenience sample of 12 hospitals from a single health care system, using the Safety Attitudes Questionnaire (SAQ). The six scales of the SAQ include teamwork climate, safety climate, job satisfaction, stress recognition, perception of management, and working conditions. For each NICU we calculated scale means, standard deviations and percent positives (percent agreement). results We found substantial variation in safety culture domains among participating NICUs. A composite mean score across the six safety culture domains ranged from 56.3 to 77.8 on a 100-point scale and NICUs in the top four NICUs were significantly different from the bottom four (p safety culture exists among this sample of NICUs. The NICU variation was similar to variation in adult ICUs, but NICU scores were generally higher than adult ICU scores. Future studies should validate whether safety culture as measured with the SAQ correlates with clinical and operational outcomes in the NICU setting. PMID:21930691
Verbakel, N.J.; Langelaan, M.; Verheij, T.J.M.; Wagner, C.; Zwart, D.L.M.
Background: A constructive safety culture is essential for the successful implementation of patient safety improvements. Aim: To assess the effect of two patient safety culture interventions on incident reporting as a proxy of safety culture. Design and setting: A three-arm cluster randomised trial
Verbakel, N.J.; Langelaan, M.; Verheij, T.J.M.; Wagner, C.; Zwart, D.L.M.
Background A constructive safety culture is essential for the successful implementation of patient safety improvements. Aim To assess the effect of two patient safety culture interventions on incident reporting as a proxy of safety culture. Design and setting A three-arm cluster randomised trial was
Saxton, James W; Finkelstein, Maggie M; Marles, Adam F
Physician practices can enhance their economics by taking patient safety to a new level within their practices. Patient safety has a lot to do with systems and processes that occur not only at the hospital but also within a physician's practice. Historically, patient safety measures have been hospital-focused and -driven, largely due to available resources; however, physician practices can impact patient safety, efficiently and effectively, with a methodical plan involving assessment, prioritization, and compliance. With the ever-increasing focus of reimbursement on quality and patient safety, physician practices that implement a true culture of safety now could see future economic benefits using this business strategy.
Martyka, Joanna; Lebecki, Kazimierz
This paper addresses the question of whether adopting safety culture improves hazard prevention in enterprises characterized by high primary risk. To answer this question, sample underground coal mines were examined to investigate the basic elements of the safety culture of employees. This paper presents the results of a diagnosis of the basic elements of the safety culture of supervisors (midlevel managers) and blue-collar workers in 3 underground coal mines. The study used 2 techniques: a Likert-type scale and a questionnaire. The results indicate the need to introduce changes in the safety culture of underground coal mine employees. This study also presents the conditions for improvement. Special attention was paid to (a) the conditions for improving safety culture and (b) a programme for modifying risky behaviours.
Smith, Scott Alan; Yount, Naomi; Sorra, Joann
A number of private and public companies calculate and publish proprietary hospital patient safety scores based on publicly available quality measures initially reported by the U.S. federal government. This study examines whether patient safety culture perceptions of U.S. hospital staff in a large national survey are related to publicly reported patient safety ratings of hospitals. The Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture (Hospital SOPS) assesses provider and staff perceptions of hospital patient safety culture. Consumer Reports (CR), a U.S. based non-profit organization, calculates and shares with its subscribers a Hospital Safety Score calculated annually from patient experience survey data and outcomes data gathered from federal databases. Linking data collected during similar time periods, we analyzed relationships between staff perceptions of patient safety culture composites and the CR Hospital Safety Score and its five components using multiple multivariate linear regressions. We analyzed data from 164 hospitals, with patient safety culture survey responses from 140,316 providers and staff, with an average of 856 completed surveys per hospital and an average response rate per hospital of 56%. Higher overall Hospital SOPS composite average scores were significantly associated with higher overall CR Hospital Safety Scores (β = 0.24, p safety culture scores were associated with higher CR patient experience scores on communication about medications and discharge. This study found a relationship between hospital staff perceptions of patient safety culture and the Consumer Reports Hospital Safety Score, which is a composite of patient experience and outcomes data from federal databases. As hospital managers allocate resources to improve patient safety culture within their organizations, their efforts may also indirectly improve consumer-focused, publicly reported hospital rating scores like the Consumer
McClain, Scott; Jones, Wendelyn; He, Xiaoyun; Ladics, Gregory; Bartholomaeus, Andrew; Raybould, Alan; Lutter, Petra; Xu, Haibin; Wang, Xue
Genetically modified (GM) crops were first introduced to farmers in 1995 with the intent to provide better crop yield and meet the increasing demand for food and feed. GM crops have evolved to include a thorough safety evaluation for their use in human food and animal feed. Safety considerations begin at the level of DNA whereby the inserted GM DNA is evaluated for its content, position and stability once placed into the crop genome. The safety of the proteins coded by the inserted DNA and potential effects on the crop are considered, and the purpose is to ensure that the transgenic novel proteins are safe from a toxicity, allergy, and environmental perspective. In addition, the grain that provides the processed food or animal feed is also tested to evaluate its nutritional content and identify unintended effects to the plant composition when warranted. To provide a platform for the safety assessment, the GM crop is compared to non-GM comparators in what is typically referred to as composition equivalence testing. New technologies, such as mass spectrometry and well-designed antibody-based methods, allow better analytical measurements of crop composition, including endogenous allergens. Many of the analytical methods and their intended uses are based on regulatory guidance documents, some of which are outlined in globally recognized documents such as Codex Alimentarius. In certain cases, animal models are recommended by some regulatory agencies in specific countries, but there is typically no hypothesis or justification of their use in testing the safety of GM crops. The quality and standardization of testing methods can be supported, in some cases, by employing good laboratory practices (GLP) and is recognized in China as important to ensure quality data. Although the number of recommended, in some cases, required methods for safety testing are increasing in some regulatory agencies, it should be noted that GM crops registered to date have been shown to be
Zhu, Junya; Li, Liping; Li, Yuxia; Shi, Meiyu; Lu, Haiying; Garnick, Deborah W; Weingart, Saul N
To develop a patient safety culture instrument for use in Chinese hospitals, we assessed the appropriateness of existing safety culture questionnaires used in the USA and Japan for Chinese respondents and identified new items and domains suitable to Chinese hospitals. Focus group study. Twenty-four physicians, nurses and other health-care workers from 11 hospitals in three Chinese cities. Three focus groups were conducted in 2010 to elicit information from hospital workers about their perceptions of the appropriateness and importance of each of 97 questionnaire items, derived from a literature review and an expert panel, characterizing hospital safety culture. understood the concepts of patient safety and safety culture and identified features associated with safe care. They judged that numerous questions from existing surveys were inappropriate, including 39 items that were dropped because they were judged unimportant, semantically redundant, confusing, ambiguous or inapplicable in Chinese settings. Participants endorsed eight new items and three additional dimensions addressing staff training, mentoring of new hires, compliance with rules and procedures, equipment availability and leadership walk-rounds they judged appropriate to assessing safety culture in Chinese hospitals. This process resulted in a 66-item instrument for testing in cognitive interviews, the next stage of survey development. Focus group participants provided important insights into the refinement of existing items and the construction of new items for measuring patient safety culture in Chinese hospitals. This is a necessary first step in producing a culturally appropriate instrument applicable to specific local contexts.
Richter, Anne; Koch, Christian
This article discusses safety cultures, drawing on the differentiation, integration and ambiguity-scheme introduced by scholars of organizational culture. An ethnographic approach has been applied in the study of meaning and symbols relating to work, hazards, occupational accidents and prevention....... The application of this approach is demonstrated through a multifacetted analysis of safety cultures. Case studies in Danish manufacturing show that it usually is necessary to differentiate between several safety cultures dispersed throughout the shop floor and other parts of the manufacturing organization....... Although some common elements are present across cultures, they are indeed a multiple configuration of cultures. The article illustrates this by providing one case showing a configuration of three cultures, metaphorically labelled Production, Welfare and Master. For example, the former views risk...
MCDONALD JA JR
In 2007, the Department of Energy (DOE) identified safety culture as one of their top Integrated Safety Management System (ISMS) related priorities. A team was formed to address this issue. The team identified a consensus set of safety culture principles, along with implementation practices that could be used by DOE, NNSA, and their contractors. Documented improvement tools were identified and communicated to contractors participating in a year long pilot project. After a year, lessons learned will be collected and a path forward determined. The goal of this effort was to achieve improved safety and mission performance through ISMS continuous improvement. The focus of ISMS improvement was safety culture improvement building on operating experience from similar industries such as the domestic and international commercial nuclear and chemical industry.
Ardeshir, A; Mohajeri, M
The construction industry is known as one of the most dangerous industries, which not only requires sound operation of executive laws and regulations, but also necessitates the safety culture of all workers at workshops. Therefore, the aim of this research is to identify the factors of safety culture and ranking occupations in jobsites based on those factors in order to proactively improve the safety culture of construction projects and subsequently promote safety conditions and worksites. In this study, safety culture criteria are weighted by a combination of Fuzzy Decision Trail and Evaluation Laboratory and Fuzzy ANP methods. Next, different job positions in high-rise projects are ranked using the Fuzzy Technique for Order of Preference by Similarity to Ideal Solution method. Findings demonstrated that the project manager, site superintendent and supervisor occupations had the highest and labourers had the lowest level of safety culture in the high-rise construction industry. Furthermore, factors such as safety supervision and training must be considered more seriously in order to create a positive safety culture among workers.
Dyhrberg, Mette Bang
The number of accidents at work in Denmark has not declined in the last decade, despite different types of preventions methods. Traditionally preventions have been based on regulation of human behaviour or machinery. Recently safety culture has been presented as a new approach for the prevention...... of occupational accidents. The implicit models of organisation and man within mainstream safety culture approaches seem to be too rationalistic compared with day to day life of organisations. A safety culture concept is presented where the basis is symbolism....
Han, Sangmin; Lee, Seung Min; Seong, Poong Hyun [KAIST, Daejeon (Korea, Republic of)
IAEA defined safety culture as follows: 'Safety Culture is that assembly of characteristics and attitudes in organizations and individuals which establishes that, as an overriding priority, nuclear plant safety issues receive the attention warranted by their significance'. Also, celebrated behavioral scientist, Cooper, defined safety culture as,'safety culture is that observable degree of effort by which all organizational members direct their attention and actions toward improving safety on a daily basis' with his internal psychological, situational, and behavioral context model. With these various definitions and criteria of safety culture, several safety culture assessment methods have been developed to improve and manage safety culture. To develop a new quantitative safety culture evaluation method for an operating team, we unified and redefined safety culture assessment items. Then we modeled a new safety culture evaluation by adopting level 1 PSA concept. Finally, we suggested the criteria to obtain nominal success probabilities of assessment items by using 'operational definition'. To validate the suggested evaluation method, we analyzed the collected audio-visual recording data collected from a full scope main control room simulator of a NPP in Korea.
Machón, M; Vergara, I; Silvestre, C; Pérez, P; Alías, G; Vrotsou, K
.... The adapted questionnaire will help to assess the level of safety of the resident culture among healthcare professionals in these centres, to identity areas for improvement, and to analyze how to evolve when organizational changes are introduced.
Nie, Yanli; Mao, Xuanyue; Cui, Hao; He, Shenghong; Li, Jing; Zhang, Mingming
Patient safety culture is an important measure in assessing the quality of health care. There is a growing recognition of the need to establish a culture of hospital focused on patient safety. This study explores the attitudes and perceptions of patient safety culture for health care workers in China by using a Hospital Survey on Patient Safety Culture (HSPSC) questionnaire and comparing it with the psychometric properties of an adapted translation of the HSPSC in Chinese hospitals with that of the US. We used the modified HSPSC questionnaire to measure 10 dimensions of patient safety culture from 32 hospitals in 15 cities all across China. The questionnaire included 1160 Chinese health-care workers who consisted of predominately internal physicians and nurses. We used SPSS 17.0 and Microsoft Excel 2007 to conduct the statistical analysis on survey data including descriptive statistics and validity and reliability of survey. All data was input and checked by two investigators independently. A total of 1500 questionnaires were distributed of which 1160 were responded validly (response rate 77%). The positive response rate for each item ranged from 36% to 89%. The positive response rate on 5 dimensions (Teamwork Within Units, Organization Learning-Continuous Improvement, Communication Openness, Non-punitive Response and Teamwork Across Units) was higher than that of AHRQ data (P survey was comparatively satisfied (Cronbach's α = 0.84). The results show that amongst the health care workers surveyed in China there was a positive attitude towards the patient safety culture within their organizations. The differences between China and the US in patient safety culture suggests that cultural uniqueness should be taken into consideration whenever safety culture measurement tools are applied in different culture settings.
Relihan, E; Glynn, S; Daly, D; Silke, B; Ryder, S
To assess the safety culture in an acute medical admissions unit (AMAU) of a teaching hospital in order to benchmark results against international data and guide a unit-based, integrated, risk management strategy. The safety attitudes questionnaire (SAQ), a validated instrument for the measurement of safety culture was applied to an AMAU. All AMAU healthcare staff (n = 92) were surveyed: doctors, nurses, healthcare assistants (HCAs) and allied healthcare professionals (AHPs). Safety attitude scores for the overall unit and individual caregiver types were assessed across six domains of safety culture. When compared against an international benchmark, the AMAU scored significantly higher for four of the six safety domains: p safety climate' and 'stress recognition' and p safety climate' (p safety spectrum: employee and environmental safety, clinical risk management and medication safety.
Richardson, Anna; Yarwood, Judy; Richardson, Sandra
Cultural safety is an essential concept within New Zealand nursing that is formally linked to registration and competency-based practice certification. Despite its centrality to New Zealand nursing philosophies and the stated expectation of cultural safety as a practice element, there is limited evidence of its application in the literature. This research presents insight into public health nurse's (PHN) experiences, demonstrating the integration of cultural safety principles into practice. These findings emerged following secondary analysis of data from a collaborative, educative research project where PHNs explored the use of family assessment tools. In particular, the 15-minute interview tool was introduced and used by the PHNs when working with families. Critical analysis of transcribed data from PHN interviews, utilising a cultural safety lens, illuminated practical ways in which cultural safety concepts infused PHN practice with families. The themes that emerged reflected the interweaving of the principles of cultural safety with the application of the five components of the 15-minute interview. This highlights elements of PHN work with individuals and families not previously acknowledged. Examples of culturally safe nursing practice resonated throughout the PHN conversations as they grappled with the increasing complexity of working with a diverse range of families. © 2016 John Wiley & Sons Ltd.
Pelzang, Rinchen; Johnstone, Megan-Jane; Hutchinson, Alison M
Studies show that if quality of healthcare in a country is to be achieved, due consideration must be given to the importance of the core cultural values as a critical factor in improving patient safety outcomes. The influence of Bhutan's traditional (core) cultural values on the attitudes and behaviours of healthcare professionals regarding patient care are not known. This study aimed to explore the possible influence of Bhutan's traditional cultural values on staff attitudes towards patient safety and quality care. Undertaken as a qualitative exploratory descriptive inquiry, a purposeful sample of 94 healthcare professionals and managers were recruited from three levels of hospitals, a training institute and the Ministry of Health. Interviews were transcribed verbatim and analysed using thematic analysis strategies. The findings of the study suggest that Bhutanese traditional cultural values have both productive and counterproductive influences on staff attitudes towards healthcare delivery and the processes that need to be in place to ensure patient safety. Productive influences encompassed: karmic incentives to avoid preventable harm and promote safe patient care; and the prospective adoption of the 'four harmonious friends' as a culturally meaningful frame for improving understanding of the role and importance of teamwork in enhancing patient safety. Counterproductive influences included: the adoption of hierarchical and authoritative styles of management; unilateral decision-making; the legitimization of karmic beliefs; differential treatment of patients; and preferences for traditional healing practices and rituals. Although problematic in some areas, Bhutan's traditional cultural values could be used positively to inform and frame an effective model for improving patient safety in Bhutan's hospitals. Such a model must entail the institution of an 'indigenized' patient safety program, with patient safety research and reporting systems framed around local
Han, Sang Min; Kim, Ar Ryum; Seong, Poong Hyun [KAIST, Daejeon (Korea, Republic of)
In this study, team safety culture competency of a team was estimated through SNA, as a team safety culture index. To overcome the limit of existing safety culture evaluation methods, the concept of competency and SNA were adopted. To estimate team safety culture competency, we defined the definition, range and goal of team safety culture competencies. Derivation of core team safety culture competencies is performed and its behavioral characteristics were derived for each safety culture competency, from the procedures used in NPPs and existing criteria to assess safety culture. Then observation was chosen as a method to provide the input data for the SNA matrix of team members versus insufficient team safety culture competencies. Then through matrix operation, the matrix was converted into the two meaningful values, which are density of team members and degree centralities of each team safety culture competency. Density of tem members and degree centrality of each team safety culture competency represent the team safety culture index and the priority of team safety culture competency to be improved.
Quillivan, Rebecca R; Burlison, Jonathan D; Browne, Emily K; Scott, Susan D; Hoffman, James M
Second victim experiences can affect the wellbeing of health care providers and compromise patient safety. Many factors associated with improved coping after patient safety event involvement are also components of a strong patient safety culture, so that supportive patient safety cultures may reduce second victim-related trauma. A cross-sectional survey study was conducted to assess the influence of patient safety culture on second victim-related distress. The Agency for Healthcare Research and Quality (AHRQ) Hospital Survey on Patient Safety Culture (HSOPSC) and the Second Victim Experience and Support Tool (SVEST), which was developed to assess organizational support and personal and professional distress after involvement in a patient safety event, were administered to nurses involved in direct patient care. Of 358 nurses at a specialized pediatric hospital, 169 (47.2%) completed both surveys. Hierarchical linear regres sion demonstrated that the patient safety culture survey dimension nonpunitive response to error was significantly associated with reductions in the second victim survey dimensions psychological, physical, and professional distress (p victim-related psychological, physical, and professional distress, which could reflect a lack of organizational support. Reducing punitive response to error and encouraging supportive coworker, supervisor, and institutional interactions may be useful strategies to manage the severity of second victim experiences.
Syarip [Yogyakarta Nuclear Research Centre, Yogyakarta (Indonesia); Hauptmanns, Ulrich [Department of Plant Design and Safety, Otto-Von-Guericke-University, Magdeburg (Germany)
The evaluation for assessing the safety culture and quality of safety management of Kartini research reactor is presented. The method is based on the concept of management control of safety (audit) as well as by using the developed method i.e. the questionnaires concerning areas of relevance which have to be answered with value statements. There are seven statements or qualifiers in answering the questions. Since such statements are vague, they are represented by fuzzy numbers. The weaknesses can be identified from the different areas contemplated. The evaluation result show that the quality of safety management of Kartini research reactor is globally rated as 'Average'. The operator behavior in the implementation of 'safety culture' concept is found as a weakness, therefore this area should be improved. (author)
Machón, M; Vergara, I; Silvestre, C; Pérez, P; Alías, G; Vrotsou, K
This article presents the first phase of a research project aimed at adapting a tool for assessing safety culture in nursing homes into Spanish. The Nursing Home on Patient Safety Culture of the Agency for Health Care Research and Quality was translated and culturally adapted. The International Quality of Life Assessment protocol was followed, which included, translation, conceptual equivalence evaluation, back-translation, content validity and a pilot study. Three of the 42 items were modified with respect to the original version. The remaining modifications were introduced in the F Section, containing sociodemographic information and job related questions. The adapted questionnaire will help to assess the level of safety of the resident culture among healthcare professionals in these centres, to identity areas for improvement, and to analyze how to evolve when organizational changes are introduced. Copyright © 2013 SECA. Published by Elsevier Espana. All rights reserved.
Patel, Saharsh; Wu, Albert W
Patient safety is increasingly recognized as a global health concern because of a staggering number of health care-related injuries and deaths. Although many hospitals are attempting to promote a patient safety agenda, there are relatively few options to track progress. The aims of this study were to translate and culturally adapt the Safety Attitudes Questionnaire (SAQ) into Gujarati and to provide evidence for its reliability and validity in hospitals in Gujarat, India. We also present preliminary data on the safety culture in these organizations. The first phase was the cultural adaptation and translation of the SAQ into Gujarati. The second phase was a cross-sectional survey of safety attitudes in 4 private hospitals. The survey was distributed to 424 health care workers and elicited an overall response rate of 79%. The questionnaire showed acceptable reliability and preliminary evidence for construct validity among health care workers in 4 private hospitals of varying size. The initial culture score results showed outcomes similar to international standards, with two-thirds of the respondents describing teamwork climate positively and more than half of the respondents describing safety climate positively. This study reveals promising initial results for patient safety culture in India, but further study is needed. The development and validation of the SAQ-Gujarati allow additional hospitals to evaluate their patient safety culture. As the first rendition of the SAQ to an Indian setting, the tool could help to initiate safety discourse and improve the potential for institutions to provide feedback to their staff members.
Full Text Available Abstract Background Aim of study was to document 1 that patient safety culture scores vary considerably by hospital department and ward, and 2 that much of the variation is across the lowest level organizational units: the wards. Setting of study: 500-bed Norwegian university hospital, September-December 2006. Methods Data collected from 1400 staff by (the Norwegian version of the generic version of the Safety Attitudes Questionnaire (SAQ Short Form 2006. Multilevel analysis by MLwiN version 1.10. Results Considerable parts of the score variations were at the ward and department levels. More organization level variation was seen at the ward level than at the department level. Conclusions Patient safety culture improvement efforts should not be limited to all-hospital interventions or interventions aimed at entire departments, but include involvement at the ward level, selectively aimed at low-scoring wards. Patient safety culture should be studied as closely to the patient as possible. There may be such a thing as "hospital safety culture" and the variance across hospital departments indicates the existence of department safety cultures. However, neglecting the study of patient safety culture at the ward level will mask important local variations. Safety culture research and improvement should not stop at the lowest formal level of the hospital (wards, out-patient clinics, ERs, but proceed to collect and analyze data on the micro-units within them.
Macchi, L.; Pietikaeinen, E.; Liinasuo, M.; Savioja, P.; Reiman, T.; Wahlstroem, M. [VTT Technical Research Centre of Finland, Espoo (Finland); Kahlbom, U. [Risk Pilot AB, Stockholm (Sweden); Rollenhagen, C. [Vattenfall, Stockholm, (Sweden)
In this report we approach design from a safety culture approach As this research area is new and understudied, we take a wide scope on the issue. Different theoretical perspectives that can be taken when improving safety of the design process are considered in this report. We suggest that in the design context the concept of safety culture should be expanded from an organizational level to the level of the network of organizations involved in the design activity. The implication of approaching the design process from a safety culture perspective are discussed and the results of the empirical part of the research are presented. In the interview study in Finland and Sweden we identified challenges and opportunities in the design process from safety culture perspective. Also, a small part of the interview study concentrated on state of the art human factors engineering (HFE) practices in Finland and the results relating to that are presented. This report provide a basis for future development of systematic good design practices and for providing guidelines that can lead to safe and robust technical solutions. (Author)
Lahtinen, Sampo J.; Boyle, Robert J.; Margolles, Abelardo; Frias, Rafael; Gueimonde, Miguel
Viable microbes have been a natural part of human diet throughout the history of mankind. Today, different fermented foods and other foods containing live microbes are consumed around the world, including industrialized countries, where the diet has become increasingly sterile during the last decades. By definition, probiotics are viable microbes with documented beneficial effects on host health. Probiotics have an excellent safety record, both in humans and in animals. Despite the wide and continuously increasing consumption of probiotics, adverse events related to probiotic use are extremely rare. Many popular probiotic strains such as lactobacilli and bifidobacteria can be considered as components of normal healthy intestinal microbiota, and thus are not thought to pose a risk for the host health - in contrast, beneficial effects on health are commonly reported. Nevertheless, the safety of probiotics is an important issue, in particular in the case of new potential probiotics which do not have a long history of safe use, and of probiotics belonging to species for which general assumption of safety cannot be made. Furthermore, safety of probiotics in high-risk populations such as critically ill patients and immunocompromized subjects deserves particular attention, as virtually all reported cases of bacteremia and fungemia associated with probiotic use, involve subjects with underlying diseases, compromised immune system or compromised intestinal integrity.
Oh, Chaewoon [International Policy Department Policy and Standard Division, Korea Institute of Nuclear Safety, 19 Gusung-Dong Yuseong-Ku, 305-338 DAEJEON (Korea, Republic of)
'Statement of Nuclear Safety Policy' declared by the Korean Government elucidates adherence to the principle of 'priority to safety'. The 3. Comprehensive Nuclear Energy Promotion Plan (2007-2011) more specifically addressed the necessity to develop and apply 'safety culture evaluation criteria' and to strengthen safety management of concerned organizations in an autonomous way. Putting these policies as a backdrop, Korean Government has taken diverse safety culture initiatives and has encouraged the relevant organizations to develop safety culture practices of their own accord. Accordingly, KHNP, the operating organization in Korea, developed a 'safety culture performance indicator', which has been used to evaluate safety mind of employees and the evaluation results have been continuously reflected in operational management and training programs. Furthermore, KHNP inserted 'nuclear safety culture subject' into every course of more than two week length, and provided employees with special lectures on safety culture. KINS, the regulatory organization, developed indicators for the safety culture evaluation based on the IAEA Guidelines. Also, KINS has hosted an annual Nuclear Safety Technology Information Meeting to share information between regulatory organizations and industries. Furthermore, KINS provided a nuclear safety culture class to the new employees and they are given a chance to participate in performance of a role-reversal socio-drama. Additionally, KINS developed a safety culture training program, published training materials and conducted a 'Nuclear Safety Culture Basic Course' in October 2007, 4 times of which are planed this year. In conclusion, from Government to relevant organizations, 'nuclear safety culture' concept is embraced as important and has been put into practice on a variety of forms. Specifically, 'education and training' is a starting line and sharing
Full Text Available Introduction: Establishment of patient safety culture is the first step in the improvement of patient safety. As such, assessment of patient safety culture in hospitals is of paramount importance. Patient safety culture is an inherent component of organizational culture, so that the study of organizational culture is required in developing patient safety. This study aimed to evaluate patient safety culture among the clinical staff of a hospital in Jakarta, Indonesia and identify organizational culture profile. Materials and Methods: This cross-sectional, descriptive, qualitative study was conducted in a hospital in Jakarta, Indonesia in 2014. Sample population consisted of nurses, midwives, physicians, pediatricians, obstetrics and gynecology specialists, laboratory personnel, and pharmacy staff (n=152. Data were collected using the Hospital Survey on Patient Safety Culture developed by the Agency for Healthcare Research and Quality (AHRQ and Organizational Culture Assessment Instrument (OCAI. Results: Teamwork within units” was the strongest dimension of patient safety culture (91.7%, while “staffing” and “non-punitive response to error” were the weakest dimensions (22.7%. Moreover, clan culture was the most dominant type of organizational culture in the studied hospital. This culture serves as a guide for the changes in the healthcare organization, especially in the development of patient safety culture. Conclusion: According to the results of this study, healthcare providers were positively inclined toward the patient safety culture within the organization. As such, the action plan was designed through consensus decision-making and deemed effective in articulating patient safety in the vision and mission of the organization.
Verbakel, N.J.; van Melle, M.; Langelaan, M.; Verheij, T.J.; Wagner, C.; Zwart, D.L.
Objective. To explore perceptions of safety culture in nine different types of primary care professions and to study possible differences. Design. Cross-sectional survey. Setting. Three hundred and thirteen practices from nine types of primary care profession groups in the Netherlands. Participants.
Akselsson, R.; Koornneef, F.; Stewart, S.; Ward, M.
Chapter 2: Resilience Safety Culture in Aviation Organisations The European Commission HILAS project (Human Integration into the Lifecycle of Aviation Systems - a project supported by the European Commission’s 6th Framework between 2005-2009) was focused on using human factors knowledge and
Lee, Wui-Chiang; Wung, Hwei-Ying; Liao, Hsun-Hsiang; Lo, Chien-Ming; Chang, Fei-Ling; Wang, Pa-Chun; Fan, Angela; Chen, Hsin-Hsin; Yang, Han-Chuan; Hou, Sheng-Mou
Safety activities have been initiated at many hospitals in Taiwan, but little is known about the safety culture at these hospitals. The aims of this study were to verify a safety culture survey instrument in Chinese and to assess hospital safety culture in Taiwan. The Taiwan Patient Safety Culture Survey was conducted in 2008, using the adapted Safety Attitude Questionnaire in Chinese (SAQ-C). Hospitals and their healthcare workers participated in the survey on a voluntary basis. The psychometric properties of the five SAQ-C dimensions were examined, including teamwork climate, safety climate, job satisfaction, perception of management, and working conditions. Additional safety measures were asked to assess healthcare workers' attitudes toward their collaboration with nurses, physicians, and pharmacists, respectively, and perceptions of hospitals' encouragement of safety reporting, safety training, and delivery delays due to communication breakdowns in clinical areas. The associations between the respondents' attitudes to each SAQ-C dimension and safety measures were analyzed by generalized estimating equations, adjusting for the clustering effects at hospital levels. A total of 45,242 valid questionnaires were returned from 200 hospitals with a mean response rate of 69.4%. The Cronbach's alpha was 0.792 for teamwork climate, 0.816 for safety climate, 0.912 for job satisfaction, 0.874 for perception of management, and 0.785 for working conditions. Confirmatory factor analyses demonstrated a good model fit for each dimension and the entire construct. The percentage of hospital healthcare workers holding positive attitude was 48.9% for teamwork climate, 45.2% for perception of management, 42.1% for job satisfaction, 37.2% for safety climate, and 31.8% for working conditions. There were wide variations in the range of SAQ-C scores in each dimension among hospitals. Compared to those without positive attitudes, healthcare workers with positive attitudes to each SAQ
Full Text Available Abstract Background Safety activities have been initiated at many hospitals in Taiwan, but little is known about the safety culture at these hospitals. The aims of this study were to verify a safety culture survey instrument in Chinese and to assess hospital safety culture in Taiwan. Methods The Taiwan Patient Safety Culture Survey was conducted in 2008, using the adapted Safety Attitude Questionnaire in Chinese (SAQ-C. Hospitals and their healthcare workers participated in the survey on a voluntary basis. The psychometric properties of the five SAQ-C dimensions were examined, including teamwork climate, safety climate, job satisfaction, perception of management, and working conditions. Additional safety measures were asked to assess healthcare workers' attitudes toward their collaboration with nurses, physicians, and pharmacists, respectively, and perceptions of hospitals' encouragement of safety reporting, safety training, and delivery delays due to communication breakdowns in clinical areas. The associations between the respondents' attitudes to each SAQ-C dimension and safety measures were analyzed by generalized estimating equations, adjusting for the clustering effects at hospital levels. Results A total of 45,242 valid questionnaires were returned from 200 hospitals with a mean response rate of 69.4%. The Cronbach's alpha was 0.792 for teamwork climate, 0.816 for safety climate, 0.912 for job satisfaction, 0.874 for perception of management, and 0.785 for working conditions. Confirmatory factor analyses demonstrated a good model fit for each dimension and the entire construct. The percentage of hospital healthcare workers holding positive attitude was 48.9% for teamwork climate, 45.2% for perception of management, 42.1% for job satisfaction, 37.2% for safety climate, and 31.8% for working conditions. There were wide variations in the range of SAQ-C scores in each dimension among hospitals. Compared to those without positive attitudes
Zwart, D.L.M.; Langelaan, M.; Vooren, R.C. van de; Kuyvenhoven, M.M.; Kalkman, C.J.; Verheij, T.J.M.; Wagner, C.
BACKGROUND: A supportive patient safety culture is considered to be an essential condition for improving patient safety. Assessing the current safety culture in general practice may be a first step to target improvements. To that end, we studied internal consistency and construct validity of a
Brown, Walter S. [Brookhaven National Lab. (BNL), Upton, NY (United States)
The results of a survey of organizational culture at a nuclear power plant are summarized and compared with those of a similar survey which has been described in the literature on ''high-reliability organizations''. A general-purpose cultural inventory showed a profile of organizational style similar to that reported in the literature; the factor structure for the styles was also similar to that of the plant previously described. A specialized scale designed to measure ''safety culture'' did not distinguished among groups within the organization that would be expected to differ.
Verbakel, Natasha J.; Langelaan, Maaike; Verheij, Theo J M; Wagner, Cordula; Zwart, Dorien L M
Background: A constructive safety culture is essential for the successful implementation of patient safety improvements. Aim: To assess the effect of two patient safety culture interventions on incident reporting as a proxy of safety culture. Design and setting: A three-arm cluster randomised trial
Marshall, Albert C.; Standley, Vaughn; Voss, Susan S.; Haskin, Eric
The Strategic Defense Initiative Organization (SDIO) decided to investigate the possibility of launching a Russian Topaz II space nuclear power system. A preliminary safety assessment was conducted to determine whether or not a space mission could be conducted safely and within budget constraints. As part of this assessment, a safety policy and safety functional requirements were developed to guide both the safety assessment and future Topaz II activities. A review of the Russian flight safety program was conducted and documented. Our preliminary safety assessment included a top level event tree, neutronic analysis of normal and accident configurations, an evaluation of temperature coefficients of reactivity, a reentry and disposal analysis, and analysis of postulated launch abort impact accidents, and an analysis of postulated propellant fire and explosion accidents. Based on the assessment, it appears that it will be possible to safely launch the Topaz II system in the U.S. with some possible system modifications. The principal system modifications will probably include design changes to preclude water flooded criticality and to assure intact reentry.
Etchegaray, Jason M; Thomas, Eric J
To examine the reliability and predictive validity of two patient safety culture surveys-Safety Attitudes Questionnaire (SAQ) and Hospital Survey on Patient Safety Culture (HSOPS)-when administered to the same participants. Also to determine the ability to convert HSOPS scores to SAQ scores. Employees working in intensive care units in 12 hospitals within a large hospital system in the southern United States were invited to anonymously complete both safety culture surveys electronically. All safety culture dimensions from both surveys (with the exception of HSOPS's Staffing) had adequate levels of reliability. Three of HSOPS's outcomes-frequency of event reporting, overall perceptions of patient safety, and overall patient safety grade-were significantly correlated with SAQ and HSOPS dimensions of culture at the individual level, with correlations ranging from r=0.41 to 0.65 for the SAQ dimensions and from r=0.22 to 0.72 for the HSOPS dimensions. Neither the SAQ dimensions nor the HSOPS dimensions predicted the fourth HSOPS outcome-number of events reported within the last 12 months. Regression analyses indicated that HSOPS safety culture dimensions were the best predictors of frequency of event reporting and overall perceptions of patient safety while SAQ and HSOPS dimensions both predicted patient safety grade. Unit-level analyses were not conducted because indices did not indicate that aggregation was appropriate. Scores were converted between the surveys, although much variance remained unexplained. Given that the SAQ and HSOPS had similar reliability and predictive validity, investigators and quality and safety leaders should consider survey length, content, sensitivity to change and the ability to benchmark when selecting a patient safety culture survey.
Lee, Soo-Hoon; Phan, Phillip H; Dorman, Todd; Weaver, Sallie J; Pronovost, Peter J
The context of the study is the Agency for Healthcare Research and Quality's Hospital Survey on Patient Safety Culture (HSOPSC). The purpose of the study is to analyze how different elements of patient safety culture are associated with clinical handoffs and perceptions of patient safety. The study was performed with hierarchical multiple linear regression on data from the 2010 Survey. We examine the statistical relationships between perceptions of handoffs and transitions practices, patient safety culture, and patient safety. We statistically controlled for the systematic effects of hospital size, type, ownership, and staffing levels on perceptions of patient safety. The main findings were that the effective handoff of information, responsibility, and accountability were necessary to positive perceptions of patient safety. Feedback and communication about errors were positively related to the transfer of patient information; teamwork within units and the frequency of events reported were positively related to the transfer of personal responsibility during shift changes; and teamwork across units was positively related to the unit transfers of accountability for patients. In summary, staff views on the behavioral dimensions of handoffs influenced their perceptions of the hospital's level of patient safety. Given the known psychological links between perception, attitude, and behavior, a potential implication is that better patient safety can be achieved by a tight focus on improving handoffs through training and monitoring.
Manzanera, Rafael; Mira, José Joaquín; Plana, Manel; Moya, Daniel; Guilabert, Mercedes; Ortner, Jordi
The aim of the study was to assess the safety culture in a mutual insurance sector, searching for improvement opportunities. This sector offers health insurance for work-related injuries and occupational illnesses and represents an annual volume of patients corresponding to approximately 10% of the working population in Europe. A cross-sectional study was conducted to assess the safety culture in the mutual insurance sector in Spain. All physicians, nurses, and physiotherapists (N = 816) working in the organization in hospitals, outpatient clinics, and managerial settings were invited to reply to an online survey. A total of 499 professionals completed the questionnaire (response rate, 61%). Two dimensions were assessed: attitudinal (5 items) and instrumental (5 items). There were no differences between professional profiles or centers in the attitudinal (7.8; standard deviation, 1.3; 95% confidence interval, 7.6-7.9) or instrumental (8.5; standard deviation, 1.0; 95% confidence interval, 8.5-8.6) factors. The lowest level of implementation (event (73%), having a quality and safety plan (75%), prioritizing the improvement of patient care (75%), and involving patients when making decisions on potential treatments (63%). Managers showed lower scores than the rest of professionals' groups (P culture assessment in the mutual insurance companies. These results may encourage the implementation of quality and safety plans in this sector by paying more attention to attitudinal aspects.
Portela Romero, Manuel; Bugarín González, Rosendo; Rodríguez Calvo, María Sol
To determine the views held by Family practice (FP) residents on the different dimensions of patient safety, in order to identify potential areas for improvement. A cross-sectional study. Seven FP of Galicia teaching units. 182 FP residents who completed the Medical Office Survey on Patient Safety Culture questionnaire. The Medical Office Survey on Patient Safety Culture questionnaire was chosen because it is translated, validated, and adapted to the Spanish model of Primary Care. The results were grouped into 12 composites assessed by the mentioned questionnaire. The study variables were the socio-demographic dimensions of the questionnaire, as well as occupational/professional variables: age, gender, year of residence, and teaching unit of FP of Galicia. The "Organisational learning" and "Teamwork" items were considered strong areas. However, the "Patient safety and quality issues", "Information exchange with other settings", and "Work pressure and pace" items were considered areas with significant potential for improvement. First-year residents obtained the best results and the fourth-year ones the worst. The results may indicate the need to include basic knowledge on patient safety in the teaching process of FP residents in order to increase and consolidate the fragile patient safety culture described in this study. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.
Frazier, Christopher B; Ludwig, Timothy D; Whitaker, Brian; Roberts, D Steve
Recent reviews of safety culture measures have revealed a host of potential factors that could make up a safety culture (Flin, Mearns, O'Connor, & Bryden, 2000; Guldenmund, 2000). However, there is still little consensus regarding what the core factors of safety culture are. The purpose of the current research was to determine the core factors, as well as the structure of those factors that make up a safety culture, and establish which factors add meaningful value by factor analyzing a widely used safety culture survey. A 92-item survey was constructed by subject matter experts and was administered to 25,574 workers across five multi-national organizations in five different industries. Exploratory and hierarchical confirmatory factor analyses were conducted revealing four second-order factors of a Safety Culture consisting of Management Concern, Personal Responsibility for Safety, Peer Support for Safety, and Safety Management Systems. Additionally, a total of 12 first-order factors were found: three on Management Concern, three on Personal Responsibility, two on Peer Support, and four on Safety Management Systems. The resulting safety culture model addresses gaps in the literature by indentifying the core constructs which make up a safety culture. This clarification of the major factors emerging in the measurement of safety cultures should impact the industry through a more accurate description, measurement, and tracking of safety cultures to reduce loss due to injury. Copyright © 2013 National Safety Council and Elsevier Ltd. All rights reserved.
Phase II of Improving Traffic Safety Culture in Iowa focuses on producing actions that will improve the traffic safety culture across the state, and involves collaboration among the three large public universities in Iowa: Iowa State University, Univ...
Profit, Jochen; Etchegaray, Jason; Petersen, Laura A; Sexton, J Bryan; Hysong, Sylvia J; Mei, Minghua; Thomas, Eric J
Neonatal intensive care unit (NICU) safety culture, as measured by the Safety Attitudes Questionnaire (SAQ), varies widely. Associations with clinical outcomes in the adult intensive care unit setting make the SAQ an attractive tool for comparing clinical performance between hospitals. Little information is available on the use of the SAQ for this purpose in the NICU setting. To determine whether the dimensions of safety culture measured by the SAQ give consistent results when used as a NICU performance measure. Cross-sectional survey of caregivers in 12 NICUs, using the six scales of the SAQ: teamwork climate, safety climate, job satisfaction, stress recognition, perceptions of management and working conditions. NICUs were ranked by quantifying their contribution to overall risk-adjusted variation across the scales. Spearman rank correlation coefficients were used to test for consistency in scale performance. The authors then examined whether performance in the top four NICUs in one scale predicted top four performance in others. There were 547 respondents in 12 NICUs. Of 15 NICU-level correlations in performance ranking, two were >0.7, seven were between 0.4 and 0.69, and the six remaining were safety culture. A culture of safety permeates many aspects of patient care and organisational functioning. The SAQ may be a useful tool for comparative performance assessments among NICUs.
The author examined the safety culture and in relation to that the safety and health-related human factors. The examination was conducted primarily in the agricultural sector. Safety culture is also a key factor in business life especially in productive sectors. Basically, it determines the general work safety and occupational hazard situations, which may have an impact on business, competitiveness, and efficiency, and also employee satisfaction.The concept of safety culture is new in the app...
Major safety culture (SC) initiatives initiated in the FRA Office of Research, Technology and Development (RT&D), such as Clear Signal for Action (CSA), the Investigation of Safety Related Occurrences Protocol (ISROP), the Participative Safety Rules ...
Hartmann, Christine W; Meterko, Mark; Rosen, Amy K; Shibei Zhao; Shokeen, Priti; Singer, Sara; Gaba, David M
Improving safety climate could enhance patient safety, yet little evidence exists regarding the relationship between hospital characteristics and safety climate. This study assessed the relationship between hospitals' organizational culture and safety climate in Veterans Health Administration (VA) hospitals nationally. Data were collected from a sample of employees in a stratified random sample of 30 VA hospitals over a 6-month period (response rate = 50%; n = 4,625). The Patient Safety Climate in Healthcare Organizations (PSCHO) and the Zammuto and Krakower surveys were used to measure safety climate and organizational culture, respectively. Higher levels of safety climate were significantly associated with higher levels of group and entrepreneurial cultures, while lower levels of safety climate were associated with higher levels of hierarchical culture. Hospitals could use these results to design specific interventions aimed at improving safety climate.
Verbakel, N.J.; de Bont, A.A.; Verheij, T.J.M.; Wagner, C.; Zwart, D.L.M.
Background When improving patient safety a positive safety culture is key. As little is known about improving patient safety culture in primary care, this study examined whether administering a culture questionnaire with or without a complementary workshop could be used as an intervention for
N.J. Verbakel (Natasha J.); A.A. de Bont (Antoinette); T.J. Verheij; C. Wagner (Cordula); D.L.M. Zwart (Dorien)
textabstractBackground When improving patient safety a positive safety culture is key. As little is known about improving patient safety culture in primary care, this study examined whether administering a culture questionnaire with or without a complementary workshop could be used as an
Reader, Tom W; Noort, Mark C; Shorrock, Steven; Kirwan, Barry
The management of safety culture in international and culturally diverse organizations is a concern for many high-risk industries. Yet, research has primarily developed models of safety culture within Western countries, and there is a need to extend investigations of safety culture to global environments. We examined (i) whether safety culture can be reliably measured within a single industry operating across different cultural environments, and (ii) if there is an association between safety culture and national culture. The psychometric properties of a safety culture model developed for the air traffic management (ATM) industry were examined in 17 European countries from four culturally distinct regions of Europe (North, East, South, West). Participants were ATM operational staff (n = 5,176) and management staff (n = 1,230). Through employing multigroup confirmatory factor analysis, good psychometric properties of the model were established. This demonstrates, for the first time, that when safety culture models are tailored to a specific industry, they can operate consistently across national boundaries and occupational groups. Additionally, safety culture scores at both regional and national levels were associated with country-level data on Hofstede's five national culture dimensions (collectivism, power distance, uncertainty avoidance, masculinity, and long-term orientation). MANOVAs indicated safety culture to be most positive in Northern Europe, less so in Western and Eastern Europe, and least positive in Southern Europe. This indicates that national cultural traits may influence the development of organizational safety culture, with significant implications for safety culture theory and practice. © 2015 Society for Risk Analysis.
Reiman, Teemu; Rollenhagen, Carl
The concept of safety culture has become established in safety management applications in all major safety-critical domains. The idea that safety culture somehow represents a "systemic view" on safety is seldom explicitly spoken out, but nevertheless seem to linger behind many safety culture discourses. However, in this paper we argue that the "new" contribution to safety management from safety culture never really became integrated with classical engineering principles and concepts. This integration would have been necessary for the development of a more genuine systems-oriented view on safety; e.g. a conception of safety in which human, technological, organisational and cultural factors are understood as mutually interacting elements. Without of this integration, researchers and the users of the various tools and methods associated with safety culture have sometimes fostered a belief that "safety culture" in fact represents such a systemic view about safety. This belief is, however, not backed up by theoretical or empirical evidence. It is true that safety culture, at least in some sense, represents a holistic term-a totality of factors that include human, organisational and technological aspects. However, the departure for such safety culture models is still human and organisational factors rather than technology (or safety) itself. The aim of this paper is to critically review the various uses of the concept of safety culture as representing a systemic view on safety. The article will take a look at the concepts of culture and safety culture based on previous studies, and outlines in more detail the theoretical challenges in safety culture as a systems concept. The paper also presents recommendations on how to make safety culture more systemic. Copyright © 2013 Elsevier Ltd. All rights reserved.
Cui, Ying; Xi, Xiuming; Zhang, Jinsheng; Feng, Jiang; Deng, Xiaoxiao; Li, Ang; Zhou, Jianxin
In China, increasing attention has been devoted to the patient safety culture within health administrative departments and healthcare organizations. However, no official version of a patient safety culture assessment tool has been published or is widely used, and little is known about the status of the safety culture in Chinese hospitals. The aims of this study were to examine the reliability and validity of the Safety Attitudes Questionnaire in Chinese and to establish benchmark data on the safety culture in Beijing. Across-sectional survey on patient safety culture was conducted from August to October 2014 using the Safety Attitudes Questionnaire in Chinese. Using a stratified random sampling method, we investigated departments from five integrative teaching hospitals in Beijing; frontline healthcare workers in each unit participated in the survey on a voluntary basis. The internal consistency and reliability were tested via Cronbach's alpha, and the structural validity of the questionnaire was tested using a correlation analysis and confirmatory factor analysis. The patient safety culture in the five hospitals was assessed and analyzed. A total of 1663 valid questionnaires were returned, for a response rate of 87.9%. Cronbach's alpha of the total scale was 0.945, and Cronbach's alpha for the six dimensions ranged from 0.785 to 0.899. The goodness-of-fit indices in the confirmatory factor analysis showed an acceptable but not ideal model fit. The safety attitude score of healthcare workers in the five hospitals was 69.72, and the positive response rate was 38.57% overall. The positive response rates of the six dimensions were between 20.80% and 59.31%. The Safety Attitudes Questionnaire in Chinese has good internal consistency, and the structural validity and reliability are acceptable. This questionnaire can be used to assess the safety culture in Beijing hospitals, but some items require further refinement. The patient safety culture in Beijing hospitals must
Muna, Alice Baca [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); LaFleur, Angela Christine [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)
Sandia National Laboratories evaluated published safety assessment methods across a variety of industries including Liquefied Natural Gas (LNG), hydrogen, land and marine transportation, as well as the US Department of Defense (DOD). All the methods were evaluated for their potential applicability for use in the LNG railroad application. After reviewing the documents included in this report, as well as others not included because of repetition, the Department of Energy (DOE) Hydrogen Safety Plan Checklist is most suitable to be adapted to the LNG railroad application. This report was developed to survey industries related to rail transportation for methodologies and tools that can be used by the FRA to review and evaluate safety assessments submitted by the railroad industry as a part of their implementation plans for liquefied or compressed natural gas storage ( on-board or tender) and engine fueling delivery systems. The main sections of this report provide an overview of various methods found during this survey. In most cases, the reference document is quoted directly. The final section provides discussion and a recommendation for the most appropriate methodology that will allow efficient and consistent evaluations to be made. The DOE Hydrogen Safety Plan Checklist was then revised to adapt it as a methodology for the Federal Railroad Administration’s use in evaluating safety plans submitted by the railroad industry.
Jafari MJ; Sadighzadeh A; Sarsangi V; Zaeri F; Zarei E
Background and Aims: Eighty five percent of accidents can be attributed to unsafe acts. Eighty five to ninety eight percent of workplace injuries caused by unsafe acts are due to attitude, behavior and culture. Safety climate is a multi-dimensional structure that describes the attitude and the correct priority of the people towards the safety at work. To assess safety climate, a valid and reliable tool is needed. The aim of this study was developing a psychometric questionnaire to assess safe...
O'Connor, Shawn; Carlson, Elizabeth
This report describes how staff-designed behavior changes among senior leaders can have a positive impact on clinical nursing staff and enhance the culture of safety in a community hospital. A positive culture of safety in a hospital improves outcomes for patients and staff. Senior leaders are accountable for developing an environment that supports a culture of safety. At 1 community hospital, surveys demonstrated that staff members did not view senior leaders as supportive of or competent in creating a culture of safety. After approval from the hospital's institutional review board was obtained, clinical nurses generated and selected ideas for senior leader behavior change. The new behaviors were assessed by a convenience sample survey of clinical nurses. In addition, culture of safety survey results were compared. Risk reports and harm events were also measured before and after behavior changes. The volume of risk and near-miss reports increased, showing that clinical staff were more inclined to report events after senior leader communication, access, and visibility increased. Harm events went down. The culture of safety survey demonstrated an improvement in the senior leadership domain in 4 of 6 units. The anonymous convenience survey demonstrated that staff members recognized changes that senior leaders had made and felt that these changes positively impacted the culture of safety. By developing skills in communication, advocacy, visibility, and access, senior leaders can enhance a hospital's culture of safety and create stronger ties with clinical staff.
Kanki, Barbara G.; Rosekind, Mark R. (Technical Monitor)
In the 1970's, flight safety professionals became profoundly concerned about the prevalence of crew-caused accidents and incidents, and the role of human error in flight operations. As result, they initiated a change in the flight safety culture which has grown to significant proportions today. At the heart of the evolution were crew concepts such as flightdeck management, crew coordination, and cockpit resource management, concepts which seemed to target critical deficiencies. In themselves, the concepts were not new but their incorporation into training as a direct means of changing the flight safety culture was an untried, almost 'grassroots' approach. The targeted crew concepts and skills were not an integral part of the typical training program; the methods, curriculum, media, and even course content itself, would have to be developed and implemented from the bottom up. A familiar truism in the pilot culture is that you should 'Train the way you fly; Fly the way you train'. In short, training was expected to provide the pilot with practical operational skills that were consistent with the performance standards they were required to maintain and the operational demands they met on a daily basis. In short, one could not simply command crews to use good CRM; one would have to research and define these skills operationally as well as develop and implement a consistent and effective training program. Furthermore, one would need active support and collaboration among the research, industry and government communities in order to ensure acceptance and continued commitment. Additional information is contained in the original extended abstract.
Xie, Jian-Fei; Ding, Si-Qing; Zhong, Zhu-Qing; Zeng, Sai-Nan; Qin, Chun-Xiang; Yi, Qi-Feng; Gong, Li-Na; Zhou, Jian-da
Positive perceptions of patient safety culture are associated with lower rates of adverse events, but they have not been widely established in many health care organizations. The purpose of this study is to examine the impacts of a safety culture training program (SCTP) on enhancing the perceptions of patient safety in nurse managers. This was a quasi-experimental design. 83 nurse managers were recruited from five randomly selected 2nd level hospitals. Sixty-seven nurse managers received training under the educational SCTP. The Hospital Survey on Patient Safety Culture (HSPSC) and Chinese Safety Attitudes Questionnaire (C-SAQ) were administered just before and six months after the educational program. The data of hospital-acquired pressure ulcers, patient falls, and unplanned extubations were collected. The total positive scores of HSPSC were significantly improved and four dimensions of C-SAQ significantly increased six months after SCTP. The rate of patient falls and rate of hospital-acquired pressure ulcers decreased significantly six months post SCTP. In conclusion, nurse manager participation in a SCTP can enhance the perceptions of patient safety and reduce the rates of adverse events. More rigorous trials with larger numbers of participants and a control group are needed to strengthen the conclusions. Copyright © 2017. Published by Elsevier Ltd.
Goncalves Filho, Anastacio Pinto; Andrade,José Célio Silveira; Marinho,Marcia Mara de Oliveira
Acesso restrito: Texto completo. p. 615-624 A framework to measure safety culture maturity in the Brazilian oil and gas companies was formulated based on the model of Hudson (2001). Following a review of the safety culture literature, a questionnaire was designed to measure five aspects of organisational safety indicative of five levels of cultural maturity. The questionnaire was completed by the safety managers of 23 petrochemical companies based in Camacari,Bahia, Brazil and they were...
Smits, M.; Christiaans-Dingelhoff, I.; Wagner, C.; Wal, G. van der; Groenewegen, P.P.
BACKGROUND: In many different countries the Hospital Survey on Patient Safety Culture (HSOPS) is used to assess the safety culture in hospitals. Accordingly, the questionnaire has been translated into Dutch for application in the Netherlands. The aim of this study was to examine the underlying
Dennison, Robin Donohoe
Medication errors are costly from human, economic, and societal perspectives. All patients are vulnerable to the detrimental effects of these errors. Recommendations regarding the problem of medication errors include: Prevention of error by learning from the nonpunitive reporting of errors and near misses; Evaluation of the system for potential causes of error through failure mode and effects analysis and encouragement of a questioning attitude; Elimination of system problems that increase the risk of error; Recognition that humans are fallible and that error will occur even in a perfect system; Minimization of the consequences of errors when they do occur. An important goal for healthcare organizations should be to create a culture that accepts the imperfection of human performance and solicits the assistance of team members in the development of safeguards for error prevention. Proposed interventions to prevent medication errors can be described by the PATIENT SAFE taxonomy, which includes: Patient participation; Adherence to established policy and procedures; Technology use; Information accessibility; Education regarding medication safety; Nonpunitive approach to reporting of errors and near misses; Teamwork, communication, and collaboration; Staffing: adequate number and staffing mix; Administration support for the clinical goal of patient safety; Failure mode and effects analysis with team member involvement; Environment and equipment to support patient safety
Mikkonen, Santtu; Saranto, Kaija; Bates, David W.
Summary Background An organization’s information culture and information management practices create conditions for processing patient information in hospitals. Information management incidents are failures that could lead to adverse events for the patient if they are not detected. Objectives To test a theoretical model that links information culture in acute care hospitals to information management incidents and patient safety outcomes. Methods Reason’s model for the stages of development of organizational accidents was applied. Study data were collected from a cross-sectional survey of 909 RNs who work in medical or surgical units at 32 acute care hospitals in Finland. Structural equation modeling was used to assess how well the hypothesized model fit the study data. Results Fit indices indicated a good fit for the model. In total, 18 of the 32 paths tested were statistically significant. Documentation errors had the strongest total effect on patient safety outcomes. Organizational guidance positively affected information availability and utilization of electronic patient records, whereas the latter had the strongest total effect on the reduction of information delays. Conclusions Patient safety outcomes are associated with information management incidents and information culture. Further, the dimensions of the information culture create work conditions that generate errors in hospitals. PMID:28272647
Vlayen, Annemie; Schrooten, Ward; Wami, Welcome; Aerts, Marc; Barrado, Leandro Garcia; Claes, Neree; Hellings, Johan
The aim of this study was to measure differences in safety culture perceptions within Belgian acute hospitals and to examine variability based on language, work area, staff position, and work experience. The Hospital Survey on Patient Safety Culture was distributed to hospitals participating in the national quality and safety program (2007-2009). Hospitals were invited to participate in a comparative study. Data of 47,136 respondents from 89 acute hospitals were used for quantitative analysis. Percentages of positive response were calculated on 12 dimensions. Generalized estimating equations models were fitted to explore differences in safety culture. Handoffs and transitions, staffing, and management support for patient safety were considered as major problem areas. Dutch-speaking hospitals had higher odds of positive perceptions for most dimensions in comparison with French-speaking hospitals. Safety culture scores were more positive for respondents working in pediatrics, psychiatry, and rehabilitation compared with the emergency department, operating theater, and multiple hospital units. We found an important gap in safety culture perceptions between leaders and assistants within disciplines. Administration and middle management had lower perceptions toward patient safety. Respondents working less than 1 year in the current hospital had more positive safety culture perceptions in comparison with all other respondents. Large comparative databases provide the opportunity to identify distinct high and low scoring groups. In our study, language, work area, and profession were identified as important safety culture predictors. Years of experience in the hospital had only a small effect on safety culture perceptions.
Parker, Dianne; Wensing, Michel; Esmail, Aneez; Valderas, Jose M
ABSTRACT Background: There is little guidance available to healthcare practitioners about what tools they might use to assess the patient safety culture. Objective: To identify useful tools for assessing patient safety culture in primary care organizations in Europe; to identify those aspects of performance that should be assessed when investigating the relationship between safety culture and performance in primary care. Methods: Two consensus-based studies were carried out, in which subject matter experts and primary healthcare professionals from several EU states rated (a) the applicability to their healthcare system of several existing safety culture assessment tools and (b) the appropriateness and usefulness of a range of potential indicators of a positive patient safety culture to primary care settings. The safety culture tools were field-tested in four countries to ascertain any challenges and issues arising when used in primary care. Results: The two existing tools that received the most favourable ratings were the Manchester patient safety framework (MaPsAF primary care version) and the Agency for healthcare research and quality survey (medical office version). Several potential safety culture process indicators were identified. The one that emerged as offering the best combination of appropriateness and usefulness related to the collection of data on adverse patient events. Conclusion: Two tools, one quantitative and one qualitative, were identified as applicable and useful in assessing patient safety culture in primary care settings in Europe. Safety culture indicators in primary care should focus on the processes rather than the outcomes of care. PMID:26339832
Parker, Dianne; Wensing, Michel; Esmail, Aneez; Valderas, Jose M
There is little guidance available to healthcare practitioners about what tools they might use to assess the patient safety culture. To identify useful tools for assessing patient safety culture in primary care organizations in Europe; to identify those aspects of performance that should be assessed when investigating the relationship between safety culture and performance in primary care. Two consensus-based studies were carried out, in which subject matter experts and primary healthcare professionals from several EU states rated (a) the applicability to their healthcare system of several existing safety culture assessment tools and (b) the appropriateness and usefulness of a range of potential indicators of a positive patient safety culture to primary care settings. The safety culture tools were field-tested in four countries to ascertain any challenges and issues arising when used in primary care. The two existing tools that received the most favourable ratings were the Manchester patient safety framework (MaPsAF primary care version) and the Agency for healthcare research and quality survey (medical office version). Several potential safety culture process indicators were identified. The one that emerged as offering the best combination of appropriateness and usefulness related to the collection of data on adverse patient events. Two tools, one quantitative and one qualitative, were identified as applicable and useful in assessing patient safety culture in primary care settings in Europe. Safety culture indicators in primary care should focus on the processes rather than the outcomes of care.
Boubaker, S.; Mekni, S.; Jerbi, H.
In this paper, the electrical safety beliefs and practices in Hail region, Saudi Arabia, have been assessed. Based on legislative recommendations and rules applied in Saudi Arabia, on official statistics regarding the electricity-caused accidents and on the analysis of more than 200 photos captured in Hail (related to electrical safety), a questionnaire composed of 36 questions (10 for the respondents information, 16 for the home safety culture and 10 for the electrical devices purchasing cul...
... four. The BSEE feels that these changes better align with the common vocabulary used on the OCS for... safety and all organization personnel, the definition of safety culture and several parts of the...
Listyowardojo, Tita Alissa; Nap, Raoul E.; Johnson, Addie
Objective. To compare the attitudes toward and perceptions of institutional practices that can influence patient safety between all professional groups at a university medical center. Design. A questionnaire measuring nine dimensions of organizational and safety culture was distributed to all
Profit, Jochen; Etchegaray, Jason; Petersen, Laura A; Sexton, J Bryan; Hysong, Sylvia J; Mei, Minghua; Thomas, Eric J
background NICU safety culture, as measured by the Safety Attitudes Questionnaire (SAQ), varies widely. Associations with clinical outcomes in the adult ICU setting make the SAQ an attractive tool for comparing clinical performance between hospitals. Little information is available on the use of the SAQ for this purpose in the NICU setting. objectives To determine whether the dimensions of safety culture measured by the SAQ give consistent results when used as a NICU performance measure. methods Cross-sectional survey of caregivers in twelve NICUs, using the six scales of the SAQ: teamwork climate, safety climate, job satisfaction, stress recognition, perceptions of management, and working conditions. NICUs were ranked by quantifying their contribution to overall risk-adjusted variation across the scales. Spearman Rank Correlation coefficients were used to test for consistency in scale performance. We then examined whether performance in the top four NICUs in one scale predicted top four performance in others. results There were 547 respondents in twelve NICUs. Of fifteen NICU-level correlations in performance ranking, two were greater than 0.7, seven were between 0.4 and 0.69, the six remaining were less than 0.4. We found a trend towards significance in comparing the distribution of performance in the top four NICUs across domains with a binomial distribution p = .051, indicating generally consistent performance across dimensions of safety culture. conclusion A culture of safety permeates many aspects of patient care and organizational functioning. The SAQ may be a useful tool for comparative performance assessments among NICUs. PMID:22337935
Mendias, Elnora P.; Guevara, Edilma B.
Eight criteria for culturally competent scholarship (contextuality, relevance, communication styles, awareness of identity and power differences, disclosure, reciprocation, empowerment, time) were applied to an international education/research nursing program. Appropriate measures for each were developed and ways to improve the program were…
Lin, Shu-Yuan; Tseng, Wei Ting; Hsu, Miao-Ju; Chiang, Hui-Ying; Tseng, Hui-Chen
To test the psychometric properties of the Chinese version of the Nursing Home Survey on Patient Safety Culture scale among staff in long-term care facilities. The Nursing Home Survey on Patient Safety Culture scale is a standard tool for safety culture assessment in nursing homes. Extending its application to different types of long-term care facilities and varied ethnic populations is worth pursuing. A national random survey. A total of 306 managers and staff completed the Chinese version of the Nursing Home Survey on Patient Safety Culture scale among 30 long-term care facilities in Taiwan. Content validity and construct validity were tested by content validity index (CVI) and principal axis factor analysis (PAF) with Promax rotation. Concurrent validity was tested through correlations between the scale and two overall rating items. Reliability was computed by intraclass correlation coefficient and Cronbach's α coefficients. Statistical analyses such as descriptive, Pearson's and Spearman's rho correlations and PAF were completed. Scale-level and item-level CVIs (0.91-0.98) of the Chinese version of the Nursing Home Survey on Patient Safety Culture scale were satisfactory. Four-factor construct and merged item composition differed from the Nursing Home Survey on Patient Safety Culture scale, and it accounted for 53% of variance. Concurrent validity was evident by existing positive correlations between the scale and two overall ratings of resident safety. Cronbach's α coefficients of the subscales and the Chinese version of the Nursing Home Survey on Patient Safety Culture scale ranged from .76-.94. The Chinese version of the Nursing Home Survey on Patient Safety Culture scale identified essential dimensions to reflect the important features of a patient safety culture in long-term care facilities. The researchers introduced the Chinese version of the Nursing Home Survey on Patient Safety Culture for safety culture assessment in long-term care facilities, but
Krupka, M.C.; Laquer, H.L.; Peaslee, A.T.
Public acceptance of alternative transportation fuels in the United States is contingent not only upon the requisite technical, environmental, and economic factors but also upon demonstration through adequate assessment, testing, and operational experience that the intrinsic risk is either equivalent to or less than that associated with energy carriers presently in common use. In support of work sponsored by the Office of Vehicle and Engine R and D of the Department of Energy, a relative safety assessment of alternative gaseous and reference liquid fuels utilized for light automotive transportation in the public sector was completed. The specific fuels considered were compressed natural gas (CNG); liquefied natural gas (LNG); liquefied petroleum gas (LPG); and the liquid fuels, gasoline and diesel. The assessment methodology describes and develops the relative hazards of these fuels from an integrated generic physicochemical property and accident scenario point of view. A technique involving a method of eliciting expert judgment combined with a comparative scoring methodology was applied in establishing fuel relative safety rankings.
Suliman, Mohammad; Aljezawi, Maen; AlBashtawy, Mohammed; Fitzpatrick, Joyce; Aloush, Sami; Al-Awamreh, Khitam
Medical error is a serious issue in hospitals in Jordan. This study explored Jordanian nurses' perceptions of the culture of safety in their hospitals. The Hospital Survey of Patient Safety Culture translated into Arabic was administered to a convenience sample of 391 nurses from 7 hospitals in Jordan. The positive responses to the 12 dimensions of safety culture ranged from 20.0% to 74.6%. These are lower than the benchmarks of the Agency for Healthcare Research and Quality. Jordanian nurses perceive their hospitals as places that need more effort to improve the safety culture.
Hamaideh, S H
Mental health nurses have a crucial role in preventing medical incidents and in promoting safety culture because they provide and coordinate most of patients' care. Therefore, they are able to enhance patients' outcomes and reduce nurses' injuries. The aims of this study were to assess the perception of mental health nurses about patients' safety culture and to detect the factors which may affect patients' safety culture at psychiatric hospitals. A predictive correlational design was employed to collect data about patient safety culture and safety outcomes from 224 mental health nurses working in psychiatric hospitals using Hospital Survey on Patient Safety Culture. Positive scores to patients' safety culture dimensions ranged between 13.4% and 81.2%. Two-thirds of mental health nurses perceived safety as excellent/very good, 20.5% perceived it as acceptable and 10.8% perceived it as poor/failing. Overall perception of safety correlated significantly with four dimensions and explained 32.6% of the variance. Frequency of events reported correlated significantly with six dimensions and explained 23.1% of the variance. Of the 12 dimensions of patients' safety culture, only one was strong, six within acceptable range and five were weak and need improvement. Healthcare managers and policy-makers should encourage educational interventions and help to establish a reporting system that focus on improving systems, not on blaming individuals and encourage open communication among mental healthcare workers. © 2016 International Council of Nurses.
Approximately 10 years ago, FRA began investigating organizational culture. Subsequent reorganization of the Volpe Center and HF Program to include Org. Culture & Safety Performance program. This is a summary of FRA field evaluations on the impact of...
Full Text Available The present study aims to assess the safety-climate level in Taiwan’s metal industries, as well as to identify the influence of workers’ backgrounds on the safety climate. An earlier report showed that a poor safety culture was related to the cause of accidents in Taiwan’s traditional manufacturing industries. This study surveyed a total of 839 workers who voluntarily participated and completed the safety-culture questionnaires. These workers were from a Taiwanese metal company and its five satellite companies. Three safety-climate factors, namely safety perception, safety communication and safety-management systems, were assessed. Confirmatory factor analysis (CFA was conducted by developing structural equation modeling to ensure the questionnaire’s validity. The influence of workers’ backgrounds on the safety climate was identified by using one-way ANOVA. The reliability result of the questionnaire was above the acceptable level. The overall safety-climate score was 4.22 out of a five-point scale for safety perception, 4.23 for safety-management systems and 3.97 for safety communication. The scores indicate a good level of safety climate, with room for improvement in safety communication. Additionally, the influence of workers’ backgrounds on the safety climate was confirmed. Based on the validity test, it was also found that the questionnaire could be improved by reconstructing its questions in its development process in order to increase the safety-climate model’s reliability and validity, as well as its model fit.
Horwitz, Sujin K; Horwitz, Irwin B
Purpose The purpose of this paper is to investigate the relationship between patient safety culture and two attitudinal constructs: affective organizational commitment and structural empowerment. In doing so, the main and interaction effects of the two constructs on the perception of patient safety culture were assessed using a cohort of physicians. Design/methodology/approach Affective commitment was measured with the Organizational Commitment Questionnaire, whereas structural empowerment was assessed with the Conditions of Work Effectiveness Questionnaire-II. The abbreviated versions of these surveys were administered to a cohort of 71 post-doctoral medical residents. For the data analysis, hierarchical regression analyses were performed for the main and interaction effects of affective commitment and structural empowerment on the perception of patient safety culture. Findings A total of 63 surveys were analyzed. The results revealed that both affective commitment and structural empowerment were positively related to patient safety culture. A potential interaction effect of the two attitudinal constructs on patient safety culture was tested but no such effect was detected. Research limitations/implications This study suggests that there are potential benefits of promoting affective commitment and structural empowerment for patient safety culture in health care organizations. By identifying the positive associations between the two constructs and patient safety culture, this study provides additional empirical support for Kanter's theoretical tenet that structural and organizational support together helps to shape the perceptions of patient safety culture. Originality/value Despite the wide recognition of employee empowerment and commitment in organizational research, there has still been a paucity of empirical studies specifically assessing their effects on patient safety culture in health care organizations. To the authors' knowledge, this study is the first
Parker, D.; Wensing, M.; Esmail, A.; Valderas, J.M.
BACKGROUND: There is little guidance available to healthcare practitioners about what tools they might use to assess the patient safety culture. OBJECTIVE: To identify useful tools for assessing patient safety culture in primary care organizations in Europe; to identify those aspects of performance
Brandis, Susan; Schleimer, Stephanie; Rice, John
Purpose Building a new hospital requires a major investment in capital infrastructure. The purpose of this paper is to investigate the impact of bricks-and-mortar on patient safety culture before and two years after the move of a large tertiary hospital to a greenfield site. The difference in patient safety perceptions between clinical and non-clinical staff is also explored. Design/methodology/approach This research uses data collected from the same workforce across two time periods (2013 and 2015) in a large Australian healthcare service. Validated surveys of patient safety culture ( n=306 and 246) were analysed using descriptive and inferential statistics. Findings Using two-way analysis of variance, the authors found that perceived patient safety culture remains unchanged for staff despite a major relocation and upgrade of services and different perceptions of patient safety culture between staff groups remains the same throughout change. Practical implications A dramatic change in physical context, such as moving an entire hospital, made no measurable impact on perceived patient safety culture by major groups of staff. Improving patient safety culture requires more than investment in buildings and infrastructure. Understanding differences in professional perspectives of patient safety culture may inform organisational management approaches, and enhance the targeting of specific strategies. Originality/value The authors believe this to be the first empirically based paper that investigates the impact of a large investment into hospital capital and a subsequent relocation of services on clinical and non-clinical staff perceptions of patient safety culture.
Patterson, P Daniel; Huang, David T; Fairbanks, Rollin J; Simeone, Scott; Weaver, Matthew; Wang, Henry E
Workplace attitude, beliefs, and culture may impact the safety of patient care. This study characterized perceptions of safety culture in a nationwide sample of emergency medical services (EMS) agencies. We conducted a cross-sectional survey involving 61 advanced life support EMS agencies in North America. We administered a modified version of the Safety Attitudes Questionnaire (SAQ), a survey instrument measuring dimensions of workplace safety culture (Safety Climate, Teamwork Climate, Perceptions of Management, Job Satisfaction, Working Conditions, and Stress Recognition). We included full-time and part-time paramedics and emergency medical technicians. We determined the variation in safety culture scores across EMS agencies. Using hierarchical linear models, we determined associations between safety culture scores and individual and EMS agency characteristics. We received 1,715 completed surveys from 61 EMS agencies (mean agency response rate 47%; 95% confidence interval [CI] 10%, 83%). There was wide variation in safety culture scores across EMS agencies [mean (minimum, maximum)]: Safety Climate 74.5 (min 49.9, max 89.7), Teamwork Climate 71.2 (min 45.1, max 90.1), Perceptions of Management 67.2 (min 31.1, max 92.2), Job Satisfaction 75.4 (min 47.5, max 93.8), Working Conditions 66.9 (min 36.6, max 91.4), and Stress Recognition 55.1 (min 31.3, max 70.6). Air medical EMS agencies tended to score higher across all safety culture domains. Lower safety culture scores were associated with increased annual patient contacts. Safety Climate domain scores were not associated with other individual or EMS agency characteristics. In this sample, workplace safety culture varies between EMS agencies.
There are still no major assessment and diagnostic tools that educators can use to properly assess our Inuit students' learning. Cultural safety as it is currently defined in New Zealand educational research (Macfarlane et al., 2007) is necessary in creating a classroom community that encourages the appreciation of culture and worldview, and…
... Culture; Organizational Leadership Perspectives on Safety Culture; Safety Culture Management and Oversight.... Opening Statement by Acting Chairman Hersman. 2. Introduction of the Technical Panels and Panelists. 3.... Opening Statement by Acting Chairman Hersman. 2. Introduction of the Technical Panels and Panelists. 3...
Fermo, Vivian Costa; Radünz, Vera; Rosa, Luciana Martins da; Marinho, Monique Mendes
Objective To identify the attitude of health professionals toward the patient safety culture at a bone marrow transplant unit. Methods Quantitative research approach, cross-sectional survey conducted at a bone marrow transplant unit in Santa Catarina, Brazil. Data were collected using a Safety Attitudes Questionnaire with 33 health professionals in August and September of 2013. A total of 37 attitudes were assessed according to six safety dimensions of patient safety culture. Data were analysed by applying descriptive and inferential statistics, ANOVA and the Kruskal-Wallis test with a p value equal to or under 0.05. Results Attitudes regarding the dimension "job satisfaction" were positive for the patient safety culture, and there was a significant difference between the professionals in this dimension (p-value 0.05). The other dimensions were not assessed positively. Conclusion The attitudes of health professionals toward patient safety must be strengthened.
Reis, Claudia Tartaglia; Laguardia, Josué; Martins, Mônica
Patient safety culture assessment allows hospitals to identify and prospectively manage safety issues in work routines. This article aimed to describe the cross-cultural adaptation of the Hospital Survey on Patient Safety Culture (HSOPSC) into Brazilian Portuguese. A universalist approach was adopted to assess conceptual, item, and semantic equivalence. The methodology involved the following stages: (1) translation of the questionnaire into Portuguese; (2) back-translation into English; (3) an expert panel to prepare a draft version; and (4) assessment of verbal understanding of the draft by a sample of the target population. The questionnaire was translated into Portuguese, and the scale's final version included 42 items. The target population sample assessed all the items as easy to understand. The questionnaire has been translated into Portuguese and adapted to the Brazilian hospital context, but it is necessary to assess its measurement equivalence, external validity, and reproducibility.
Herner, Sheryl J; Rawlings, Julia E; Swartzendruber, Kelly; Delate, Thomas
This study's objective was to assess the patient safety culture in a large, integrated health delivery system's pharmacy department to allow for benchmarking with other health systems. This was a cross-sectional survey conducted in a pharmacy department consisting of staff members who provide dispensing, clinical, and support services within an integrated health delivery system. The U.S. Agency for Healthcare Research and Quality's 11-composite, validated Pharmacy Survey on Patient Safety Culture questionnaire was transcribed into an online format. All departmental staff members were invited to participate in this anonymous survey. Cronbach α and overall results and contrasts between dispensing and clinical services staff and dispensing pharmacists and technicians/clerks as percentage positive scores (PPSs) are presented. Differences in contrasts were assessed with χ tests of association. Completed questionnaires were received from 598 (69.9%) of 855 employees. Cronbach α ranged from 0.55 to 0.90. Overall, the highest and lowest composite PPSs were for patient counseling (94.5%) and staffing and work pressure (44.7%), respectively. Compared with dispensing service, the clinical service participants had statistically higher PPSs for all composites except patient counseling, communication about mistakes, and staffing and work pressure (all P > 0.05). The technicians/clerks had a statistically higher PPS compared with the pharmacists for communication about mistakes (P = 0.007). All other composites were equivalent between groups. Patient counseling consistently had the highest PPS among composites measured, but opportunities existed for improvement in all aspects measured. Future research should identify and assess interventions targeted to improving the patient safety culture in pharmacy.
Haugen, A. S.; Søfteland, E.; Eide, G. E.; Sevdalis, N.; Vincent, C. A.; Nortvedt, M. W.; Harthug, S.
Background Positive changes in safety culture have been hypothesized to be one of the mechanisms behind the reduction in mortality and morbidity after the introduction of the World Health Organization's Surgical Safety Checklist (SSC). We aimed to study the checklist effects on safety culture perceptions in operating theatre personnel using a prospective controlled intervention design at a single Norwegian university hospital. Methods We conducted a study with pre- and post-intervention surveys using the intervention and control groups. The primary outcome was the effects of the Norwegian version of the SSC on safety culture perceptions. Safety culture was measured using the validated Norwegian version of the Hospital Survey on Patient Safety Culture. Descriptive characteristics of operating theatre personnel and checklist compliance data were also recorded. A mixed linear regression model was used to assess changes in safety culture. Results The response rate was 61% (349/575) at baseline and 51% (292/569) post-intervention. Checklist compliance ranged from 77% to 85%. We found significant positive changes in the checklist intervention group for the culture factors ‘frequency of events reported’ and ‘adequate staffing’ with regression coefficients at −0.25 [95% confidence interval (CI), −0.47 to −0.07] and 0.21 (95% CI, 0.07–0.35), respectively. Overall, the intervention group reported significantly more positive culture scores—including at baseline. Conclusions Implementation of the SSC had rather limited impact on the safety culture within this hospital. PMID:23404986
Arnetz, Judith E.; Zhdanova, Ludmila S.; Elsouhag, Dalia; Lichtenberg, Peter; Luborsky, Mark R.; Arnetz, Bengt B.
Purpose of the Study: In recent years, there has been an increasing focus on the role of safety culture in preventing costly adverse events, such as medication errors and falls, among nursing home residents. However, little is known regarding critical organizational determinants of a positive safety culture in nursing homes. The aim of this study…
Gimenes, Fernanda Raphael Escobar; Torrieri, Mayara Carvalho Godinho Rigobello; Gabriel, Carmen Silvia; Rocha, Fernanda Ludmilla Rossi; Silva, Ana Elisa Bauer de Camargo; Shasanmi, Rebecca O; Cassiani, Silvia Helena De Bortoli
To gain an understanding of medication safety culture and other quality issues in a Brazilian intensive care unit using a restorative approach. Patient safety should be considered one of the pillars of quality in health care. Thus, patient safety culture is increasingly being explored as a guide for quality improvement efforts. A qualitative approach. Participatory photographic research methods from the field of ecological restoration were adapted in this study. This study used focus groups, then subsequent nurse-led photo-narrated walkabouts, and photo elicitation with 23 nurses and one physician in interactive phases of data collection and analysis over an eight-month timeframe. The core themes identified were: the 'medication system shapes patient safety' and the 'feeling of helplessness in the face of the prevailing organization culture'. Participants discussed supports exiting in the intensive care unit that shape medication safety, the barriers that impede safe medication management, the solutions to improve medication safety and the creation of a better medication safety culture. The methods used allowed participants to visualise sound practices as well as key safety issues, reflect on their day-to-day work, re-think potential improvements, and enact changes to improve medication safety and medication safety culture. However, the patient safety culture is also marked by administrative pressure. The hospital needs to adopt participatory management, where the health professionals can act together with the organisational leaders to promote a just culture. The participatory photographic research methods from the field of ecological restoration provided participants with a tool to promote patient safety culture and engage policy change dialogue. However, it will be important in future restorative research to track-specific safety outcomes over time to assess the cost-benefit of the adoption of participatory management models. © 2016 John Wiley & Sons Ltd.
Kristensen, Solvejg; Christensen, Karl Bang; Jaquet, Annette
in the Safety Attitudes Questionnaire. To broaden knowledge and strengthen leadership skills, a multicomponent programme consisting of academic input, exercises, reflections and discussions, networking, and action learning was implemented among the clinical area level leaders. RESULTS: In total, 358 and 325...... in a Danish psychiatric department before and after a leadership intervention. METHODS: A repeated cross-sectional experimental study by design was applied. In 2 surveys, healthcare staff were asked about their perceptions of the patient safety culture using the 7 patient safety culture dimensions...... rated job satisfaction lower than the staff staying on (pleadership can act as a significant catalyst for patient safety culture improvement. Further studies using...
Faanu, A; Schandorf, C; Darko, E O; Boadu, M; Emi-Reynolds, G; Awudu, A R; Gyekye, P K; Kpeglo, D O
The safety culture of selected practices and facilities in Ghana utilising radiation sources or radiation emitting devices has been assessed using a performance indicator, which provided status information on management and operating staff commitment to safety. The questionnaire was based on the following broad areas: general safety considerations, safety policy at the facility level, safety practices at the facility level, definition of responsibility, staff training, safety of the physical structure of the facility and the emergency plans. The analysis showed that the percentage levels of commitment to safety for the respective practices are as follows: conventional radiography, 23.3-90.0%; research reactor, 73.3%; gamma irradiation facility, 53.3%; radiotherapy, 76.7%; X-ray scanner, 80.0%; gamma scanner, 76.7%; industrial radiography 86.7% and nuclear density practice, 78%. None of the practices or facilities was able to satisfy all the requirements that will ensure a 100% level of safety culture.
The focus of this research is to explore the issues surrounding traditional approaches towards understanding the safety culture of an organisation operating in a high risk environment and to identify an effective technique to educate corporate management in how to measure and evaluate the underlying safety culture of their own organisations. The results of the first part of the research highlight the concerns being expressed by both academic and industrial communities that current safety cult...
This study aimed to measure safety culture, examine variations among neonatal intensive care units (NICUs), and assess the associations with caregiver characteristics. A cross-sectional design was used, utilizing the Arabic version of the Safety Attitudes Questionnaire, administered to all 305 nurses and physicians working in the 16 NICUs in the West Bank. There were 204 participants, comprising of mainly nurses (80.4%), women (63%), 30 years or younger (62.6%), holding a bachelor's degree or more (66.7%), and with at least 5 years of experience in the profession (60.3%). Safety Attitudes Questionnaire mean domain scores ranged from 71.22 for job satisfaction to 63 for stress recognition on a 100-point scale; the scores varied significantly among NICUs (Psafety grade either excellent or very good; 71.0% did not report any event in the past year. We found large variations in safety culture within and between a comprehensive sample of Palestinian NICUs. The findings suggest the need for a customized approach that builds on existing strengths and targets areas of opportunities for improvement to optimize health care delivery to the most vulnerable of patients, sick newborns in the NICU setting. © 2013.
Alayed, Abdulrahman S; Lööf, Helena; Johansson, Unn-Britt
The purpose of this paper is to examine nurses' attitudes towards safety culture in six Saudi Arabian intensive care units (ICUs). The study is descriptive with a cross-sectional design. The Safety Attitude Questionnaire (SAQ)-ICU version was distributed and 216 completed questionnaires were returned. The findings provide a basis for further research on Saudi Arabian ICU safety culture. This study showed that the SAQ-ICU can be used to measure safety climate to identify areas for improvement according to nurse attitudes and perceptions. Findings indicate that ICU safety culture is an important issue that hospital managers should prioritise. The SAQ-ICU questionnaire, used to measure safety climate in Saudi Arabian ICUs, identifies service strengths and improvement areas according to attitudes and perceptions. To the knowledge, this is the first study to use SAQ to examine nurses' safety culture attitudes in Saudi Arabian ICUs. The present findings provide a baseline and further details about Saudi Arabian ICU safety. Study participants represented nine nationalities, indicating the nursing workforce's diversity, which is expected to continue in the future. Such a nursing cultural heterogeneity calls for further studies to examine and evaluate attitudes and values to improve ICU safety culture.
Abu-El-Noor, Nasser Ibrahim; Hamdan, Motasem Abduallah; Abu-El-Noor, Mysoon Khalil; Radwan, Abdal-Karim Said; Alshaer, Ahmed Ali
Assessment of the prevailing safety culture within the Gazan health care system can be used to identify problem areas. Specifically, the need for improvements, raising awareness about patient safety, the identification and evaluation of existing safety programs and interventions for improving the safety culture. This study aims to assess the safety culture in the neonatal intensive care units (NICUs) in Gaza Strip hospitals and to assess the safety culture in regards to caregivers' characteristics. In a cross-sectional study using a census sample, we surveyed all nurses and physicians working in at all the NICUs in the Gaza Strip, Palestine. The Safety Attitudes Questionnaire (SAQ) which includes six scales was used to assess participants' attitudes towards safety culture. The overall score for SAQ was 63.9. Domains' scores ranged between 55.5 (perception of management) and 71.8 (stress recognition). The scores reported by our participants fell below the 75 out of a possible score of 100, which was considered as a cut-off point for a positive score. Moreover, our results revealed substantial variation in safety culture domain scores among participating NICUs. These results should be an indicator to our health care policy makers to modify current or adopt new health care policies to improve safety culture. It should also be a call to design customized programs for improving the safety culture in NICUs in the Gaza Strip. Copyright © 2017 Elsevier Inc. All rights reserved.
Bump, Gregory M; Calabria, Jaclyn; Gosman, Gabriella; Eckart, Catherine; Metro, David G; Jasti, Harish; McCausland, Julie B; Itri, Jason N; Patel, Rita M; Buchert, Andrew
The Accreditation Council for Graduate Medical Education has begun to evaluate teaching institutions' learning environments with Clinical Learning Environment Review visits, including trainee involvement in institutions' patient safety and quality improvement efforts. We sought to address the dearth of metrics that assess trainee patient safety perceptions of the clinical environment. Using the Hospital Survey on Patient Safety Culture (HSOPSC), we measured resident and fellow perceptions of patient safety culture in 50 graduate medical education programs at 10 hospitals within an integrated health system. As institution-specific physician scores were not available, resident and fellow scores on the HSOPSC were compared with national data from 29 162 practicing providers at 543 hospitals. Of the 1337 residents and fellows surveyed, 955 (71.4%) responded. Compared with national practicing providers, trainees had lower perceptions of patient safety culture in 6 of 12 domains, including teamwork within units, organizational learning, management support for patient safety, overall perceptions of patient safety, feedback and communication about error, and communication openness. Higher perceptions were observed for manager/supervisor actions promoting patient safety and for staffing. Perceptions equaled national norms in 4 domains. Perceptions of patient safety culture did not improve with advancing postgraduate year. Trainees in a large integrated health system have variable perceptions of patient safety culture, as compared with national norms for some practicing providers. Administration of the HSOPSC was feasible and acceptable to trainees, and may be used to track perceptions over time.
Bishop, Andrea C; Boyle, Todd A
To determine how provider perceptions of safety culture influence their involvement in patient safety practices. Health-care providers were surveyed in 2 tertiary hospitals located in Atlantic Canada, composed of 4 units in total. The partial least squares (PLS) approach to structural equation modeling was used to analyze the data. Latent variables provider PLS model encompassed the hypothesized relationships between provider characteristics, safety culture, perceptions of patient safety practices, and actual performance of patient safety practices, using the Health Belief Model (HBM) as a guide. Data analysis was conducted using SmartPLS. A total of 113 health-care providers completed a survey out of an eligible 318, representing a response rate of 35.5%. The final PLS model showed acceptable internal consistency with all four latent variables having a composite reliability score above the recommended 0.70 cutoff value (safety culture = 0.86, threat = 0.76, expectations = 0.83, PS practices = 0.75). Discriminant validity was established, and all path coefficients were found to be significant at the α = 0.05 level using nonparametric bootstrapping. The survey results show that safety culture accounted for 34% of the variance in perceptions of threat and 42% of the variance in expectations. This research supports the role that safety culture plays in the promotion and maintenance of patient safety activities for health-care providers. As such, it is recommended that the introduction of new patient safety strategies follow a thorough exploration of an organization's safety culture.
Hunter, P.H.; Barg, D.C.; Baird, R.D.; Card, D.H.; de Souza, F.; Elder, J.; Felthauser, K.; Jensen, C.; Winkler, V.
A brief radiological safety and risk assessment of a nuclear power generation center with an adjacent on-site waste disposal facility at a specific site in the State of Utah is presented. The assessment was conducted to assist in determining the feasibility and practicality of developing a nuclear energy center (NEC) in Utah consisting of nine 1250 MWe nuclear pressurized water reactor (PWR) electrical generating units arranged in 3 clusters of 3 units each known as triads. The site selected for this conceptual study is in the Horse Bench area about 15 miles directly south of the town of Green River, Utah. The radiological issues included direct radiation exposures to on-site workers and the off-site population, release of radioactive material, and effects of these releases for both normal operations and accidental occurrences. The basic finding of this study is that the concept of an NEC in the Green River area, specifically at the Horse Bench site, is radiologically feasible.
Nielsen, Kent J
International research indicates that internal health and safety organizations (HSO) and health and safety committees (HSC) do not have the intended impact on companies' safety performance. The aim of this case study at an industrial plant was to test whether the HSO can improve company safety culture by creating more and better safety-related interactions both within the HSO and between HSO members and the shop-floor. A quasi-experimental single case study design based on action research with both quantitative and qualitative measures was used. Based on baseline mapping of safety culture and the efficiency of the HSO three developmental processes were started aimed at the HSC, the whole HSO, and the safety representatives, respectively. Results at follow-up indicated a marked improvement in HSO performance, interaction patterns concerning safety, safety culture indicators, and a changed trend in injury rates. These improvements are interpreted as cultural change because an organizational double-loop learning process leading to modification of the basic assumptions could be identified. The study provides evidence that the HSO can improve company safety culture by focusing on safety-related interactions. © 2013. Published by Elsevier Ltd and National Safety Council.
Purpose: To assess the culture of safety among nurses in a tertiary teaching hospital in Saudi Arabia. Methods: A cross-sectional survey was conducted in King Khaled University Hospital in Riyadh, Saudi Arabia. A random sample of 492 nurses was included in the survey using a pre-validated instrument, Safety Attitudes ...
Reiman, T.; Pietikaeinen, E. (Technical Research Centre of Finland, VTT (Finland)); Kahlbom, U. (RiskPilot AB (Sweden)); Rollenhagen, C. (Royal Institute of Technology (KTH) (Sweden))
The project aimed at studying the concept of nuclear safety culture and the Nordic nuclear branch safety culture. The project also aimed at looking how the power companies and the regulators view the current responsibilities and role of subcontractors in the Nordic nuclear safety culture as well as to inspect the special demands for safety culture in subcontracting chains. Interview data was collected in Sweden (n = 14) and Finland (n = 16) during 2009. Interviewees represented the major actors in the nuclear field (regulators, power companies, expert organizations, waste management organizations). Results gave insight into the nature and evaluation of safety culture in the nuclear industry. Results illustrated that there is a wide variety of views on matters that are considered important for nuclear safety within the Nordic nuclear community. However, the interviewees considered quite uniformly such psychological states as motivation, mindfulness, sense of control, understanding of hazards and sense of responsibility as important for nuclear safety. Results also gave insight into the characteristics of Nordic nuclear culture. Various differences in safety cultures in Finland and Sweden were uncovered. In addition to the differences, historical reasons for the development of the nuclear safety cultures in Finland and Sweden were pointed out. Finally, results gave implications that on the one hand subcontractors can bring new ideas and improvements to the plants' practices, but on the other hand the assurance of necessary safety attitudes and competence of the subcontracting companies and their employees is considered as a challenge. The report concludes that a good safety culture requires a deep and wide understanding of nuclear safety including the various accident mechanisms of the power plants as well as a willingness to continuously develop one's competence and understanding. An effective and resilient nuclear safety culture has to foster a constant
Bishop, Andrea C; Cregan, Brianna R
The purpose of this paper is to determine what patient and family stories can tell us about patient safety culture within health care organizations and how patients experience patient safety culture. A total of 11 patient and family stories of adverse event experiences were examined in September 2013 using publicly available videos on the Canadian Patient Safety Insitute web site. Videos were transcribed verbatim and collated as one complete data set. Thematic analysis was used to perform qualitative inquiry. All qualitative analysis was done using NVivo 10 software. A total of three themes were identified: first, Being Passed Around; second, Not Having the Conversation; and third, the Person Behind the Patient. Results from this research also suggest that while health care organizations and providers might expect patients to play a larger role in managing their health, there may be underlying reasons as to why patients are not doing so. The findings indicate that patient experiences and narratives are useful sources of information to better understand organizational safety culture and patient experiences of safety while hospitalized. Greater inclusion and analysis of patient safety narratives is important in understanding the needs of patients and how patient safety culture interventions can be improved to ensure translation of patient safety strategies at the frontlines of care. Greater acknowledgement of the patient and family experience provides organizations with an integral perspective to assist in defining and addressing deficiencies within their patient safety culture and to identify opportunities for improvement.
Jespersen, Lone; Wallace, Carol A
The research evaluates maturity of food safety culture in five multi-national food companies using method triangulation, specifically self-assessment scale, performance documents, and semi-structured interviews. Weaknesses associated with each individual method are known but there are few studies in food safety where a method triangulation approach is used for both data collection and data analysis. Significantly, this research shows that individual results taken in isolation can lead to wrong conclusions, resulting in potentially failing tactics and wasted investments. However, by applying method triangulation and reviewing results from a range of culture measurement tools it is possible to better direct investments and interventions. The findings add to the food safety culture paradigm beyond a single evaluation of food safety culture using generic culture surveys. Copyright © 2017. Published by Elsevier Ltd.
Hsu, Shang Hwa; Lee, Chun-Chia
A relationship-oriented culture predominates in the Greater China region, where it is more important than in Western countries. Some characteristics of this culture influence strongly the organizational structure and interactions among members in an organization. This study aimed to explore the possible influence of relationships on safety management in relationship-oriented cultures. We hypothesized that organizational factors (management involvement and harmonious relationships) within a relationship-oriented culture would influence supervisory work (ongoing monitoring and task instructions), the reporting system (selective reporting), and teamwork (team communication and co-ordination) in safety management at a group level, which would in turn influence individual reliance complacency, risk awareness, and practices. We distributed a safety climate questionnaire to the employees of Taiwanese high-risk industries. The results of structural equation modeling supported the hypothesis. This article also discusses the findings and implications for safety improvement in countries with a relationship-oriented culture.
McEldowney, Rose; Connor, Margaret J
New writings broadening the construct of cultural safety, a construct initiated in Aotearoa New Zealand, are beginning to appear in the literature. Therefore, it is considered timely to integrate these writings and advance the construct into a new theoretical model. The new model reconfigures the constructs of cultural safety and cultural competence as an ethic of care informed by a postmodern perspective. Central to the new model are three interwoven, co-occurring components: an ethic of care, which unfolds within a praxiological process shaped by the context. Context is expanded through identifying the three concepts of relationality, generic competence, and collectivity, which are integral to each client-nurse encounter. The competence associated with cultural safety as an ethic of care is always in the process of development. Clients and nurses engage in a dialogue to establish the level of cultural safety achieved at given points in a care trajectory.
Petitta, Laura; Probst, Tahira M; Barbaranelli, Claudio; Ghezzi, Valerio
Despite increasing attention to contextual effects on the relationship between supervisor enforcement and employee safety compliance, no study has yet explored the conjoint influence exerted simultaneously by organizational safety climate and safety culture. The present study seeks to address this literature shortcoming. We first begin by briefly discussing the theoretical distinctions between safety climate and culture and the rationale for examining these together. Next, using survey data collected from 1342 employees in 32 Italian organizations, we found that employee-level supervisor enforcement, organizational-level safety climate, and autocratic, bureaucratic, and technocratic safety culture dimensions all predicted individual-level safety compliance behaviors. However, the cross-level moderating effect of safety climate was bounded by certain safety culture dimensions, such that safety climate moderated the supervisor enforcement-compliance relationship only under the clan-patronage culture dimension. Additionally, the autocratic and bureaucratic culture dimensions attenuated the relationship between supervisor enforcement and compliance. Finally, when testing the effects of technocratic safety culture and cooperative safety culture, neither safety culture nor climate moderated the relationship between supervisor enforcement and safety compliance. The results suggest a complex relationship between organizational safety culture and safety climate, indicating that organizations with particular safety cultures may be more likely to develop more (or less) positive safety climates. Moreover, employee safety compliance is a function of supervisor safety leadership, as well as the safety climate and safety culture dimensions prevalent within the organization. Copyright © 2016 Elsevier Ltd. All rights reserved.
Sivanandy, Palanisamy; Maharajan, Mari Kannan; Rajiah, Kingston; Wei, Tan Tyng; Loon, Tan Wee; Yee, Lim Chong
Patient safety is a major public health issue, and the knowledge, skills, and experience of health professionals are very much essential for improving patient safety. Patient safety and medication error are very much associated. Pharmacists play a significant role in patient safety. The function of pharmacists in the medication use process is very different from medical and nursing colleagues. Medication dispensing accuracy is a vital element to ensure the safety and quality of medication use. To evaluate the attitude and perception of the pharmacist toward patient safety in retail pharmacies setup in Malaysia. A Pharmacy Survey on Patient Safety Culture questionnaire was used to assess patient safety culture, developed by the Agency for Healthcare Research and Quality, and the convenience sampling method was adopted. The overall positive response rate ranged from 31.20% to 87.43%, and the average positive response rate was found to be 67%. Among all the eleven domains pertaining to patient safety culture, the scores of "staff training and skills" were less. Communication openness, and patient counseling are common, but not practiced regularly in the Malaysian retail pharmacy setup compared with those in USA. The overall perception of patient safety of an acceptable level in the current retail pharmacy setup. The study revealed that staff training, skills, communication in patient counseling, and communication across shifts and about mistakes are less in current retail pharmacy setup. The overall perception of patient safety should be improved by educating the pharmacists about the significance and essential of patient safety.
Thornton, Kevin C; Schwarz, Jennifer J; Gross, A Kendall; Anderson, Wendy G; Liu, Kathleen D; Romig, Mark C; Schell-Chaple, Hildy; Pronovost, Peter J; Sapirstein, Adam; Gropper, Michael A; Lipshutz, Angela K M
Preventing harm remains a persistent challenge in the ICU despite evidence-based practices known to reduce the prevalence of adverse events. This review seeks to describe the critical role of safety culture and patient and family engagement in successful quality improvement initiatives in the ICU. We review the evidence supporting the impact of safety culture and provide practical guidance for those wishing to implement initiatives aimed at improving safety culture and more effectively integrate patients and families in such efforts. Literature review using PubMed including evaluation of key studies assessing large-scale quality improvement efforts in the ICU, impact of safety culture on patient outcomes, methodologies for quality improvement commonly used in healthcare, and patient and family engagement. Print and web-based resources from leading patient safety organizations were also searched. Our group completed a review of original studies, review articles, book chapters, and recommendations from leading patient safety organizations. Our group determined by consensus which resources would best inform this review. A strong safety culture is associated with reduced adverse events, lower mortality rates, and lower costs. Quality improvement efforts have been shown to be more effective and sustainable when paired with a strong safety culture. Different methodologies exist for quality improvement in the ICU; a thoughtful approach to implementation that engages frontline providers and administrative leadership is essential for success. Efforts to substantively include patients and families in the processes of quality improvement work in the ICU should be expanded. Efforts to establish a culture of safety and meaningfully engage patients and families should form the foundation for all safety interventions in the ICU. This review describes an approach that integrates components of several proven quality improvement methodologies to enhance safety culture in the ICU and
Simons, Pascale A M; Houben, Ruud; Vlayen, Annemie; Hellings, Johan; Pijls-Johannesma, Madelon; Marneffe, Wim; Vandijck, Dominique
The importance of a safety culture to maximize safety is no longer questioned. However, achieving sustainable culture improvements are less evident. Evidence is growing for a multifaceted approach, where multiple safety interventions are combined. Lean management is such an integral approach to improve safety, quality and efficiency and therefore, could be expected to improve the safety culture. This paper presents the effects of lean management activities on the patient safety culture in a radiotherapy institute. Patient safety culture was evaluated over a three year period using triangulation of methodologies. Two surveys were distributed three times, workshops were performed twice, data from an incident reporting system (IRS) was monitored and results were explored using structured interviews with professionals. Averages, chi-square, logistical and multi-level regression were used for analysis. The workshops showed no changes in safety culture, whereas the surveys showed improvements on six out of twelve dimensions of safety climate. The intention to report incidents not reaching patient-level decreased in accordance with the decreasing number of reports in the IRS. However, the intention to take action in order to prevent future incidents improved (factorial survey presented β: 1.19 with p: 0.01). Due to increased problem solving and improvements in equipment, the number of incidents decreased. Although the intention to report incidents not reaching patient-level decreased, employees experienced sustained safety awareness and an increased intention to structurally improve. The patient safety culture improved due to the lean activities combined with an organizational restructure, and actual patient safety outcomes might have improved as well. Copyright © 2014 Elsevier Ltd. All rights reserved.
Full Text Available Workplace safety continues to be an area of concern in the maritime industry due to the international nature of the operations. The effectiveness of extensive legislation to manage shipboard safety remains in doubt. The focus must therefore shift towards the human element - seafarers and their perceptions of safety. The study aims to understand the alignment that exists between safety culture and safety climate on board ships as perceived by seafarers. The underlying factors of safety climate were identified using factor analysis which isolated seven factors - Support on Safety, Organizational Support, Resource Availability, Work Environment, Job Demands, ‘Just’ Culture, and Safety Compliance. The perception of safety level of seafarers was found to be low indicating the existence of misalignments between safety culture values and the actual safety climate. The study also reveals that the safety perceptions of officers employed directly by ship owners and those by managers do not differ significantly, nor do they differ between senior and junior officers. A shift in perspective towards how seafarers themselves feel towards safety might provide more effective solutions – instead of relying on regulations - and indeed aid in reducing incidents on board. This paper details practical suggestions on how to identify the factors that contribute towards a better safety climate on board ships.
and linking acts inspired from research in social capital, and supplemented with acts of exclusion, all to describe the power conflicts which includes and excludes members in the unitary, divided or fragmented safety cultures that I met on board. The data shows that foreign seafarers are treated equally...... as long as the basic structures are not addressed. They are however treated equally on the majority´s terms, which still lead to a minority position even in the safety culture. A shared safety culture is therefore difficult to achieve....
Kaufman, Gerri; McCaughan, Dorothy
This article explores the links between organisational culture and patient safety. The key elements associated with a safety culture, most notably effective leadership, good teamwork, a culture of learning and fairness, and fostering patient-centred care, are discussed. The broader aspects of a systems approach to promoting quality and safety, with specific reference to clinical governance, human factors, and ergonomics principles and methods, are also briefly explored, particularly in light of the report of the public inquiry into care failings at Mid Staffordshire NHS Foundation Trust.
Bordin Vongvitayapirom; Punnamee Sachakamol; Hanna Kropsu-Vehkapera; Pekka Kess
Purpose – The purpose of this paper it to provide practitioner and researcher lessons learned from applying a safety culture maturity model in the oil and gas industry in Thailand. It proposes a roadmap to improve safety culture maturity in an organization. Design/methodology/approach – A safety culture maturity of 5 levels was chosen (Hudson’s model) to be applied in oil and gas company, and a questionnaire survey was conducted with 2,251 employees or 74% of the target group across the compa...
Full Text Available Background: Occupational incidents still account for a high percentage of causes of death and disability. A study was designed to determine the relationship between employee safe behavior and safety culture. Methods: In this analytical study, all employees of an industrial livestock units of Tehran participated (n = 200. The data on the employee behavior was evaluated using the safety sampling technique based on the ANSI Dangerous Acts List (Modified Form. A standard questionnaire was used to assess the safety culture. Data were analyzed by the SPSS software, at the significance level of 0.05. Results: The mean safety score of people (138 was acceptable. The rate of unsafe behaviors was 35%. The most unsafe behaviors were due to improper manual handling (83%. A reverse correlation between unsafe behavior and safety culture score (P value = 0.001 was seen. Conclusion: The results of this study indicate that there is a significant negative reciprocal relationship between safety culture and unsafe behavior, that is, with the increase in the safety culture, the rate of unsafe behavior decreases. As a result, by promoting the level of safety culture, the rate of unsafe behavior can be reduced.
Hill, M R; Roberts, M J; Alderson, M L; Gale, T C E
Improvements in safety culture have been postulated as one of the mechanisms underlying the association between the introduction of the World Health Organisation (WHO) Surgical Safety Checklist with perioperative briefings and debriefings, and enhanced patient outcomes. The 5 Steps to Safer Surgery (5SSS) incorporates pre-list briefings, the three steps of the WHO Surgical Safety Checklist (SSC) and post-list debriefings in one framework. We aimed to identify any changes in safety culture associated with the introduction of the 5SSS in orthopaedic operating theatres. We assessed the safety culture in the elective orthopaedic theatres of a large UK teaching hospital before and after introduction of the 5SSS using a modified version of the Safety Attitude Questionnaire - Operating Room (SAQ-OR). Primary outcome measures were pre-post intervention changes in the six safety culture domains of the SAQ-OR. We also analysed changes in responses to two items regarding perioperative briefings. The SAQ-OR survey response rate was 80% (60/75) at baseline and 74% (53/72) one yr later. There were significant improvements in both the reported frequency (Psafety culture domain scores (Working Conditions, Perceptions of Management, Job Satisfaction, Safety Climate and Teamwork Climate) of the SAQ-OR (Psafety culture of elective orthopaedic operating theatres. © The Author 2015. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: email@example.com.
Jung, Su Jin; Choi, Young Sung; Oh, Jang Jin [Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of)
In Korea, the safety policy statement declared in 1994 by government stressed the importance of safety culture and licensees were encouraged to manage and conduct their self-assessments. A change in regulatory position about safety culture oversight was made after the event of SBO cover-up in Kori unit 1 and several subsequent falsification events. Since then KINS has been developing licensee's safety culture oversight system including conceptual framework of oversight, prime focus area for oversight, and specific details on regulatory expectations, all of which are based on defence-in-depth (DiD) safety enhancement approach. Development and gathering of performance data which is related to actual 'safety' of nuclear power plant are needed to identify the relationship between safety culture and safety performance. Authors consider this study as pilot which has a contribution on verifying the construct validity of the model and the effectiveness of survey based research. This is the first attempt that the validity of safety culture oversight model has been investigated with empirical data obtained from Korean nuclear power operating organization.
Nebuloni, M. [Centro Ricerche Lepetit, Gerenzano, Varese (Italy)
The culture of laboratory safety implements the priority of safety first through a greatly increased emphasis on experiment planning, including habitual attention to the risk assessment and consideration of hazards for oneself, on fellow workers and the public. Continuous basic respect and care for the health and safety of laboratory workers and greater society constitute the starting point for safe practices in the chemical laboratory.
Verbakel, Natasha J; de Bont, Antoinette A; Verheij, Theo J M; Wagner, Cordula; Zwart, Dorien L M
When improving patient safety a positive safety culture is key. As little is known about improving patient safety culture in primary care, this study examined whether administering a culture questionnaire with or without a complementary workshop could be used as an intervention for improving safety culture. To gain insight into how two interventions affected patient safety culture in everyday practice. After conducting a randomised control trial of two interventions, this was a qualitative study conducted in 30 general practices to aid interpretation of the previous quantitative findings. Interviews were conducted at practice locations (n = 27) with 24 GPs and 24 practice nurses. The theory of communities of practice--in particular, its concepts of a domain, a community, and a practice--was used to interpret the findings by examining which elements were or were not present in the participating practices. Communal awareness of the problem was only raised after getting together and discussing patient safety. The combination of a questionnaire and workshop enhanced the interaction of team members and nourished team feelings. This shared experience also helped them to understand and develop tools and language for daily practice. In order for patient safety culture to improve, the safety culture questionnaire was more successful when accompanied by a practice workshop. Initial discussion and negotiation of shared goals during the workshop fuelled feelings of coherence and belonging to a community wishing to learn about enhancing patient safety. Team meetings and day-to-day interactions enhanced further liaison and sharing, making patient safety a common and conscious goal. © British Journal of General Practice 2015.
Palacios-Derflingher, Luz; O'Beirne, Maeve; Sterling, Pam; Zwicker, Karen; Harding, Brianne K; Casebeer, Ann
Safety culture has been shown to affect patient safety in healthcare. While the United States and United Kingdom have studied the dimensions that reflect patient safety culture in family practice settings, to date, this has not been done in Canada. Differences in the healthcare systems between these countries and Canada may affect the dimensions found to be relevant here. Thus, it is important to identify and compare the dimensions from the United States and the United Kingdom in a Canadian context. The objectives of this study were to explore the dimensions of patient safety culture that relate to family practice in Canada and to determine if differences and similarities exist between dimensions found in Canada and those found in previous studies undertaken in the United States and the United Kingdom. A qualitative study was undertaken applying thematic analysis using focus groups with family practice offices and supplementary key stakeholders. Analysis of the data indicated that most of the dimensions from the United States and United Kingdom are appropriate in our Canadian context. Exceptions included owner/managing partner/leadership support for patient safety, job satisfaction and overall perceptions of patient safety and quality. Two unique dimensions were identified in the Canadian context: disclosure and accepting responsibility for errors. Based on this early work, it is important to consider differences in care settings when understanding dimensions of patient safety culture. We suggest that additional research in family practice settings is critical to further understand the influence of context on patient safety culture.
Jespersen, Lone; Griffiths, Mansel; Wallace, Carol Anne
The purpose of the research was firstly, to analyze existing culture evaluation systems for commonalities and differences in research quality, applied validation strategies, and content. Secondly, to suggest a simple structure of food safety cultural dimensions to help unify the culture evaluation field. To achieve these goals, a comparison of eight culture evaluation models applied to varing degrees in the food industry was conducted. The systems were found to vary significantly in applied v...
Wischet, Werner; Eitzinger, Claudia
The publication of the IOM report "To err is human: building a safer health system" in 1999 put spotlight on the primacy of the principle of primum non nocere and made patient safety a central topic of quality management. A key conclusion of the report was the need for a well-developed safety culture. While concepts of quality management have evolved along the lines of ISO and Total Quality Management over the last decades patient safety still has not got the same amount of attention (PubMed). Evidence from other safety-critical areas but also from the field of medicine itself suggests that an efficient culture of safety is a conditio sine qua non for the sustainable improvement of patient safety. Considering these arguments the present paper aims at emphasizing the importance of an efficient culture of safety for patient safety and quality management in healthcare. In addition, key instruments of safety culture as well as their limitations will be presented.
Huang, David T.; Clermont, Gilles; Kong, Lan; Weissfeld, Lisa A.; Sexton, J. Bryan; Rowan, Kathy M.; Angus, Derek C.
Objective Safety culture may influence patient outcomes, but evidence is limited. We sought to determine if intensive care unit (ICU) safety culture is independently associated with outcomes. Design Cohort study combining safety culture survey data with the Project IMPACT Critical Care Medicine (PICCM) clinical database. Setting Thirty ICUs participating in the PICCM database. Participants A total of 65 978 patients admitted January 2001–March 2005. Interventions None. Main outcome measures Hospital mortality and length of stay (LOS). Methods From December 2003 to April 2004, we surveyed study ICUs using the Safety Attitudes Questionnaire-ICU version, a validated instrument that assesses safety culture across six factors. We calculated factor mean and percent-positive scores (% respondents with mean score ≥75 on a 0–100 scale) for each ICU, and generated case-mix adjusted, patient-level, ICU-clustered regression analyses to determine the independent association of safety culture and outcome. Results We achieved a 47.9% response (2103 of 4373 ICU personnel). Culture scores were mostly low to moderate and varied across ICUs (range: 13–88, percent-positive scores). After adjustment for patient, hospital and ICU characteristics, for every 10% decrease in ICU perceptions of management percent-positive score, the odds ratio for hospital mortality was 1.24 (95% CI: 1.07–1.44; P = 0.005). For every 10% decrease in ICU safety climate percent-positive score, LOS increased 15% (95% CI: 1−30%; P = 0.03). Sensitivity analyses for non-response bias consistently associated safety climate with outcome, but also yielded some counterintuitive results. Conclusion In a multicenter study conducted in the USA, perceptions of management and safety climate were moderately associated with outcomes. Future work should further develop methods of assessing safety culture and association with outcomes. PMID:20382662
Fleming, Tania; Creedy, Debra K; West, Roianne
Cultural safety in higher education learning and teaching environments is paramount to positive educational outcomes for Aboriginal and/or Torres Strait Islander (hereafter called First Peoples) students. There is a lack of research evaluating the impact of continuing professional development on midwifery academics' awareness of cultural safety. To implement and evaluate a continuing professional development intervention to improve midwifery academics' awareness of cultural safety in supporting First Peoples midwifery students success. A pre-post intervention mixed methods design was used. Academics (n=13) teaching into a Bachelor of Midwifery program agreed to participate. The intervention consisted of two workshops and five yarning circles across a semester. Data included the Awareness of Cultural Safety Scale, self-assessment on cultural safety and perceptions of racism, evaluation of the intervention, participants' journal entries, and researcher's reflections. Responses on the Awareness of Cultural Safety Scale revealed significant improvement in participants' awareness of cultural safety. There was an upward trend in self-assessment ratings. Participants reported high levels of satisfaction with the intervention or workshops and yarning circles. Participants' journal entries revealed themes willingness to participate and learn, confidence as well as anger and distress. Increased awareness of cultural safety can be transformative for midwifery academics. Workshops and yarning circles can support academics in moving beyond a 'sense of paralysis' and engage in challenging conversations to transform their learning and teaching and in turn foster a culturally safe learning and teaching environment for First Peoples midwifery students towards success. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
Andkjær, Søren; Arvidsen, Jan
water-based outdoor activities: small boat fishing, sea kayaking, and kite surfing. The theoretical framework used was cultural analysis and the methodological approach was mixed methods using case studies with survey and qualitative interviews. The study indicates that safety is a complex matter...... and that safety culture can be understood as the sum and interaction among six categories. The safety culture is closely related to the activity and differs widely among activities. We suggest a broad perspective be taken on risk management wherein risk and safety can be managed at different levels. Small boat...... fishing is a critical example with obvious critical points according to risk management. We also present suggestions for improving safety in small boat fishing....
Verbakel, Natasha J; Langelaan, Maaike; Verheij, Theo J M; Wagner, Cordula; Zwart, Dorien L M
A constructive safety culture is essential for the successful implementation of patient safety improvements. To assess the effect of two patient safety culture interventions on incident reporting as a proxy of safety culture. A three-arm cluster randomised trial was conducted in a mixed method study, studying the effect of administering a patient safety culture questionnaire (intervention I), the questionnaire complemented with a practice-based workshop (intervention II) and no intervention (control) in 30 general practices in the Netherlands. The primary outcome, the number of reported incidents, was measured with a questionnaire at baseline and a year after. Analysis was performed using a negative binomial model. Secondary outcomes were quality and safety indicators and safety culture. Mixed effects linear regression was used to analyse the culture questionnaires. The number of incidents increased in both intervention groups, to 82 and 224 in intervention I and II respectively. Adjusted for baseline number of incidents, practice size and accreditation status, the study showed that practices that additionally participated in the workshop reported 42 (95% confidence interval [CI] = 9.81 to 177.50) times more incidents compared to the control group. Practices that only completed the questionnaire reported 5 (95% CI = 1.17 to 25.49) times more incidents. There were no statistically significant differences in staff perception of patient safety culture at follow-up between the three study groups. Educating staff and facilitating discussion about patient safety culture in their own practice leads to increased reporting of incidents. It is beneficial to invest in a team-wise effort to improve patient safety. © British Journal of General Practice 2015.
Lee, Nae U; Lee, Ji U; Jeon, Seong Gyun; Lee, Yeong Sun
This book deals with risk assessment and dangerous material of definition cases and industrial disaster, risk assessment of summary, ways of assessment and effect model, material safety data sheet system such as management, writing skill and use, product and storage of dangerous material like chemical reaction of homogeneous catalysis, harmfulness of material, corrosion and anti corrosion like crevice corrosion and erosion corrosion and range, classification, application of safety assessment.
Patient's safety culture among Tunisian healthcare workers: results of a cross sectional study in university hospital. Asma Ben Cheikh, Nabiha Bouafia, Mohamed Mahjoub, Olfa Ezzi, Amel Nouira, Mansour Njah ...
Despite evidence of significant management contributions to the causes of major accidents, recent events at Millstone Nuclear Power Station in the US and Ontario Hydro in Canada might lead one to conclude that the significance of safety culture, and the role of management in developing and maintaining an appropriate safety culture, is either not being understood or not being taken serious as integral to the safe operation of some complex, high-reliability operations. It is the purpose of this paper to address four aspects of management that are particularly important to safety culture, and to illustrate how development of an appropriate safety culture is more a matter of common sense than rocket science.
Tingle, John; Minford, Jen
John Tingle, Reader in Health Law at Nottingham Trent University, and Jen Minford, Junior Doctor Coordinator, Nottingham University Hospitals NHS Trust, look at the role of patient safety culture change agents in the NHS.
The main objective of this research was to provide guidance to the Kansas Department of Transportation (KDOT) in establishing strategies to improve the traffic safety culture in Kansas. This was done by analyzing crash data with respect to the seven ...
Poley, Marten J; van der Starre, Cynthia; van den Bos, Ada; van Dijk, Monique; Tibboel, Dick
Nowadays, the belief is widespread that a safety culture is crucial to achieving patient safety, yet there has been virtually no analysis of the safety culture in pediatric hospital settings so far. Our aim was to measure the safety climate in our unit, compare it with benchmarking data, and identify potential deficiencies. Prospective longitudinal survey study at two points in time. Pediatric surgical intensive care unit at a Dutch university hospital. All unit personnel. To measure the safety climate, the Safety Attitudes Questionnaire was administered to physicians, nurses, nursing assistants, pharmacists, technicians, and ward clerks in both May 2006 and May 2007. This questionnaire assesses caregiver attitudes through use of the six following scales: teamwork climate, job satisfaction, perceptions of management, safety climate, working conditions, and stress recognition. Earlier research showed that the Safety Attitudes Questionnaire has good psychometric properties and produced benchmarking data that can be used to evaluate strengths and weaknesses in a given clinical unit against peers. The response rates for the Safety Attitudes Questionnaire were 85% (May 2006) and 74% (May 2007). There were mixed findings regarding the difference between physicians and nurses: on three scales (i.e., teamwork climate, safety climate, and stress recognition), physicians scored better than nurses at both points in time. On another two scales (i.e., perceptions of management and working conditions), nurses consistently had higher mean scale scores. Probably due to the small number of physicians, only some of these differences between physicians and nurses reached the level of statistical significance. Compared to benchmarking data, scores on perceptions of management were higher than expected (p safety climate), or somewhat below (working conditions) what was expected on the basis of benchmarking data, but no persistent significant differences were observed on these scales
Sitnica, A., E-mail: firstname.lastname@example.org [Westinghouse Electric Co., 1000 Westinghouse Drive, Cranberry Township, PA 16066 (United States)
No industry, organization, individual or even the government is immune to the information security risks which are associated with nuclear power. It can no longer be ignored, delayed or treated as unimportant. Nuclear safety is paramount to our industry, and cyber security must be woven into the fabric of our safety culture in order to succeed. Achieving this in an environment which has remained relatively unchanged and conservative prior to digitalisation demands a shift in behavior and culture. (Author)
Iraj Mohammadfam; Hanie Nikoomaram; Mohammad Faridan
Studies have determined that the application of technical safety measures is not adequate to protect human, economic and environmental assets in industries. Therefore, promoting Health, Safety and Environment (HSE culture), as an alternative approach, is of great importance. The aim of this study was to evaluate and manage HSE culture among employees of an industrial sector in Iran. This descriptive-analytic research was carried out during the years 2009 and 2010. The statistical population i...
Haber, S.B.; Shurberg, D.A.
The importance of safety culture in the safe and reliable operation of nuclear organizations is not a new concept. The greatest barriers to this area of research are twofold: (1) the definition and criteria of safety culture for a nuclear organization and (2) the measurement of those attributes in an objective and systematic fashion. This paper will discuss a proposed resolution of those barriers as demonstrated by the collection of data across nuclear and non-nuclear facilities over a two year period.
Varmazyar, Sakineh; Mortazavi, Seyed Bagher; Arghami, Shirazeh; Hajizadeh, Ebrahim
Knowing about organisational safety culture in public transportation system can provide an appropriate guide to establish effective safety measures and interventions to improve safety at work. The aim of this study was investigation of association between safety culture dimensions (leadership styles and company values, usage of crashes information and prevention programmes, management commitment and safety policy, participation and control) with involved self-reported crashes. The associations were considered through Spearman correlation, Pearson chi-square test and logistic regression. The results showed an association among self-reported crashes (occurrence or non-occurrence) and factors including leadership styles and company values; management commitment and safety policy; and control. Moreover, it was found a negative correlation and an odds ratio less than one between control and self-reported crashes.
Full Text Available In this paper, the electrical safety beliefs and practices in Hail region, Saudi Arabia, have been assessed. Based on legislative recommendations and rules applied in Saudi Arabia, on official statistics regarding the electricity-caused accidents and on the analysis of more than 200 photos captured in Hail (related to electrical safety, a questionnaire composed of 36 questions (10 for the respondents information, 16 for the home safety culture and 10 for the electrical devices purchasing culture has been devised and distributed to residents. 228 responses have been collected and analyzed. Using a scale similar to the one adopted for a university student GPA calculation, the electrical safety level (ESL in Hail region has been found to be 0.76 (in a scale of 4 points which is a very low score and indicates a poor electrical safety culture. Several recommendations involving different competent authorities have been proposed. Future work will concern the assessment of safety in industrial companies in Hail region.
Hargis, Barbara C. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)
On December 21, 2012 Secretary of Energy Chu transmitted to the Defense Nuclear Facilities Safety Board (DNFSB) revised commitments on the implementation plan for Safety Culture at the Waste Treatment and Immobilization Plant. Action 2-5 was revised to require contractors and federal organizations to complete Safety Conscious Work Environment (SCWE) selfassessments and provide reports to the appropriate U.S. Department of Energy (DOE) - Headquarters Program Office by September 2013. Los Alamos National Laboratory (LANL) planned and conducted a Safety Conscious Work Environment (SCWE) Self-Assessment over the time period July through August, 2013 in accordance with the SCWE Self-Assessment Guidance provided by DOE. Significant field work was conducted over the 2-week period August 5-16, 2013. The purpose of the self-assessment was to evaluate whether programs and processes associated with a SCWE are in place and whether they are effective in supporting and promoting a SCWE.
Giménez-Júlvez, Teresa; Hernández-García, Ignacio; Aibar-Remón, Carlos; Gutiérrez-Cía, Isabel; Febrel-Bordejé, Mercedes
To assess patient safety culture in directors/managers. Cross-sectional descriptive study carried out from February to June 2011 among the executive/managing staff of the Aragón Health Service through semi-structured interviews. A total of 12 interviews were carried out. All the respondents admitted that there were many patient safety problems and agreed that patient safety was a priority from a theoretical rather than practical perspective. The excessive changes in executive positions was considered to be an important barrier which made it difficult to establish long-term strategies and achieve medium-term continuity. This study recorded perceptions on patient safety culture in directors, an essential factor to improve patient safety culture in this group and in the organisations they run. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.
Lorenzini, Elisiane; Oelke, Nelly D; Marck, Patricia Beryl; Dall'agnol, Clarice Maria
Safety culture is a key component of patient safety. Many patient safety strategies in health care have been adapted from high-reliability organizations (HRO) such as aviation. However, to date, attempts to transform the cultures of health care settings through HRO approaches have had mixed results. We propose a methodological approach for safety culture research, which integrates the theory and practice of restoration science with the principles and methods of deliberative dialogue to support active engagement in critical reflection and collective debate. Our aim is to describe how these two innovative approaches in health services research can be used together to provide a comprehensive effective method to study and implement change in safety culture. Restorative research in health care integrates socio-ecological theory of complex adaptive systems concepts with collaborative, place-sensitive study of local practice contexts. Deliberative dialogue brings together all stakeholders to collectively develop solutions on an issue to facilitate change. Together these approaches can be used to actively engage people in the study of safety culture to gain a better understanding of its elements. More importantly, we argue that the synergistic use of these approaches offers enhanced potential to move health care professionals towards actionable strategies to improve patient safety within today's complex health care systems. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: email@example.com.
Verbakel, Natasha J; Langelaan, Maaike; Verheij, Theo J M; Wagner, Cordula; Zwart, Dorien L M
Patient safety culture, described as shared values, attitudes and behavior of staff in a health-care organization, gained attention as a subject of study as it is believed to be related to the impact of patient safety improvements. However, in primary care, it is yet unknown, which effect interventions have on the safety culture. To review literature on the use of interventions that effect patient safety culture in primary care. Searches were performed in PubMed, EMBASE, CINAHL, and PsychINFO on March 4, 2013. Terms defining safety culture were combined with terms identifying intervention and terms indicating primary care. Inclusion followed if the intervention effected patient safety culture, and effect measures were reported. The search yielded 214 articles from which two were eligible for inclusion. Both studies were heterogeneous in their interventions and outcome; we present a qualitative summary. One study described the implementation of an electronic medical record system in general practices as part of patient safety improvements. The other study facilitated 2 workshops for general practices, one on risk management and another on significant event audit. Results showed signs of improvement, but the level of evidence was low because of the design and methodological problems. These studies in general practice provide a first understanding of improvement strategies and their effect in primary care. As the level of evidence was low, no clear preference can be determined. Further research is needed to help practices make an informed choice for an intervention.
Ling, Lowell; Gomersall, Charles David; Samy, Winnie; Joynt, Gavin Matthew; Leung, Czarina Ch; Wong, Wai-Tat; Lee, Anna
Patient safety culture is an integral aspect of good standard of care. A good patient safety culture is believed to be a prerequisite for safe medical care. However, there is little evidence on whether general education can enhance patient safety culture. Our aim was to assess the impact of a standardized patient safety course on health care worker patient safety culture. Health care workers from Intensive Care Units (ICU) at two hospitals (A and B) in Hong Kong were recruited to compare the changes in safety culture before and after a patient safety course. The BASIC Patient Safety course was administered only to staff from Hospital A ICU. Safety culture was assessed in both units at two time points, one before and one after the course, by using the Hospital Survey on Patient Safety Culture questionnaire. Responses were coded according to the Survey User's Guide, and positive response percentages for each patient safety domain were compared to the 2012 Agency for Healthcare Research and Quality ICU sample of 36,120 respondents. We distributed 127 questionnaires across the two hospitals with an overall response rate of 74.8% (95 respondents). After the safety course, ICU A significantly improved on teamwork within hospital units (P=.008) and hospital management support for patient safety (Psafety culture was poorer in the two ICUs than the average ICU in the Agency for Healthcare Research and Quality database, both overall and in every individual domain except hospital management support for patient safety and hospital handoffs and transitions. Our study demonstrates that a structured, reproducible short course on patient safety may be associated with an enhancement in several domains in ICU patient safety culture.
Jia, P L; Zhang, L H; Zhang, M M; Zhang, L L; Zhang, C; Qin, S F; Li, X L; Liu, K X
To explore the attitudes and perceptions of patient safety culture for pharmacy workers in China by using a Pharmacy Survey on Patient Safety Culture (PSOPSC), and to assess the psychometric properties of the translated Chinese language version of the PSOPSC. Cross-sectional study. Data were obtained from 20 hospital pharmacies in the southwest part of China. We performed χ(2) test to explore the differences on pharmacy staff in different hospital and qualification levels and countries towards patient safety culture. We also computed descriptive statistics, internal consistency coefficients and intersubscale correlation analysis, and then conducted an exploratory factor analysis. A test-retest was performed to assess reproducibility of the items. A total of 630 questionnaires were distributed of which 527 were responded to validly (response rate 84%). The positive response rate for each item ranged from 37% to 90%. The positive response rate on three dimensions ('Teamwork', 'Staff Training and Skills' and 'Staffing, Work Pressure and Pace') was higher than that of Agency for Healthcare Research and Quality (AHRQ) data (psafety culture at different hospital and qualification levels. The internal consistency of the total survey was comparatively satisfied (Cronbach's α=0.89). The results demonstrated that among the pharmacy staffs surveyed in China, there was a positive attitude towards patient safety culture in their organisations. Identifying perspectives of patient safety culture from pharmacists in different hospital and qualification levels are important, since this can help support decisions about action to improve safety culture in pharmacy settings. The Chinese translation of the PSOPSC questionnaire (V.2012) applied in our study is acceptable. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
St Pierre, Michael
Safety culture is positioned at the heart of an organization's vulnerability to error because of its role in framing organizational awareness to risk and in providing and sustaining effective strategies of risk management. Safety related attitudes of leadership and management play a crucial role in the development of a mature safety culture ("top-down process"). A type marker for organizational culture and thus a predictor for an organization's maturity in respect to safety is information flow and in particular an organization's general way of coping with information that suggests anomaly. As all values and beliefs, relationships, learning, and other aspects of organizational safety culture are about sharing and processing information, safety culture has been termed "informed culture". An informed culture is free of blame and open for information provided by incidents. "Incident reporting systems" are the backbone of a reporting culture, where good information flow is likely to support and encourage other kinds of cooperative behavior, such as problem solving, innovation, and inter-departmental bridging. Another facet of an informed culture is the free flow of information during perioperative patient care. The World Health Organization's safe surgery checklist" is the most prevalent example of a standardized information exchange aimed at preventing patient harm due to information deficit. In routine tasks mandatory standard operating procedures have gained widespread acceptance in guaranteeing the highest possible process quality. Technical and non-technical skills of healthcare professionals are the decisive human resource for an efficient and safe delivery of patient care and the avoidance of errors. The systematic enhancement of staff qualification by providing training opportunities can be a major investment in patient safety. In recent years several otorhinolaryngology departments have started to incorporate stimulation based team trainings into their
St Pierre, M
Safety culture is positioned at the heart of an organisation's vulnerability to error because of its role in framing organizational awareness to risk and in providing and sustaining effective strategies of risk management. Safety related attitudes of leadership and management play a crucial role in the development of a mature safety culture ("top-down process"). A type marker for organizational culture and thus a predictor for an organizations maturity in respect to safety is information flow and in particular an organization's general way of coping with information that suggests anomaly. As all values and beliefs, relationships, learning, and other aspects of organizational safety culture are about sharing and processing information, safety culture has been termed "informed culture". An informed culture is free of blame and open for information provided by incidents. "Incident reporting systems" are the backbone of a reporting culture, where good information flow is likely to support and encourage other kinds of cooperative behavior, such as problem solving, innovation, and inter-departmental bridging. Another facet of an informed culture is the free flow of information during perioperative patient care. The World Health Organisation's "safe surgery checklist" is the most prevalent example of a standardized information exchange aimed at preventing patient harm due to information deficit. In routine tasks mandatory standard operating procedures have gained widespread acceptance in guaranteeing the highest possible process quality.Technical and non-technical skills of healthcare professionals are the decisive human resource for an efficient and safe delivery of patient care and the avoidance of errors. The systematic enhancement of staff qualification by providing training opportunities can be a major investment in patient safety. In recent years several otorhinolaryngology departments have started to incorporate simulation based team trainings into their curriculum
Casey, Tristan; Griffin, Mark A; Flatau Harrison, Huw; Neal, Andrew
Safety climate research has reached a mature stage of development, with a number of meta-analyses demonstrating the link between safety climate and safety outcomes. More recently, there has been interest from systems theorists in integrating the concept of safety culture and to a lesser extent, safety climate into systems-based models of organizational safety. Such models represent a theoretical and practical development of the safety climate concept by positioning climate as part of a dynamic work system in which perceptions of safety act to constrain and shape employee behavior. We propose safety climate and safety culture constitute part of the enabling capitals through which organizations build safety capability. We discuss how organizations can deploy different configurations of enabling capital to exert control over work systems and maintain safe and productive performance. We outline 4 key strategies through which organizations to reconcile the system control problems of promotion versus prevention, and stability versus flexibility. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Gibson, Russell; Armstrong, Alexander; Till, Alex; McKimm, Judy
A recent shift towards more collective leadership in the NHS can help to achieve a culture of safety, particularly through encouraging frontline staff to participate and take responsibility for improving safety through learning from error and near misses. Leaders must ensure that they provide psychological safety, organizational fairness and learning systems for staff to feel confident in raising concerns, that they have the autonomy and skills to lead continual improvement, and that they have responsibility for spreading this learning within and across organizations.
Fan, Caleb J; Pawlik, Timothy M; Daniels, Tania; Vernon, Nora; Banks, Katie; Westby, Peggy; Wick, Elizabeth C; Sexton, J Bryan; Makary, Martin A
Hospital workplace culture may have an impact on surgical outcomes; however, this association has not been established. We designed a study to evaluate the association between safety culture and surgical site infection (SSI). Using the Hospital Survey on Patient Safety Culture and National Healthcare Safety Network definitions, we measured 12 dimensions of safety culture and colon SSI rates, respectively, in the surgical units of Minnesota community hospitals. A Pearson's r correlation was calculated for each of 12 dimensions of surgical unit safety culture and SSI rate and then adjusted for surgical volume and American Society of Anesthesiologists (ASA) classification. Seven hospitals participated in the study, with a mean survey response rate of 43%. The SSI rates ranged from 0% to 30%, and surgical unit safety culture scores ranged from 16 to 92 on a scale of 0 to 100. Ten dimensions of surgical unit safety culture were associated with colon SSI rates: teamwork across units (r = -0.96; 95% CI [-0.76, -0.99]), organizational learning (r = -0.95; 95% CI [-0.71, -0.99]), feedback and communication about error (r = -0.92; 95% CI [-0.56, -0.99]), overall perceptions of safety (r = -0.90; 95% CI [-0.45, -0.99]), management support for patient safety (r = -0.90; 95% CI [-0.44, -0.98]), teamwork within units (r = -0.88; 95% CI [-0.38, -0.98]), communication openness (r = -0.85; 95% CI [-0.26, -0.98]), supervisor/manager expectations and actions promoting safety (r = -0.85; 95% CI [-0.25, -0.98]), non-punitive response to error (r = -0.78; 95% CI [-0.07, -0.97]), and frequency of events reported (r = -0.76; 95% CI [-0.01, -0.96]). After adjusting for surgical volume and ASA classification, 9 of 12 dimensions of surgical unit safety culture were significantly associated with lower colon SSI rates. These data suggest an important role for positive safety and teamwork culture and engaged hospital management in producing high-quality surgical
Culturally diverse refugee and migrant groups under-utilise health services in New Zealand and cultural barriers are cited as reasons for not using health services. According to the Nursing Council nurses are required to demonstrate competency in culturally safe practice, yet cultural safety is determined by the person receiving the care. This article critically examines the theoretical base of the cultural safety guidelines for nursing practice with respect to culturally and linguistically diverse (CALD) groups. Two key questions were posed: have the guidelines led to culturally safe nursing practice in health care for CALD groups, and have the guidelines contributed to provision of culturally acceptable health care for CALD groups? It is concluded that further theoretical consideration should be given to the conceptual basis for including CALD groups in the cultural safety model. The cultural competencies required for culturally safe nursing practice need to apply to the care of all culturally diverse groups present in New Zealand. Recommendations are made for strengthening the cultural safety model, and the registered nurse competencies for culturally safe practise.
Guldenmund, Frank W
Although the concept of safety culture was coined in relation to major accidents like Chernobyl and Piper Alpha, it has been embraced by the safety community at large as a cause for unsafe practice. In this article, three approaches to safety culture are discussed in terms of their underlying concepts of culture and organizational culture. Culture is an intangible, fuzzy concept encompassing acquired assumptions that is shared among the members of a group and that provides meaning to their perceptions and actions and those of others. The basic assumptions that form the essence of a culture are shared, yet tacit, convictions, which manifest themselves subtly in the visible world. As applied by safety researchers, the culture concept is deprived of much of its depth and subtlety, and is morphed into a grab bag of behavioral and other visible characteristics, without reference to the meaning these characteristics might actually have, and often infused with normative overtones. By combining the three approaches, we can resurrect the notion of safety culture and strengthen its analytical potential in understanding the development and implementation of safety management systems.
Chen, I-Chi; Ng, Hui-Fuang; Li, Hung-Hui
As health-care organizations endeavor to improve their quality of care, there is a growing recognition of the importance of establishing a culture of patient safety. The main objective of this study was to investigate the cross-level influences of organizational culture on patient safety behavior in Taiwan's hospitals. The authors measured organizational culture (bureaucratic, supportive and innovative culture), patient safety culture and behavior from 788 hospital workers among 42 hospitals in Taiwan. Multilevel analysis was applied to explore the relationship between organizational culture (group level) and patient safety behavior (individual level). Patient safety culture had positive impact on patient safety behavior in Taiwan's hospitals. The results also indicated that bureaucratic, innovative and supportive organizational cultures all had direct influence on patient safety behavior. However, only supportive culture demonstrated significant moderation effect on the relationship between patient safety culture and patient safety behavior. Furthermore, organizational culture strength was shown correlated negatively with patient safety culture variability. Overall, organizational culture plays an important role in patient safety activities. Safety behaviors of hospital staff are partly influenced by the prevailing cultural norms in their organizations and work groups. For management implications, constructed patient priority from management commitment to leadership is necessary. For academic implications, research on patient safety should consider leadership, group dynamics and organizational learning. These factors are important for understanding the barriers and the possibilities embedded in patient safety. Copyright © 2011 John Wiley & Sons, Ltd.
This paper reports a study the aim of which was to further understanding of cultural safety by focusing on the social health of a small immigrant community of Muslims in a relatively homogeneous region of Canada following the terror attacks on 11 September 2001 (9/11). The aftermath of 9/11 negatively affected Muslims living in many centers of Western Europe and North America. Little is known about the social health of Muslims in smaller areas with little cultural diversity. Developed by Maori nurses, the cultural safety concept captures the negative health effects of inequities experienced by the indigenous people of New Zealand. Nurses in Canada have used the concept to understand the health of Aboriginal peoples. It has also been used to investigate the nursing care of immigrants in a Canadian metropolitan centre. Findings indicated, however, that the dichotomy between culturally safe and unsafe groups was blurred. The methodology was qualitative, based on the constructivist paradigm. A purposive sample of 26 Muslims of Middle Eastern, Indian or Pakistani origin and residing in the province of New Brunswick, Canada were interviewed in 2002-2003. Findings. Participants experienced a sudden transition from cultural safety to cultural risk following 9/11. Their experience of cultural safety included a sense of social integration in the community and invisibility as a minority. Cultural risk stemmed from being in the spotlight of an international media and becoming a visible minority. Cultural risk is not necessarily rooted in historical events and may be generated by outside forces rather than by longstanding inequities in relationships between groups within the community. Nurses need to think about the cultural safety of their practices when caring for members of socially disadvantaged cultural minority groups as this may affect the health services delivered to them.
Baker, Jonathan D
This paper examines the debate about the safety of kava (Piper methysticum Forst. f, Piperaceae), a plant native to Oceania, where it has a long history of traditional use. Kava became popular as an anti-anxiety treatment in Western countries in the late 1990s, but it was subsequently banned in many places due to adverse reports of liver toxicity. This paper focuses on the responses to the bans by scientists involved in kava research, contrasting their evidential culture with that employed by clinicians and regulatory officials. Cultural constructions and social negotiations of risk are shown to be context-specific, and are shaped by professional, disciplinary, and organizational factors, among others. Though the science of hepatotoxicity is uncertain enough to allow for multiple interpretations of the same data, the biomedical/clinical narrative about kava remains dominant. This case study explores the influence of these cultural, social, and political factors on the production of scientific knowledge and the assessment of benefit/risk posed by comestibles.
Kagan, Ilya; Barnoy, Sivia
To investigate the association between patient safety culture (PSC) and the incidence and reporting rate of medical errors by Israeli nurses. Self-administered structured questionnaires were distributed to a convenience sample of 247 registered nurses enrolled in training programs at Tel Aviv University (response rate = 91%). The questionnaire's three sections examined the incidence of medication mistakes in clinical practice, the reporting rate for these errors, and the participants' views and perceptions of the safety culture in their workplace at three levels (organizational, departmental, and individual performance). Pearson correlation coefficients, t tests, and multiple regression analysis were used to analyze the data. Most nurses encountered medical errors from a daily to a weekly basis. Six percent of the sample never reported their own errors, while half reported their own errors "rarely or sometimes." The level of PSC was positively and significantly correlated with the error reporting rate. PSC, place of birth, error incidence, and not having an academic nursing degree were significant predictors of error reporting, together explaining 28% of variance. This study confirms the influence of an organizational safety climate on readiness to report errors. Senior healthcare executives and managers can make a major impact on safety culture development by creating and promoting a vision and strategy for quality and safety and fostering their employees' motivation to implement improvement programs at the departmental and individual level. A positive, carefully designed organizational safety culture can encourage error reporting by staff and so improve patient safety. © 2013 Sigma Theta Tau International.
Håvold, Jon Ivar
Although there has been considerable interest in safety culture and safety climate in many industries, little attention has been given to safety culture in one of the world's riskiest industries, shipping. Using both self developed items and items from published research on safety culture, safety climate, and quality and management style, a 40-item safety culture questionnaire was developed. The questionnaire was distributed in a self-administered form to sailors onboard 20 vessels and to officers attending a seminar in Manila. A total of 349 questionnaires were collected (total response rate, 60%). Principal component analysis (PCA) revealed 11 factors when the Kaiser eigenvalue rule was used and four factors when the scree test criterion was used. The factor structure in the material confirmed structures found in other industries. The relative importance of the factors from the factor analysis on "level of safety" measures was tested by canonical correlation analysis and regression analysis. The results confirmed previous research and showed that the most important factors were influential across industries. To determine weather differences existed between nationalities, occupations, and vessels the factors from the PCA was subjected to Multiple Discriminant Analysis. Significant differences between occupations, nations, and vessels were found on one or more of the factors from the PCA.
Janssen, Brandi; Nonnenmann, Matthew W
Health and safety professionals often call for an improved safety culture in agriculture. Such a shift would result in agricultural practices that prioritize safe work habits and see safety as both an effective means to improve production and a goal worth pursuing in its own right. This article takes an anthropological approach and demonstrates the potential for new institutional theory to conceptualize broader cultural change in agriculture. New institutional theory examines the roles of organizations and the ways that they inform and support broad social institutions. Using preliminary data from the agricultural lending industry in Iowa and integrated poultry production in Texas, this article considers the ability of these organizations to contribute to systemic change and an improved culture of safety in agriculture.
This paper argues that the globalisation of nursing and the internationalisation of nursing education have lead to Western values being embedded into nursing curricula in nations where the cultural values and beliefs may be based in quite different philosophies. It argues for critical examination of assumptions underpinning ethics education in nursing and proposes that the principles of cultural safety need to be incorporated into ethics education to create a culturally safe ethic for both nurses and patients in a multicultural healthcare environment.
Full Text Available A rigorous framework for safety assessment is established in all countries where nuclear technology is used for the production of electricity. On the one side, industry, i.e. reactor designers, vendors and utilities perform safety analysis and demonstrate consistency between results of safety analyses and requirements. On the other side, regulatory authorities perform independent assessment of safety and confirm the acceptability of safety of individual reactor units. The process of comparing results from analyses by reactor utilities and regulators is very complex. The process is also highly dependent upon mandatory approaches pursued for the analysis and from very many details which required the knowledge of sensitive proprietary data (e.g. spacer designs. Furthermore, all data available for the design, construction and operation of reactors produced by the nuclear industry are available to regulators. Two areas for improving the process of safety assessment for individual Nuclear Power Plant Units are identified: New details introduced by industry are not always and systematically requested by regulators for the independent assessment; New analytical techniques and capabilities are not necessarily used in the analyses by regulators (and by the industry. The established concept of independent assessment constitutes the way for improving the process of safety assessment. This is possible, or is largely facilitated, by the recent availability of the so-called Best Estimate Plus Uncertainty approach.
EPA's existing chemicals programs address pollution prevention, risk assessment, hazard and exposure assessment and/or characterization, and risk management for chemicals substances in commercial use.
Any outdoor educator knows about rules. Outdoor educators spend a considerable amount of time at conferences talking about them: risk management plans, accepted safety practices, and first aid protocols. You name it, they've got a rule. When a Buddhist friend asked if rules really made programs safer, the author's first response was yes. His…
Toxopeus, Marten E.; Lutters, Diederick; Nee, Andrew Y.C.; Song, Bin; Ong, Soh-Khim
This publication discusses aspects of the development of an impact assessment method (IAM) for safety. Compared to the many existing IAM’s for environmentally oriented LCA, this method should translate the impact of a product life cycle on the subject of safety. Moreover, the method should be
Johnstone, Megan-Jane; Kanitsaki, Olga
It has been well recognized internationally that hospitals are not as safe as they should be. In order to redress this situation, health care services around the world have turned their attention to strategically implementing robust patient safety and quality care programmes to identify circumstances that put patients at risk of harm and then acting to prevent or control those risks. Despite the progress that has been made in improving hospital safety in recent years, there is emerging evidence that patients of minority cultural and language backgrounds are disproportionately at risk of experiencing preventable adverse events while in hospital compared with mainstream patient groups. One reason for this is that patient safety programmes have tended to underestimate and understate the critical relationship that exists between culture, language, and the safety and quality of care of patients from minority racial, ethno-cultural, and language backgrounds. This article suggests that the failure to recognize the critical link between culture and language (of both the providers and recipients of health care) and patient safety stands as a 'resident pathogen' within the health care system that, if not addressed, unacceptably exposes patients from minority ethno-cultural and language backgrounds to preventable adverse events in hospital contexts. It is further suggested that in order to ensure that minority as well as majority patient interests in receiving safe and quality care are properly protected, the culture-language-patient-safety link needs to be formally recognized and the vulnerabilities of patients from minority cultural and language backgrounds explicitly identified and actively addressed in patient safety systems and processes.
Dupree, Erin; Anderson, Rebecca; McEvoy, Mary Dee; Brodman, Michael
A safety culture requires the highest levels of professionalism. A Code of Professionalism was created in an obstetrics service line as a mechanism to address unprofessional behavior. In this initiative, a multidisciplinary Code of Professionalism was established, with the support of leadership and the employee and nursing unions, to help create a safety culture. In 2005 the Code of Professionalism was introduced to physicians, nurses, and support staff. The U.S. Agency for Healthcare Research and Quality (AHRQ) Patient Safety Culture Survey was used, along with a portion of the Institute for Safe Medication Practices (ISMP) Survey on Workplace Intimidation to measure changes in the safety culture. Data were collected in 2005, 2008, and 2011. One hundred thirty-four reports were made to the committee on professionalism between February 2005 and December 2010. Some 96 (72%) of the reports were submitted by nurses, with physicians accounting for 13%. Seventy-five of the reports (56%) were about unprofessional behavior by physicians and 46 (34%) were about unprofessional nursing behavior. On the AHRQ Patient Safety Culture Survey, statistically significant improvement was shown in the Teamwork Within Units dimension, from 2005 to 2008; the Management Support dimension, from 2005 to 2008; the Organizational Learning dimension, from 2005 to 2008 and also from 2008 to 2011; and the Frequency of Events Reported dimension, from 2008 to 2011. Implementing a multidisciplinary Code of Professionalism can improve the safety culture in a hospital. When leadership sets clear standards and holds physicians and staff to the same standard, improvements in an organization's safety culture can serve as the foundation for the delivery of safer care.
Abdi, Zhaleh; Delgoshaei, Bahram; Ravaghi, Hamid; Abbasi, Mohsen; Heyrani, Ali
To explore nurses' and physicians' attitudes and perceptions relevant to safety culture and to elicit strategies to promote safety culture in an intensive care unit. A strong safety culture is essential to ensure patient safety in the intensive care unit. This case study adopted a mixed method design. The Safety Attitude Questionnaire (SAQ-ICU version), assessing the safety climate through six domains, was completed by nurses and physicians (n = 42) in an academic intensive care unit. Twenty semi-structured interviews and document analyses were conducted as well. Interviews were analysed using a framework analysis method. Mean scores across the six domains ranged from 52.3 to 72.4 on a 100-point scale. Further analysis indicated that there were statistically significant differences between physicians' and nurses' attitudes toward teamwork (mean scores: 64.5/100 vs. 52.6/100, d = 1.15, t = 3.69, P safety challenges including underreporting, failure to learn from errors, lack of speaking up, low job satisfaction among nurses and ineffective nurse-physician communication. The results indicate that all the domains need improvements. However, further attention should be devoted to error reporting and analysis, communication and teamwork among professional groups, and nurses' job satisfaction. Nurse managers can contribute to promoting a safety culture by encouraging staff to report errors, fostering learning from errors and addressing inter-professional communication problems. © 2013 John Wiley & Sons Ltd.
Bump, Gregory M; Coots, Nordisha; Liberi, Cindy A; Minnier, Tamra E; Phrampus, Paul E; Gosman, Gabriella; Metro, David G; McCausland, Julie B; Buchert, Andrew
The Accreditation Council for Graduate Medical Education implemented the Clinical Learning Environment Review (CLER) program to evaluate and improve the learning environment in teaching hospitals. Hospitals receive a report after a CLER visit with observations about patient safety, among other domains, the accuracy of which is unknown. Thus, the authors set out to identify complementary measures of trainees' patient safety experience. In 2014, they administered the Hospital Survey on Patient Safety Culture to residents and fellows and general staff at 10 hospitals in an integrated health system. The survey measured perceptions of patient safety in 12 domains and incorporated two outcome measures (number of medical errors reported and overall patient safety). Domain scores were calculated and compared between trainees and staff. Of 1,426 trainees, 926 responded (65% response rate). Of 18,815 staff, 12,015 responded (64% response rate). Trainees and staff scored five domains similarly-communication openness, facility management support for patient safety, organizational learning/continuous improvement, teamwork across units, and handoffs/transitions of care. Trainees scored four domains higher than staff-nonpunitive response to error, staffing, supervisor/manager expectations and actions promoting patient safety, and teamwork within units. Trainees scored three domains lower than staff-feedback and communication about error, frequency of event reporting, and overall perceptions of patient safety. Generally, trainees had comparable to more favorable perceptions of patient safety culture compared with staff. They did identify opportunities for improvement though. Hospitals can use perceptions of patient safety culture to complement CLER visit reports to improve patient safety.
US Fish and Wildlife Service, Department of the Interior — The purpose of this environmental assessment is to analyze the impacts of designating a 70 acre parcel of the Alaska Maritime National Wildlife Refuge as the Safety...
The evaluation of safety performance in occupational health and safety assessment series (OHSAS) 18001-certified companies provides useful information about the quality of the management system. A certified organization should employ an adequate level of safety management and a positive safety culture to achieve a satisfactory safety performance. The present study conducted in six manufacturing companies: three OHSAS 18001-certified, and three non-certified to assess occupational health and safety (OHS) as well as OHSAS 18001 practices. The certified companies had a better OHS practices compared with the non-certified companies. The certified companies slightly differed in OHS and OHSAS 18001 practices and one of the certified companies had the highest activity rates for both practices. The results indicated that the implemented management systems have not developed and been maintained appropriately in the certified companies. The in-depth analysis of the collected evidence revealed shortcomings in safety culture improvement in the certified companies. This study highlights the importance of safety culture to continuously improve the quality of OHSAS 18001 and to properly perform OHS/OHSAS 18001 practices in the certified companies.
Full Text Available According to A. Maslow’s  hierarchy of human needs the need for safety and security is a priority for mankind. The concept ‘safety culture’ appeared only in 1986, when theChernobyldisaster made the whole world muse upon human relationship with technology . This global catastrophe was a caution, but not for everyone. Potent academic systems and elaborated instruments of a huge economical value have been invoked in maintaining the satisfaction of biogenetic needs, whereas any manual on safety topic has not been issued yet. Even such progressive communities as the European Union, elaborating long-term strategic decisions, do not find clear and reasonable principles that would encourage to choose safe technologies with respect to present and future generations. Giving way to the ostensible effectiveness of centralized technologies such as equipment, communication, energetic that are well-disposed to big business, the majority of politicians and even scientists are not able to estimate the risk that is programmed in the choice of dangerous and insecure technical decisions. It is not still realized that none of the technologies is worth a human life or safety.The level of social maturity is a factor stipulating the merge of two concepts ‘safety’ and „a person“. At the time when industrial priorities were dominant the concept ‘safety techniques’ had been used putting stress on peculiarities of working with technical devices and on the ways manpower could be adjusted to them. Later the term ‘Safety of labour’ appeared. It drew attention to the labour process and its peculiarities. The assimilation of European culture has determined the introduction of the notion ‘personnel safety and health’ to labour relations. The postindustrial stage of humanity development brings the new understanding of major values. Individual is now identified as a personality as well as human life is understood as the major value. The natural
Alswat, Khalid; Abdalla, Rawia Ahmad Mustafa; Titi, Maher Abdelraheim; Bakash, Maram; Mehmood, Faiza; Zubairi, Beena; Jamal, Diana; El-Jardali, Fadi
Measuring patient safety culture can provide insight into areas for improvement and help monitor changes over time. This study details the findings of a re-assessment of patient safety culture in a multi-site Medical City in Riyadh, Kingdom of Saudi Arabia (KSA). Results were compared to an earlier assessment conducted in 2012 and benchmarked with regional and international studies. Such assessments can provide hospital leadership with insight on how their hospital is performing on patient safety culture composites as a result of quality improvement plans. This paper also explored the association between patient safety culture predictors and patient safety grade, perception of patient safety, frequency of events reported and number of events reported. We utilized a customized version of the patient safety culture survey developed by the Agency for Healthcare Research and Quality. The Medical City is a tertiary care teaching facility composed of two sites (total capacity of 904 beds). Data was analyzed using SPSS 24 at a significance level of 0.05. A t-Test was used to compare results from the 2012 survey to that conducted in 2015. Two adopted Generalized Estimating Equations in addition to two linear models were used to assess the association between composites and patient safety culture outcomes. Results were also benchmarked against similar initiatives in Lebanon, Palestine and USA. Areas of strength in 2015 included Teamwork within units, and Organizational Learning-Continuous Improvement; areas requiring improvement included Non-Punitive Response to Error, and Staffing. Comparing results to the 2012 survey revealed improvement on some areas but non-punitive response to error and Staffing remained the lowest scoring composites in 2015. Regression highlighted significant association between managerial support, organizational learning and feedback and improved survey outcomes. Comparison to international benchmarks revealed that the hospital is performing at or
Zwetsloot, G.I.J.M.; Bezemer, R.; Guldener, V.
Safety culture is increasingly recognised as the third important determinant of safety, complementary to technology and safety organisation. There are no legal requirements with respect to safety culture, except for nuclear power plants. Safety culture is and remains therefore a responsibility of
Gasperini, Frank A
Most US farmers are small, independent owner-operators, many of whom are exempt from safety regulation and enforcement, as well as age restrictions relative to family members performing hazardous tasks. These smaller farms account for a disproportionate share of the total fatality and injury statistics from farming incidents, contributing to an agriculture-industry death rate that is seven times greater than all occupations combined. In contrast, large agricultural enterprises that employ larger numbers of non-family workers are more regulated and more highly incentivized by economic, supply chain, and societal factors to implement cultures of safety, and are more readily influenced by agricultural opinion leaders, agribusinesses, farm organizations, and agricultural media. These agricultural influencer institutions must find ways to play more significant roles in changing the culture on operations that use only family labor. They will find willing partners in safety organizations such as the Agricultural Safety and Health Council of America (ASHCA), Agricultural Extension, and other health and safety advocates, including the National Institute for Occupational Safety and Health (NIOSH)-funded agricultural research centers. The overall workplace injury statistics for agriculture remain alarming; however, with leadership from the larger farm operations, and help from ASHCA, academia, the healthcare community, and others, the current culture of workplace safety and health in agriculture can be impacted in positive ways.
Machida, Y.; Shimakura, D. [NSnet, Tokyo (Japan)
On September 30, 1999, a criticality accident occurred at the uranium processing facility of the JCO Co. Ltd. (hereinafter referred to as ''JCO'') Tokai plant, located in Tokaimura, Ibaraki Prefecture. This was an unprecedented accident in Japan's history of peaceful use of nuclear power, resulting in three workers exposed to severe radiation, two of whom died, and the evacuation and enforced indoor confinement of local residents. Nuclear power suppliers must take personal responsibility for ensuring safety. In this connection, the electric power industry, heavy electric machinery manufacturers, fuel fabricators, and nuclear power research organizations gathered together to establish the Nuclear Safety Network (NSnet) in December 1999, based on the resolve to share and improve the level of the safety culture across the entire nuclear power industry and to assure that such an accident never occurs again. NSnet serves as a link between nuclear power enterprises, research organizations, and other bodies, based on the principles of equality and reciprocity. A variety of activities are pursued, such as diffusing a safety culture, implementing mutual evaluation among members, and exchanging safety-related information. Aiming to share and improve the safety culture throughout the entire nuclear power industry, NSnet thoroughly implements the principle of safety first, while at the same time making efforts to restore trust in nuclear power.
Passenier, D.F.; Mols, C.; Bím, J.; Sharpanskykh, A.
Safety culture is often understood as encompassing organizational members’ shared attitudes, beliefs, perceptions and values associated with safety. Safety culture theory development is fraught with inconsistencies and superficiality of measurement methods, because the dynamic and political nature
Passenier, D; Mols, C; Bim, J; Sharpans'kykh, Alexei
Safety culture is often understood as encompassing organizational members’ shared attitudes, beliefs, perceptions and values associated with safety. Safety culture theory development is fraught with inconsistencies and superficiality of measurement methods, because the dynamic and political nature
Rowan, Margo S; Rukholm, Ellen; Bourque-Bearskin, Lisa; Baker, Cynthia; Voyageur, Evelyn; Robitaille, Annie
Cultural competence and cultural safety are essential knowledge in contemporary nursing care. Using a three-phase, mixed methods sequential triangulation design, this study examines the extent to which Anglophone Schools of Nursing in Canada have integrated cultural competence and/or cultural safety into the undergraduate nursing curricula. Factors that influence successful integration are identified through the lens of Donabedian's structure, process, and outcome model. Results suggest that several facilitating factors are present, such as leadership, partnerships and linkages, and educational supports for students. Of particular concern is the lack of policies to recruit and retain Aboriginal faculty, financial resources, and outcome evaluation indicators. A conceptual model of integration is offered to explain how Schools of Nursing function to support the implementation of these concepts into their curriculum. This study provides theoretical and practical implications for initiation and improvement of cultural competence and/or cultural safety integration strategies in Schools of Nursing.
Zwart Dorien LM
Full Text Available Abstract Background A supportive patient safety culture is considered to be an essential condition for improving patient safety. Assessing the current safety culture in general practice may be a first step to target improvements. To that end, we studied internal consistency and construct validity of a safety culture questionnaire for general practice (SCOPE which was derived from a comparable questionnaire for hospitals (Dutch-HSOPS. Methods The survey was conducted among caregivers of Dutch general practice as part of an ongoing quality accreditation process using a 46 item questionnaire. We conducted factor analyses and studied validity by calculating correlations between the subscales and testing the hypothesis that respondents' patient safety grade of their practices correlated with their scores on the questionnaire. Results Of 72 practices 294 respondents completed the questionnaire. Eight factors were identified concerning handover and teamwork, support and fellowship, communication openness, feedback and learning from error, intention to report events, adequate procedures and staffing, overall perceptions of patient safety and expectations and actions of managers. Cronbach's alpha of the factors rated between 0.64 and 0.85. The subscales intercorrelated moderately, except for the factor about intention to report events. Respondents who graded patient safety highly scored significantly higher on the questionnaire than those who did not. Conclusions The SCOPE questionnaire seems an appropriate instrument to assess patient safety culture in general practice. The clinimetric properties of the SCOPE are promising, but future research should confirm the factor structure and construct of the SCOPE and delineate its responsiveness to changes in safety culture over time.
Background A supportive patient safety culture is considered to be an essential condition for improving patient safety. Assessing the current safety culture in general practice may be a first step to target improvements. To that end, we studied internal consistency and construct validity of a safety culture questionnaire for general practice (SCOPE) which was derived from a comparable questionnaire for hospitals (Dutch-HSOPS). Methods The survey was conducted among caregivers of Dutch general practice as part of an ongoing quality accreditation process using a 46 item questionnaire. We conducted factor analyses and studied validity by calculating correlations between the subscales and testing the hypothesis that respondents' patient safety grade of their practices correlated with their scores on the questionnaire. Results Of 72 practices 294 respondents completed the questionnaire. Eight factors were identified concerning handover and teamwork, support and fellowship, communication openness, feedback and learning from error, intention to report events, adequate procedures and staffing, overall perceptions of patient safety and expectations and actions of managers. Cronbach's alpha of the factors rated between 0.64 and 0.85. The subscales intercorrelated moderately, except for the factor about intention to report events. Respondents who graded patient safety highly scored significantly higher on the questionnaire than those who did not. Conclusions The SCOPE questionnaire seems an appropriate instrument to assess patient safety culture in general practice. The clinimetric properties of the SCOPE are promising, but future research should confirm the factor structure and construct of the SCOPE and delineate its responsiveness to changes in safety culture over time. PMID:22040087
Verbeek-van Noord, Inge; de Bruijne, Martine C; Zwijnenberg, Nicolien C; Jansma, Elise P; van Dyck, Cathy; Wagner, Cordula
To evaluate the evidence of the effectiveness of classroom-based Crew Resource Management training on safety culture by a systematic review of literature. Studies were identified in PubMed, Cochrane Library, PsycINFO, and Educational Resources Information Center up to 19 December 2012. The Methods Guide for Comparative Effectiveness Reviews was used to assess the risk of bias in the individual studies. In total, 22 manuscripts were included for review. Training settings, study designs, and evaluation methods varied widely. Most studies reporting only a selection of culture dimensions found mainly positive results, whereas studies reporting all safety culture dimensions of the particular survey found mixed results. On average, studies were at moderate risk of bias. Evidence of the effectiveness of Crew Resource Management training in health care on safety culture is scarce and the validity of most studies is limited. The results underline the necessity of more valid study designs, preferably using triangulation methods.
Hickner, John; Smith, Scott A; Yount, Naomi; Sorra, Joann
Experts in patient safety stress the importance of a shared culture of safety. Lack of consensus may be detrimental to patient safety. This study examines differences in patient safety culture perceptions among providers, management and staff in a large national survey of safety culture in ambulatory practices in the USA. The US Agency for Healthcare Research and Quality Medical Office Survey on Patient Safety Culture (SOPS) assesses perceptions about patient safety issues and event reporting in medical offices (ie, ambulatory practices). Using the 2014 data, we analysed responses from medical offices with at least five respondents. We calculated differences in perceptions of patient safety culture across six job positions (physicians, management, nurse practitioners (NPs)/physician assistants (PAs), nurses, clinical support staff and administrative/clerical staff) for 10 survey composites, the average of the 10 composites and an overall patient safety rating using multivariate hierarchical linear regressions. We analysed data from 828 medical offices with responses from 15 523 providers and staff, with an average 20 completed surveys per medical office (range: 5-367) and an average medical office response rate of 65% (range: 3%-100%). Management had significantly more positive patient safety culture perceptions on nine of 10 composite scores compared with all other job positions, including physicians. The composite that showed the largest difference was Communication Openness; Management (85% positive) was 22% points more positive than other clinical and support staff and administrative/clerical staff. Physicians were significantly more positive than PAs/NPs, nursing staff, other clinical and support staff and administrative/clerical staff on four composites: Communication About Error, Communication Openness, Staff Training and Teamwork, ranging from 3% to 20% points more positive. These findings suggest that managers need to pay attention to the training needs
Occelli, P; Quenon, J-L; Kret, M; Domecq, S; Delaperche, F; Claverie, O; Castets-Fontaine, B; Amalberti, R; Auroy, Y; Parneix, P; Michel, P
To assess the psychometric properties of the French version of the Hospital Survey on Patient Safety Culture questionnaire (HSOPSC) and study the hierarchical structure of the measured dimensions. Cross-sectional survey of the safety culture. 18 acute care units of seven hospitals in South-western France. Full- and part-time healthcare providers who worked in the units. None. Item responses measured with 5-point agreement or frequency scales. Data analyses A principal component analysis was used to identify the emerging components. Two structural equation modeling methods [LInear Structural RELations (LISREL) and Partial Least Square (PLS)] were used to verify the model and to study the relative importance of the dimensions. Internal consistency of the retained dimensions was studied. A test-retest was performed to assess reproducibility of the items. Overall response rate was 77% (n = 401). A structure in 40 items grouped in 10 dimensions was proposed. The LISREL approach showed acceptable data fit of the proposed structure. The PLS approach indicated that three dimensions had the most impact on the safety culture: 'Supervisor/manager expectations & actions promoting safety' 'Organizational learning-continuous improvement' and 'Overall perceptions of safety'. Internal consistency was above 0.70 for six dimensions. Reproducibility was considered good for four items. The French HSOPSC questionnaire showed acceptable psychometric properties. Classification of the dimensions should guide future development of safety culture improving action plans.
Full Text Available Abstract Background From a management perspective, it is necessary to examine how a hospital's top management assess the patient safety culture in their organisation. This study examines whether the Hospital Survey on Patient Safety Culture for hospital management (HSOPS_M has the same psychometric properties as the HSOPS for hospital employees does. Methods In 2008, a questionnaire survey including the HSOPS_M was conducted with 1,224 medical directors from German hospitals. When assessing the psychometric properties, we performed a confirmatory factor analysis (CFA. Additionally, we proved construct validity and internal consistency. Results A total of 551 medical directors returned the questionnaire. The results of the CFA suggested a satisfactory global data fit. The indices of local fit indicated a good, but not satisfactory convergent validity. Analyses of construct validity indicated that not all safety culture dimensions were readily distinguishable. However, Cronbach's alpha indicated that the dimensions had an acceptable level of reliability. Conclusion The analyses of the psychometric properties of the HSOPS_M resulted in reasonably good levels of property values. Although the set of dimensions within the HSOPS_M needs further scale refinement, the questionnaire covers a broad range of sub-dimensions and supplies important information on safety culture. The HSOPS_M, therefore, is eligible to measure safety culture from the hospital management's points of view and could be used in nationwide hospital surveys to make inter-organisational comparisons.
Gkoumas, Konstantinos; Giuliani, Luisa; Petrini, Francesco
durability provisions, commitment to environmental aspects, issues of sustainability and safety assurance, for their whole lifecycle. The design for safety of tunnel infrastructures is a multifaceted process, since there are many aspects that need to be accounted for, regarding different aspects (e.......g. structural and non structural, organizational, human behavior). This is even more truth for the fire safety design of such structures. Fire safety in tunnels is challenging because of the particular environment, bearing in mind also that a fire can occur in different phases of the tunnel’s lifecycle. Plans...... for upgrading fire safety provisions and tunnel management are also important for existing tunnels. In this study, following a brief introduction of issues regarding the above mentioned aspects, the structural performance of a steel rib for a tunnel infrastructure subject to fire is assessed by means...
Davies, James; Pucher, Philip H; Ibrahim, Heba; Stubbs, Ben
Electronic prescribing (EP) systems are online technology platforms by which medicines can be prescribed, administered, and stock controlled. The actual impact of EP on patient safety is not truly understood. This study seeks to assess the impact of the implementation of an EP system on safety culture, as well as assessing differences between clinical respondent groups and considering their implications. Staff completed a modified Safety Attitudes Questionnaire survey, 6 weeks following the introduction of EP across surgical services in a hospital in Dorset, England. Responses were assessed and differences between respondent groups compared. Rates of self-reported adverse events were compared before and after implementation. Overall response rate was 34.5%. There was no significant difference between usage patterns and previous experience with EP between user groups. Overall safety was felt to have been reduced by the introduction of EP. Significant differences between clinician and nonclinicians were seen in ability to discuss errors (3.23 ± 0.5 versus 2.8 ± 0.69, P = 0.004), drug chart access, and ease of medication prescribing. Regression analysis did not identify any confounding factors. Despite a significant reduction in the adverse event rate in other divisions of the hospital that did not implement EP at the same time, this same reduction was not seen in the surgical department. This is the first study to assess the impact of EP on safety culture using a validated assessment tool (Safety Attitudes Questionnaire). Overall safety culture deteriorated following introduction of EP. Problems with system usability/intuitiveness, nonstandardized implementation, and competence assessment strategies may have all contributed to this result. Centers seeking to implement EP in future must consider these factors to ensure a positive impact on patient safety and outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.
Reiman, Teemu; Pietikaeinen, Elina (VTT, Technical Research Centre of Finland (Finland))
Safety indicators play a role in providing information on organizational performance, motivating people to work on safety and increasing organizational potential for safety. The aim of this report is to provide an overview on leading safety indicators in the domain of nuclear safety. The report explains the distinction between lead and lag indicators and proposes a framework of three types of safety performance indicators - feedback, monitor and drive indicators. Finally the report provides guidance for nuclear energy organizations for selecting and interpreting safety indicators. It proposes the use of safety culture as a leading safety performance indicator and offers an example list of potential indicators in all three categories. The report concludes that monitor and drive indicators are so called lead indicators. Drive indicators are chosen priority areas of organizational safety activity. They are based on the underlying safety model and potential safety activities and safety policy derived from it. Drive indicators influence control measures that manage the socio technical system; change, maintain, reinforce, or reduce something. Monitor indicators provide a view on the dynamics of the system in question; the activities taking place, abilities, skills and motivation of the personnel, routines and practices - the organizational potential for safety. They also monitor the efficacy of the control measures that are used to manage the socio technical system. Typically the safety performance indicators that are used are lagging (feedback) indicators that measure the outcomes of the socio technical system. Besides feedback indicators, organizations should also acknowledge the important role of monitor and drive indicators in managing safety. The selection and use of safety performance indicators is always based on an understanding (a model) of the socio technical system and safety. The safety model defines what risks are perceived. It is important that the safety
Kok, E.J.; Kuiper, H.A.
Since the first discussions on strategies to assess the food safety of genetically modified (GM) crop plants, assessment of GM plants and derived tissues has been based on comparisons with their traditionally bred counterparts. This was termed the Principle of Substantial Equivalence. However,
EVANS, C B
The purpose of the Hanford Safety Analysis and Risk Assessment Handbook (SARAH) is to support the development of safety basis documentation for Hazard Category 2 and 3 (HC-2 and 3) U.S. Department of Energy (DOE) nuclear facilities to meet the requirements of 10 CFR 830, ''Nuclear Safety Management''. Subpart B, ''Safety Basis Requirements.'' Consistent with DOE-STD-3009-94, Change Notice 2, ''Preparation Guide for U.S. Department of Energy Nonreactor Nuclear Facility Documented Safety Analyses'' (STD-3009), and DOE-STD-3011-2002, ''Guidance for Preparation of Basis for Interim Operation (BIO) Documents'' (STD-3011), the Hanford SARAH describes methodology for performing a safety analysis leading to development of a Documented Safety Analysis (DSA) and derivation of Technical Safety Requirements (TSR), and provides the information necessary to ensure a consistently rigorous approach that meets DOE expectations. The DSA and TSR documents, together with the DOE-issued Safety Evaluation Report (SER), are the basic components of facility safety basis documentation. For HC-2 or 3 nuclear facilities in long-term surveillance and maintenance (S&M), for decommissioning activities, where source term has been eliminated to the point that only low-level, residual fixed contamination is present, or for environmental remediation activities outside of a facility structure, DOE-STD-1120-98, ''Integration of Environment, Safety, and Health into Facility Disposition Activities'' (STD-1120), may serve as the basis for the DSA. HC-2 and 3 environmental remediation sites also are subject to the hazard analysis methodologies of this standard.
Full Text Available Palanisamy Sivanandy,1 Mari Kannan Maharajan,1 Kingston Rajiah,1 Tan Tyng Wei,2 Tan Wee Loon,2 Lim Chong Yee2 1Department of Pharmacy Practice, School of Pharmacy, 2School of Pharmacy, International Medical University, Wilayah Persekutuan Kuala Lumpur, Malaysia Background: Patient safety is a major public health issue, and the knowledge, skills, and experience of health professionals are very much essential for improving patient safety. Patient safety and medication error are very much associated. Pharmacists play a significant role in patient safety. The function of pharmacists in the medication use process is very different from medical and nursing colleagues. Medication dispensing accuracy is a vital element to ensure the safety and quality of medication use.Objective: To evaluate the attitude and perception of the pharmacist toward patient safety in retail pharmacies setup in Malaysia.Methods: A Pharmacy Survey on Patient Safety Culture questionnaire was used to assess patient safety culture, developed by the Agency for Healthcare Research and Quality, and the convenience sampling method was adopted.Results: The overall positive response rate ranged from 31.20% to 87.43%, and the average positive response rate was found to be 67%. Among all the eleven domains pertaining to patient safety culture, the scores of “staff training and skills” were less. Communication openness, and patient counseling are common, but not practiced regularly in the Malaysian retail pharmacy setup compared with those in USA. The overall perception of patient safety of an acceptable level in the current retail pharmacy setup.Conclusion: The study revealed that staff training, skills, communication in patient counseling, and communication across shifts and about mistakes are less in current retail pharmacy setup. The overall perception of patient safety should be improved by educating the pharmacists about the significance and essential of patient safety. Keywords
Sivanandy, Palanisamy; Maharajan, Mari Kannan; Rajiah, Kingston; Wei, Tan Tyng; Loon, Tan Wee; Yee, Lim Chong
Background Patient safety is a major public health issue, and the knowledge, skills, and experience of health professionals are very much essential for improving patient safety. Patient safety and medication error are very much associated. Pharmacists play a significant role in patient safety. The function of pharmacists in the medication use process is very different from medical and nursing colleagues. Medication dispensing accuracy is a vital element to ensure the safety and quality of medication use. Objective To evaluate the attitude and perception of the pharmacist toward patient safety in retail pharmacies setup in Malaysia. Methods A Pharmacy Survey on Patient Safety Culture questionnaire was used to assess patient safety culture, developed by the Agency for Healthcare Research and Quality, and the convenience sampling method was adopted. Results The overall positive response rate ranged from 31.20% to 87.43%, and the average positive response rate was found to be 67%. Among all the eleven domains pertaining to patient safety culture, the scores of “staff training and skills” were less. Communication openness, and patient counseling are common, but not practiced regularly in the Malaysian retail pharmacy setup compared with those in USA. The overall perception of patient safety of an acceptable level in the current retail pharmacy setup. Conclusion The study revealed that staff training, skills, communication in patient counseling, and communication across shifts and about mistakes are less in current retail pharmacy setup. The overall perception of patient safety should be improved by educating the pharmacists about the significance and essential of patient safety. PMID:27524887
Full Text Available Background: The goal of this research was to measure patient safety culture in all Slovenian acute general hospitals.Methods: The hospital survey on patient safety culture questionnaire developed by researchers at Westat was used. Prior to this study, the questionnaire was psychometrically tested in three pilot hospitals and the results showed no need to modify the original model for the Slovene setting. Responses were scored on the 5-level Likert scale. The questionnaire was distributed to all hospital staff. After the exclusion of 159 questionnaires, which did not fulfil the inclusion criteria, 2932 (48.5 % questionnaires were analysed. Descriptive statistics, confirmatory factor analysis, reliability of the scales, and construct validity were computed. For each item the percentage of positive, neutral and negative responses were calculated. Areas for improvement were defined as those answered positively by 50 % or less of the respondents. With one-way analysis of variance a comparison of the means among different sizes of the hospitals was performed.Results: The confirmative factor analysis showed adequate fit for the model and the questionnaire reliability was also adequate. The average positive percentage for all 12 composites was 53 %. Composite scores of patient safety culture revealed that none reached the level that would establish safety strengths. Statistically significant differences of means for hospital size were found (d.f. 2, 337,006; p < 0,0005 but were practically unimportant.Conclusion: The survey showed overall low patient safety culture, however it has provided the first insight into patient safety culture in acute general hospitals in Slovenia with several opportunities for improvement.
Thomas, Lily; Galla, Catherine
Medical errors continue to occur despite multiple strategies devised for their prevention. Although many safety initiatives lead to improvement, they are often short lived and unsustainable. Our goal was to build a culture of patient safety within a structure that optimised teamwork and ongoing engagement of the healthcare team. Teamwork impacts the effectiveness of care, patient safety and clinical outcomes, and team training has been identified as a strategy for enhancing teamwork, reducing medical errors and building a culture of safety in healthcare. Therefore, we implemented Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS), an evidence-based framework which was used for team training to create transformational and/or incremental changes; facilitating transformation of organisational culture, or solving specific problems. To date, TeamSTEPPS (TS) has been implemented in 14 hospitals, two Long Term Care Facilities, and outpatient areas across the North Shore LIJ Health System. 32 150 members of the healthcare team have been trained. TeamSTEPPS was piloted at a community hospital within the framework of the health system's organisational care delivery model, the Collaborative Care Model to facilitate sustainment. AHRQ's Hospital Survey on Patient Safety Culture, (HSOPSC), was administered before and after implementation of TeamSTEPPS, comparing the perception of patient safety by the heathcare team. Pilot hospital results of HSOPSC show significant improvement from 2007 (pre-TeamSTEPPS) to 2010. System-wide results of HSOPSC show similar trends to those seen in the pilot hospital. Valuable lessons for organisational success from the pilot hospital enabled rapid spread of TeamSTEPPS across the rest of the health system.
van den Berg, Suzanne J P L; Serra-Majem, Lluis; Coppens, Patrick; Rietjens, Ivonne M C M
Botanicals and botanical preparations, including plant food supplements (PFS), are widely used in Western diets. The growing use of PFS is accompanied by an increasing concern because the safety of these PFS is not generally assessed before they enter the market. Regulatory bodies have become more aware of this and are increasing their efforts to ensure the safety of PFS. The present review describes an overview of the general framework for the safety assessment of PFS, focusing on the different approaches currently in use to assess the safety of botanicals and/or botanical compounds, including their history of safe use, the tiered approach proposed by the European Food Safety Authority (EFSA), the Threshold of Toxicological Concern (TTC) and the Margin of Exposure (MOE) concept. Moreover, some examples of botanical compounds in PFS that may be of concern are discussed. Altogether, it is clear that "natural" does not equal "safe" and that PFS may contain compounds of concern at levels far above those found in the regular diet. In addition, the traditional use of a PFS compound as a herb or tea does not guarantee its safety when used as a supplement. This points at a need for stricter regulation and control of botanical containing products, especially given their expanding market volume.
Ong, M M; Perkins, M P; Brown, C G; Crull, E W; Streit, R D
Lightning is a safety hazard for high-explosives (HE) and their detonators. In the However, the current flowing from the strike point through the rebar of the building The methodology for estimating the risk from indirect lighting effects will be presented. It has two parts: a method to determine the likelihood of a detonation given a lightning strike, and an approach for estimating the likelihood of a strike. The results of these two parts produce an overall probability of a detonation. The probability calculations are complex for five reasons: (1) lightning strikes are stochastic and relatively rare, (2) the quality of the Faraday cage varies from one facility to the next, (3) RF coupling is inherently a complex subject, (4) performance data for abnormally stressed detonators is scarce, and (5) the arc plasma physics is not well understood. Therefore, a rigorous mathematical analysis would be too complex. Instead, our methodology takes a more practical approach combining rigorous mathematical calculations where possible with empirical data when necessary. Where there is uncertainty, we compensate with conservative approximations. The goal is to determine a conservative estimate of the odds of a detonation. In Section 2, the methodology will be explained. This report will discuss topics at a high-level. The reasons for selecting an approach will be justified. For those interested in technical details, references will be provided. In Section 3, a simple hypothetical example will be given to reinforce the concepts. While the methodology will touch on all the items shown in Figure 1, the focus of this report is the indirect effect, i.e., determining the odds of a detonation from given EM fields. Professor Martin Uman from the University of Florida has been characterizing and defining extreme lightning strikes. Using Professor Uman's research, Dr. Kimball Merewether at Sandia National Laboratory in Albuquerque calculated the EM fields inside a Faraday-cage type
Bowman, Chelsea; Neeman, Naama; Sehgal, Niraj L.
Purpose Safety culture may exert an important influence on the adoption and learning of patient safety practices by learners at clinical training sites. This study assessed students’ perceptions of safety culture and identified curricular gaps in patient safety training. Method A total of 170 fourth-year medical students at the University of California, San Francisco, were asked to complete a modified version of the Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture in 2011. Students responded on the basis of either their third-year internal medicine or surgery clerkship experience. Responses were recorded on a five-point Likert scale. Percent positive responses were compared between the groups using a chi-square test. Results One hundred twenty-one students (71% response rate) rated “teamwork within units” and “organizational learning” highest among the survey domains; “communication openness” and “nonpunitive response to error” were rated lowest. A majority of students reported that they would not speak up when witnessing a possible adverse event (56%) and were afraid to ask questions if things did not seem right (55%). In addition, 48% of students reported feeling that mistakes were held against them. Overall, students reported a desire for additional patient safety training to enhance their educational experience. Conclusions Assessing student perceptions of safety culture highlighted important observations from their clinical experiences and helped identify areas for curricular development to enhance patient safety. This assessment may also be a useful tool for both clerkship directors and clinical service chiefs in their respective efforts to promote safe care. PMID:23619067
Verbakel, N.J.; Melle, M. van; Langelaan, M.; Verheij, T.J.M.; Wagner, C.; Zwart, D.L.M.
Objective: To explore perceptions of safety culture in nine different types of primary care professions and to study possible differences. Design Cross-sectional survey: Setting: Three hundred and thirteen practices from nine types of primary care profession groups in the Netherlands. Participants:
... at the NRC are ] available online in the NRC Library at http://www.nrc.gov/reading-rm/adams.html... must be taken as a strategic utterance;'' or either misunderstood or disregarded the concept of a... safety culture and included the concept of complacency in the Statement of Policy under the trait...
Arieli, Daniella; Mashiach, Michal; Hirschfeld, Miriam J; Friedman, Victor
This research explores the experiences of cultural safety among nursing students from majority and minority groups in a divided society with implications for academic satisfaction and success. The study takes place in an academic nursing program in Israel, where Arab and Jewish students study together. A researcher-developed questionnaire was used with 17 statements concerning social relations between students, faculty support, and the effects of social relations on academic satisfaction and outcomes. Significant differences were found in the ways Arab and Jewish students perceived the cultural safety of the environment. Arab students perceived social relations and faculty attitude as less positive than Jewish students and perceived cultural safety as having greater influence on academic satisfaction and success. The findings indicate that students from different groups will perceive the same shared reality in significantly different ways. Nurse faculty and administrators need to make efforts to bring perceptions into closer alignment and to minimize the negative impact of external conflicts on feelings of cultural safety.
Cauwelier, Peter; Ribière, Vincent M.; Bennet, Alex
Purpose: The purpose of this paper was to evaluate if the concept of team psychological safety, a key driver of team learning and originally studied in the West, can be applied in teams from different national cultures. The model originally validated for teams in the West is applied to teams in Thailand to evaluate its validity, and the views team…
Even, Megha S; Sandusky, Chad B; Barnard, Neal D
Despite considerable progress in the development of cell culture techniques, including the development of the serum- and protein-free media that now routinely support hybridoma and mammalian cell growth, fetal bovine serum (FBS) supplemented media are still commonly used: a practice that raises ethical, scientific and safety concerns. The use of FBS in hybridoma culture media is examined here, with regards to the development and production of monoclonal antibodies (mAbs), and it is our recommendation that researchers adopt serum-free cell culture methods to reduce animal use in this area.
Full Text Available Background & aim: One of the most important problems in the health sector, particularly in clinical centers, is the quality of healthcare. Patient safety is one of the most important elements in creating health care quality due to the fact that it is a critical component to the quality of health care and many errors are present in patient care and treatment practices.. Thus, the aim of the present study was to determine the status of the patient safety culture and its relationship with events reported in Yasuj hospitals. Methods: The present descriptive cross-sectional study was conducted on 361 medical staff of Yasuj hospitals. The data were collected through a hospital survey on patient safety culture. The collected data were analyzed by using SPSS statistics soft ware version 21, using Descriptive methods, Pearson Coefficient, ANOVA, and T-Test. Results: The results of the present study revealed that the teamwork among hospital units (71/89percent, with expectations and management measures (66/38% in the case of safety obtained the most score and non-punitive response to errors (48/79% and manager support (55/88 percent obtained the least score. 73/7% of employees of three hospitals in the past 12 months did not report any event. In addition, there was a meaningful statistical relationship between the total score of safety culture and reporting the events. In this study, 15.5 % of respondents assess their safety culture in work as good, 44.3 % as acceptable and 30.5 percent reported poor. The overall safety culture among the three studied hospitals was 61.81 %. Results confirmed that the culture safety of patient in studied hospitals was average. Conclusions: The hospitals may rely on their strong points in terms of patient safety culture and try to remove their weak points to form a safe environment and appropriate
Ka'opua, Lana Sue I.; Diaz, Tressa P.; Park, Soon H.; Bowen, Talita; Patrick, Kevin; Tamang, Suresh; Braun, Kathryn L.
Background: The incidence of non-AIDS-defining cancers has increased significantly among persons living with HIV (PLHIV). Screening education is recommended. Purpose: Social learning, minority stress, and cultural safety theories informed this pilot to assess the feasibility of a colorectal cancer screening intervention targeted to PLHIV, with…
Stroeve, S.; Sharpanskykh, O.; Kirwan, B.
Assessment of safety culture is done predominantly by questionnaire-based studies, which tend to reveal attitudes on immaterial characteristics (values, beliefs, norms). There is a need for a better understanding of the implications of the material aspects of an organization (structures, processes,
Park, H. C.; Park, H. G.; Park, Y. W.; Park, J. Y. [KAIST, Daejeon (Korea, Republic of)
It has been found that almost 80 % of the incidents and accidents occurred recently, such as the Fukushima Daiichi disaster and Domestic SBO accident etc. were analyzed to be caused from human errors. (IAEA NES NG-G-2.1) Which strongly claims the importance of the safety culture system. Accordingly, it should be away from a cursory approach like one-off field survey or Snap shop which were being conducted at present for the continued improvement of safety culture. This study introduces an analytical methodology which approaches the generic form of the safety both consciously and unconsciously expressed with behavior, thoughts, and attitude etc. This study was implemented only for open materials such as Inspection report, incidents and accidents reports, QA documents because of the limitation in accessibility to data. More effective use with securing operational data will be possible in future.
Reiman, Teemu; Silla, Inmaculada; Pietikäinen, Elina
Patient safety culture (PSC) has been postulated to have a significant influence on the quality of health care. This study aims to evaluate the psychometric properties of the TUKU PSC questionnaire. The questionnaire development was based on the view that patient safety constitutes not only the absence of adverse events, but also the presence of certain organizational attributes that enable safety. The TUKU questionnaire has two parts: a measure of psychological dimensions, and a measure of employees' perceptions of organizational functions. The TUKU questionnaire was validated using a sample of 1162 health care professionals from seven Finnish health care organizations. Two studies were carried out, one focusing on construct validity and the other on criterion validity. Regarding construct validity, the empirical model matched the theory quite well. The results of Study 2 concerning criterion validity were more ambiguous. Four of the organizational dimensions and two of the psychological dimensions were related to patient safety incidents occurring 16 months after administering the questionnaire. The study provided evidence on the key organizational dimensions that comprise patient safety culture and affect patient safety. The study further contributed towards validation of an instrument for measuring these dimensions.
... COMMISSION Draft Safety Culture Policy Statement: Request for Public Comments; Extension of Comment Period AGENCY: Nuclear Regulatory Commission (NRC). ACTION: Issuance of draft safety culture policy statement... a draft policy statement on safety culture to include the unique aspects of nuclear safety and...
Groves, Patricia S; Meisenbach, Rebecca J; Scott-Cawiezell, Jill
This paper presents a discussion of the use of structuration theory to facilitate understanding and improvement of safety culture in healthcare organizations. Patient safety in healthcare organizations is an important problem worldwide. Safety culture has been proposed as a means to keep patients safe. However, lack of appropriate theory limits understanding and improvement of safety culture. The proposed structuration theory of safety culture was based on a critique of available English-language literature, resulting in literature published from 1983 to mid-2009. CINAHL, Communication and Mass Media Complete, ABI/Inform and Google Scholar databases were searched using the following terms: nursing, safety, organizational culture and safety culture. When viewed through the lens of structuration theory, safety culture is a system involving both individual actions and organizational structures. Healthcare organization members, particularly nurses, share these values through communication and enact them in practice, (re)producing an organizational safety culture system that reciprocally constrains and enables the actions of the members in terms of patient safety. This structurational viewpoint illuminates multiple opportunities for safety culture improvement. Nurse leaders should be cognizant of competing value-based culture systems in the organization and attend to nursing agency and all forms of communication when attempting to create or strengthen a safety culture. Applying structuration theory to the concept of safety culture reveals a dynamic system of individual action and organizational structure constraining and enabling safety practice. Nurses are central to the (re)production of this safety culture system. © 2011 Blackwell Publishing Ltd.
Akbari, Nahid; Malek, Marzieh; Ebrahimi, Parvin; Haghani, Hamid; Aazami, Sanaz
Improving quality of maternal care as well as patients' safety are two important issues in health-care service. Therefore, this study aimed to assess the culture of patient safety at maternity units. This cross-sectional study was conducted among staffs working at maternity units in seven hospitals of Ilam city, Iran. The staffs included in this study were gynecologists and midwifes working in different positions including matron, supervisors, head of departments and staffs. Data were collected using the Hospital Survey on Patient Safety Culture (HSOPSC). This study indicated that 59.1% of participants reported fair level of overall perceptions of safety and 67.1% declared that no event was reported during the past 12 months. The most positively perceived dimension of safety culture was teamwork within departments in view of managers (79.41) and personnel (81.10). However, the least positively perceived dimensions of safety culture was staffing levels. The current study revealed areas of strength (teamwork within departments) and weakness (staffing, punitive responses to error) among managers and personnel. In addition, we found that staffs in Ilam's hospitals accept the patient safety culture in maternity units, but, still are far away from excellent culture of patient safety. Therefore, it is necessary to promote culture of patient's safety among professions working in the maternity units of Ilam's hospitals.
Raso-Raso, Rafael; Uris-Selles, Joaquín; Nolasco-Bonmatí, Andreu; Grau-Jornet, Guillermo; Revert-Gandia, Rosa; Jiménez-Carreño, Rebeca; Sánchez-Soriano, Ruth M; Chamorro-Fernández, Carlos I; Marco-Francés, Elvira; Albero-Martínez, José V
Safety culture is one of the requirements for preventing the occurrence of adverse effects. However, this has not been studied in the field of cardiology. The aim of this study is to evaluate the safety culture in a cardiology unit that has implemented and certified an integrated quality and risk management system for patient safety. A cross-sectional observational study was conducted in 2 consecutive years, with all staff completing the Spanish version of the questionnaire, "Hospital Survey on Patient Safety Culture" of the "Agency for Healthcare Research and Quality", with 42 items grouped into 12 dimensions. The percentage of positive responses in each dimension in 2014 and 2015 were compared, as well as national data and United States data, following the established rules. The overall assessment out of a possible 5, was 4.5 in 2014 and 4.7 in 2015. Seven dimensions were identified as strengths. The worst rated were: staffing, management support and teamwork between units. The comparison showed superiority in all dimensions compared to national data, and in 8 of them compared to American data. The safety culture in a Cardiology Unit with an integrated quality and risk management patient safety system is high, and higher than nationally in all its dimensions and in most of them compared to the United States. Copyright © 2017 Instituto Nacional de Cardiología Ignacio Chávez. Publicado por Masson Doyma México S.A. All rights reserved.
Azami-Aghdash, Saber; Ebadifard Azar, Farbod; Rezapour, Aziz; Azami, Akbar; Rasi, Vahid; Klvany, Khalil
Nowadays, for quality improvement, measuring patient safety culture (PSC) in healthcare organizations is being increasingly used. The aim of this study was to clarify PSC status in Iranian hospitals using a meta-analysis method. Six databases were searched: PubMed, Scopus, Google Scholar, Cochrane Library, Magiran, SID and IranMedex using the search terms including patient safety, patient safety culture, patient safety climate and combined with hospital (such as "hospital survey on patient safety culture"), measurement, assessment, survey and Iran. A total of 11 articles which conducted using Hospital Survey on Patient Safety Culture (HSOPSC) questionnaire initially were reviewed. To estimate overall PSC status and perform the meta-analyses, Comprehensive Meta-Analysis (CMA) software v. 2 was employed. The overall PSC score based on the random model was 50.1%. "Teamwork within hospital units" dimension received the highest score of PSC (67.4%) and "Non-punitive response to error" the lowest score (32.4%). About 41% of participants in reviewed articles evaluate their hospitals' performance in PSC as 'excellent/very good'. Approximately %52.7 of participants did not report any adverse event in the past 12 months. The results of this study show that Iranian hospitals' performances in PSC were poor. Among the 12 dimensions of HSOPSC questionnaire, the "Non-punitive response to error" achieved the lowest score and could be a priority for future interventions. In this regard, hospitals staff should be encouraged to report adverse event without fear of punitive action.
Abrahamson, Kathleen; Hass, Zach; Morgan, Kristopher; Fulton, Bradley; Ramanujam, Rangaraj
The purpose of this study was to better understand the relationship between nurse-reported safety culture and the patient experience in a multistate sample of nurses and patients, matched by hospital unit/service line and timeframe of care delivery. Nurses play a key role in the patient experience and patient safety. A strong safety culture may produce positive spillover effects throughout the nurse caregiving experience, resulting in patient perception of a high-quality experience. Multivariate mixed-effects regression models were specified using data from a multistate sample of hospital units that administered both the Agency for Healthcare Research and Quality (AHRQ) staff safety culture survey and the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient satisfaction survey over a 12-month period. Survey response variables are measured at the unit (service line) and hospital level. Key variables in the HCAHPS and AHRQ surveys were significantly correlated. Findings highlight the relationship between 3 safety culture domains: teamwork, adequate staffing, and organizational learning on the achievement of a positive patient experience. Modifiable aspects of hospital culture can influence the likelihood of achieving high HCAHPS top box percentages in the nursing and global domains, which directly impact hospital reimbursement.
Daugherty Biddison, Elizabeth Lee; Paine, Lori; Murakami, Peter; Herzke, Carrie; Weaver, Sallie J
With the growth of the patient safety movement and development of methods to measure workforce health and success have come multiple modes of assessing healthcare worker opinions and attitudes about work and the workplace. Safety culture, a group-level measure of patient safety-related norms and behaviours, has been proposed to influence a variety of patient safety outcomes. Employee engagement, conceptualised as a positive, work-related mindset including feelings of vigour, dedication and absorption in one's work, has also demonstrated an association with a number of important worker outcomes in healthcare. To date, the relationship between responses to these two commonly used measures has been poorly characterised. Our study used secondary data analysis to assess the relationship between safety culture and employee engagement over time in a sample of >50 inpatient hospital units in a large US academic health system. With >2000 respondents in each of three time periods assessed, we found moderate to strong positive correlations (r=0.43-0.69) between employee engagement and four Safety Attitudes Questionnaire domains. Independent collection of these two assessments may have limited our analysis in that minimally different inclusion criteria resulted in some differences in the total respondents to the two instruments. Our findings, nevertheless, suggest a key area in which healthcare quality improvement efforts might be streamlined. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
De Jesus-Rivas, Mayra; Conlon, Helen Acree; Burns, Candace
Occupational health nursing plays a critical part in improving the safety of foreign labor workers. The development and implementation of safety training programs do not always regularly take into account language barriers, low literacy levels, or cultural elements. This oversight can lead to more injuries and fatalities among this group. Despite established health and safety training programs, a significant number of non-native English speakers are injured or killed in preventable, occupation-related accidents. Introducing safety programs that use alternative teaching strategies such as pictograms, illustrations, and hands-on training opportunities will assist in addressing challenges for non-English laborers. Occupational health nursing has an opportunity to provide guidance on this subject and assist businesses in creating a safer and more productive work environment. © 2015 The Author(s).
... COMMISSION Development of NRC's Safety Culture Policy Statement: Cancellation of Public Workshops Scheduled... forging a consensus around the objectives, strategies, activities and measures that enhance safety culture... culture common terminology effort comprised of: (1) Development of a common safety culture definition; and...
Szekendi, Marilyn K; Barnard, Cynthia; Creamer, Julie; Noskin, Gary A
Although creating a culture of safety to support clinicians and improve the quality of patient care is a common goal among health care organizations, it can be difficult to envision specific efforts to directly influence organizational culture. To promote transparency and reinforce a nonpunitive attitude throughout the organization, a forum for the open, interdisciplinary discussion of patient safety problems--the Patient Safety Morbidity and Mortality (M&M) Conference--was created at Northwestern Memorial Hospital (Chicago). The intent of the M&M conference was to inform frontline providers about adverse events that occur at the hospital and to engage their input in root cause analysis, thereby encouraging reporting and promoting systems-based thinking among clinicians. Convened under the purview of the organization's quality program, and modeled on the traditional M&M conferences historically used by physicians, the conference is a monthly live meeting at which case studies are presented for retrospective (root cause) analysis by an interdisciplinary audience. Since its start in 2003, approximately 60 patient safety M&M programs have been presented. Audiences typically represent a mix of physicians, nurses, pharmacists, management, therapists, and administrative and support staff. Staff perceptions of culture, as measured by the Hospital Survey on Patient Safety Culture, showed statistically significant improvements over time. Ensuring the patient safety M&M conference program's sustained success requires an ongoing commitment to identifying events of clinical importance and to pursuing the productive discussion of these events in an open and safe forum. Patient safety M&M conferences are a valued opportunity to engage staff in exploring adverse events and to promote transparency and a nonpunitive culture.
Westfall, Robert Michael [ORNL; Hopper, Calvin Mitchell [ORNL
The issue of nuclear criticality safety (NCS) in Department of Energy Environmental Management (DOE/EM) fissionable material operations presents challenges because of the large quantities of material present in the facilities and equipment that are committed to storage and/or material conditioning and dispositioning processes. Given the uncertainty associated with the material and conditions for many DOE/EM fissionable material operations, ensuring safety while maintaining operational efficiency requires the application of the most-effective criticality safety practices. In turn, more-efficient implementation of these practices can be achieved if the best NCS technologies are utilized. In 2002, DOE/EM-1 commissioned a survey of criticality safety technical needs at the major EM sites. These needs were documented in the report Analysis of Nuclear Criticality Safety Technology Supporting the Environmental Management Program, issued May 2002. Subsequent to this study, EM safety management personnel made a commitment to applying the best and latest criticality safety technology, as described by the DOE Nuclear Criticality Safety Program (NCSP). Over the past 7 years, this commitment has enabled the transfer of several new technologies to EM operations. In 2008, it was decided to broaden the basis of the EM NCS needs assessment to include not only current needs for technologies but also NCS operational areas with potential for improvements in controls, analysis, and regulations. A series of NCS workshops has been conducted over the past years, and needs have been identified and addressed by EM staff and contractor personnel. These workshops were organized and conducted by the EM Criticality Safety Program Manager with administrative and technical support by staff at Oak Ridge National Laboratory (ORNL). This report records the progress made in identifying the needs, determining the approaches for addressing these needs, and assimilating new NCS technologies into EM
Potts, T. Todd; Smith, Ken; Hylko, James M.
Industrial accidents are typically reported in terms of technological malfunctions, ignoring the human element in accident causation. However, over two-thirds of all accidents are attributable to human and organizational factors (e.g., planning, written procedures, job factors, training, communication, and teamwork), thereby affecting risk perception, behavior and attitudes. This paper reviews the development of WESKEM, LLC's Environmental, Safety, and Health (ES&H) Program that addresses human and organizational factors from a top-down, bottom-up approach. This approach is derived from the Department of Energy's Integrated Safety Management System. As a result, dispelling common myths and misconceptions about safety, while empowering employees to ''STOP work'' if necessary, have contributed to reducing an unusually high number of vehicle, ergonomic and slip/trip/fall incidents successfully. Furthermore, the safety culture that has developed within WESKEM, LLC's workforce consists of three common characteristics: (1) all employees hold safety as a value; (2) each individual feels responsible for the safety of their co-workers as well as themselves; and (3) each individual is willing and able to ''go beyond the call of duty'' on behalf of the safety of others. WESKEM, LLC as a company, upholds the safety culture and continues to enhance its existing ES&H program by incorporating employee feedback and lessons learned collected from other high-stress industries, thereby protecting its most vital resource - the employees. The success of this program is evident by reduced accident and injury rates, as well as the number of safe work hours accrued while performing hands-on field activities. WESKEM, LLC (Paducah + Oak Ridge) achieved over 800,000 safe work hours through August 2002. WESKEM-Paducah has achieved over 665,000 safe work hours without a recordable injury or lost workday case since it started operations on
Kobuse, Hiroe; Morishima, Toshitaka; Tanaka, Masayuki; Murakami, Genki; Hirose, Masahiro; Imanaka, Yuichi
To develop a reliable and valid questionnaire that can distinguish features of organizational culture for patient safety across subgroups such as hospitals, professions, management/non-management positions and units/wards. We developed a Hospital Organizational Culture Questionnaire based on a conceptual framework incorporating items from a review of existing literature. The questionnaire was administered to hospital staff including doctors, nurses, allied health personnel, and administrative staff at six public hospitals in Japan. Reliability and validity were assessed through exploratory factor analysis, multitrait scaling analysis, Cronbach's alpha coefficient and multiple regression analysis using staff-perceived achievement of safety as the response variable. Discriminative power across subgroups was assessed with radar chart profiling. Of the 3304 hospital staff surveyed, 2924 (88.5%) responded. After exploratory factor analysis and multitrait analysis, the finalized questionnaire was composed of 24 items in the following eight dimensions: improvement orientation, passion for mission, professional growth, resource allocation prioritization, inter-sectional collaboration, responsibility and authority, teamwork, and information sharing. Construct validity and internal consistency of dimensions were confirmed with multitrait analysis and Cronbach's alpha coefficients, respectively. Multiple regression analysis showed that improvement orientation, passion for mission, resource allocation prioritization and information sharing were significantly associated with higher achievement in safety practices. Our questionnaire tool was able to distinguish features of safety culture among different subgroups. Our questionnaire demonstrated excellent validity and reliability, and revealed distinct cultural patterns among different subgroups. Quantitative assessment of organizational safety culture with this tool may further the understanding of associated characteristics of
Hwang, Sun Chul; Jung, Su Jin; Choi, Young Sung [KAERI, Daejeon (Korea, Republic of)
In modern society, it has been acknowledged that disasters caused by civilization became inevitable. With growing attention to role of human as one component of the system to cope with accident to prevent disasters, various efforts have been deployed to keep safety. Most of the industries with high hazard have adopted the term as their banner in the efforts to promote safety in their installations and operations. Recently, the Fukushima nuclear power plants(NPPs) accident happened in Japan in 2011 resulted in great impact over the world and have highlighted the importance of safety culture again.
Kleter, G.A.; Noordam, M.Y.
The cultivation of genetically modified (GM) crops has steadily increased since their introduction to the market in the mid-1990s. Before these crops can be grown and sold they have to obtain regulatory approval in many countries, the process of which includes a pre-market safety assessment. The
Berg, van den S.J.P.L.; Serra-Majem, L.; Coppens, P.; Rietjens, I.
Botanicals and botanical preparations, including plant food supplements (PFS), are widely used in Western diets. The growing use of PFS is accompanied by an increasing concern because the safety of these PFS is not generally assessed before they enter the market. Regulatory bodies have become more
20 184.108.40.206.3 Servo Control Unit and...machine interface development and soldier task-load and cognition research. In the mid-1990’s, TARDEC contracted with MTS Systems (Eden Prairie, MN...in the MTS Technical Report, entitled “Ride Motion Simulator Safety Assessment Report” , remains the best account of the maximum acceleration
Ibrahim, Farah A.; Dykeman, Cass
In this article, the authors identify the cultural and spiritual assessments needed to conduct counseling with Muslim Americans and Muslim immigrants to the United States. Assessment processes are outlined that include cultural identity (which subsumes several variables); worldview; spiritual assessment along with acculturation level and migration…
Waters, Richard Thomas [Idaho National Laboratory
Abstract – Electrical workers, regardless of experience, are faced with a major barrier when first introduced to NFPA 70E, “The Standard for Electrical Safety in the Workplace,” and an erroneous electrical safety culture pre-exists. This paper describes, from the author’s point of view, the barrier that he and other electrical workers have experienced and his insight into overcoming the barrier. The author in conclusion will present a series of techniques that can be used to assist other electrical workers in overcoming the barrier.
Nordfjærn, Trond; Şimşekoğlu, Özlem; Rundmo, Torbjorn
The majority of previous cross-country studies of human factors relevant to traffic safety have not operationalized and measured culture. Also studies in this vein have mostly been carried out in Europe and the United States. The aim of the study was to examine country cluster differences, based on the Culture's Consequences framework, in road traffic risk perception, attitudes towards traffic safety and driver behaviour in samples from Norway, Russia, India, Ghana, Tanzania, Uganda, Turkey and Iran. An additional aim was to examine cluster differences in road traffic culture as symbol use and to investigate whether this theoretical cultural framework predicts risk perception, attitudes towards traffic safety and driver behaviour in the country clusters. The sample consisted of a total of 2418 individuals who were obtained by convenience sampling in the different countries. The countries segmented into four Culture's Consequences clusters; Norway, Russia and India, Sub-Saharan Africa, and Near East countries. The findings showed that Norwegians reported overall safer attitudes towards traffic safety and driver behaviour than the remaining country clusters. Individuals in Africa reported the highest risk perception. The countries also differed substantially in road traffic culture as symbol use. Contrary to established cultural theory, prediction models revealed that cultural factors were stronger predictors of driver behaviour than of risk perception. Also, the social cognitive risk constructs (i.e. risk perception and attitudes) solely explained variance in driver behaviour in the Norwegian and Russia/India clusters. Previous empirical efforts, which aimed to demonstrate that culture is important for the risk perception criterion, may have focused on a criterion variable that is not strongly related to driver behaviour. Furthermore, countermeasures aimed to influence social cognition may have stronger applicability in countries with a more individualistic western
On March 11, 2011, a large part of the Japanese eastern coastal area was devastated by an earthquake, followed by an immense tsunami. As a result, thousands of people were killed, injured or made homeless. In the days that followed, the situation was further complicated because of the failing nuclear reactors on the Fukushima coast. The local environment suffered from radioactive releases, requiring evacuation zones, and generating international concerns about nuclear safety. In the wake of this disaster the European Union decided to assess safety on all operating nuclear reactors in its member states. This safety evaluation initiated by the European Union focusses on extreme natural hazards, beyond the standard safety evaluations which regularly have to be performed to demonstrate the safety of a nuclear power plant. Consequences of these extreme hazards for the Borssele NPP have been evaluated based on available safety analyses, supplemented by engineering judgement. In this way, the robustness of the existing plant has been assessed and possible measures to further increase the safety margins have been identified. This document presents the results of the Complementary Safety margin Assessment (CSA) performed for the NPP Borssele. The distinct difference between this report and former risk analysis reports in general and the existing Safety Report of the NPP Borssele is that the maximum resistance of the plant against redefined and more challenging events has been investigated, whereas traditionally the plant design is investigated against certain events that are determined on a historical basis. This different approach requires different analyses and studies, which in turn presents new insights into the robustness of the plant. This document has been prepared in the short time period between June 1 and October 31, 2011. If more time had been granted for this study, some of the subjects could have been pursued in greater depth. The EPZ project team has been
Soldovieri, Francesco; Masini, Nicola; Alvarez de Buergo, Monica; Dumoulin, Jean
This special issue is the fourth of its kind in Journal of Geophysics and Engineering , containing studies and applications of geophysical methodologies and sensing technologies for the knowledge, conservation and security of products of human activity ranging from civil infrastructures to built and cultural heritage. The first discussed the application of novel instrumentation, surface and airborne remote sensing techniques, as well as data processing oriented to both detection and characterization of archaeological buried remains and conservation of cultural heritage (Eppelbaum et al 2010). The second stressed the importance of an integrated and multiscale approach for the study and conservation of architectural, archaeological and artistic heritage, from SAR to GPR to imaging based diagnostic techniques (Masini and Soldovieri 2011). The third enlarged the field of analysis to civil engineering structures and infrastructures, providing an overview of the effectiveness and the limitations of single diagnostic techniques, which can be overcome through the integration of different methods and technologies and/or the use of robust and novel data processing techniques (Masini et al 2012). As a whole, the special issue put in evidence the factors that affect the choice of diagnostic strategy, such as the material, the spatial characteristics of the objects or sites, the value of the objects to be investigated (cultural or not), the aim of the investigation (knowledge, conservation, restoration) and the issues to be addressed (monitoring, decay assessment). In order to complete the overview of the application fields of sensing technologies this issue has been dedicated to monitoring of cultural heritage and critical infrastructures to address safety and security issues. Particular attention has been paid to the data processing methods of different sensing techniques, from infrared thermography through GPR to SAR. Cascini et al (2013) present the effectiveness of a
Tereanu, Carmen; Smith, Scott A; Sampietro, Giuseppe; Sarnataro, Francesco; Mazzoleni, Giuliana; Pesenti, Bruno; Sala, Luca C; Cecchetti, Roberto; Arvati, Massimo; Brioschi, Dania; Viscardi, Michela; Prati, Chiara; Barbaglio, Giorgio G
The Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture (HSOPS) was designed to assess staff views on patient safety culture in hospital. This study examines psychometrics of the Italian translation of the HSOPS for use in territorial prevention facilities. After minimal adjustments and pre-test of the Italian version, a qualitative cross-sectional study was carried out. Departments of Prevention (DPs) of four Local Health Authorities in Northern Italy. Census of medical and non-medical staff (n. 479). Web-based self-administered questionnaire. Descriptive statistics, internal reliability, Confirmatory Factor Analysis (CFA) and intercorrelations among survey composites. Initial CFA of the 12 patient safety culture composites and 42 items included in the original version of the questionnaire revealed that two dimensions (Staffing and Overall Perception of Patient Safety) and nine individual items did not perform well among Italian territorial Prevention staff. After dropping those composites and items, psychometric properties were acceptable (comparative fit index = 0.94; root mean square error of approximation = 0.04; standardized root mean square residual = 0.04). Internal consistency for each remaining composite met or exceeded the criterion 0.70. Intercorrelations were all statistically significant. Psychometric analyses provided overall support for 10 of the 12 initial patient safety culture composites and 33 of the 42 initial composite items. Although the original instrument was intended for US Hospitals, the Italian translation of the HSOPS adapted for use in territorial prevention facilities performed adequately in Italian DPs.
Aboneh, Ephrem A; Look, Kevin A; Stone, Jamie A; Lester, Corey A; Chui, Michelle A
The U.S. Agency for Healthcare Research and Quality (AHRQ) developed a hospital patient safety culture survey in 2004 and has adapted this survey to other healthcare settings, such as nursing homes and medical offices, and most recently, community pharmacies. However, it is unknown whether safety culture dimensions developed for hospitals can be transferred to community pharmacies. The aim of this study was to assess the psychometric properties of the Community Pharmacy Survey on Patient Safety Culture. The survey was administered to 543 community pharmacists in Wisconsin, USA. Confirmatory factor analysis was used to assess the fit of our data with the proposed AHRQ model. Exploratory factor analysis was used to determine the underlying factor structure. Internal consistency reliabilities were calculated. A total of 433 usable surveys were returned (response rate 80%). Results from the confirmatory factor analysis showed inadequate model fit for the original 36 item, 11-factor structure. Exploratory factor analysis showed that a modified 27-item, four-factor structure better reflected the underlying safety culture dimensions in community pharmacies. The communication openness factor, with three items, dropped in its entirety while six items dropped from multiple factors. The remaining 27 items redistributed to form the four-factor structure: safety-related communication, staff training and work environment, organisational response to safety events, and staffing, work pressure and pace. Cronbach's α of 0.95 suggested good internal consistency. Our findings suggest that validation studies need to be conducted before applying safety dimensions from other healthcare settings into community pharmacies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Oedewald, Pia; Pietikaeinen, Elina; Reiman, Teemu [VTT, Technical Research Centre of Finland, Espoo (Finland)
Organizations in the nuclear industry need to maintain an overview on their vulnerabilities and strengths with respect to safety. Systematic periodical self assessments are necessary to achieve this overview. This guidebook provides suggestions and examples to assist power companies but also external evaluators and regulators in carrying out organizational evaluations. Organizational evaluation process is divided into five main steps. These are: 1) planning the evaluation framework and the practicalities of the evaluation process, 2) selecting data collection methods and conducting the data acquisition, 3) structuring and analysing the data, 4) interpreting the findings and 5) reporting the evaluation results with possible recommendations. The guidebook emphasises the importance of a solid background framework when dealing with multifaceted phenomena like organisational activities and system safety. The validity and credibility of the evaluation stem largely from the evaluation team's ability to crystallize what they mean by organization and safety when they conduct organisational safety evaluations - and thus, what are the criteria for the evaluation. Another important and often under-considered phase in organizational evaluation is interpretation of the findings. In this guidebook a safety culture evaluation in a Nordic nuclear power plant is presented as an example of organizational evaluation. With the help of the example, challenges of each step in the organizational evaluation process are described. Suggestions for dealing with them are presented. In the case example, the DISC (Design for Integrated Safety culture) model is used as the evaluation framework. The DISC model describes the criteria for a good safety culture and the organizational functions necessary to develop a good safety culture in the organization.
Singer, Sara; Meterko, Mark; Baker, Laurence; Gaba, David; Falwell, Alyson; Rosen, Amy
Objective To describe the development of an instrument for assessing workforce perceptions of hospital safety culture and to assess its reliability and validity. Data Sources/Study Setting Primary data collected between March 2004 and May 2005. Personnel from 105 U.S. hospitals completed a 38-item paper and pencil survey. We received 21,496 completed questionnaires, representing a 51 percent response rate. Study Design Based on review of existing safety climate surveys, we developed a list of key topics pertinent to maintaining a culture of safety in high-reliability organizations. We developed a draft questionnaire to address these topics and pilot tested it in four preliminary studies of hospital personnel. We modified the questionnaire based on experience and respondent feedback, and distributed the revised version to 42,249 hospital workers. Data Collection We randomly divided respondents into derivation and validation samples. We applied exploratory factor analysis to responses in the derivation sample. We used those results to create scales in the validation sample, which we subjected to multitrait analysis (MTA). Principal Findings We identified nine constructs, three organizational factors, two unit factors, three individual factors, and one additional factor. Constructs demonstrated substantial convergent and discriminant validity in the MTA. Cronbach's α coefficients ranged from 0.50 to 0.89. Conclusions It is possible to measure key salient features of hospital safety climate using a valid and reliable 38-item survey and appropriate hospital sample sizes. This instrument may be used in further studies to better understand the impact of safety climate on patient safety outcomes. PMID:17850530
Cano-del Pozo, M I; Obón-Azuara, B; Valderrama-Rodríguez, M; Revilla-López, C; Brosed-Yuste, C; Fajardo-Trasobares, E; Garcés-Baquero, P; Mateo-Clavería, J; Molina-Estrada, I; Perona-Flores, N; Salcedo-de Dios, S; Tomé-Rey, A
The aim of this study is to measure the degree of safety culture (CS) among healthcare professional workers of an out-of-hospital Emergency Medical Service. Most patient safety studies have been conducted in relation to the hospital rather than pre-hospital Emergency Medical Services. The objective is to analyze the dimensions with lower scores in order to plan futures strategies. A descriptive study using the AHRQ (Agency for Healthcare Research and Quality) questionnaire. The questionnaire was delivered to all healthcare professionals workers of 061 Advanced Life Support Units of Aragón, during the month of August 2013. The response rate was 55%. Main strengths detected: an adequate number of staff (96%), good working conditions (89%), tasks supported from immediate superior (77%), teamwork climate (74%), and non-punitive environment to report adverse events (68%). Areas for improvement: insufficient training in patient safety (53%) and lack of feedback of incidents reported (50%). The opportunities for improvement identified focus on the training of professionals in order to ensure safer care, while extending the safety culture. Also, the implementation of a system of notification and registration of adverse events in the service is deemed necessary. Copyright © 2014 SECA. Published by Elsevier Espana. All rights reserved.
Girasek, Deborah C
The purpose of this study was to increase our understanding of traffic safety culture (TSC) by identifying its constituent components. A review of existing safety culture literature was conducted. Next, 18 international experts participated in a Delphi Technique to rate candidate TSC components. Corresponding survey items were then developed and pretested. Our final survey instrument was mailed to a representative sample of 1700 US households. Their data were used to conduct a factor analysis that yielded a 15 factor structure. The factors that explained the most variance in TSC were support for increased government attention to traffic safety, strict monitoring and control of alcohol-impaired drivers, disapproval of speeding, and avoidance of aggressive driving. Other factors included local engagement, desire for government and private sector accountability, more information, school involvement, teen restrictions, willingness to invest and seatbelt use. This work represents a first attempt to operationalise TSC. Future research will be needed to refine and extend the tentative structure that has been identified. Valid and reliable measurement of this construct should facilitate traffic safety advocates' efforts to overcome the social challenges they face.
Full Text Available This research aims to examine the effects of national culture and leadership style on safety performance in bulk shipping companies. Survey data collected from 322 respondents working in dry bulk carriers was used, a multiple regression analysis was conducted to analyze the influence of national culture and leadership styles (i.e. transformational, passive management, and contingent reward on safety attitude and safety behavior. The results indicate that national culture dimensions such as power distance, uncertainty avoidance, collectivism, and long-term orientation had a positive influence on safety behaviour. Long-term orientation had a positive influence on safety attitude, whereas masculinity had a negative influence on safety attitude of seafarers. Specifically, this research found that transformational leadership had a positive influence on safety attitude and safety behaviour of seafarers. Moreover, practical implication from the research findings to improve ship safety in dry bulk shipping were discussed.
Akkermans, Louis MA; Haller, Dirk; Hammerman, Cathy; Heimbach, James; Hörmannsperger, Gabriele; Huys, Geert; Levy, Dan D; Lutgendorff, Femke; Mack, David; Phothirath, Phoukham; Solano-Aguilar, Gloria; Vaughan, Elaine
The safety of probiotics is tied to their intended use, which includes consideration of potential vulnerability of the consumer or patient, dose and duration of consumption, and both the manner and frequency of administration. Unique to probiotics is that they are alive when administered, and unlike other food or drug ingredients, possess the potential for infectivity or in situ toxin production. Since numerous types of microbes are used as probiotics, safety is also intricately tied to the nature of the specific microbe being used. The presence of transferable antibiotic resistance genes, which comprises a theoretical risk of transfer to a less innocuous member of the gut microbial community, must also be considered. Genetic stability of the probiotic over time, deleterious metabolic activities, and the potential for pathogenicity or toxicogenicity must be assessed depending on the characteristics of the genus and species of the microbe being used. Immunological effects must be considered, especially in certain vulnerable populations, including infants with undeveloped immune function. A few reports about negative probiotic effects have surfaced, the significance of which would be better understood with more complete understanding of the mechanisms of probiotic interaction with the host and colonizing microbes. Use of readily available and low cost genomic sequencing technologies to assure the absence of genes of concern is advisable for candidate probiotic strains. The field of probiotic safety is characterized by the scarcity of studies specifically designed to assess safety contrasted with the long history of safe use of many of these microbes in foods. PMID:21327023
Smits, M.; Wagner, C.; Spreeuwenberg, P.; Timmermans, D.R.M.; van der Wal, G.; Groenewegen, P.P.
Aims and objectives. To examine whether the relationship between specialty and patient safety is mediated by safety culture. Background. Research has shown that patient safety in hospitals varies by specialty. The safety culture among healthcare professionals in hospital units is believed to
Smits, M.; Wagner, C.; Spreeuwenberg, P.; Timmermans, D.R.M.; Wal, G. van der; Groenewegen, P.P.
Aims and objectives: To examine whether the relationship between specialty and patient safety is mediated by safety culture. Background: Research has shown that patient safety in hospitals varies by specialty. The safety culture among healthcare professionals in hospital units is believed to
..., participation in a Special Joint Session on Safety Culture at the Health Physics Society Annual Meeting, and... COMMISSION Revised Draft Safety Culture Policy Statement: Request for Comments AGENCY: Nuclear Regulatory Commission (NRC). ACTION: Issuance of revised Draft Safety Culture Policy Statement and notice of opportunity...
Solano-Flores, Guillermo; Nelson-Barber, Sharon
We propose the concept of cultural validity as a form of test validity in science assessment. The conceptual relevance of cultural validity is supported by evidence that culture and society shape an individual's mind and thinking. To attain cultural validity, the process of assessment development must consider how the sociocultural context in which students live influences the ways in which they make sense of science items and the ways in which they solve them. These sociocultural influences include the values, beliefs, experiences, communication patterns, teaching and learning styles, and epistemologies inherent in the students' cultural backgrounds, as well as the socioeconomic conditions prevailing in their cultural groups. We contend that current approaches to handling student diversity in assessment (e.g., adapting or translating tests, providing assessment accommodations, estimating test cultural bias) are limited and lack sociocultural perspective. We find that attaining cultural validity may conflict with current basic principles and assumptions in testing, such as item independence and standardization. We discuss the ways in which adopting cultural validity as a criterion for test validity makes it necessary to shift assessment paradigms and adopt new procedures for assessment development.
de Castro, Borja López; Gracia, Francisco J; Tomás, Inés; Peiró, José M
This paper presents the Safety Culture Enactment Questionnaire (SCEQ), designed to assess the degree to which safety is an enacted value in the day-to-day running of nuclear power plants (NPPs). The SCEQ is based on a theoretical safety culture model that is manifested in three fundamental components of the functioning and operation of any organization: strategic decisions, human resources practices, and daily activities and behaviors. The extent to which the importance of safety is enacted in each of these three components provides information about the pervasiveness of the safety culture in the NPP. To validate the SCEQ and the model on which it is based, two separate studies were carried out with data collection in 2008 and 2014, respectively. In Study 1, the SCEQ was administered to the employees of two Spanish NPPs (N=533) belonging to the same company. Participants in Study 2 included 598 employees from the same NPPs, who completed the SCEQ and other questionnaires measuring different safety outcomes (safety climate, safety satisfaction, job satisfaction and risky behaviors). Study 1 comprised item formulation and examination of the factorial structure and reliability of the SCEQ. Study 2 tested internal consistency and provided evidence of factorial validity, validity based on relationships with other variables, and discriminant validity between the SCEQ and safety climate. Exploratory Factor Analysis (EFA) carried out in Study 1 revealed a three-factor solution corresponding to the three components of the theoretical model. Reliability analyses showed strong internal consistency for the three scales of the SCEQ, and each of the 21 items on the questionnaire contributed to the homogeneity of its theoretically developed scale. Confirmatory Factor Analysis (CFA) carried out in Study 2 supported the internal structure of the SCEQ; internal consistency of the scales was also supported. Furthermore, the three scales of the SCEQ showed the expected correlation
Olsen, Sherrlyn S.; Cordray, Joseph C.; Sapp, Stephen; Sebranek, Joseph G.; Anderson, Barbara; Wenger, Matt
Challenges arise when teaching food safety to culturally diverse employees working in meatpacking and food manufacturing industries. A food safety training program was developed in English, translated into Spanish, and administered to 1,265 adult learners. Assessments were conducted by comparing scores before and immediately following training.…
George D Loizou
Full Text Available The exponential growth of the Internet of Things and the global popularity and remarkable decline in cost of the mobile phone is driving the digital transformation of medical practice. The rapidly maturing digital, nonmedical world of mobile (wireless devices, cloud computing and social networking is coalescing with the emerging digital medical world of omics data, biosensors and advanced imaging which offers the increasingly realistic prospect of personalized medicine. Described as a potential seismic shift from the current healthcare model to a wellness paradigm that is predictive, preventative, personalized and participatory, this change is based on the development of increasingly sophisticated biosensors which can track and measure key biochemical variables in people. Additional key drivers in this shift are metabolomic and proteomic signatures, which are increasingly being reported as pre-symptomatic, diagnostic and prognostic of toxicity and disease. These advancements also have profound implications for toxicological evaluation and safety assessment of pharmaceuticals and environmental chemicals. An approach based primarily on human in vivo and high-throughput in vitro human cell-line data is a distinct possibility. This would transform current chemical safety assessment practise which operates in a human data poor to a human data rich environment. This could also lead to a seismic shift from the current animal-based to an animal-free chemical safety assessment paradigm.
Bernalte-Martí, Vicente; Orts-Cortés, María Isabel; Maciá-Soler, Loreto
To assess nursing professionals and health care assistants' perceptions, opinions and behaviours on patient safety culture in the operating room of a public hospital of the Spanish National Health Service. To describe strengths and weaknesses or opportunities for improvement according to the Agency for Healthcare Research and Quality criteria, as well as to determine the number of events reported. A descriptive, cross-sectional study was conducted using the Spanish version of the questionnaire Hospital Survey on Patient Safety Culture. The sample consisted of nursing professionals, who agreed to participate voluntarily in this study and met the selection criteria. A descriptive and inferential analysis was performed depending on the nature of the variables and the application conditions of statistical tests. Significance if p < .05. In total, 74 nursing professionals responded (63.2%). No strengths were found in the operating theatre, and improvements are needed concerning staffing (64.0%), and hospital management support for patient safety (52.9%). A total of 52.3% (n = 65) gave patient safety a score from 7 to 8.99 (on a 10 point scale); 79.7% (n = 72) reported no events last year. The total variance explained by the regression model was 0.56 for "Frequency of incident reporting" and 0.26 for "Overall perception of safety". There was a more positive perception of patient safety culture at unit level. Weaknesses have been identified, and they can be used to design specific intervention activities to improve patient safety culture in other nearby operating theatres. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.
Johnston, Roger G
Safety and security share numerous attributes. The author, who heads the (Security) Vulnerability Assessment Team at Los Alamos National Laboratory, therefore argues that techniques used to optimize security might be useful for optimizing safety. There are three main ways to attempt to improve security-security surveys, risk assessment (or "design basis threat"), and vulnerability assessments. The latter is usually the most effective. Vulnerability assessment techniques used to improve security can be applied to safety analysis--even though safety is not ordinarily viewed as having malicious adversaries (other than hazards involving deliberate sabotage). Thinking like a malicious adversary can nevertheless have benefits in identifying safety vulnerabilities. The attributes of an effective safety vulnerability assessment are discussed, and recommendations are offered for how such an adversarial assessment might work. A safety vulnerability assessment can potentially provide new insights, a fresh and vivid perspective on safety hazards, and increased safety awareness.
Profit, Jochen; Sharek, Paul J; Amspoker, Amber B; Kowalkowski, Mark A; Nisbet, Courtney C; Thomas, Eric J; Chadwick, Whitney A; Sexton, J Bryan
Background Burnout is widespread among healthcare providers and is associated with adverse safety behaviours, operational and clinical outcomes. Little is known with regard to the explanatory links between burnout and these adverse outcomes. Objectives (1) Test the psychometric properties of a brief four-item burnout scale, (2) Provide neonatal intensive care unit (NICU) burnout and resilience benchmarking data across different units and caregiver types, (3) Examine the relationships between caregiver burnout and patient safety culture. Research design Cross-sectional survey study. Subjects Nurses, nurse practitioners, respiratory care providers and physicians in 44 NICUs. Measures Caregiver assessments of burnout and safety culture. Results Of 3294 administered surveys, 2073 were returned for an overall response rate of 62.9%. The percentage of respondents in each NICU reporting burnout ranged from 7.5% to 54.4% (mean=25.9%, SD=10.8). The four-item burnout scale was reliable (α=0.85) and appropriate for aggregation (intra-class correlation coefficient−2=0.95). Burnout varied significantly between NICUs, pburnout had lower teamwork climate (r=−0.48, p=0.001), safety climate (r=−0.40, p=0.01), job satisfaction (r=−0.64, pburnout appears to have ‘climate-like’ features, is prevalent, and associated with lower perceptions of patient safety culture. PMID:24742780
Profit, Jochen; Sharek, Paul J; Amspoker, Amber B; Kowalkowski, Mark A; Nisbet, Courtney C; Thomas, Eric J; Chadwick, Whitney A; Sexton, J Bryan
Burnout is widespread among healthcare providers and is associated with adverse safety behaviours, operational and clinical outcomes. Little is known with regard to the explanatory links between burnout and these adverse outcomes. (1) Test the psychometric properties of a brief four-item burnout scale, (2) Provide neonatal intensive care unit (NICU) burnout and resilience benchmarking data across different units and caregiver types, (3) Examine the relationships between caregiver burnout and patient safety culture. Cross-sectional survey study. Nurses, nurse practitioners, respiratory care providers and physicians in 44 NICUs. Caregiver assessments of burnout and safety culture. Of 3294 administered surveys, 2073 were returned for an overall response rate of 62.9%. The percentage of respondents in each NICU reporting burnout ranged from 7.5% to 54.4% (mean=25.9%, SD=10.8). The four-item burnout scale was reliable (α=0.85) and appropriate for aggregation (intra-class correlation coefficient-2=0.95). Burnout varied significantly between NICUs, pburnout had lower teamwork climate (r=-0.48, p=0.001), safety climate (r=-0.40, p=0.01), job satisfaction (r=-0.64, pburnout appears to have 'climate-like' features, is prevalent, and associated with lower perceptions of patient safety culture. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Steyrer, Johannes; Latzke, Markus; Pils, Katharina; Vetter, Elisabeth; Strunk, Guido
Older patients (≥65 years) are exposed to more harm resulting from adverse events in hospitals than younger patients. Theoretical considerations and empirical findings suggest that safety culture is the key to improving the quality of health care. To describe the development of a German-language instrument for assessing patient safety culture (PSC) and its reliability and validity; to verify criterion validity by means of a cross-sectional analysis of the impact of PSC on clinical quality that compares acute geriatric units with a sample from intensive care, surgery and trauma surgery departments, and to report variations in the PSC profile between these groups. Using a review of existing safety culture surveys, multidimensional scaling procedures and expert interviews, we tested the content and convergent validity of a 158-item questionnaire completed by 508 physicians and nurses from 31 acute geriatric units and 7 comparison departments. Criterion validity was verified by various regression models with a self-reported measure of adverse events. Differences in PSC profiles were analyzed using a one-factorial ANOVA and regression models. We identified 7 constructs of PSC and demonstrated substantial convergent and criterion validity. In the acute geriatric units, higher levels of 'management commitment to patient safety' and lower levels of 'error fatalism' were associated with a reduced incidence of medical errors. In the comparison group, only the variable 'active learning from mistakes' was relevant for safety performance. Our results also indicate that acute geriatric units display higher standards than the comparison group in all the aspects of patient safety examined. It is possible to measure salient features of PSC using a valid and reliable survey. Some aspects of PSC are more closely related to safety events than others. In acute geriatric units, patient safety appears to be influenced mainly by management's determination of how things are done whereas
Full Text Available Abstract Background Patient safety has been a priority for many societies and health care systems in the last decades. Identification of preventable risks and aversion of potentially unsafe situations and fatal complications in maternity units is life saving. The explicit need to focus on quality of care underpins the aim of the study to initially evaluate the safety culture and teamwork climate in the public Maternity Units of the 5 Regional Hospitals in Cyprus as measured by a validated safety attitudes tool. Methods Data were collected from 140 midwives working in the public sector all over Cyprus by the Greek Version of the Safety Attitudes Questionnaire-Labor version. Results One hundred and six (75.71% registered midwives completed the questionnaire fully. The median of total work experience as a registered midwife was 3 years (IQR: 2-18.25; whereas the median of total working experience in the nursing and maternity units was 5 years (IQR: 2-21.75. Experienced midwives rated the following domains higher: team work, safety climate, job satisfaction and working conditions as opposed to the midwives with less experience. Additionally those with a longer working life in the current maternity units rated these domains higher: safety climate, job satisfaction and working conditions as opposed to the less experienced midwives. Conclusions The high mean total score on team work and safety climate in the more experienced group of midwives is a predominant finding for the maternity units of Cyprus. In Cyprus where facilities are small in size and midwives know each other, share more responsibility towards patient safety. It could be suggested that younger midwives need more support and teamwork practice to enhance the safety and teamwork climate towards self-confidence.
Raftopoulos, Vasilios; Savva, Nicos; Papadopoulou, Maria
Patient safety has been a priority for many societies and health care systems in the last decades. Identification of preventable risks and aversion of potentially unsafe situations and fatal complications in maternity units is life saving. The explicit need to focus on quality of care underpins the aim of the study to initially evaluate the safety culture and teamwork climate in the public Maternity Units of the 5 Regional Hospitals in Cyprus as measured by a validated safety attitudes tool. Data were collected from 140 midwives working in the public sector all over Cyprus by the Greek Version of the Safety Attitudes Questionnaire-Labor version. One hundred and six (75.71%) registered midwives completed the questionnaire fully. The median of total work experience as a registered midwife was 3 years (IQR: 2-18.25); whereas the median of total working experience in the nursing and maternity units was 5 years (IQR: 2-21.75). Experienced midwives rated the following domains higher: team work, safety climate, job satisfaction and working conditions as opposed to the midwives with less experience. Additionally those with a longer working life in the current maternity units rated these domains higher: safety climate, job satisfaction and working conditions as opposed to the less experienced midwives. The high mean total score on team work and safety climate in the more experienced group of midwives is a predominant finding for the maternity units of Cyprus. In Cyprus where facilities are small in size and midwives know each other, share more responsibility towards patient safety. It could be suggested that younger midwives need more support and teamwork practice to enhance the safety and teamwork climate towards self-confidence.
Taniguchi, Taketoshi [Central Research Inst. of Electric Power Industry, Tokyo (Japan)
For safely operating nuclear power facilities, in addition to the technical countermeasures, the performance of the organizations that operate and manage them is important. In this paper, the spontaneous cooperation type management system that supported the introduction and development of nuclear power generation in electric power business is analyzed from the viewpoints of organization science and behavioral psychology, and based on the results of the investigation of the sense of value and psychological characteristics of young organization members who bear future nuclear power generation, on how to foster and establish safety culture which is called second safety principle in organizations, the subjects for hereafter are discussed from the viewpoints of respect of individuals and their integration with organizations, upbringing of talents and systematic learning. The factors which compose the safety culture are shown. The form of operating and managing the organizations are seen in first generation nuclear power generation, the similarity to Japanese type enterprise operation system, the change of the prerequisite of spontaneous cooperation type management and the difference of conscience among the generations of organization members are discussed. The above subjects for hereafter are discussed. (K.I.)
Full Text Available . This paper highlights the Safety culture and issue in the Malaysian Manufacturing Sector and emphasis the high occupational accidents due to lack of safety culture and non-compliance of the requirements of Occupational Safety and Health Act 1994. The aim of this study is to review the occupational accidents occurrence in the Malaysia workplace since 2012-2016. Malaysia aimed to reduce the occupational accidents, the results show by DOSH increase that Occupational Noise Induced Hearing Loss 83.7%, occupational musculoskeletal diseases, 4.4% and occupational lung diseases 2.3%. But the as per the record from DOSH that in last 5-Years, the increment in the fatal accidents by Average 26%, Permanent Disability by Average 71% and Non-Permanent Disability by 64 % are investigated only in Manufacturing Industries. The government must show their high interest on such a vulnerable employees to accomplish the above aim. This step will be helpful for planning to reduce the accidents in workplaces and it will also detect the prevention for the future accidents.
Song, Tae Young [Nuclear Engineering and Technology Institute, Daejeon (Korea, Republic of)
At present, the 10-year Periodic Safety Review(PSR) has been performing to confirm all the aspects of safety issues for all the operating plants in compliance with domestic nuclear law of article 23, subarticle 3. For each plant, in addition, Probabilistic Safety Assessment(PSA) and Severe Accident Management Guideline(SAMG) are being implemented and revised periodically to reflect the latest safety level according to principle fulfillment of severe accident policy statement. The assessment reports, as one of outcomes from these activities, are submitted into and reviewed by domestic regulatory body. During reviewing (in-office duty) and licensing (regulatory duty) process, a large number of outcomes of which most are the formal technical reports and licensing materials, are inevitably produced. Moreover, repeated review process over the plants can make them accumulated and produce a variety of documents additionally. This circumstance motivates to develop effective tool or system for the management of these reports and related technical documents for the future use in licensing process and for subsequent plant assessments. This paper presents the development status of Safety Assessment Information System(SAIS) which manages safety-related documents of PSR, PSA and SAMG for practical use for experienced engineers in charge of these areas.
Santiago, Thaiana Helena Roma; Turrini, Ruth Natalia Teresa
Objective To assess the perception of health professionals about patient safety climate and culture in different intensive care units (ICUs) and the relationship between scores obtained on the Hospital Survey on Patient Safety Culture (HSOPSC) and the Safety Attitudes Questionnaire (SAQ). Method A cross-sectional study conducted at a teaching hospital in the state of São Paulo, Brazil, in March and April 2014. As data gathering instruments, the HSOPSC, SAQ and a questionnaire with sociodemographic and professional information about the staff working in an adult, pediatric and neonatal ICU were used. Data analysis was conducted with descriptive statistics. Results The scales presented good reliability. Greater weaknesses in patient safety were observed in the Working conditions andPerceptions of management domains of the SAQ and in the Nonpunitive response to error domain of the HSOPSC. The strengths indicated by the SAQ wereTeamwork climate and Job satisfactionand by the HSOPC, Supervisor/manager expectations and actions promoting safety and Organizational learning-continuous improvement. Job satisfaction was higher among neonatal ICU workers when compared with the other ICUs. The adult ICU presented lower scores for most of the SAQ and HSOPSC domains. The scales presented moderate correlation between them (r=0.66). Conclusion There were differences in perception regarding patient safety among ICUs, which corroborates the existence of local microcultures. The study did not demonstrate equivalence between the SAQ and the HSOPSC.
Gassino, Jean; Peron, Jean-Claude; Regnier, Pascal; Soubies, Brigitte [Institut de Radioprotection et de Surete Nucleaire BP 17, 92262 Fontenay-aux-Roses Cedex (France)
In order to provide a technical advice to the Safety Authority in the field of safety-critical software, IRSN's work relies significantly on code examination. Unfortunately, no absolute solution exists - and will ever exist - to answer a global question like 'is this program correct?' The fast growth of computer capacities allows software 'complexity' (size, number of branches, etc) to be multiplied by ten with each generation. Due to software characteristics like the combinatorial blast or the absence of continuity, the verification by the manufacturer and the assessment by IRSN increase in difficulty even much faster than this. Also, new industrial practices raise new challenges as they could suppress crucial verification steps. To handle these difficulties, IRSN devotes efforts to research and development actions in order to introduce new tools and methodologies based on the newest scientific progress. However, hard scientific difficulties prevent the evolution in this area to be as fast as the complexity increase. Thus, maintaining an acceptable safety level requires limiting the complexity escalation to a rate compatible with the verification and assessment means, either by the will of the utilities or imposed by the regulator. (authors)
The purpose of this report is to document an assessment performed to evaluate the safety of the radiochemical operations conducted at the Los Alamos National Laboratory operations area designated as TA-48. This Safety Assessment for the TA-48 radiochemical operations was prepared to fulfill the requirements of US Department of Energy (DOE) Order 5481.1B, ``Safety Analysis and Review System.`` The area designated as TA-48 is operated by the Chemical Science and Technology (CST) Division and is involved with radiochemical operations associated with nuclear weapons testing, evaluation of samples collected from a variety of environmental sources, and nuclear medicine activities. This report documents a systematic evaluation of the hazards associated with the radiochemical operations that are conducted at TA-48. The accident analyses are limited to evaluation of the expected consequences associated with a few bounding accident scenarios that are selected as part of the hazard analysis. Section 2 of this report presents an executive summary and conclusions, Section 3 presents pertinent information concerning the TA-48 site and surrounding area, Section 4 presents a description of the TA-48 radiochemical operations, and Section 5 presents a description of the individual facilities. Section 6 of the report presents an evaluation of the hazards that are associated with the TA-48 operations and Section 7 presents a detailed analysis of selected accident scenarios.
Zullo, Melissa D; McCarroll, Michele L; Mendise, Thomas M; Ferris, Edward F; Roulette, G D; Zolton, Jessica; Andrews, Stephen J; von Gruenigen, Vivian E
To measure the safety culture in the robotics surgery operating room before and after implementation of the Robotic Operating Room Computerized Checklist (RORCC). Prospective study. Gynecology surgical staff (n = 32). An urban community hospital. The Safety Attitudes Questionnaire domains examined were teamwork, safety, job satisfaction, stress recognition, perceptions of management, and working conditions. Questions and domains were described using percent agreement and the Cronbach alpha. Paired t-tests were used to describe differences before and after implementation of the checklist. Mean (SD) staff age was 46.7 (9.5) years, and most were women (78%) and worked full-time (97%). Twenty respondents (83% of nurses, 80% of surgeons, 66% of surgical technicians, and 33% of certified registered nurse anesthetists) completed the Safety Attitudes Questionnaire; 6 were excluded because of non-matching identifiers. Before RORCC implementation, the highest quality of communication and collaboration was reported by surgeons and surgical technicians (100%). Certified registered nurse anesthetists reported only adequate levels of communication and collaboration with other positions. Most staff reported positive responses for teamwork (48%; α = 0.81), safety (47%; α = 0.75), working conditions (37%; α = 0.55), stress recognition (26%; α = 0.71), and perceptions of management (32%; α = 0.52). No differences were observed after RORCC implementation. Quality of communication and collaboration in the gynecology robotics operating room is high between most positions; however, safety attitude responses are low overall. No differences after RORCC implementation and low response rates may highlight lack of staff support. Copyright © 2014. Published by Elsevier Inc.
Carruth, Ann K; Levin, Jeffrey L; Gilmore, Karen; Bui, Thu; Gallardo, Gilbert; Evert, William; Sealey, Lorinda
Every ethnic group has its own cultural background and history that influences how it views health behaviors. By virtue of their work history, many Vietnamese have pursued the fishing industry when migrating to the United States. Even though the fishing trades are among the most dangerous jobs in the world, there has been little attention in the literature to the significant role that culture plays in the expression and experience of occupational health practices among Vietnamese shrimp fishermen. Three focus group sessions were conducted to identify factors that hinder or facilitate receptivity to available training and to guide culturally appropriate content. Participants were recruited using purposive sampling among various Vietnamese shrimp fishermen communities in Texas. Utilizing a series of open-ended questions, sessions were conducted in their native language among owners/captains/deckhands; support infrastructure--adult family members and religious/community leaders; and industry management and insurance representatives. Translations of transcribed documents were compared with simultaneous translations to ensure thematic consistency. Conducting hands-on training among Vietnamese by experienced fishermen, specifically targeting captains, was considered key to safety culture on the vessels. Findings of the study support that training should occur in a variety of formats (hands-on), but should be periodic, current, practical, convenient, taught in the primary language of the audience by an experienced individual, culminate in a certificate of completion, and target captains first. These findings illustrate the importance of considering cultural factors in the design of workplace interventions that focus on changes in safety and occupational health behaviors.
Full Text Available Abstract Background The Hospital Survey on Patient Safety Culture (HSOPS is used to assess safety culture in many countries. Accordingly, the questionnaire has been translated into Turkish for the study of patient safety culture in Turkish hospitals. The aim of this study is threefold: to determine the validity and reliability of the translated form of HSOPS, to evaluate physicians' and nurses' perceptions of patient safety in Turkish public hospitals, and to compare finding with U.S. hospital settings. Methods Physicians and nurses working in all public hospitals in Konya, a large city in Turkey, were asked to complete a self-administrated patient safety culture survey (n = 309. Data collection was carried out using the Turkish version of HSOPS, developed by Agency for Healthcare Research and Quality (AHRQ. Data were summarized as percentages, means, and SD values. Factor analysis, correlation coefficient, Cronbach's alpha, ANOVA, and t tests were employed in statistical analyses. Items on patient safety were categorized into 10 factors. Factor loadings and internal consistencies of dimension items were high. Results Most of the scores related to dimensions, and the overall patient safety score (44% were lower than the benchmark score. "Teamwork within hospital units" received the highest score (70%, and the lowest score belonged to the "frequency of events reported" (15%. The study revealed that more than three quarters of the physicians and nurses were not reporting errors. Conclusion The Turkish version of HSOPS was found to be valid and reliable in determining patient safety culture. This tool will be helpful in tracking improvements and in heightening awareness on patient safety culture in Turkey.
Background The Hospital Survey on Patient Safety Culture (HSOPS) is used to assess safety culture in many countries. Accordingly, the questionnaire has been translated into Turkish for the study of patient safety culture in Turkish hospitals. The aim of this study is threefold: to determine the validity and reliability of the translated form of HSOPS, to evaluate physicians' and nurses' perceptions of patient safety in Turkish public hospitals, and to compare finding with U.S. hospital settings. Methods Physicians and nurses working in all public hospitals in Konya, a large city in Turkey, were asked to complete a self-administrated patient safety culture survey (n = 309). Data collection was carried out using the Turkish version of HSOPS, developed by Agency for Healthcare Research and Quality (AHRQ). Data were summarized as percentages, means, and SD values. Factor analysis, correlation coefficient, Cronbach's alpha, ANOVA, and t tests were employed in statistical analyses. Items on patient safety were categorized into 10 factors. Factor loadings and internal consistencies of dimension items were high. Results Most of the scores related to dimensions, and the overall patient safety score (44%) were lower than the benchmark score. "Teamwork within hospital units" received the highest score (70%), and the lowest score belonged to the "frequency of events reported" (15%). The study revealed that more than three quarters of the physicians and nurses were not reporting errors. Conclusion The Turkish version of HSOPS was found to be valid and reliable in determining patient safety culture. This tool will be helpful in tracking improvements and in heightening awareness on patient safety culture in Turkey. PMID:20109186
Raeissi, Pouran; Sharifi, Marziye; Khosravizadeh, Omid; Heidari, Mohammad
Background: Patient safety culture plays an important role in healthcare systems, especially in chemotherapy and oncology departments (CODs), and its assessment can help to improve quality of services and hospital care. Objective: This study aimed to evaluate and compare items and dimensions of patient safety culture in the CODs of selected teaching hospitals of Iran and Tehran University of Medical Sciences. Materials and Methods: This descriptive-analytical crosssectional survey was conducted during a six-month period on 270 people from chemotherapy and oncology departments selected through a cluster sampling method. All participants answered the standard questionnaire for “Hospital Survey of Patient Safety Culture” (HSOPSC). Statistical analyses were performed using SPSS/18 software. Results: The average score for patient safety culture was three for the majority of the studied CODs. Statistically significant differences were observed for supervisor actions, teamwork within various units, feedback and communications about errors, and the level of hospital management support. (ppatient safety culture were not statistically significant (p>0.05). Conclusion: Our results showed that the overall status of patient safety culture is not good in the studied CODs. In particular, teamwork across different units and organizational learning with continuous improvement were the only two properly operating items among 12 dimensions of patient safety culture. Therefore, systematic interventions are strongly required to promote communication. Creative Commons Attribution License
Taylor, N.P. [EURATOM/UKAEA Fusion Association, Culham Science Centre, Abingdon, Oxfordshire, OX14 3DB (United Kingdom)]. E-mail: firstname.lastname@example.org; Branas, B. [EURATOM-CIEMAT Association for Fusion, Madrid (Spain); Eriksson, E. [Studsvik Nuclear AB, Nykoeping (Sweden); Natalizio, A. [ENSAC Associates Ltd., Toronto, (Canada); Pinna, T. [ENEA FUS/TEC - Fusion Technology, Safety and Environment Section, Frascati (Italy); Rodriguez-Rodrigo, L. [EURATOM-CIEMAT Association for Fusion, Madrid (Spain); Ciattaglia, S. [EFDA Close Support Unit, Garching (Germany); Laesser, R. [EFDA Close Support Unit, Garching (Germany)
The International Fusion Materials Irradiation Facility (IFMIF) is a planned high-energy neutron source for the testing of candidate materials for future fusion power plants. Safety studies performed during the various stages of the conceptual design of IFMIF have been brought together in a preliminary assessment of the safety of IFMIF, identifying the principal hazards and the means to prevent or mitigate them. The design is based on dual high-energy deuteron accelerators delivering beams onto a flowing lithium target, in which neutrons are produced through a d-Li stripping reaction. The neutrons irradiate material samples in controlled conditions in a test cell. In all these systems, potential hazards arise, but analyses show that no postulated off-normal event can result in a significant risk of harm to the public. However, care must be taken in forthcoming detailed design development to minimise occupational radiation exposure during IFMIF operation and maintenance.
Krupka, M.C.; Peaslee, A.T. Jr.; Laquer, H.L.
A relative safety assessment of alternative gaseous and reference liquid fuels utilized for light automotive transportation in the public sector was completed. The specific fuels considered were compressed natural gas (CNG), liquefied natural gas (LNG), liquefied petroleum gas (LPG), and the liquid fuels, gasoline and diesel. The assessment methodology describes and develops the relative hazards of these fuels from an integrated generic physicochemical property and accident scenario point of view. A technique involving a method of eliciting expert judgment combined with a comparative scoring methodology was applied in establishing fuel relative safety rankings. Limitations of this type of assessment are discussed. Selected accident scenarios included fuel leakage in both residential and public garages; fueling line rupture at a refueling station in the presence of user vehicles or delivery vehicles; and vehicle collisions under rural, urban, and vehicular tunnel conditions. Overall, the results obtained demonstrate dependency upon the specific application or scenario. Gaseous fuels have increased relative risks in certain situations and are relatively safe in others. The results suggest that alternative gaseous fuels are not disqualified for public usage. The assessment also provides rationale for the development of selected safe handling criteria and recommendations.
Magill, Stephen T; Wang, Doris D; Rutledge, W Caleb; Lau, Darryl; Berger, Mitchel S; Sankaran, Sujatha; Lau, Catherine Y; Imershein, Sarah G
Patient safety is foundational to neurosurgical care. Postprocedural "debrief" checklists have been proposed to improve patient safety, but data about their use in neurosurgery are limited. Here, we implemented an initiative to routinely perform postoperative debriefs and evaluated the impact of debriefing on operating room (OR) safety culture. A 10-question safety attitude questionnaire (SAQ) was sent to neurosurgical OR staff at a major academic medical center before and 18 months after the implementation of a postoperative debriefing initiative. Rates of debrief compliance and changes in attitudes before and after the survey were evaluated. The survey used a Likert scale and analyzed with standard statistical methods. After the debrief initiative, the rate of debriefing increased from 51% to 86% of cases for the neurosurgery service. Baseline SAQ responses found that neurosurgeons had a more favorable perception of OR safety than did anesthesiologists and nurses. After implementation of the postoperative debriefing process, perceptions of OR safety significantly improved for neurosurgeons, anesthesiologists, and nurses. Furthermore, the disparity between nurses and surgeons was no longer significant. After debrief implementation, neurosurgical OR staff had improved perceptions of patient safety compared with surgical services that did not commonly perform debriefing. Debriefing identified OR efficiency concerns in 26.9% of cases, and prevention of potential adverse events/near misses was reported in 8% of cases. Postoperative debriefing can be effectively introduced into the OR and improves the safety culture after implementation. Debriefing is an effective tool to identify OR inefficiencies and potential adverse events. Copyright © 2017 Elsevier Inc. All rights reserved.
Leone, Rita Marie; Adams, Rachel Joy
The purpose of this article is to review a quality improvement project aimed to examine how nurse leaders in an inpatient rehabilitation (IPR) unit can reduce the number of patient falls by implementing multiple fall prevention interventions and sustain their results by promoting a strong culture of safety on the unit. A retrospective review of IPR fall rates was performed. Quarterly fall rates were then compared with implementation dates of fall prevention interventions (safety huddles, signage, and hourly rounding). Culture of safety scores were also examined to assess the effect of an enhanced culture of safety on the sustainability of lowered fall rates. The largest decrease in fall rate was noted after initial revitalization efforts of the IPR unit's culture of safety concurrently with hourly rounding. Fall rates rise and fall despite multiple fall prevention interventions and encouraging a positive shift in the culture of safety. Physical injuries following a fall can reduce mobility and increase morbidity. Costs associated with falls negatively impact costs and reimbursement. Employing evidence-based fall prevention strategies are then of critical importance to nurse leaders as falls remain an ongoing serious adverse event. © 2015 Association of Rehabilitation Nurses.
Merino-Plaza, María José; Carrera-Hueso, Francisco Javier; Roca-Castelló, María Rosa; Morro-Martín, María Dolores; Martínez-Asensi, Amparo; Fikri-Benbrahim, Narjis
To evaluate the relationship between safety culture and job satisfaction in a medium-stay hospital, showing the relationships between the dimensions that define both constructs and identifying the dimensions with the greatest impact on both variables. Cross-sectional study conducted in 2015, using the Basque Health Service Job Satisfaction Survey and the Spanish version of the «Hospital Survey on Patient Safety» questionnaire (Agency for Healthcare Research and Quality). Result Variables: high job satisfaction and high degree of perceived security (score ≥75th percentile). Predictor variables: socio-demographic characteristics and perception of the evaluated dimensions. The association between variables was quantified by adjusted odds ratio (OR) and the 95% confidence interval. The mean job satisfaction was 7.21 (standard deviation [SD]: 2.01) and the mean of perceived safety was 7.48 (SD=1.98). The 75th percentile of the distribution in both cases was 9. The socio-demographic variables had little significance, while a positive perception of many of the considered dimensions, was associated with high perception of the result variables. In the data analysis were obtained multiple significant correlations and cross-relations between the dimensions that define both constructs, as well as between the degree of satisfaction of the dimensions considered and the outcome variables. The results obtained evidenced the relationship between job satisfaction and safety culture and quantify the association degree between the studied variables. The adjusted OR identifies the variables most strongly associated with the effect and helps to select improvement areas. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.
Full Text Available Background and Objectives: Patient safety is crucial for promotion of healthcare quality and is monitored as an important parameter by all healthcare provider organizations worldwide. Nurses play a major role in maintaining and promoting patient safety due to the nature of their work. The purpose of this study was to compare the effect of patient safety education program on patient safety culture among nurses working in Ilam education-treatment centers. Methods: In this experimental study, 40 nurses were selected from Ilam educational-treatment centers and randomly allocated to two groups of virtual patient safety education and lecture-based education. Hospital Survey on Patient Safety Culture questionnaire was completed by nurses of the two groups before and after patient safety education program. Statistical analysis was performed using Kolmogorov-Smirnov, independent t-, and paired t-tests. The significance level was considered less that 0.05. Results: Patient safety culture was significantly improved in both virtual and lecture groups after educational intervention (p<0.01. In the virtual education group, the mean score of patient safety culture was higher than lecture group, and this difference was significant (p<0.01. Conclusion: The findings of this study indicated that educational programs could be used by administrators of health service providers to improve patient safety culture among nurses. Also, providing patient safety educations as virtual or lecture both will be helpful.
Heritage, Brody; Pollock, Clare; Roberts, Lynne
Organizational culture is a commonly studied area in industrial/organizational psychology due to its important role in workplace behaviour, cognitions, and outcomes. Jung et al.'s  review of the psychometric properties of organizational culture measurement instruments noted many instruments have limited validation data despite frequent use in both theoretical and applied situations. The Organizational Culture Assessment Instrument (OCAI) has had conflicting data regarding its psychometric ...
Moon, Kwangsu; Kim, Sa Kil; Oh, Yeon Ju; Shin, Youmin; Lee, Yong-Hee; Jang, Tong Il [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)
The term of safety competency in nuclear field was presented in the OECD/NEA workshop held in 1999. A model of the safety culture competencies in nuclear power plants was developed by KAERI (Korea Atomic Energy Research Institute). In general, a competency (competence) is defined as 'cluster of employee's attribute, knowledge, skill, ability or other characteristic that contributes to successful job performance'. We also defined safety culture competency as 'cluster of various internal characteristics (e.g., knowledge, skill, ability, motive, attitude and etc.) of employee that contribute to perform job safely and shape a healthy and strong safety culture.' By this definition, the safety culture competency is the broader construct including job competency. An employee having high level of safety culture competency shows extra discretionary effort to improve safety of peer, team and organization in addition to the individual's successful and safe job accomplishment. The behavioral indicators for each of the competencies are focal points of conversations on progress and are monitored continuously by self-assessment and managers or supervisors' intervention. Deficiencies in any of these indicators can point to coaching, training or other learning opportunities that employees may be required in order to improve. The purpose of this study was to derive a model of safety competencies for improving safety culture of NPPs and develop a set of behavioral indicators of each competency. In addition, the method of measuring behavioral indicators was suggested. For the application of developed safety culture competences and behavioral indicators, the most suitable measuring method for behavioral indicators must be developed. In the case of behavioral observations, behavioral dimensions (frequency, persistence and latency), observation possibility, occurrence basis of behavior (daily job performance, situational dependent) are considered to
Collier, Susan L; Fitzpatrick, Joyce J; Siedlecki, Sandra L; Dolansky, Mary A
A descriptive, retrospective design was used to explore the relationship between employee engagement and culture of safety in ICUs within a large Midwestern healthcare system. Results demonstrated a strong positive relationship between total engagement score and total patient safety score (r = 0.645, P engagement score and the 12 safety culture dimensions. These findings have implications for improving managerial strategies relative to employee engagement that may ultimately impact perceptions of a safety culture.
Farahnaz Abdolahzadeh; Vahid Zamanzadeh; Aniroda Boroumand
Introduction: Safety culture is considered as an important factor in improving patient safety. Therefore, identifying individual and organizational factors affecting safety culture is crucial. This study was carried out to determine individual and organizational factors associated with nurses' perception of patient safety culture. Methods: The present descriptive study included 940 nurses working in four training hospitals affiliated with Urmia University of Medical Sciences (Iran). Data was ...
d'Agincourt-Canning, Lori G; Kissoon, Niranjan; Singal, Mona; Pitfield, Alexander F
Communication is a critical component of effective teamwork and both are essential elements in providing high quality of care to patients. Yet, communication is not an innate skill but a process influenced by internal (personal/cultural values) as well as external (professional roles and hierarchies) factors. To provide illustrative cases, themes and tools for improving communication. Literature review and consensus opinion based on extensive experience. Professional autonomy should be de-emphasized. Tools such as SBAR and simulation are important in communication and teamwork. Tools designed to improve communication and safety in the aviation industry may have applicability to the pediatric intensive care unit.
Clark, Lauren; Thornam, Christine
A module to prepare nursing students to conduct cultural assessments of patients covers multicultural health care environments, genogram skills, self-awareness, theoretical lenses, and cross-cultural communication skills. Instructional materials use multimedia CD-ROM and web-based technologies. (Contains 17 references.) (SK)
Elmontsri, Mustafa; Almashrafi, Ahmed; Banarsee, Ricky; Majeed, Azeem
To explore the status of patient safety culture in Arab countries based on the findings of the Hospital Survey on Patient Safety Culture (HSPSC). Systematic review. We performed electronic searches of the MEDLINE, EMBASE, CINAHL, ProQuest and PsychINFO, Google Scholar and PubMed databases, with manual searches of bibliographies of included articles and key journals. We included studies that were conducted in the Arab countries that were focused on patient safety culture. 2 reviewers independently verified that the studies met the inclusion criteria and critically assessed the quality of the studies. 18 studies met our inclusion criteria. The review identified that non-punitive response to error is seen as a serious issue which needs to be improved. Healthcare professionals in the Arab countries tend to think that a 'culture of blame' still exists that prevents them from reporting incidents. We found an overall similarity between the reported composite score for dimension of teamwork within units in all of the reviewed studies. Teamwork within units was found to be better than teamwork across hospital units. All of the reviewed studies reported that organisational learning and continuous improvement was satisfactory as the average score of this dimension for all studies was 73.2%. Moreover, the review found that communication openness seems to be a concerning issue for healthcare professionals in the Arab countries. There is a need to promote patient safety culture as a strategy for improving the patient safety in the Arab world. Improving patient safety culture should include all stakeholders, like policymakers, healthcare providers and those responsible for medical education. This review was limited only to English language publications. The varied settings in which the HSPSC was used may have influenced the areas of strengths and weaknesses as healthcare workers' perception of safety culture may differ. Published by the BMJ Publishing Group Limited. For
Constructivism maintains that instruction is more meaningful when it is relevant, social and interactive. Formative assessment has been empirically demonstrated as being an effective form of instruction and assessment for learners (Black & Wiliam, 1998a, 1998b). Since assessment orients instruction and learning, combining student culture with…
Silvestre-Busto, C; Torijano-Casalengua, M L; Olivera-Cañadas, G; Astier-Peña, M P; Maderuelo-Fernández, J A; Rubio-Aguado, E A
To adapt the Medical Office Survey on Patient Safety Culture (MOSPSC) Excel(®) tool for its use by Primary Care Teams of the Spanish National Public Health System. The process of translation and adaptation of MOSPSC from the Agency for Healthcare and Research in Quality (AHRQ) was performed in five steps: Original version translation, Conceptual equivalence evaluation, Acceptability and viability assessment, Content validity and Questionnaire test and response analysis, and psychometric properties assessment. After confirming MOSPSC as a valid, reliable, consistent and useful tool for assessing patient safety culture in our setting, an Excel(®) worksheet was translated and adapted in the same way. It was decided to develop a tool to analyze the "Spanish survey" and to keep it linked to the "Original version" tool. The "Spanish survey" comparison data are those obtained in a 2011 nationwide Spanish survey, while the "Original version" comparison data are those provided by the AHRQ in 2012. The translated and adapted tool and the analysis of the results from a 2011 nationwide Spanish survey are available on the website of the Ministry of Health, Social Services and Equality. It allows the questions which are decisive in the different dimensions to be determined, and it provides a comparison of the results with graphical representation. Translation and adaptation of this tool enables a patient safety culture in Primary Care in Spain to be more effectively applied. Copyright © 2014 SECA. Published by Elsevier Espana. All rights reserved.
Halligan, Michelle H; Zecevic, Aleksandra; Kothari, Anita R; Salmoni, Alan W; Orchard, Treena
This case study aimed to understand safety culture in a high-risk secured unit for cognitively impaired residents in a long-term care (LTC) facility. Specific objectives included the following: diagnosing the present level of safety culture maturity using the Patient Safety Culture Improvement Tool (PSCIT), examining the barriers to a positive safety culture, and identifying actions for improvement. A mixed methods design was used within a secured unit for cognitively impaired residents in a Canadian nonprofit LTC facility. Semistructured interviews, a focus group, and the Modified Stanford Patient Safety Culture Survey Instrument were used to explore this topic. Data were synthesized to situate safety maturity of the unit within the PSCIT adapted for LTC. Results indicated a reactive culture, where safety systems were piecemeal and developed only in response to adverse events and/or regulatory requirements. A punitive regulatory environment, inadequate resources, heavy workloads, poor interdisciplinary collaboration, and resident safety training capacity were major barriers to improving safety. This study highlights the importance of understanding a unit's safety culture and identifies the PSCIT as a useful framework for planning future improvements to safety culture maturity. Incorporating mixed methods in the study of health care safety culture provided a good model that can be recommended for future use in research and LTC practice.
This paper presents an alternative way to use records from safety investigations as a means to support the evaluation of safety management (SM) aspects. Datasets from safety investigation reports and progress records of an aviation organization were analyzed with the scope of assessing safety
Almén, A; Lundh, C
Quality assurance has been identified as an important part of radiation protection and safety for a considerable time period. A rational expansion and improvement of quality assurance is to integrate radiation protection and safety in a management system. The aim of this study was to explore factors influencing the implementing strategy when introducing a management system including radiation protection and safety in hospitals and to outline benefits of such a system. The main experience from developing a management system is that it is possible to create a vast number of common policies and routines for the whole hospital, resulting in a cost-efficient system. One of the key benefits is the involvement of management at all levels, including the hospital director. Furthermore, a transparent system will involve staff throughout the organisation as well. A management system supports a common view on what should be done, who should do it and how the activities are reviewed. An integrated management system for radiation protection and safety includes key elements supporting a safety culture. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: email@example.com.
Cappelen, Kathrine; Aase, Karina; Storm, Marianne; Hetland, Jørn; Harris, Anette
Developing a culture where staff are actively aware of how to prevent adverse events is a challenge. The use of survey tools to assess the status of patient safety culture seems to be acceptable as an early step in improving patient safety. The Nursing Home Survey on Patient Safety Culture (NHSOPSC) includes 12 dimensions and is specifically developed for nursing homes. In this study, we describe a Norwegian version of the NHSOPSC and assess its psychometric properties when tested on a sample of healthcare staff in nursing homes. The NHSOPSC was translated into Norwegian and pilot tested before being distributed to 12 nursing homes in Norway. Of the 671 healthcare staff invited, 466 (69 %) answered the questionnaire. SPSS 23.0 was used for descriptive data analysis and estimating internal consistency (Cronbach's alpha). The dimensional structure of the questionnaire was tested by confirmatory factor analysis (CFA) using Mplus (version 7.2). The CFA testing of the original 12-factor solution suggested that some modifications were needed because of the high correlations between three of the latent factors. A subsequent analysis resulted in a final ten-factor solution. The final model showed acceptable fit to the data (root mean square error of approximation = 0.060, 90 % confidence interval: 0.057-0.063, comparative fit index = 0.934, Tucker-Lewis index = 0.926, χ (2) = 2058.33, df = 765, p safety in the nursing home. Factor analysis indicated that a modified ten-factor model fitted the data set in a Norwegian community healthcare context with acceptable goodness-of-fit values and could be recommended as a useful tool to assess staff perceptions of patient safety issues in Norwegian nursing homes.
Sambale, Franziska; Lavrentieva, Antonina; Stahl, Frank; Blume, Cornelia; Stiesch, Meike; Kasper, Cornelia; Bahnemann, Detlef; Scheper, Thomas
Nanoparticles are widely employed for many applications and the number of consumer products, incorporating nanotechnology, is constantly increasing. A novel area of nanotechnology is the application in medical implants. The widespread use of nanoparticles leads to their higher prevalence in our environment. This, in turn, raises concerns regarding potential risks to humans. Previous studies have shown possible hazardous effects of some nanoparticles on mammalian cells grown in two-dimensional (2D) cultures. However, 2D in vitro cell cultures display several disadvantages such as changes in cell shape, cell function, cell responses and lack of cell-cell contacts. For this reason, the development of better models for mimicking in vivo conditions is essential. In the present work, we cultivated A549 cells and NIH-3T3 cells in three-dimensional (3D) spheroids and investigated the effects of zinc oxide (ZnO-NP) and titanium dioxide nanoparticles (TiO2-NP). The results were compared to cultivation in 2D monolayer culture. A549 cells in 3D cell culture formed loose aggregates which were more sensitive to the toxicity of ZnO-NP in comparison to cells grown in 2D monolayers. In contrast, NIH-3T3 cells showed a compact 3D spheroid structure and no differences in the sensitivity of the NIH-3T3 cells to ZnO-NP were observed between 2D and 3D cultures. TiO2-NP were non-toxic in 2D cultures but affected cell-cell interaction during 3D spheroid formation of A549 and NIH-3T3 cells. When TiO2-NP were directly added during spheroid formation in the cultures of the two cell lines tested, several smaller spheroids were formed instead of a single spheroid. This effect was not observed if the nanoparticles were added after spheroid formation. In this case, a slight decrease in cell viability was determined only for A549 3D spheroids. The obtained results demonstrate the importance of 3D cell culture studies for nanoparticle safety testing, since some effects cannot be revealed in 2D
Myers, Douglas J; Nyce, James M; Dekker, Sidney W A
The concept of culture is now widely used by those who conduct research on safety and work-related injury outcomes. We argue that as the term has been applied by an increasingly diverse set of disciplines, its scope has broadened beyond how it was defined and intended for use by sociologists and anthropologists. As a result, this more inclusive concept has lost some of its precision and analytic power. We suggest that the utility of this "new" understanding of culture could be improved if researchers more clearly delineated the ideological - the socially constructed abstract systems of meaning, norms, beliefs and values (which we refer to as culture) - from concrete behaviors, social relations and other properties of workplaces (e.g., organizational structures) and of society itself. This may help researchers investigate how culture and social structures can affect safety and injury outcomes with increased analytic rigor. In addition, maintaining an analytical distinction between culture and other social factors can help intervention efforts better understand the target of the intervention and therefore may improve chances of both scientific and instrumental success. Copyright © 2013 Elsevier Ltd. All rights reserved.
dimension of culture of safety among nurse participants (92.7 ± 14.6) followed by working conditions. (82.1 ± 16.6) and safety (75.5 ... management and stress recognition in order to improve safety culture among nurses in Saudi Arabia. Keywords: Nurses ... acknowledgement of how performance is influenced by stressors ...
Verbakel, N.J.; Zwart, D.L.M.; Langelaan, M.; Verheij, T.J.M.; Wagner, C.
Background: Patient safety has been a priority in primary healthcare in the last years. The prevailing culture is seen as an important condition for patient safety in practice and several tools to measure patient safety culture have therefore been developed. Although Dutch primary care consists of
Verbakel, N.J.; Zwart, D.L.M.; Langelaan, M.; Verheij, T.J.M.; Wagner, C.
Background: Patient safety has been a priority in primary healthcare in the last years. The prevailing culture is seen as an important condition for patient safety in practice and several tools to measure patient safety culture have therefore been developed. Although Dutch primary care consists of
van Noord, I.; Wagner, C.; van Dyck, C.; Twisk, J.; de Bruijne, M.C.
Objectives: To describe the patient safety culture of Dutch emergency departments (EDs), to examine associations between safety culture dimensions and patient safety grades as reported by ED staff and to compare these associations between nurses and physicians. Design: Cross-sectional survey
Verbeek-van Noord, I.; Wagner, C.; Dyck, C. van; Twisk, J.W.R.; Bruijne, M.C. de
Objective: To describe the patient safety culture of Dutch emergency departments (EDs), to examine associations between safety culture dimensions and patient safety grades as reported by ED staff and to compare these associations between nurses and physicians. DESIGN: Cross-sectional survey
The purpose of this study was to evaluate if the Surrogate Safety Assessment Model (SSAM) could be used to assess the safety of a highway segment or an intersection in terms of the number and type of conflicts and to compare the safety effects of mul...
Lám, Judit; Merész, Gergő; Bakacsi, Gyula; Belicza, Éva; Surján, Cecília; Takács, Erika
The accreditation system for health care providers was developed in Hungary aiming to increase safety, efficiency, and efficacy of care and optimise its organisational operation. The aim of this study was to assess changes of organisational culture in pilot institutes of the accreditation program. 7 volunteer pilot institutes using an internationally validated questionnaire were included. The impact study was performed in 2 rounds: the first before the introduction of the accreditation program, and the second a year later, when the standards were already known. Data were analysed using descriptive statistics and logistic regression models. Statistically significant (psafety, and patient safety within the unit. Organisational culture in the observed institutes needs improvement, but positive changes already point to a safer care. Orv. Hetil., 2016, 157(42), 1667-1673.
Food safety assessment is an effective means of discovering knowledge and data gaps that limit effective risk analysis and at the same time providing information to develop public policies on food safety management. The study assessed the cassava food safety practices among cassava processors in selected rural ...
Esqué Ruiz, M T; Moretones Suñol, M G; Rodríguez Miguélez, J M; Parés Tercero, S; Cortés Albuixech, R; Varón Ramírez, E M; Figueras Aloy, J
A safety culture is the collective effort of an institution to direct its resources toward the goal of safety. An analysis is performed on the six years of experience of the Committee on the Safety of Neonatal Patient. A mailbox was created for the declaration of adverse events, and measures for their correction were devised, such as case studies, continuous education, prevention of nosocomial infections, as well as information on the work done and its assessment. A total of 1287 reports of adverse events were received during the six years, of which 600 (50.8%) occurred in the neonatal ICU, with 15 (1.2%) contributing to death, and 1282 (99.6%) considered preventable. Simple corrective measures (notification, security alerts, etc.) were applied in 559 (43.4%), intermediate measures (protocols, monthly newsletter, etc.) in 692 (53.8%), and more complex measures (causal analysis, scripts, continuous education seminars, prospective studies, etc.) in 66 (5.1%). As regards nosocomial infections, the prevention strategies implemented (hand washing, insertion and maintenance of catheters) directly affected their improvement. Two surveys were conducted to determine the level of satisfaction with the Committee on the Safety of Neonatal Patient. A rating 7.5/10 was obtained in the local survey, while using the Spanish version of the Hospital Survey on Patient Safety Culture the rate was 7.26/10. A path to a culture of safety has been successfully started and carried out. Reporting the adverse events is the key to obtaining information on their nature, etiology and evolution, and to undertake possible prevention strategies. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.
...; Collection of Safety Culture Data for Program Evaluation AGENCY: Research & Innovative Technology... Culture Data for Program Evaluation. Type of Request: Approval of a new information collection. OMB... separate OMB approval for the collection of the remaining safety culture surveys because of changes to the...
Theobald, A.; Arcella, D.; Carere, A.; Croera, C.; Engel, K.H.; Gott, D.; Gurtler, R.; Meier, D.; Pratt, I.; Rietjens, I.M.C.M.; Simon, R.; Walker, R.
This paper summarises the safety assessments of eleven smoke flavouring primary products evaluated by the European Food Safety Authority (EFSA). Data on chemical composition, content of polyaromatic hydrocarbons and results of genotoxicity tests and subchronic toxicity studies are presented and
Fuller, Matthew B.; Skidmore, Susan T.; Bustamante, Rebecca M.; Holzweiss, Peggy C.
Although touted as beneficial to student learning, cultures of assessment have not been examined adequately using validated instruments. Using data collected from a stratified, random sample (N = 370) of U.S. institutional research and assessment directors, the models tested in this study provide empirical support for the value of using the…
... collective commitment by leaders and individuals to emphasize safety over competing goals to ensure...--Leaders demonstrate a commitment to safety in their decisions and behaviors; (2) Problem Identification... Bureau of Safety and Environmental Enforcement Draft Safety Culture Policy Statement: Request for Public...
Kola M Owonikoko
Full Text Available Background: Culture has been known to influence practices and beliefs of people world over. Several cultural practices have been noted among pregnant women who were passed from one generation to the next with its potential harmful and beneficial effect. The use of safety pin in is one of such cultural practices that are widely practiced by many pregnant Nigerian women. Objective: We sought to gain a deeper understanding of the source of knowledge and motivation behind the use of safety pin on garments during pregnancy as well as explore potential harmful side effects of this cultural practice. Methodology: A total of 419 pregnant women completed questionnaires for a hospital-based cross-sectional study. Safety pin knowledge and motivation for use on garments were assessed using a pre-tested 16 item questionnaire. Consenting women either completed a self-administered structured questionnaire or utilized the help of trained research assistants. Chi-square tests were used to assess relationships between safety pin use on garments and predictor variables. Analysis was done with Statistical Package for Social Sciences version 17. Results: Of 419 participants, over half (n = 227 reported safety pin use on garments in pregnancy. About two-thirds (n = 177 of women who use safety pin reported older female relatives as their source of information. The mean age of the participants was 29.1 ± 5.74 (range 16–45 years. Traditional religion worshippers were more likely (81.2% and Christians were least likely to use safety pin (50.7% during pregnancy. Pregnant women with a tertiary education (50.4% were least likely to use safety pin compared with women with no or less than a tertiary level of education. Protection of pregnancy against demons/witchcrafts was the reason given by 129 (56.8% of participants using safety pin in pregnancy. Conclusion: The use of safety pin on garments during pregnancy is a common cultural practice in southwest Nigeria. Our
This report summarizes the results of a study that assessed and compared six industry and government safety standards relevant to the safety and reliability of automotive electronic control systems. These standards include ISO 26262 (Road Vehicles - ...
Charles, Kathryn; McKee, Lorna; McCann, Sharon
To use organizational change theory to explore the interplay of contextual influences on patient safety. A multi-level comparative case study of eight National Health Service (NHS) acute hospital trusts in England, including 144 depth interviews with senior managers, staff involved with risk analysis and reporting, middle managers, and senior and junior clinicians, supplemented with documentary data and observation of nine meetings. Organizational change theory was used to identify content, contextual and process influences on patient safety. Organizational stability and staff engagement appeared to influence patient safety and specific contextual factors appeared to influence both organizational stability and staff engagement, both of which were important for patient safety. These contextual factors comprised: environmental shocks; cultural characteristics; processes and structures supportive of patient safety; and trust leadership style. A model is suggested that analyses the trusts in terms of these factors and then groups them into four trust types. The study highlights the massive and unpredictable impact of both internal and external environmental shocks and how they destabilize trusts distracting attention from patient safety. It also underlines the importance of regular self-assessment of internal and external risks and awareness of context.
Banaszak-Holl, Jane; Reichert, Heidi; Todd Greene, M; Mody, Lona; Wald, Heidi L; Crnich, Christopher; McNamara, Sara E; Meddings, Jennifer
assess barriers, facilitators, and changes in safety culture. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.
Ginsburg, Liane; Norton, Peter G; Casebeer, Ann; Lewis, Steven
Objective To design a training intervention and then test its effect on nurse leaders' perceptions of patient safety culture. Study Setting Three hundred and fifty-six nurses in clinical leadership roles (nurse managers and educators/CNSs) in two Canadian multi-site teaching hospitals (study and control). Study Design A prospective evaluation of a patient safety training intervention using a quasi-experimental untreated control group design with pretest and posttest. Nurses in clinical leadership roles in the study group were invited to participate in two patient safety workshops over a 6-month period. Individuals in the study and control groups completed surveys measuring patient safety culture and leadership for improvement prior to training and 4 months following the second workshop. Extraction Methods Individual nurse clinical leaders were the unit of analysis. Exploratory factor analysis of the safety culture items was conducted; repeated-measures analysis of variance and paired t-tests were used to evaluate the effect of the training intervention on perceived safety culture (three factors). Hierarchical regression analyses looked at the influence of demographics, leadership for improvement, and the training intervention on nurse leaders' perceptions of safety culture. Principal Findings A statistically significant improvement in one of three safety culture measures was shown for the study group (pLeadership support for improvement was found to explain significant amounts of variance in all three patient safety culture measures; workshop attendance explained significant amounts of variance in one of the three safety culture measures. The total R2 for the three full hierarchical regression models ranged from 0.338 and 0.554. Conclusions Sensitively delivered training initiatives for nurse leaders can help to foster a safety culture. Organizational leadership support for improvement is, however, also critical for fostering a culture of safety. Together, training
Heritage, Brody; Pollock, Clare; Roberts, Lynne
Organizational culture is a commonly studied area in industrial/organizational psychology due to its important role in workplace behaviour, cognitions, and outcomes. Jung et al.'s  review of the psychometric properties of organizational culture measurement instruments noted many instruments have limited validation data despite frequent use in both theoretical and applied situations. The Organizational Culture Assessment Instrument (OCAI) has had conflicting data regarding its psychometric properties, particularly regarding its factor structure. Our study examined the factor structure and criterion validity of the OCAI using robust analysis methods on data gathered from 328 (females = 226, males = 102) Australian employees. Confirmatory factor analysis supported a four factor structure of the OCAI for both ideal and current organizational culture perspectives. Current organizational culture data demonstrated expected reciprocally-opposed relationships between three of the four OCAI factors and the outcome variable of job satisfaction but ideal culture data did not, thus indicating possible weak criterion validity when the OCAI is used to assess ideal culture. Based on the mixed evidence regarding the measure's properties, further examination of the factor structure and broad validity of the measure is encouraged. PMID:24667839
Heritage, Brody; Pollock, Clare; Roberts, Lynne
Organizational culture is a commonly studied area in industrial/organizational psychology due to its important role in workplace behaviour, cognitions, and outcomes. Jung et al.'s  review of the psychometric properties of organizational culture measurement instruments noted many instruments have limited validation data despite frequent use in both theoretical and applied situations. The Organizational Culture Assessment Instrument (OCAI) has had conflicting data regarding its psychometric properties, particularly regarding its factor structure. Our study examined the factor structure and criterion validity of the OCAI using robust analysis methods on data gathered from 328 (females = 226, males = 102) Australian employees. Confirmatory factor analysis supported a four factor structure of the OCAI for both ideal and current organizational culture perspectives. Current organizational culture data demonstrated expected reciprocally-opposed relationships between three of the four OCAI factors and the outcome variable of job satisfaction but ideal culture data did not, thus indicating possible weak criterion validity when the OCAI is used to assess ideal culture. Based on the mixed evidence regarding the measure's properties, further examination of the factor structure and broad validity of the measure is encouraged.
Full Text Available Organizational culture is a commonly studied area in industrial/organizational psychology due to its important role in workplace behaviour, cognitions, and outcomes. Jung et al.'s  review of the psychometric properties of organizational culture measurement instruments noted many instruments have limited validation data despite frequent use in both theoretical and applied situations. The Organizational Culture Assessment Instrument (OCAI has had conflicting data regarding its psychometric properties, particularly regarding its factor structure. Our study examined the factor structure and criterion validity of the OCAI using robust analysis methods on data gathered from 328 (females = 226, males = 102 Australian employees. Confirmatory factor analysis supported a four factor structure of the OCAI for both ideal and current organizational culture perspectives. Current organizational culture data demonstrated expected reciprocally-opposed relationships between three of the four OCAI factors and the outcome variable of job satisfaction but ideal culture data did not, thus indicating possible weak criterion validity when the OCAI is used to assess ideal culture. Based on the mixed evidence regarding the measure's properties, further examination of the factor structure and broad validity of the measure is encouraged.
Conclusion: According to the results, adherence to the dimensions of the patient safety culture was poor in the studied hospitals. Therefore, the patient safety culture requires special attention by providing proper facilities, adequate staff, developing checklists for handoffs and transitions, and surveillance and continuous monitoring by healthcare centers. Furthermore, a system-based approach should be implemented to deal with errors, while a persuasive reporting approach is needed to promote the patient safety culture in the NICUs of these hospitals.
Yoon, Myunghyun; Choi, Young Sung; Yi, Kyungjoo [Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of)
Fukushima accident revealed not only licensees but also regulatory bodies' (RBs) establishment of robust safety culture (SC) is crucial to implement effective safety regulation. Result of the IAEA IRRS held in 2011 required regulatory body in Korea to make improvement measure for the enhancement of safety culture of regulatory body (SCRB). Compared to works done to assess SC focused on working organizations of nuclear industry, not enough attention has been paid to assess the RBs. To achieve this goal, long-term comprehensive drive plan has to be made. The IAEA is putting great effort to establish and enhance SC in RBs. OECD/NEA CNRA is planning to produce Green Booklet on SCRB for regulatory guidance. SCRB is an organization's culture, RBs ultimately has to possess in order to assure secure use of nuclear energy. An organization's culture emerges from, and is manifested in, the interplay of its members' emotion, cognition, attitudes, behaviors and interaction patterns. As a result of this mechanism, organizational structures and culture influence individual's attitude and behavior when entered into a situation. Each organization has its strengths and weakness in SC. Safety culture defective components of the Fukushima accident was analyzed by JNES in 2012. According to the casual factors indicated in the investigation report, Nuclear Regulatory Organizations (NROs) of Korea also had weakness of the SCRB in terms of questioning attitude, continuous learning, issue identification and resolution and safety leadership. It doesn't have to be same but necessary for both NSSC and KINS to be consistent in building SC traits to carry out a coherent policy with synergy effect. NROs should communicated and convey consistent message to the stakeholders. Not limited to development of SCRB itself, influence of SCRB on licensee's SC is recommended for further study. Also, what behaviors are expected to make positive effects and whether they can
Full Text Available Background & Aims of the Study: The purpose of the hospital accreditation program is to improve the patients' safety. Prevention of mistakes in medical procedures, patients' safety risk identification and infection prevention besides the patients' safety culture (PSC are the key factors that must be considered in a successful patients' safety program.This study aimed to assess PSC and its association with demographic factors among nurses of a hospital in Qom, Iran. Materials & Methods: This research as a descriptive-analytical andcross-sectional study on the effect of individual and organizational variables on patients' safety culture among nurses was conducted in 2015. The final sample included 106 employees from one of the hospitals located in Qom province of Iran. The questionnaires consisted demographic questions and a valid questionnaire about patients' safety culture. T-test, ANOVA and Pearson correlation were conducted to analyze the data by SPSS V20. Results:The age of nurses was 35.15±10.33 (Mean±SD years. Results showed that the patients' safety climate scoreamongnurseswas 70.15±7.23. In addition, there are significant differences between groups of work shift and also education levels in the viewpoints of patients' safety (p0.05. Conclusions: Although, based on our finding,considered hospital had a suitable situation of patients' safety culture, but it is important to pay attention to continuous improvement in the scope of health care workers and patient safety to achieve criticalmission and visions of organizing. Job selection on the basis of demographic considerations and implementation of an accreditation plan for health care systems are two examples of how occupational safety and health tools can be used to provide quality improvement information for health care organizations such as hospitals.
Saleh, Ali M; Darawad, Muhammad W; Al-Hussami, Mahmoud
The objectives of this study were to examine nurses' perceptions of the hospital safety culture in Jordan and to identify the relationships between aspects of hospital safety culture and selected safety outcomes. Data from 242 registered nurses in five Jordanian hospitals were analyzed. Aspects of hospital safety culture and outcomes were measured using the Hospital Survey on Patient Safety Culture. Among various aspects of hospital safety culture, teamwork within units had the highest average percentage of positive responses (49.8%). Additionally, participants reported deficits in other aspects of safety culture, particularly in staffing and nonpunitive response to errors, with average percentages of positive responses of 30.4% and 30.7%, respectively. Pearson correlation analysis revealed that 9 of 10 subscales of hospital safety culture were significantly correlated to one or more of the hospital safety outcomes. The findings of this study can help policymakers and healthcare administrators identify the weaknesses and strengths of hospital safety issues in order to propose effective strategies to improve patient safety and quality of care. © 2015 Wiley Publishing Asia Pty Ltd.
Bernard, Laurence; Biron, Alain; Lavigne, Geneviève; Frechette, Julie; Bernard, Agnès; Mitchell, Jonathan; Lavoie-Tremblay, Mélanie
The objectives of the study were to: (1) examine the relationships between three different qualitative perceptions of safety culture and the Canadian Patient Safety Climate Survey factors; (2) determine whether these perceptions are associated with different hand hygiene practices. Healthcare-associated infections and safety cultures are a worldwide issue. During the A/H1N1 Influenza pandemic, Europe and North America did not have the same responses. Importantly, healthcare professionals' perceptions can influence patient safety through infection prevention practices like hand hygiene. A cross-sectional design was used with data collected in 2015. The Canadian Patient Safety Culture Survey and hand hygiene observations were gathered from three healthcare centres (two Canadian and one European). Descriptive analyses and ANOVAs were conducted to explore healthcare professionals' safety perceptions and practices. The rates of hand hygiene practices varied widely between the three sites, ranging from 35-77%. One site (Site 3) was found to have the highest scores of management follow-up, feedback about incidents, supervisory leadership for safety, unit learning culture and senior leadership support for safety, and the highest levels of overall patient safety grades for the unit and organization. The quantitative results of this study support the previously described model based on qualitative results: individual culture, blaming culture and collaborative culture. Differences between continents emerged regarding infection prevention practices and the way we qualify infections. The results raise concerns about infection practices and about safety cultures and challenges worldwide. © 2017 John Wiley & Sons Ltd.
This Safety Assessment is based on information derived from the Conceptual Design Report for the Environmental Restoration Disposal Facility (DOE/RL 1994) and ancillary documentation developed during the conceptual design phase of Project W-296. The Safety Assessment has been prepared to support the Solid Waste Burial Ground Interim Safety Basis document. The purpose of the Safety Assessment is to provide an evaluation of the design to determine if the process, as proposed, will comply with US Department of Energy (DOE) Limits for radioactive and hazardous material exposures and be acceptable from an overall health and safety standpoint. The evaluation considered affects on the worker, onsite personnel, the public, and the environment.
Rogers, David G.
Would you like to lead a world renowned team that draws out all the talents and expertise of its members and consistently out performs all others in the industry? Ever wonder why so many organizations fail to truly learn from past mistakes only to repeat the same ones at a later date? Are you a program/project manager or team member in a high-risk organization where the decisions made often carry the highest of consequences? Leadership, communication, team building, critical decision-making and continuous team improvement skills and behaviors are mere talking points without the attitudes, commitment and strategies necessary to make them the very fabric of a team. Developing Expert Teams with a Strong Safety Culture, will provide you with proven knowledge and strategies to take your team soaring to heights you may have not thought possible. A myriad of teams have applied these strategies and techniques within their organization team environments: military and commercial aviation, astronaut flight crews, Shuttle flight controllers, members of the Space Shuttle Program Mission Management Team, air traffic controllers, nuclear power control teams, surgical teams, and the fire service report having spectacular success. Many industry leaders are beginning to realize that although the circumstances and environments of these teams may differ greatly to their own, the core elements, governing principles and dynamics involved in managing and building a stellar safety conscious team remain identical.
Full Text Available Although the error in health care has received attention recently, patient safety culture in health centers has been relatively neglected. To measure the patient safety culture in primary health centers. A cross-sectional study, utilizing the modified version of the Hospital Survey on Patient Safety Culture (HSOPSC developed by the Agency for Healthcare Research and Quality (AHRQ and a demographic questionnaire. Healthcare staffs from health centers were participated in the survey. The patient safety culture score including subscores on 11 dimensions and 39 items; patient safety grade and number of events reported. The overall positive response rate of patient safety culture was 57 ±16.8 (CI 9555%-59%. The dimensions that received higher positive response rate were "Teamwork across units of health center", "Teamwork within units", "Head of center support for patient safety". The lowest percentage of positive responses was "Non punitive response to error". There were no relationship between working years and patients safely culture score. Similarly, no relationship was found between professional, gender and total patients safely culture score. Statistical analysis showed discrepancies between Iranian health centers and the US hospitals in three dimensions. For improving patient safety culture in health centers, it is necessary to have enough staff and establish an environment to be open and fair with staff which helps report errors spontaneously and without any fear. The findings of this study could be used to measure changes in patient safety culture over the time.
Tabrizchi, Narges; Sedaghat, Mojtaba
Although the error in health care has received attention recently, patient safety culture in health centers has been relatively neglected. To measure the patient safety culture in primary health centers. A cross-sectional study, utilizing the modified version of the Hospital Survey on Patient Safety Culture (HSOPSC) developed by the Agency for Healthcare Research and Quality (AHRQ) and a demographic questionnaire. Healthcare staffs from health centers were participated in the survey. The patient safety culture score including subscores on 11 dimensions and 39 items; patient safety grade and number of events reported. The overall positive response rate of patient safety culture was 57 ± 16.8 (CI (95)55%-59%). The dimensions that received higher positive response rate were "Teamwork across units of health center", "Teamwork within units", "Head of center support for patient safety". The lowest percentage of positive responses was "Non punitive response to error". There were no relationship between working years and patients safely culture score. Similarly, no relationship was found between professional, gender and total patients safely culture score. Statistical analysis showed discrepancies between Iranian health centers and the US hospitals in three dimensions. For improving patient safety culture in health centers, it is necessary to have enough staff and establish an environment to be open and fair with staff which helps report errors spontaneously and without any fear. The findings of this study could be used to measure changes in patient safety culture over the time.
Sacks, Greg D; Shannon, Evan M; Dawes, Aaron J; Rollo, Johnathon C; Nguyen, David K; Russell, Marcia M; Ko, Clifford Y; Maggard-Gibbons, Melinda A
To define the target domains of culture-improvement interventions, to assess the impact of these interventions on surgical culture and to determine whether culture improvements lead to better patient outcomes and improved healthcare efficiency. Healthcare systems are investing considerable resources in improving workplace culture. It remains unclear whether these interventions, when aimed at surgical care, are successful and whether they are associated with changes in patient outcomes. PubMed, Cochrane, Web of Science and Scopus databases were searched from January 1980 to January 2015. We included studies on interventions that aimed to improve surgical culture, defined as the interpersonal, social and organisational factors that affect the healthcare environment and patient care. The quality of studies was assessed using an adapted tool to focus the review on higher-quality studies. Due to study heterogeneity, findings were narratively reviewed. The 47 studies meeting inclusion criteria (4 randomised trials and 10 moderate-quality observational studies) reported on interventions that targeted three domains of culture: teamwork (n=28), communication (n=26) and safety climate (n=19); several targeted more than one domain. All moderate-quality studies showed improvements in at least one of these domains. Two studies also demonstrated improvements in patient outcomes, such as reduced postoperative complications and even reduced postoperative mortality (absolute risk reduction 1.7%). Two studies reported improvements in healthcare efficiency, including fewer operating room delays. These findings were supported by similar results from low-quality studies. The literature provides promising evidence for various strategies to improve surgical culture, although these approaches differ in terms of the interventions employed as well as the techniques used to measure culture. Nevertheless, culture improvement appears to be associated with other positive effects, including
Latief, Yusuf; Machfudiyanto, Rossy A.; Arifuddin, Rosmariani; Yogiswara, Yoko
Based on the data, 32% of accidental cases in Indonesia occurs on constructional sectors. It is supported by the data from Public Work and Housing Department that 27.43% of the implementation level of Safety Management System policy at construction companies in Indonesia remains unsafe categories. Moreover, there are dimensions of occupational safety culture formed including leadership, behavior, strategy, policy, process, people, safety cost, value and contract system. The aim of this study is to determine the model of an effective safety culture and know the relationship between dimensions in construction industry. The method used in this research was questionnaire survey which was distributed to the sample of construction companies either in a national private one in Indonesia. The result of this research is supposed to be able to illustrate the development of the relationship among occupational safety culture dimensions which have influences to the performances of constructional companies in Indonesia.
Vinodkumar, M N; Bhasi, M
Safety management practices not only improve working conditions but also positively influence employees' attitudes and behaviours with regard to safety, thereby reducing accidents in workplace. This study measured employees' perceptions on six safety management practices and self-reported safety knowledge, safety motivation, safety compliance and safety participation by conducting a survey using questionnaire among 1566 employees belonging to eight major accident hazard process industrial units in Kerala, a state in southern part of India. The reliability and unidimesionality of all the scales were found acceptable. Path analysis using AMOS-4 software showed that some of the safety management practices have direct and indirect relations with the safety performance components, namely, safety compliance and safety participation. Safety knowledge and safety motivation were found to be the key mediators in explaining these relationships. Safety training was identified as the most important safety management practice that predicts safety knowledge, safety motivation, safety compliance and safety participation. These findings provide valuable guidance for researchers and practitioners for identifying the mechanisms by which they can improve safety of workplace. 2010 Elsevier Ltd. All rights reserved.
Cooke, Simon; Tyler, John P. P.; Driscoll, Geoff
Purpose: To assess the ability of various facets of embryo culture (microscope stage warmers, volumes of culture media, culture vessel lids, and type of culture incubator) to maintain a constant temperature in vitro.
Yoo, Moon Sook; Kim, Kyoung Ja
The aim of this study was to explore the influence of nurse work environments and patient safety culture on attitudes toward incident reporting. Patient safety culture had been known as a factor of incident reporting by nurses. Positive work environment could be an important influencing factor for the safety behavior of nurses. A cross-sectional survey design was used. The structured questionnaire was administered to 191 nurses working at a tertiary university hospital in South Korea. Nurses' perception of work environment and patient safety culture were positively correlated with attitudes toward incident reporting. A regression model with clinical career, work area and nurse work environment, and patient safety culture against attitudes toward incident reporting was statistically significant. The model explained approximately 50.7% of attitudes toward incident reporting. Improving nurses' attitudes toward incident reporting can be achieved with a broad approach that includes improvements in work environment and patient safety culture.
Skagius, Kristina (ed.) (Kemakta Konsult AB, Stockholm (Sweden))
This report documents geosphere processes identified as relevant to the long-term safety of a KBS-3 repository, and forms an important part of the reporting of the safety assessment SR-Site. The detailed assessment methodology, including the role of the process reports in the assessment, is described in the SR-Site Main report /SKB 2011/
PhD thesis in Risk management and societal safety This thesis is based on the following papers: (only paper 3 is not in open access but it is available on Science direct Elsevier) PAPER 1 : Olsen, E. (2008). Reliability and Validity of the Hospital Survey on Patient Safety Culture at a Norwegian Hospital. In J. Øvretveit and P. J. Sousa (Eds.), Quality and Safety Improvement Research: Methods and Research Practice from the International Quality Improvement Research Netwo...
Maqueda Palau, M; Pérez Juan, E
To determine the level of risk in the preparation and administration of antibiotics frequently used in the Intensive Care Unit using a risk matrix. A study was conducted using situation analysis and literature review of databases, protocols and good practice guidelines on intravenous therapy, drugs, and their administration routes. The most used antibiotics in the ICU registered in the ENVIN-HELICS program from 1 April to 30 June 2015 were selected. In this period, 257 patients received antimicrobial treatment and 26 antibiotics were evaluated. Variables studied: A risk assessment of each antibiotic using the scale Risk Assessment Tool, of the National Patient Safety Agency, as well as pH, osmolarity, type of catheter recommended for administration, and compatibility and incompatibility with other antibiotics studied. Almost two-thirds (65.3%) of antibiotics had more than 3 risk factors (represented by a yellow stripe), with the remaining 34.7% of antibiotics having between 0 and 2 risk factors (represented by a green stripe). There were no antibiotics with 6 or more risk factors (represented by a red stripe). Most drugs needed reconstitution, additional dilution, and the use of part of the vial to administer the prescribed dose. More than half of the antibiotics studied had a moderate risk level; thus measures should be adopted in order to reduce it. The risk matrix is a useful tool for the assessment and detection of weaknesses associated with the preparation and administration of intravenous antibiotics. Copyright © 2016 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.
González-Formoso, Clara; Martín-Miguel, María Victoria; Fernández-Domínguez, Ma José; Rial, Antonio; Lago-Deibe, Fernando Isidro; Ramil-Hermida, Luis; Pérez-García, Margarita; Clavería, Ana
Patient safety is a leading item on the policy agenda of both major international health organizations and advanced countries generally. The quantitative description of the phenomena has given rise to intense concern with the issue in institutions and organizations, leading to a number of initiatives and research projects and the promotion of patient safety culture, with training becoming a priority both in Spain and internationally. To date, most studies have been conducted in a hospital setting, even though primary care is the type most commonly used by the public, in our experience. Our study aims to achieve the following:--Assess the registry of adverse events as an education tool to improve patient safety culture in the Family and Community Teaching Units of Galicia.--Find and analyze educational tools to improve patient safety culture in primary care.--Evaluate the applicability of the Hospital Survey on Patient Safety Culture by the Agency for Healthcare Research and Quality, Spanish version, in the context of primary health care. Experimental unifactorial study of two groups, control and intervention. Tutors and residents in Family and Community Medicine in last year of studies in Galicia, Spain. From the population universe through voluntary participation. Twenty-seven tutor-resident units in each group required, randomly assigned. Residents and their respective tutor (tutor-resident pair) in teaching units on Family and Community Medicine from throughout Galicia will be invited to participate. Tutor-resident pair that agrees to participate will be sent the Hospital Survey on Patient Safety Culture. Then, tutor-resident pair will be assigned to each group--either intervention or control--through simple random sampling. The intervention group will receive specific training to record the adverse effects found in patients under their care, with subsequent feedback, after receiving instruction on the process. No action will be taken in the control group. After
Rao, Suman [Risk Analyst (India)]. E-mail: firstname.lastname@example.org
One of the biggest challenges for organizations in today's competitive business environment is to create and preserve a self-sustaining safety culture. Typically, Key drivers of safety culture in many organizations are regulation, audits, safety training, various types of employee exhortations to comply with safety norms, etc. However, less evident factors like networking relationships and social trust amongst employees, as also extended networking relationships and social trust of organizations with external stakeholders like government, suppliers, regulators, etc., which constitute the safety social capital in the Organization-seem to also influence the sustenance of organizational safety culture. Can erosion in safety social capital cause deterioration in safety culture and contribute to accidents? If so, how does it contribute? As existing accident analysis models do not provide answers to these questions, CAMSoC (Curtailing Accidents by Managing Social Capital), an accident analysis model, is proposed. As an illustration, five accidents: Bhopal (India), Hyatt Regency (USA), Tenerife (Canary Islands), Westray (Canada) and Exxon Valdez (USA) have been analyzed using CAMSoC. This limited cross-industry analysis provides two key socio-management insights: the biggest source of motivation that causes deviant behavior leading to accidents is 'Faulty Value Systems'. The second biggest source is 'Enforceable Trust'. From a management control perspective, deterioration in safety culture and resultant accidents is more due to the 'action controls' rather than explicit 'cultural controls'. Future research directions to enhance the model's utility through layering are addressed briefly.
Natasha Dejigov Monteiro da Silva
Full Text Available Abstract OBJECTIVE To identify the perceptions of leaderships toward patient safety culture dimensions in the routine of hospitals with different administrative profiles: government, social and private organizations, and make correlations among participating institutions regarding dimensions of patient safety culture used. METHOD A quantitative cross-sectional study that used the Self Assessment Questionnaire 30 translated into Portuguese. The data were processed by analysis of variance (ANOVA in addition to descriptive statistics, with statistical significance set at p-value ≤ 0.05. RESULTS According to the participants' perceptions, the significant dimensions of patient safety culture were 'patient safety climate' and 'organizational learning', with 81% explanatory power. Mean scores showed that among private organizations, higher values were attributed to statements; however, the correlation between dimensions was stronger among government hospitals. CONCLUSION Different hospital organizations present distinct values for each dimension of patient safety culture and their investigation enables professionals to identify which dimensions need to be introduced or improved to increase patient safety.
Oswal, V. H.
Risk management of lasers can be broadly define das a process of identification of the risk, assessment of the risk and steps taken to avert the risk. The risk management may be divided into: Risk inherent to the technology and risk in clinical use. Within the National Health Service in the UK, a useful document, which provides hospital laser users with advice on safety, is the 'Guidance on the Safe Use of Lasers in Medical and Dental Practice' issued by the Medical Devices Agency for the Department of Health in the UK. It recommends the appointment of a Laser Protection Adviser (LPA) who is knowledgeable in the evaluation of laser hazards. One of the duties LPA is to ensure that Local Rules are drawn up for each specific application of a laser. A Laser Protection Supervisor (LPS) should also be appointed with responsibility to ensure that the Local Rules are observed. It is a sensible precaution that laser users should be those approved by the Laser Protection Supervisor in consultation with the Laser Protection Advisor. All laser users should sign a statement that they have read and understood the Local Rules.
Potential enviornmental, health, and safety (E,H and S) concerns associated with all phases of the photovoltaic (PV) energy system life cycle are identified and assessed. E,H and S concerns affecting the achievement of National PV Program goals or the viability of specific PV technologies are emphasized. The report is limited to near-term manufacturing process alternatives for crystalline silicon PV materials, addresses flat-plate and concentrator collector designs, and reviews system deployment in grid-connected, roof-mounted, residential and ground-mounted central-station applications. The PV life-cycle phases examined include silicon refinement and manufacture of PV collectors, system deployment, and decommissioning. The primary E,H and S concerns that arise during collector fabrication are associated with occupational exposure to materials of undetermined toxicity or to materials that are known to be hazardous, but for which process control technology may be inadequate. Stricter exposure standards are anticipated for some materials and may indicate a need for further control technology development. Minimizing electric shock hazards is a significant concern during system construction, operation and maintenance, and decommissioning.
Kuosmanen, Anssi; Tiihonen, Jari; Repo-Tiihonen, Eila; Eronen, Markku; Turunen, Hannele
Safety culture refers to the way patient safety is regarded and implemented within an organization and the structures and procedures in place to support this. The aim of this study was to evaluate patient safety culture, identify areas for improvement, and establish a baseline for improving state hospitals in Finland. Cross-sectional design data were collected from two state-run forensic hospitals in Finland using an anonymous, Web-based survey targeted to hospital staff based on the Hospital Survey on Patient Safety Culture questionnaire. The response rate was 43% (n = 283). The overall patient safety level was rated as excellent or very good by 58% of respondents. The highest positive grade was for "teamwork within units" (72%). The lowest rating was for "nonpunitive response to errors" (26% positive). Good opportunities for supplementary education had a statistically significant (p ≤ 0.05) effect on 9 of 12 Hospital Survey on Patient Safety Culture dimensions. Statistically significant (p ≤ 0.05) differences in patient safety culture were also found in the staff's educational background, manager status, and between the two hospitals. These findings suggest there are a number of patient safety problems related to cultural dimensions. Supplementary education was shown to be a highly significant factor in transforming patient safety culture and should therefore be taken into account alongside sufficient resources.
Vifladt, Anne; Simonsen, Bjoerg O; Lydersen, Stian; Farup, Per G
Compare changes in registered nurses' perception of the patient safety culture in restructured and not restructured intensive care units during a four-year period. Two cross-sectional surveys were performed, in 2008/2009 (time 1) and 2012/2013 (time 2). During a period of 0-3 years after time 1, three of six hospitals merged their general and medical intensive care units (restructured). The other hospitals maintained their structure of the intensive care units (not restructured). Intensive care units in hospitals at one Norwegian hospital trust. The safety culture was measured with Hospital Survey on Patient Safety Culture. At times 1 and 2, 217/302 (72%) and 145/289 (50%) registered nurses participated. Restructuring was negatively associated with change in the safety culture, in particular, the dimensions of the safety culture within the unit level. The dimensions most vulnerable for restructuring were manager expectations and actions promoting safety, teamwork within hospital units and staffing. In this study, the restructuring of intensive care units was associated with a negative impact on the safety culture. When restructuring, the management should be particularly aware of changes in the safety culture dimensions manager expectations and actions promoting safety, teamwork within hospital units and staffing. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.
Thorp, Jonathon; Baqai, Waheed; Witters, Dan; Harter, Jim; Agrawal, Sangeeta; Kanitkar, Kirti; Pappas, James
Demonstrate the relationship between employee engagement and workplace safety for predicting patient safety culture. Patient safety is an issue for the U.S. health-care system, and health care has some of the highest rates of nonfatal workplace injuries. Understanding the types of injuries sustained by health-care employees, the type of safety environment employees of health-care organizations work in, and how employee engagement affects patient safety is vital to improving the safety of both employees and patients. The Gallup Q survey and an approved, abbreviated, and validated subset of questions from the Hospital Survey on Patient Safety Culture were administered to staff at a large tertiary academic medical center in 2007 and 2009. After controlling for demographic variables, researchers conducted a longitudinal, hierarchical linear regression analysis to study the unique contributions of employee engagement, changes in employee engagement, and employee safety in predicting patient safety culture. Teams with higher baseline engagement, more positive change in engagement, fewer workers' compensation claims, and fewer part-time associates in previous years had stronger patient safety cultures in 2009. Baseline engagement and change in engagement were the strongest independent predictors of patient safety culture in 2009. Engagement and compensation claims were additive and complimentary predictors, independent of other variables in the analysis, including the demographic composition of the workgroups in the study. A synergistic effect exists between employee engagement and decreased levels of workers' compensation claims for improving patient safety culture. Organizations can improve engagement and implement safety policies, procedures, and devices for employees with an ultimate effect of improving patient safety culture.
An Organizational Cultural Assessment (OCA) was performed at the Idaho National Engineering Laboratory (INEL) by administering an Organizational Culture Survey (OCS) that queried employees on the subjects of organizational culture, various aspects of communications, employee commitment, work group cohesion, coordination of work, environmental concerns, hazardous nature of work, safety and overall job satisfaction. Many of these subjects are assessed in the OCS through highly developed and validated scales that have been administered in many different types of organizations. The purpose of the OCS is to measure in a quantitative and objective way the notion of culture;'' that is, the values, attitudes, and beliefs of the individuals working within the organization. In addition, through the OCS, a broad sample of individuals can be reached that would probably not be interviewed or observed during the course of a typical assessment. The OCS also provides a descriptive profile of the organization at one point in time that can then be compared to a profile taken at a different point in time to assess changes in the culture of the organization. The OCS administration at the INEL was the sixth to occur at a Department of Energy (DOE) facility. The INEL Organization is somewhat different from other DOE facilities are which the OCS was administered, due to the presence of six different major operating contractors. The seven organizations assessed at the INEL are: (1) Argonne National Laboratory -- West; (2) DOE Fire Department/Radiological and Environmental Sciences Laboratory; (3) EG G Idaho Incorporated; (4) MK Ferguson; (5) Protection Technology Incorporated; (6) Rockwell; and (7) Westinghouse Idaho Nuclear Company Incorporated. All data from the OCS is presented in group summaries by organization, Supervisory Level, Staff Classification, and department within organization. Statistically significant differences between groups are identified and discussed.
Full Text Available Patient safety culture is a concept which describes how leader and staff interaction, attitudes, routines and practices protect patients from adverse events in healthcare. We aimed to investigate patient safety culture in Slovenian out-of-hours health care (OOHC clinics, and determine the possible factors that might be associated with it.
Kingma, S.F.; Atak, A.
This article deals with a case study about the safety culture of an aircraft maintenance organisation. The case study provides ethnographic accounts based on participant observation, interviews and document analysis. Safety culture is specifically related to the development and growth phase of the
DiCuccio, Margaret Hardt
In the past 13 years since the Institute of Medicine report, To Err is Human, was published, considerable attention was placed on the relationship between patient safety culture and patient outcomes. Research to understand this relationship has been conducted; however, now, it is important to systematically review these studies to determine if there are tools, levels of measure and outcomes that have been shown to result in significant correlations. The purpose of this review is to evaluate the state of research connecting patient safety culture and patient outcomes to determine nurse-sensitive patient outcomes that have been significantly correlated to culture of safety and commonly used tools to measure culture of safety in the studies with significant correlations. Published English only research articles were considered for the review. Only studies that directly measured patient outcomes in relationship to patient safety culture in hospitals involving registered nurses as a participant were included. Evidence of relationships between patient safety culture and patient outcomes exist at the hospital and nursing unit level of analysis; however, the number of studies finding statistically significant correlations particularly using nurse-sensitive outcomes is limited. The findings from this review suggest that there are emerging trends indicating that the specific patient safety culture measurement tools, the level of analysis, and selection of outcome measures are important considerations in study design. More research is needed to determine interventions that improve patient safety culture and outcomes.
..., Human Resources (HR) for URS was interested only in implementing management's demand that the employee... contractor management to implement their roles as advocates for a strong safety culture. The record shows... decision to allow management to be involved in the HSS investigation raises concerns about safety culture...
Marsteller, Jill A; Wen, Mei; Hsu, Yea-Jen; Bauer, Laura C; Schwann, Nanette M; Young, Christopher J; Sanchez, Juan A; Errett, Nicole A; Gurses, Ayse P; Thompson, David A; Wahr, Joyce A; Martinez, Elizabeth A
Little is known about safety culture in the area of cardiac surgery as compared with other types of surgery. The unique features of cardiac surgical teams may result in different perceptions of patient safety and patient safety culture. We measured and described safety culture in five cardiovascular surgical centers using the Hospital Survey on Patient Safety Culture, and compared the data with the Agency for Healthcare Research and Quality (AHRQ) 2010 comparative database in surgery and anesthesiology (all types). We reported mean scores, standard deviations, and percent positive responses for the two single-item measures and 12 patient safety climate dimensions in the Hospital Survey on Patient Safety Culture. In the five cardiac surgical programs, the dimension of teamwork within hospital units had the highest positive score (74% positive responses), and the dimension of nonpunitive response to error had the lowest score (38% positive responses). Surgeons and support staff perceived better safety climate than nurses, perfusionists, and anesthesia practitioners. The cardiac surgery cohort reported more positive safety climate than the AHRQ all-type surgery cohort in four dimensions but lower frequency of reporting mistakes. The cardiac anesthesiology cohort scored lower on two dimensions compared with the AHRQ all-type anesthesiology cohort. This study identifies patient safety areas for improvement in cardiac surgical teams in comparison with all-type surgical teams. We also found that different professional disciplines in cardiac surgical teams perceive patient safety differently. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Becker, Lillian C; Bergfeld, Wilma F; Belsito, Donald V; Hill, Ronald A; Klaassen, Curtis D; Liebler, Daniel C; Marks, James G; Shank, Ronald C; Slaga, Thomas J; Snyder, Paul W; Andersen, F Alan
The Cosmetic Ingredient Review Expert Panel (Panel) reviewed the safety of 6 dialkyl malate compounds used in cosmetics. These ingredients function mostly as skin-conditioning agents-emollients. The Panel reviewed relevant animal and human data related to the ingredients along with a previous safety assessment of malic acid. The similar structure, properties, functions, and uses of these ingredients enabled grouping them and using the available toxicological data to assess the safety of the entire group. The Panel concluded that these dialkyl maleate compounds are safe in the present practices of use and concentration as given in this safety assessment. © The Author(s) 2015.
Hessels, Amanda J; Murray, Meghan; Cohen, Bevin; Larson, Elaine L
Children with complex medical needs are increasing in number and demanding the services of pediatric long-term care facilities (pLTC), which require a focus on patient safety culture (PSC). However, no tool to measure PSC has been tested in this unique hybrid acute care-residential setting. The objective of this study was to evaluate the psychometric properties of the Nursing Home Survey on Patient Safety Culture tool slightly modified for use in the pLTC setting. Factor analyses were performed on data collected from 239 staff at 3 pLTC in 2012. Items were screened by principal axis factoring, and the original structure was tested using confirmatory factor analysis. Exploratory factor analysis was conducted to identify the best model fit for the pLTC data, and factor reliability was assessed by Cronbach alpha. The extracted, rotated factor solution suggested items in 4 (staffing, nonpunitive response to mistakes, communication openness, and organizational learning) of the original 12 dimensions may not be a good fit for this population. Nevertheless, in the pLTC setting, both the original and the modified factor solutions demonstrated similar reliabilities to the published consistencies of the survey when tested in adult nursing homes and the items factored nearly identically as theorized. This study demonstrates that the Nursing Home Survey on Patient Safety Culture with minimal modification may be an appropriate instrument to measure PSC in pLTC settings. Additional psychometric testing is recommended to further validate the use of this instrument in this setting, including examining the relationship to safety outcomes. Increased use will yield data for benchmarking purposes across these specialized settings to inform frontline workers and organizational leaders of areas of strength and opportunity for improvement.
Becker, Lillian C; Bergfeld, Wilma F; Belsito, Donald V; Hill, Ronald A; Klaassen, Curtis D; Liebler, Daniel C; Marks, James G; Shank, Ronald C; Slaga, Thomas J; Snyder, Paul W; Andersen, F Alan
The Cosmetic Ingredient Review Expert Panel (the Panel) reviewed the safety of synthetic fluorphlogopite as used in cosmetics. Synthetic fluorphlogopite functions as a bulking agent and a viscosity-increasing agent. The Panel reviewed available animal and human data related to this ingredient along with a previous safety assessment of other magnesium silicates. The Panel concluded that synthetic fluorphlogopite was safe as cosmetic ingredients in the practices of use and concentration as given in this safety assessment. © The Author(s) 2015.
Marsella, Anthony J.; Leong, Frederick T. L.
Cross-cultural issues in personality and career assessment include ethnocentrism; the concept of culture; whether personality is culturally constructed; and linguistic, conceptual, scale, and normative equivalencies of assessment instruments across cultures. Research should include broader cultural pools, and counseling must take a cross-cultural…
This document compiles radionuclide transport calculations of a KBS-3 repository for the safety assessment SR-Site. The SR-Site assessment supports the licence application for a final repository at Forsmark, Sweden
Despite many attempts in the food safety risk assessment, there are a few studies and methods to cover the entire food supply chain. This study introduce a new model to perform the food risk assessment considering human factor along the entire food supply chain. The multi-discipline methodology of risk assessment tool, in combination of Key Performance Indicators (KPIs) has been applied in order to assess high safety risk point along the entire supply chain of food products. The method has be...
Gartshore, Emily; Waring, Justin; Timmons, Stephen
In recent years, there has been an increasing focus on the role of safety culture in preventing incidents such as medication errors and falls. However, research and developments in safety culture has predominantly taken place in hospital settings, with relatively less attention given to establishing a safety culture in care homes. Despite safety culture being accepted as an important quality indicator across all health and social care settings, the understanding of culture within social care settings remains far less developed than within hospitals. It is therefore important that the existing evidence base is gathered and reviewed in order to understand safety culture in care homes. A scoping review was undertaken to describe the availability of evidence related to care homes' patient safety culture, what these studies focused on, and identify any knowledge gaps within the existing literature. Included papers were each reviewed by two authors for eligibility and to draw out information relevant to the scoping review. Twenty-four empirical papers and one literature review were included within the scoping review. The collective evidence demonstrated that safety culture research is largely based in the USA, within Nursing Homes rather than Residential Home settings. Moreover, the scoping review revealed that empirical evidence has predominantly used quantitative measures, and therefore the deeper levels of culture have not been captured in the evidence base. Safety culture in care homes is a topic that has not been extensively researched. The review highlights a number of key gaps in the evidence base, which future research into safety culture in care home should attempt to address.
Full Text Available Abstract Background In recent years, there has been an increasing focus on the role of safety culture in preventing incidents such as medication errors and falls. However, research and developments in safety culture has predominantly taken place in hospital settings, with relatively less attention given to establishing a safety culture in care homes. Despite safety culture being accepted as an important quality indicator across all health and social care settings, the understanding of culture within social care settings remains far less developed than within hospitals. It is therefore important that the existing evidence base is gathered and reviewed in order to understand safety culture in care homes. Methods A scoping review was undertaken to describe the availability of evidence related to care homes’ patient safety culture, what these studies focused on, and identify any knowledge gaps within the existing literature. Included papers were each reviewed by two authors for eligibility and to draw out information relevant to the scoping review. Results Twenty-four empirical papers and one literature review were included within the scoping review. The collective evidence demonstrated that safety culture research is largely based in the USA, within Nursing Homes rather than Residential Home settings. Moreover, the scoping review revealed that empirical evidence has predominantly used quantitative measures, and therefore the deeper levels of culture have not been captured in the evidence base. Conclusions Safety culture in care homes is a topic that has not been extensively researched. The review highlights a number of key gaps in the evidence base, which future research into safety culture in care home should attempt to address.
Eisenach, James C; Tong, Chuanyao; Curry, Regina
Preclinical data suggest that oxytocin reduces hypersensitivity by actions in the spinal cord, but whether it produces antinociception to acute stimuli is unclear. In this article, the authors examined the safety of intrathecal oxytocin and screened its effects on acute noxious stimuli. After institutional review board and Food and Drug Administration approval, healthy adult volunteers received 5, 15, 50, or 150 μg intrathecal oxytocin in a dose-escalating manner in cohorts of five subjects. Hemodynamic and neurologic assessments were performed for 4 h after injections and 24 h later, at which time serum sodium was also measured. Cerebrospinal fluid was obtained 60 min after injection, and responses to noxious heat stimuli in arm and leg as well as temporal summation to repeated application of a von Frey filament were obtained. One subject receiving the highest dose experienced transient hypotension and bradycardia as well as subjective numbness in a lumbo-sacral distribution. No other subject experienced subjective or objective neurologic symptoms. Overall, blood pressure and heart rate increased 1 to 4 h after injection by less than 15% with no dose dependency. There was no effect on serum sodium, and cerebrospinal fluid oxytocin increased in a dose-dependent manner after injection. Pain scores to noxious heat stimuli were unaffected by oxytocin, and the temporal summation protocol failed to show summation before or after drug treatment. This small study supports further investigation on oxytocin for analgesia for hypersensitivity states, with continued systematic surveillance for possible effects on blood pressure, heart rate, and neurologic function.
Woodhouse, Kristina Demas; Volz, Edna; Maity, Amit; Gabriel, Peter E; Solberg, Timothy D; Bergendahl, Howard W; Hahn, Stephen M
High-reliability organizations (HROs) focus on continuous identification and improvement of safety issues. We sought to advance a large, multisite radiation oncology department toward high reliability through the implementation of a comprehensive safety culture (SC) program at the University of Pennsylvania Department of Radiation Oncology. In 2011, with guidance from safety literature and experts in HROs, we designed an SC framework to reduce radiation errors. All state-reported medical events (SRMEs) from 2009 to 2016 were retrospectively reviewed and plotted on a control chart. Changes in SC grade were assessed using the Agency for Healthcare Research and Quality Hospital Survey. Outcomes measured included the number of radiation treatment fractions and days between SRMEs, as well as SC grade. Multifaceted safety initiatives were implemented at our main academic center and across all network sites. Postintervention results demonstrate increased staff fundamental safety knowledge, enhanced peer review with an electronic system, and special cause variation of SRMEs on control chart analysis. From 2009 to 2016, the number of days and fractions between SRMEs significantly increased, from a mean of 174 to 541 days (P patient SC grade over time. Our journey toward becoming an HRO has led to the development of a robust SC through a comprehensive safety framework. Our multifaceted initiatives, focusing on culture and system changes, can be successfully implemented in a large academic radiation oncology department to yield measurable improvements in SC and outcomes. Copyright © 2016 by American Society of Clinical Oncology.
McGough, Shirley; Wynaden, Dianne; Wright, Michael
The need for mental health clinicians to practice cultural safety is vital in ensuring meaningful care and in moving towards improving the mental health outcomes for Aboriginal people. The concept of cultural safety is particularly relevant to mental health professionals as it seeks to promote cultural integrity and the promotion of social justice, equity and respect. A substantive theory that explained the experience of providing cultural safety in mental health care to Aboriginal patients was developed using grounded theory methodology. Mental health professionals engaged in a social psychological process, called seeking solutions by navigating the labyrinth to overcome the experience of being unprepared. During this process participants moved from a state of being unprepared to one where they began to navigate the pathway of cultural safety. The findings of this research suggest health professionals have a limited understanding of the concept of cultural safety. The experience of providing cultural safety has not been adequately addressed by organizations, health services, governments, educational providers and policy makers. Health services, organizations and government agencies must work with Aboriginal people to progress strategies that inform and empower staff to practice cultural safety. © 2017 Australian College of Mental Health Nurses Inc.
The functions and operations of the Safety Board as related to technology assessment are described, and a brief history of the Safety Board is given. Recommendations made for safety in all areas of transportation and the actions taken are listed. Although accident investigation is an important aspect of NTSB's activity, it is felt that the greatest contribution is in pressing for development of better accident prevention programs. Efforts of the Safety Board in changing transportation technology to improve safety and prevent accidents are illustrated.
Lee, Yong Hee [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)
The culture of an organization is very complex to study and evaluate, but it is possible to examine the specific norms that figure out the culture for the safety of a system. This paper describes an initiation plan to study the safety culture issue in Korean NPPs. Recently there happened successively events that turned out to be socially prominent in Korea. Many issues on the safety culture aspect of NPPs have been raised including the types of errors such as violations, an intended concealment of safety-related information, counterfeit items, forgery process in procurement, and so on. Those were investigated in detail for the root causes of these issues as human and organizational errors and for the countermeasures to prevent those events. They are integrated into a correspondent long-term plan including the establishment of a fundamental infrastructure of safety