1
|
Berdida DJE, Grande RAN, Alshammari MH. RETRACTED: Safety climate, quality of care, adherence to and compliance with standard precautions among nurses: Structural equation modeling. Int Nurs Rev 2024; 71:1-11. [PMID: 38436471 DOI: 10.1111/inr.12946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 02/08/2024] [Indexed: 03/05/2024]
Abstract
AIMS The aim was to investigate the interrelationships of nurses' safety climate, quality of care, and adherence to and compliance with standard precautions (SPs). BACKGROUND Investigations about nurses' safety climate and quality care and their association with adherence to and compliance with SPs remain remarkably scant across literature, specifically among developing countries like the Philippines. DESIGN Cross-sectional design and structural equation modeling (SEM) approach while complying with STROBE guidelines. METHODS Participant nurses were recruited using convenience sampling (n = 870). Four validated self-report instruments were used to collect data from February to August 2022. Spearman rho, SEM, mediation, and path analyses were employed for data analysis. RESULTS The emerging model showed acceptable model fit parameters. The safety climate positively influenced the quality of care and adherence to and compliance with SPs. Quality of care directly affected adherence to SPs, while adherence to SPs directly affected compliance with SPs. The quality of care mediated the relationship between safety climate and adherence to SPs. Whereas adherence to SPs mediated the relationships between safety climate and compliance with SPs and the quality of care and compliance with SPs. CONCLUSIONS Nurses' safety climate directly affected the quality of care and SPs adherence and compliance. The quality of care mediated the impact of safety climate on SPs adherence. Finally, SPs adherence demonstrated a mediating effect among quality of care, safety climate, and SPs compliance. IMPLICATIONS FOR NURSING POLICY AND PRACTICE Nursing policymakers and administrators can use the findings to design strategic policies and sustainable in-service educational courses fostering and maintaining nurses' safety climate, quality of care, and SPs adherence and compliance.
Collapse
Affiliation(s)
| | - Rizal Angelo N Grande
- Mental Health Nursing Department, College of Nursing, University of Ha'il, Ha'il City, Saudi Arabia
| | | |
Collapse
|
2
|
Kida R, Fujitani K, Matsushita H. Impact of Collaborative Leadership, Workplace Social Capital, and Interprofessional Collaboration Practice on Patient Safety Climate. J Healthc Qual 2024:01445442-990000000-00072. [PMID: 38759146 DOI: 10.1097/jhq.0000000000000443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2024]
Abstract
PURPOSE Patient safety climate is an important factor in promoting patient safety for healthcare organizations. This study investigated the relationship between collaborative leadership and patient safety climate, the mediation effect of workplace social capital, or interprofessional collaboration practice. METHODS A web-based cross-sectional questionnaire survey was administered between May 2021 and May 2022, to employees of three acute care hospitals in Japan. The relationship between variables was verified by structural equation modeling. RESULTS A total of 1,276 staff members participated in the study. Collaborative leadership affected the workplace social capital (β = .734) and interprofessional collaboration (β = .561), which were positively associated with patient safety climate (β = .403 and .405, respectively), verifying the mediating relationship of workplace social capital and interprofessional collaboration between collaborative leadership and patient safety climate. CONCLUSIONS Collaborative leadership enhances the reciprocity and interprofessional practices of the healthcare team. The interaction among interprofessional team members fosters a patient safety climate. The results of this survey suggest that the development of collaborative leadership, which encourages interprofessional collaboration and fosters workplace social capital, is inherently crucial for cultivating a patient safety climate.
Collapse
|
3
|
Berdida DJE, Grande RAN. Nurses' safety climate, quality of care, and standard precautions adherence and compliance: A cross-sectional study. J Nurs Scholarsh 2024; 56:442-454. [PMID: 38284297 DOI: 10.1111/jnu.12960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 01/08/2024] [Accepted: 01/15/2024] [Indexed: 01/30/2024]
Abstract
INTRODUCTION Investigations about the interrelationships of nurses' safety climate, quality of care, and standard precautions (SP) adherence and compliance remain particularly scarce in the literature. Thus, we tested a model of the associations between nurses' safety climate, quality of care, and the factors influencing adherence and compliance with SPs utilizing the structural equation modeling (SEM) approach. DESIGN Cross-sectional design complying with STROBE guidelines. METHODS Using convenience sampling, nurses (n = 730) from the Philippines were recruited. Data were collected between April and September 2022 using four validated self-report measures. Spearman Rho, mediation and path analyses, and SEM were employed for data analysis. RESULTS Acceptable model fit indices were shown by the emerging model. The safety climate is positively associated with quality of care and factors influencing adherence to and compliance with SPs. Quality of care directly affected factors influencing adherence to SPs. The factors influencing adherence to SPs directly affected SP compliance. Quality of care mediated between safety climate and the factors influencing adherence to SPs. Factors influencing adherence to SPs mediated between safety climate, quality of care, and SP compliance. CONCLUSIONS The study's variables are not distinct but overlapping nursing concepts that must be examined collectively. Nurse administrators can utilize the emerging model to formulate strategies and regulations for evaluating and enhancing nurses' safety climate, quality of care, and SP adherence and compliance. CLINICAL RELEVANCE Our findings may impact policymaking, organizational, and individual levels to improve nurses' clinical practice. PATIENT OR PUBLIC CONTRIBUTION This study had no patient contribution or public funding.
Collapse
Affiliation(s)
- Daniel Joseph E Berdida
- Faculty, College of Nursing, University of Santo Tomas, Manila, Philippines
- Northern College of Nursing, Arar, Northern Borders, Saudi Arabia
| | | |
Collapse
|
4
|
Shim W, Kim KY. Effects of individual and environmental factors on COVID-19 infection control practices in small to medium-sized hospitals. Am J Infect Control 2024:S0196-6553(24)00471-1. [PMID: 38677658 DOI: 10.1016/j.ajic.2024.04.200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 04/17/2024] [Accepted: 04/21/2024] [Indexed: 04/29/2024]
Abstract
BACKGROUND This study analyzed the influence of individual and environmental factors on infection control practices among nurses in small to medium-sized hospitals of South Korea during the pandemic. METHODS We enrolled 171 nurses from 5 infectious disease-specialized hospitals with 200 to 299 beds located in metropolitan areas of South Korea. Individual factors, including general characteristics, coronavirus disease 2019 (COVID-19) knowledge, attitude, and risk perception, and environmental factors including COVID-19 safety climate, were collected using self-report questionnaires. Individual and environmental factors were analyzed using multiple logistic regression. RESULTS COVID-19-related safety climate (β = 0.423) had the greatest association with infection control practices, followed by COVID-19-related attitude (β = 0.174). Higher safety climate and attitude scores were associated with higher scores in infection control practices. The explanatory power of these variables was 30.6%. CONCLUSIONS This study indicated that safety climate and COVID-19-related attitudes significantly influence infection control practices in small to medium-sized hospitals. This provides a basis to establish policies for responses to emerging infectious diseases in small to medium-sized hospitals and contributes to consistent guidelines.
Collapse
Affiliation(s)
- Woori Shim
- Infection Prevention and Control Team, National Medical Center, Seoul, Republic of Korea; General graduate school, Gachon University, Incheon, Republic of Korea
| | - Ka Young Kim
- College of Nursing, Gachon University, Incheon, Republic of Korea.
| |
Collapse
|
5
|
Compliance with standard precautions and associated factors among undergraduate nursing students at governmental universities of Amhara region, Northwest Ethiopia. BMC Nurs 2022; 21:375. [PMID: 36581879 PMCID: PMC9800055 DOI: 10.1186/s12912-022-01165-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 12/26/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Standard precautions are minimum infection control practices used to prevent the transmission of diseases and applied to all patient care. Nursing students are at high risk of exposure to occupational biologic hazards because they are obligated to provide care to patients admitted with unknown infection statuses. Compliance with standard precautions is an effective and efficient means of infection prevention. However, their compliance with standard precautions among nursing students is not known in Ethiopia. Therefore, this study aimed to assess compliance with standard precautions and associated factors among undergraduate BSc nursing students at governmental universities located in the Amhara Region, northwest Ethiopia. METHODS An institutional-based cross-sectional study was conducted among undergraduate BSc nursing students at the governmental universities located in Amhara Region, northwest Ethiopia, from April 15 to May 15, 2021. A simple random sampling technique was used to select 423 samples. Descriptive statistics were presented in text, tables, and charts. Multicollinearity and model fitness were checked. All variables were entered into multivariable logistic regression and a P-value of < 0.05 was considered to identify statistically significant factors. RESULT Around 221 (53.4%) of the study participants were males. Good compliance of nursing students towards standard precautions was 56.3% (95% CI = 51.4-60.9), which is significantly associated with good knowledge (AOR = 2.52, 95% CI = 1.61-3.94), a perceived safe workplace climate (AOR = 2.15, 95% CI = 1.24-3.71), and training or seminars related to standard precautions in the last six months (AOR = 1.52, 95% CI = 1.01-2.29). CONCLUSION The overall compliance of nursing students with standard precautions was low, with nearly half of the nursing students failing to comply with standard precautions. The major factors associated with good compliance were good knowledge, a perceived safe workplace, and having seminars or training in the last six months. Training, enhancing knowledge, and creating a safe hospital environment are recommended to improve nursing students' compliance with standard precautions.
Collapse
|
6
|
Tartari E, Kilpatrick C, Allegranzi B, Pittet D. “Unite for safety – clean your hands”: the 5 May 2022 World Health Organization SAVE LIVES—Clean Your Hands campaign. Antimicrob Resist Infect Control 2022; 11:63. [PMID: 35488302 PMCID: PMC9052484 DOI: 10.1186/s13756-022-01105-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
7
|
Saati AA, Alkalash SH. Promotion of knowledge, attitude, and practice among medical undergraduates regarding infection control measures during COVID-19 pandemic. Front Public Health 2022; 10:932465. [PMID: 36187651 PMCID: PMC9521352 DOI: 10.3389/fpubh.2022.932465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 08/15/2022] [Indexed: 01/25/2023] Open
Abstract
Background Medical students are exposed to many serious healthcare-associated infections throughout their learning and training time particularly during a pandemic like COVID-19. Therefore, promotion of their knowledge, attitude, and practice regarding infection control measures is a mandatory action. Objective This study was executed to evaluate the knowledge, attitude, and practice of medical undergraduates toward infection control measures before and after the implementation of practical infection control training for them. Methods A quasi-experimental prospective study was conducted on a simple random sample of medical undergraduates at Al-Qunfudah College of Medicine, Umm Al-Qura University, KSA. A total of 177 medical undergraduates were recruited for this study and completed a predesigned survey on their knowledge regarding infection control measures. Moreover, their practice of infection control measures was evaluated through a checklist before and 6 months after receiving practical infection control training during their academic year 2020-2021. Results A total of 177 and 176 responses were obtained at the pre-test and post-test, respectively. The mean ages of students who participated in pre-training and post-training assessments were (22.50 ± 1.02 and 22.03 ± 1.34), respectively with female sex predominance (62.1 and 61.9%). Mean knowledge and practice scores among them were enhanced from (7.79 ± 2.10 and 4.56 ± 2.58) at their pre-test to (11.06 ± 1.27 and 15.68 ± 1.90) at post-test (P-value 0.001 and <0.001), respectively. After training, almost all of them recommended infection control training for all medical students due to its great value. Conclusion The training course has shown its capability in the promotion of medical undergraduates' knowledge, attitude, and practice toward infection control measures.
Collapse
Affiliation(s)
- Abdullah A. Saati
- Department of Community Medicine and Pilgrims Healthcare, Faculty of Medicine, Umm Al-Qura University, Mecca, Saudi Arabia
| | - Safa H. Alkalash
- Department of Community Medicine and Healthcare, Faculty of Medicine, Umm Al-Qura University, Al-Qunfudah, Saudi Arabia,Department of Family Medicine, Faculty of Medicine, Menoufia University, Shibin El-Kom, Egypt,*Correspondence: Safa H. Alkalash
| |
Collapse
|
8
|
Nilsson K, Brulin C, Grankvist K, Juthberg C. Senior nursing students' reflections on deviations from guideline adherence regarding venous blood specimen collection practice: A qualitative study. NURSE EDUCATION TODAY 2022; 115:105375. [PMID: 35653918 DOI: 10.1016/j.nedt.2022.105375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 03/20/2022] [Accepted: 04/12/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Venous blood specimen collection is a common procedure within healthcare and both diagnoses as well as treatment evaluation, are often based on results from these analyses. However, studies among both students and staff have demonstrated suboptimal adherence to venous blood specimen collection practice guidelines which in turn might jeopardize patient safety. OBJECTIVES This study aimed to describe final semester nursing students' experiences of deviations from venous blood specimen collection practice guidelines during clinical training. METHODS This study adopted a qualitative design. Twentysix final (6th) semester nursing students were recruited through purposive sampling at a Swedish university. Data were collected through semi-structured, face-to-face, focus group interviews in September 2015. The transcribed interviews were analyzed using qualitative content analysis. RESULTS The students' experiences generated two categories; 1) Striving to blend in (subcategories Feeling uncomfortable and Adapting to the prevailing practice culture) and 2) Diminished confidence (subcategories Being confused due to inconsistency and Being uncertain about guideline usefulness) forming the overall theme Being a copycat. CONCLUSION The research concludes that nursing students adapt to the prevailing practice culture encountered during clinical training, often at the expense of guidelines adherence. Since the students are being assessed during clinical training, the eagerness to belong to the team and be well-liked might be stronger than the ambition to follow guidelines. As a consequence, nursing students in clinical training might become copycats by aligning themselves with the prevailing practice culture which in turn might jeopardize adherence with VBSC guideline practice and thereby patient safety. With the ambition to support nursing students' learning in clinical training, facilitators of learning to comprise both students and supervisors need to be further addressed. TWEETABLE ABSTRACT Nursing students adapt to the prevailing venous blood sample collection practice culture and become copycats.
Collapse
Affiliation(s)
- Karin Nilsson
- Department of Nursing, Umeå University, S-891 18 Örnsköldsvik, Sweden.
| | | | - Kjell Grankvist
- Department of Medical Biosciences, Clinical Chemistry, Umeå University, S-901 85 Umeå, Sweden.
| | | |
Collapse
|
9
|
Kim JS, Lee E. Difference between self-reported adherence to standard precautions and surveillance and factors influencing observed adherence: a quantile regression approach. BMC Nurs 2022; 21:199. [PMID: 35879717 PMCID: PMC9310710 DOI: 10.1186/s12912-022-00984-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 07/14/2022] [Indexed: 11/22/2022] Open
Abstract
Background Standard precautions are minimum healthcare-associated infection prevention practices applied in all healthcare settings. The aim of this study was to investigate adherence to standard precautions using a survey and surveillance. Factors affecting observed adherence to standard precautions were also determined. Methods This cross-sectional observational study included 163 clinical nurses who were directly involved in patient care. Differences in adherence according to investigative methods are represented as a boxplot. Quantile regression was used to identify factors affecting observed adherence, including organizational factors (such as department, safety environment, and patient safety climate) and personal factors (such as knowledge and awareness). Stata SE version 14.2 was used for all statistical analyses. Results The observed adherence to standard precautions was 76.8 out of 100, whereas the self-reported adherence was approximately 95. Hand hygiene adherence received the lowest score of less than 70. Factors influencing observed adherence were self-reported adherence (p = 0.043) in 25% and 50% quantiles, work experience (p = 0.002) in the 25% quantile, and working department (p = 0.030) in the 50% quantile. There were no significant factors in the 75% quantile. Conclusion Inadequate adherence to standard precautions might increase healthcare-associated infections. Thus, an organizational environment such as nurse staffing needs to be established so that clinical nurses with high competency can comply with standard precautions in clinical settings.
Collapse
Affiliation(s)
- Jin Suk Kim
- Hallym University Medical Center Kangnam, Seoul, Korea
| | - Eunhee Lee
- School of Nursing, Hallym University, 1 Hallymdaehak-Gil, Chuncheon, Gangwon-do, 24252, Republic of Korea.
| |
Collapse
|
10
|
"Unite for safety-Clean your hands": The May 5, 2022, World Health Organization SAVE LIVES: Clean Your Hands campaign. Infect Control Hosp Epidemiol 2022; 43:665-666. [PMID: 35416138 DOI: 10.1017/ice.2022.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
|
11
|
"Unite for safety - clean your hands": The 5 May 2022 World Health Organization SAVE LIVES: Clean your hands campaign. Am J Infect Control 2022; 50:588-590. [PMID: 35491048 DOI: 10.1016/j.ajic.2022.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 03/05/2022] [Indexed: 01/13/2023]
|
12
|
Tartari E, Kilpatrick C, Allegranzi B, Pittet D. WHO SAVE LIVES: Clean Your Hands campaign. THE LANCET. INFECTIOUS DISEASES 2022; 22:577-579. [PMID: 35364021 DOI: 10.1016/s1473-3099(22)00211-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 03/14/2022] [Indexed: 06/14/2023]
Affiliation(s)
- Ermira Tartari
- Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, WHO, Geneva, Switzerland; Faculty of Health Sciences, University of Malta, Malta
| | - Claire Kilpatrick
- Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, WHO, Geneva, Switzerland
| | - Benedetta Allegranzi
- Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, WHO, Geneva, Switzerland
| | - Didier Pittet
- Infection Control Programme, University of Geneva Hospitals and Faculty of Medicine, Geneva 1205, Switzerland.
| |
Collapse
|
13
|
Tartari E, Kilpatrick C, Allegranzi B, Pittet D. "Unite for safety - clean your hands": the 5 May 2022 World Health Organization SAVE LIVES: Clean Your Hands campaign. J Hosp Infect 2022; 123:108-111. [PMID: 35525537 DOI: 10.1016/j.jhin.2022.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 03/04/2022] [Indexed: 01/13/2023]
Affiliation(s)
- E Tartari
- Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, World Health Organization (WHO), Geneva, Switzerland; Faculty of Health Sciences, University of Malta, Malta
| | - C Kilpatrick
- Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, World Health Organization (WHO), Geneva, Switzerland
| | - B Allegranzi
- Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, World Health Organization (WHO), Geneva, Switzerland
| | - D Pittet
- Infection Control Programme, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.
| |
Collapse
|
14
|
McMillan S. Preventing healthcare-associated infections by decontaminating the clinical environment. Nurs Stand 2022; 37:e11935. [PMID: 35477994 DOI: 10.7748/ns.2022.e11935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2022] [Indexed: 11/09/2022]
Abstract
Healthcare-associated infections (HAIs) continue to cause patient harm and at increasing rates. Factors contributing to this increase include suboptimal hand hygiene, antimicrobial resistance, and inadequate decontamination of the patient environment and shared patient equipment. To reduce the risk of HAIs and enhance patient safety, it is important that nurses and other healthcare professionals adhere to infection prevention and control guidance, including decontamination procedures. It is also important to identify and address the barriers that can affect adherence to this guidance. This article discusses effective decontamination of the patient environment and non-critical shared patient equipment, the barriers to adhering to guidance and strategies for improving decontamination procedures.
Collapse
Affiliation(s)
- Sacha McMillan
- Christchurch Hospital Campus, Canterbury District Health Board, Christchurch, Canterbury, New Zealand
| |
Collapse
|
15
|
Tartari E, Kilpatrick C, Allegranzi B, Pittet D. “Unite for safety – Clean your hands”: the 5 May 2022 World Health Organization SAVE LIVES: clean your hands campaign. Clin Microbiol Infect 2022; 28:757-758. [DOI: 10.1016/j.cmi.2022.03.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 03/14/2022] [Accepted: 03/14/2022] [Indexed: 11/03/2022]
|
16
|
Author's response to comment on “Exploring infection prevention practices in home-based nursing care: a qualitative observational study”. Int J Nurs Stud 2022; 129:104215. [DOI: 10.1016/j.ijnurstu.2022.104215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 02/23/2022] [Indexed: 11/23/2022]
|
17
|
Li J, Goerlandt F, van Nunen K, Ponnet K, Reniers G. Conceptualizing the Contextual Dynamics of Safety Climate and Safety Culture Research: A Comparative Scientometric Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020813. [PMID: 35055635 PMCID: PMC8775979 DOI: 10.3390/ijerph19020813] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 01/06/2022] [Accepted: 01/07/2022] [Indexed: 11/29/2022]
Abstract
Safety climate and safety culture are important research domains in risk and safety science, and various industry and service sectors show significant interest in, and commitment to, applying its concepts, theories, and methods to enhance organizational safety performance. Despite the large body of literature on these topics, there are disagreements about the scope and focus of these concepts, and there is a lack of systematic understanding of their development patterns and the knowledge domains on which these are built. This article presents a comparative analysis of the literature focusing on safety climate and safety culture, using various scientometric analysis approaches and tools. General development patterns are identified, including the publication trends, in terms of temporal and geographical activity, the science domains in which safety culture and safety climate research occurs, and the scientific domains and articles that have primarily influenced their respective development. It is found that the safety culture and safety climate domains show strong similarities, e.g., in dominant application domains and frequently occurring terms. However, safety culture research attracts comparatively more attention from other scientific domains, and the research domains rely on partially different knowledge bases. In particular, while measurement plays a role in both domains, the results suggest that safety climate research focuses comparatively more on the development and validation of questionnaires and surveys in particular organizational contexts, whereas safety culture research appears to relate these measurements to wider organizational features and management mechanisms. Finally, various directions for future research are identified based on the obtained results.
Collapse
Affiliation(s)
- Jie Li
- National Science Library, Chinese Academy of Sciences, Beijing 100190, China;
- State Key Laboratory of Explosion Science and Technology, Beijing Institute of Technology, Beijing 100081, China
- College of Safety Science & Engineering, Liaoning Technical University, Huludao 125105, China
| | - Floris Goerlandt
- Department of Industrial Engineering, Dalhousie University, Halifax, NS B3H 4R2, Canada
- Correspondence: (F.G.); (G.R.)
| | - Karolien van Nunen
- Research Chair Vandeputte, University of Antwerp, 2000 Antwerp, Belgium;
- Safety and Security Science, Faculty of Technology, Policy and Management, Delft University of Technology, 2600 AA Delft, The Netherlands
| | - Koen Ponnet
- Faculty of Political and Social Sciences, imec-mict-Ghent University, 9000 Ghent, Belgium;
| | - Genserik Reniers
- Safety and Security Science, Faculty of Technology, Policy and Management, Delft University of Technology, 2600 AA Delft, The Netherlands
- Antwerp Research Group on Safety and Security (ARGoSS), Faculty of Applied Economics, University of Antwerp, 2000 Antwerp, Belgium
- Centre for Economics and Corporate Sustainability (CEDON), KU Leuven, 1000 Brussels, Belgium
- Correspondence: (F.G.); (G.R.)
| |
Collapse
|
18
|
Trinkoff AM, Baldwin CM, Chasens ER, Dunbar-Jacob J, Geiger-Brown J, Imes CC, Landis CA, Patrician PA, Redeker NS, Rogers AE, Scott LD, Todero CM, Tucker SJ, Weinstein SM. CE: Nurses Are More Exhausted Than Ever: What Should We Do About It? Am J Nurs 2021; 121:18-28. [PMID: 34743129 DOI: 10.1097/01.naj.0000802688.16426.8d] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
ABSTRACT For nurses, the challenges posed by demanding work environments and schedules often lead to fatigue, and this can be exacerbated during crises like the COVID-19 pandemic. In this article, the authors discuss causes and challenges of nurse fatigue and consider several evidence-based strategies and solutions for individual nurses and organizations. Barriers to implementation, including a negative workplace culture and inadequate staffing, are also described, and several resources are presented.
Collapse
Affiliation(s)
- Alison M Trinkoff
- Alison M. Trinkoff is a professor at the University of Maryland School of Nursing, Baltimore. Carol M. Baldwin is professor emeritus and a Southwest Borderlands Scholar at Arizona State University's Edson College of Nursing and Health Innovation, Phoenix. Eileen R. Chasens is a professor and chair of the Department of Health and Community Systems, University of Pittsburgh School of Nursing, Pittsburgh, PA, where Jacqueline Dunbar-Jacob is dean and a distinguished service professor and Christopher C. Imes is an assistant professor. Now retired, at the time of this writing Jeanne Geiger-Brown was a professor and associate dean for research at the George Washington University School of Nursing, Washington, DC. Carol A. Landis is a professor emeritus at the University of Washington School of Nursing, Seattle. Patricia A. Patrician is a professor and the Rachel Z. Booth Endowed Chair at the University of Alabama at Birmingham School of Nursing, and a retired U.S. Army colonel. Nancy S. Redeker is the Beatrice Renfield Term Professor of Nursing at the Yale University School of Nursing, New Haven, CT. Ann E. Rogers is a professor at the Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta. Linda D. Scott is a professor and dean of the University of Wisconsin-Madison School of Nursing. Catherine M. Todero is dean of the College of Nursing and vice provost of Health Sciences at Creighton University, Omaha, NE, and Phoenix, AZ. Sharon J. Tucker is the Grayce Sills Endowed Professor in Psychiatric-Mental Health Nursing and director of the Translational/Implementation Research Core at the Ohio State University College of Nursing, Columbus. Sharon M. Weinstein is chief executive officer of the Global Education Development Institute, and SMW Group LLC, North Bethesda, MD, and a clinical assistant professor at the College of Nursing, University of Illinois, Chicago. This article was a collaborative effort by the Fatigue Subgroup of the Health Behavior Expert Panel, American Academy of Nursing. The authors acknowledge Claire C. Caruso, PhD, RN, a research health scientist at the National Institute for Occupational Safety and Health, for her help in reviewing the manuscript. Contact author: Alison M. Trinkoff, . The authors and planners have disclosed no potential conflicts of interest, financial or otherwise. A podcast with the authors is available at www.ajnonline.com
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Hwang JI, Kim SW, Park HA. Relationships Between Nurses' Work System, Safety-Related Performance, and Outcomes: A Structural Equation Model. J Patient Saf 2021; 17:e1638-e1645. [PMID: 34852419 PMCID: PMC8612905 DOI: 10.1097/pts.0000000000000866] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES We examined relationships between nurses' work system, safety-related performance, and outcomes based on a modified Systems Engineering Initiative for Patient Safety model. METHODS A cross-sectional survey was conducted with 408 nurses from 2 general hospitals. Data on work system factors (person, organization, environment, tools, and task), processes (safety-related performance), and outcomes (staff and clinical outcomes) were collected. Structural equation modeling was used to determine the relationships between nurses' work system factors, safety-related processes, and outcomes. RESULTS Structural equation modeling yielded a comparative fit index of 0.918, standardized root mean square residual of 0.055, and root mean square error of approximation of 0.054, indicating an acceptable model fit. The person factor had a significant positive direct effect on nurses' safety-related performance, and significant negative direct and indirect effects on the clinical outcome. The organization factor had significant positive direct effects on nurses' safety-related performance and staff outcome, and a negative indirect effect on the clinical outcome. The task factor had a significant positive direct effect on staff outcome. However, the environment and tools factors had no significant effects on safety-related performance or outcomes. CONCLUSIONS The findings demonstrated the usefulness of the Systems Engineering Initiative on Patient Safety model to explain safety-related performance and outcomes, indicating differential effects of work system factors. Although the person factor significantly affected safety performance and clinical outcomes, the organization factor was the most influential component for promoting safety-related performance and staff and clinical outcomes. These results can be used to prioritize activities for patient safety.
Collapse
Affiliation(s)
| | - Sung Wan Kim
- Department of ORL-HNS, College of Medicine, Kyung Hee University
| | - Hyeoun-Ae Park
- College of Nursing and Research Institute of Nursing Science, Seoul National University, Seoul, Republic of Korea
| |
Collapse
|
20
|
Thompson L, Bidwell S, Seaton P. The COVID-19 pandemic: Analysing nursing risk, care and careerscapes. Nurs Inq 2021; 29:e12468. [PMID: 34750928 PMCID: PMC8646573 DOI: 10.1111/nin.12468] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 09/28/2021] [Accepted: 10/01/2021] [Indexed: 12/13/2022]
Abstract
This qualitative study explores how junior nurses, and some who were still in training, navigated the complexities and uncertainties engendered by the COVID-19 pandemic. Data are drawn from in-depth interviews with 18 students/nurses in Christchurch, New Zealand. Managing intertwining risk, care and careerscapes takes an intensified form as existing infection control rules, established norms of care, boundaries between home and work and expected career trajectories roil. 'Safe' and 'risky' spaces are porous but maintained using contextual, critical, clinical judgement. Carescapes are stretched, both within and beyond the walls of healthcare settings. Within the COVID-19 riskscape, careerscapes are open to both threat and opportunity. Countries demand much of their healthcare staff in times of heath crises, but have a limited appreciation of what it takes to translate seemingly tightly bounded protocols into effective practice. The labour required in this work of translation is navigated moment by moment. To surface some of this invisible work, those implementing pandemic plans may need to more carefully consider how to incorporate attention to the work/home/public boundary as well as overtly acknowledging the invisible emotional, physical and intellectual labour carried out in crisis risk, care and careerscapes.
Collapse
Affiliation(s)
- Lee Thompson
- Department of Population Health, University of Otago, Christchurch, New Zealand
| | - Susan Bidwell
- Department of Population Health, University of Otago, Christchurch, New Zealand
| | - Philippa Seaton
- Department of Postgraduate Nursing, University of Otago, Christchurch, New Zealand
| |
Collapse
|
21
|
Ravi D, Tawfik DS, Sexton JB, Profit J. Changing safety culture. J Perinatol 2021; 41:2552-2560. [PMID: 33024255 DOI: 10.1038/s41372-020-00839-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 08/31/2020] [Accepted: 09/18/2020] [Indexed: 02/02/2023]
Abstract
Safety culture, an aspect of organizational culture, that reflects work place norms toward safety, is foundational to high-quality care. Improvements in safety culture are associated with improved operational and clinical outcomes. In the neonatal intensive care unit (NICU), where fragile infants receive complex, coordinated care over prolonged time periods, it is critically important that unit norms reflect the high priority placed on safety. Changing the safety culture of the NICU involves a systematic process of measurement, identifying strengths and weaknesses, deploying targeted interventions, and learning from the results, to set the stage for an iterative process of improvement. Successful change efforts require: effective partnerships with key stakeholders including management, clinicians, staff, and families; using data to make the case for improvement; and leadership actions that motivate change, channel resources, and support active problem- solving. Sustainable change requires buy-in from NICU staff and management, resources, and long-term institutional commitment.
Collapse
Affiliation(s)
- Dhurjati Ravi
- Perinatal Epidemiology and Health Outcomes Research Unit, Division of Neonatology, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA. .,California Perinatal Quality Care Collaborative, Palo Alto, CA, USA.
| | - Daniel S Tawfik
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - J Bryan Sexton
- Department of Psychiatry, Duke University School of Medicine, Duke University Health System, Durham, NC, USA.,Duke Center for Healthcare Safety and Quality, Duke University Health System, Durham, NC, USA
| | - Jochen Profit
- Perinatal Epidemiology and Health Outcomes Research Unit, Division of Neonatology, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.,California Perinatal Quality Care Collaborative, Palo Alto, CA, USA
| |
Collapse
|
22
|
Measuring Safety Climate in the Construction Industry: A Systematic Literature Review. SUSTAINABILITY 2021. [DOI: 10.3390/su131910603] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Recent studies on safety in various fields use the concept of safety climate to explain the causes of safety accidents. Many studies attempt to measure the safety climates and identify the causes for accidents in the high-risk construction industry. Studies have shown that the higher the level of the safety climate, the lower the accident rate at construction sites. Methods of measuring safety climate, including the NOSACQ-50 survey, have been presented. Studies on the methodology of measuring safety climate should be continued to improve reliability and precision. Although many studies have been conducted to measure safety climate, such as questionnaires, regression analysis, and suggestions for safety climate measurement methods, there are few studies on a systematic literature review of them. This requires a systematic literature review (SLR) of the studies conducted so far. This study conducted an SLR on the definition and measurement methods of safety climate in the construction industry published since 2000, when safety climate’s impact on accidents began to be established. This review study utilized the PRISMA method, analyzed 735 studies, and selected 57 papers finally. SLR was carried out for selected research works, and the results were summarized. There are three methods to measure safety climate: literature survey, questionnaire, and data analysis. Factor analysis, development of measuring model, development of questionnaire, statistical analysis, and machine learning were investigated as their sub-methods. This study’s results can be used as fundamental sources for improving existing methods and developing new methods of measuring safety climate in the construction industry.
Collapse
|
23
|
Effects of Infection Control Education for Nursing Students Using Standardized Patients vs. Peer Role-Play. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:ijerph18010107. [PMID: 33375222 PMCID: PMC7794753 DOI: 10.3390/ijerph18010107] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 12/22/2020] [Accepted: 12/23/2020] [Indexed: 12/15/2022]
Abstract
This study was conducted to identify and compare the effects of two education programs for infection control―a simulation using standardized patients and a peer role-play―on standard precaution knowledge, standard precaution awareness, infection-related anxiety, and infection control performance. This study used a nonequivalent control group pretest-posttest design. A total of 62 undergraduate nursing students in their 3rd year participated in the study, and were assigned to the experimental and control groups, accordingly. The infection control education program was developed based on the analysis, design, development, implementation, and evaluation model. The program for the experimental group included lectures, skills training, simulation using standardized patients, and debriefing, while the control group participated in the usual infection control education, consisting of lectures, skills training, and peer tutoring practices. Both groups exhibited statistically significant increases in knowledge, awareness of standard precaution, and infection control performance after the intervention. Infection-related anxiety and infection control performance were significantly higher in the simulation using a standardized patient group. Both education programs influenced compliance with the standard precaution for infection control. The results of this study contribute to the evidence regarding effective educational methods to improve infection control.
Collapse
|
24
|
Braun BI, Chitavi SO, Suzuki H, Soyemi CA, Puig-Asensio M. Culture of Safety: Impact on Improvement in Infection Prevention Process and Outcomes. Curr Infect Dis Rep 2020; 22:34. [PMID: 33288982 PMCID: PMC7710367 DOI: 10.1007/s11908-020-00741-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2020] [Indexed: 12/21/2022]
Abstract
Purpose Safety culture is known to be related to a wide range of outcomes, and measurement of safety culture is now required for many hospitals in the U.S.A. In previous reviews, the association with outcomes has been limited by the research design and strength of the evidence. The goal of this review was to examine recent literature on the relationship between safety culture and infection prevention and control-related (IPC) processes and healthcare-associated infections (HAIs) in U.S. healthcare organizations. We also sought to quantitatively characterize the challenges to empirically establishing these relationships and limitations of current research. Recent Findings A PubMed search for U.S. articles published 2009–2019 on the topics of infection prevention, HAIs, and safety culture yielded 448 abstracts. After screening, 55 articles were abstracted for information on purpose, measurement, analysis, and conclusions drawn about the role of safety culture in the outcome. Approximately ½ were quality improvement (QI) initiatives and ½ were research studies. Overall, 51 (92.7%) concluded there was an association between safety culture and IPC processes or HAIs. However, only 39 studies measured safety culture and 26 statistically analyzed safety culture data for associations. Though fewer QI initiatives analyzed associations, a higher proportion concluded an association exists than among research studies. Summary Despite limited empirical evidence and methodologic challenges to establishing associations, most articles supported a positive relationship between safety culture, improvement in IPC processes, and decreases in HAIs. Authors frequently reported experiencing improvements in safety culture when not directly measured. The findings suggest that associations between improvement and safety culture may be bi-directional such that positive safety culture contributes to successful interventions and implementing effective interventions drives improvements in culture. Greater attention to article purpose, design, and analysis is needed to confirm these presumptive relationships.
Collapse
Affiliation(s)
- Barbara I Braun
- Department of Research, The Joint Commission, Oakbrook Terrace, IL USA
| | - Salome O Chitavi
- Department of Research, The Joint Commission, Oakbrook Terrace, IL USA
| | - Hiroyuki Suzuki
- Department of Internal Medicine - Infectious Diseases, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA USA
| | - Caroline A Soyemi
- Neihoff School of Nursing, Loyola University Chicago, Chicago, IL USA
| | - Mireia Puig-Asensio
- Department of Internal Medicine, Carver College of Medicine, Iowa City, IA USA.,Present Address: Department of Infectious Diseases, Hospital Universitari de Bellvitge: L'Hospitalet de Llobregat, Barcelona, Catalunya Spain
| |
Collapse
|
25
|
Tumala RB. Predictors of nursing interns' standard precautions compliance during internship training in four teaching hospitals in Saudi Arabia. Int J Nurs Pract 2020; 27:e12897. [PMID: 33051969 DOI: 10.1111/ijn.12897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 09/06/2020] [Accepted: 09/25/2020] [Indexed: 11/28/2022]
Abstract
AIM The aim of this study was to assess compliance with standard precautions by Saudi nursing interns who were undergoing their internship training in four governmental tertiary teaching hospitals in Riyadh, Kingdom of Saudi Arabia, and to determine factors predictive of this. BACKGROUND Cross-transmission and infection prevention when delivering care must be strictly followed by nursing interns by complying with standard precautions during internship training. DESIGN The study employed a descriptive-correlational and cross-sectional design. METHODS A total of 224 nursing interns participated in the study by completing the Compliance with Standard Precautions Scale Arabic version between March 2017 and June 2017. RESULTS/FINDINGS A high overall compliance rate (84.8%) was observed. Nursing interns reported the highest compliance score in changing gloves between each patient contact and the lowest score in disposing of sharps boxes only when full. Nursing interns in hospital D showed the highest compliance rate over those in other hospitals. Age, sex, marital status, months in internship training and attendance of nursing interns in infection control seminars/trainings influenced their standard precautions compliance. CONCLUSION The study revealed good compliance by nursing interns with standard precautions. However, regular educational and clinical interventions are still needed to improve some areas and to ensure the continuity of high levels of compliance in other areas of standard precautions among nursing interns.
Collapse
|
26
|
Taylor K, Thomas S, Mendez D, Chicken C, Carrick J, Heller J, Durrheim D. "Prevention is the biggest success": Barriers and enablers to personal biosecurity in the thoroughbred breeding industry. Prev Vet Med 2020; 183:105135. [PMID: 32961422 DOI: 10.1016/j.prevetmed.2020.105135] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 08/24/2020] [Accepted: 08/28/2020] [Indexed: 11/25/2022]
Abstract
Employees in the equine industry are at occupational risk of zoonoses such as Hendra virus and equine chlamydiosis through exposure to infected materials. This study aimed to gain a deeper understanding of the views and experiences of employees, and the key drivers of infection control and personal biosecurity (PB) practices in the Thoroughbred breeding industry. Methods: An exploratory qualitative study was conducted in 2018 in New South Wales, Australia using interviews (9) and small group discussions (7). The 29 participants included veterinarians, veterinary nurses, foaling staff, stud managers and laboratory personnel working in a range of equine medicine settings. Interviews and focus groups were recorded, transcribed and analysed manually by at least two members of the research team. An iterative approach was used to derive themes. Results: Five main themes emerged: (i) greater awareness of current and emerging infectious risks promotes use of Personal Protective Equipment (PPE); (ii) currently available PPE is not comfortable, practical or well-suited to equine reproductive work in Australia's hot climate; (iii) creating supportive environments for PB reduces risk of exposure to infectious materials; (iv) strong leadership is required to implement sustainable change in workplace culture and practices; and (v) policy and economic factors play an important role in adopting biosecurity (BS) and PB measures in the workplace. Personnel working in the Australian Thoroughbred breeding industry face unique zoonotic risks in a challenging physical environment. A qualitative approach provided rich insights into social and physical factors motivating BS and PB in this occupational group. There is an opportunity for collaboration between Public Health services and industry partners to develop and implement strategies most likely to be effective in ensuring consistent uptake of PB measures in the workplace.
Collapse
Affiliation(s)
- Kathryn Taylor
- University of Newcastle, Australia; Hunter New England Local Health District, Australia.
| | - Susan Thomas
- University of Newcastle, Australia; Hunter New England Local Health District, Australia
| | | | | | | | | | - David Durrheim
- University of Newcastle, Australia; Hunter New England Local Health District, Australia
| |
Collapse
|
27
|
Shahabinejad M, Khoshab H, Najafr K, Haghshenas A. The Relationship between Patient Safety Climate and Medical Error Reporting Rate among Iranian Hospitals Using a Structural Equation Modeling. Ethiop J Health Sci 2020; 30:319-328. [PMID: 32874074 PMCID: PMC7445949 DOI: 10.4314/ejhs.v30i3.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Improving patient safety is a global health imperative, and patient safety climate is one of the components one that plays an important role in promoting patient safety. Medical error reporting is a way through which it can be evaluated and prevented in the future. The aim of this study was to assess the relationship between patient safety climate and medical error reporting in military and civilian hospitals. Methods This research was conducted by using structural equation modeling in the selected hospitals of Iran in 2018. The study community consisted of 200 nurses in the military and 400 nurses in the civilian hospitals. By using Structural Equation Modeling, the relationship between patient safety climate and the rate of medical error reporting in the hospitals was measured by a questionnaire. Data was analyzed using SPSS 17 and LISREL 8.8 software. Results The mean score of patient safety climate was moderate in the hospitals. There was no significant relationship between the rate of medical error reporting and patient safety climate, while a significant difference was found between patient safety climate score and age, sex, job category, and type of hospital (P < 0.05). Conclusion The results suggested that patient safety climate and the rate of reporting errors were not favorable in the studied hospitals, while there was a difference between safety climate dimensions.
Collapse
Affiliation(s)
- Mostefa Shahabinejad
- Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Hadi Khoshab
- School of Nursing and Midwifery, Bam University of Medical Sciences, Bam, Iran
| | - Kazem Najafr
- School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | |
Collapse
|
28
|
Samur M, Seren Intepeler S, Lam SC. Adaptation and validation of the Compliance with Standard Precautions Scale amongst nurses in Turkey. Int J Nurs Pract 2020; 26:e12839. [PMID: 32304177 DOI: 10.1111/ijn.12839] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 03/23/2020] [Accepted: 03/25/2020] [Indexed: 11/30/2022]
Abstract
AIMS To adapt and psychometrically test the Compliance with Standard Precautions Scale for use by Turkish nurses. BACKGROUND Measurement of standard precautions compliance is important to manage the safety of both patients and health care teams. METHODS This two-phase methodological study employed a correlational design with repeated measures. In phase one, the scale's adaptation, including translation, semantic equivalence, content and face validity, was implemented. In phase two, internal consistency and stability were used to examine the reliability of the scale. Construct validity was tested using the Rasch rating scale model. This study was conducted by recruiting 411 nurses from three different hospitals between September 2015 and September 2016. RESULTS Adaptation results showed that the Turkish version of the Compliance with Standard Precautions Scale (CSPS-T) is adequate for linguistic and content validation. The content validity index and comprehensibility of the scale were similarly satisfactory. The reliability of the CSPS-T was examined by Cronbach's alpha, corrected item-total correlations and intraclass correlation coefficient, and good results were obtained. The Rasch model showed that all items were compatible with the model. Whereas Item 4 was the most difficult, Item 10 was the easiest. CONCLUSION The CSPS-T is a reliable and valid tool for assessing compliance with standard precautions amongst Turkish nurses.
Collapse
Affiliation(s)
- Menevse Samur
- Nursing Management Department, Nursing Faculty, Dokuz Eylul University, Balcova, Izmir, Turkey
| | - Seyda Seren Intepeler
- Nursing Management Department, Nursing Faculty, Dokuz Eylul University, Balcova, Izmir, Turkey
| | - Simon Ching Lam
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| |
Collapse
|
29
|
Sands M, Aunger R. Determinants of hand hygiene compliance among nurses in US hospitals: A formative research study. PLoS One 2020; 15:e0230573. [PMID: 32255783 PMCID: PMC7138309 DOI: 10.1371/journal.pone.0230573] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 03/03/2020] [Indexed: 12/02/2022] Open
Abstract
Hand hygiene is the simplest and most effective measure for preventing healthcare-associated infections. Despite the simplicity of this procedure and advances made in infection control, hospital health care workers’ compliance to hand hygiene recommendations is generally low. Nurses have the most frequent patient care interactions, and thus more opportunities to practice hand hygiene. As such, it is important to identify and understand determinants of nurses’ reported compliance. Formative research was undertaken to assess the potential impact of several unexamined factors that could influence HH among nurses: professional role and status, social affiliation, social norms, and physical modifications to the work environment (as well as institutional factors like safety climate). A survey questionnaire was developed primarily to inform the creation of a behaviour change intervention. The survey looked at how these factors influence HH among nurses and sought to identify barriers and levers to reported hand hygiene. It was administered to a survey panel of acute care nurses, working in US hospitals, with a year or more of experience. Multivariate regression modelling suggested that reported hand hygiene compliance was most likely to be a function of a hospital management’s communication openness, perceived performance by peers, increased interactions with patients and other staff members, and the reduction in stress, busyness, and cognitive load associated with role performance. A powerful, effective intervention on HH among nurses therefore could be directed at improving communication openness, consider the impact of perceived performance by peers, increase interactions with patients and staff, and determine how to reduce the stress and cognitive load associated with role performance.
Collapse
Affiliation(s)
- Madeline Sands
- Department of Infectious Disease, London School of Hygiene and Tropical Medicine, London, United Kingdom
- University of Arizona College of Medicine, Tucson, Arizona, United States of America
- * E-mail:
| | - Robert Aunger
- Department of Infectious Disease, London School of Hygiene and Tropical Medicine, London, United Kingdom
| |
Collapse
|
30
|
Vaismoradi M, Tella S, A. Logan P, Khakurel J, Vizcaya-Moreno F. Nurses' Adherence to Patient Safety Principles: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17062028. [PMID: 32204403 PMCID: PMC7142993 DOI: 10.3390/ijerph17062028] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 03/11/2020] [Accepted: 03/16/2020] [Indexed: 12/18/2022]
Abstract
Background: Quality-of-care improvement and prevention of practice errors is dependent on nurses’ adherence to the principles of patient safety. Aims: This paper aims to provide a systematic review of the international literature, to synthesise knowledge and explore factors that influence nurses’ adherence to patient-safety principles. Methods: Electronic databases in English, Norwegian, and Finnish languages were searched, using appropriate keywords to retrieve empirical articles published from 2010–2019. Using the theoretical domains of the Vincent’s framework for analysing risk and safety in clinical practice, we synthesized our findings according to ‘patient’, ‘healthcare provider’, ‘task’, ‘work environment’, and ‘organisation and management’. Findings: Six articles were found that focused on adherence to patient-safety principles during clinical nursing interventions. They focused on the management of peripheral venous catheters, surgical hand rubbing instructions, double-checking policies of medicines management, nursing handover between wards, cardiac monitoring and surveillance, and care-associated infection precautions. Patients’ participation, healthcare providers’ knowledge and attitudes, collaboration by nurses, appropriate equipment and electronic systems, education and regular feedback, and standardization of the care process influenced nurses’ adherence to patient-safety principles. Conclusions: The revelation of individual and systemic factors has implications for nursing care practice, as both influence adherence to patient-safety principles. More studies using qualitative and quantitative methods are required to enhance our knowledge of measures needed to improve nurse’ adherence to patient-safety principles and their effects on patient-safety outcomes.
Collapse
Affiliation(s)
- Mojtaba Vaismoradi
- Faculty of Nursing and Health Sciences, Nord University, 8049 Bodø, Norway
- Correspondence: ; Tel.: +47-75517813
| | - Susanna Tella
- Faculty of Health and Social Care, LAB University of Applied Sciences, 53850 Lappeenranta, Finland;
| | - Patricia A. Logan
- Faculty of Science, Charles Sturt University, 2795 Bathurst, Australia;
| | - Jayden Khakurel
- Research Centre for Child Psychiatry, Department of Child Psychiatry, Faculty of Medicine, University of Turku, 20014 Turku, Finland;
| | - Flores Vizcaya-Moreno
- Nursing Department, Faculty of Health Sciences, University of Alicante, 03080 Alicante, Spain;
| |
Collapse
|
31
|
Bamel UK, Pandey R, Gupta A. Safety climate: Systematic literature network analysis of 38 years (1980-2018) of research. ACCIDENT; ANALYSIS AND PREVENTION 2020; 135:105387. [PMID: 31838322 DOI: 10.1016/j.aap.2019.105387] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 11/23/2019] [Accepted: 11/26/2019] [Indexed: 06/10/2023]
Abstract
The objective of this paper is to examine the safety climate knowledge epistemology using bibliometric and systematic literature network analysis. For this purpose, bibliometric information of research article published on safety climate topic was retrieved from Scopus databases. In total, 494 articles published between 1980 and 2018 were retrieved. These articles cover 1373 authors, 203 journals and 2511 keywords. Information collected was analyzed employing bibliometric and network analysis approach using an open source computer program R and VOSviewer. The main findings of the study reveal the publication trends in safety climate literature since 1980 to present, identifies most productive authors, and most influential research work. Our findings suggest that Huang and Zohar are the top publishing authors in safety climate domain. Zohar's work has the highest citations. The most influential articles have been published in Journals such as Accident Analysis and Prevention, Journal of Applied Psychology, Safety Science and Journal of Safety Research. Network analysis of these articles yielded co-citation networks of most influential works, bibliographical coupling network and keywords co-occurrence network yielded the structure of safety climate knowledge. Findings of our research have theoretical and practical implications in the area of safety climate.
Collapse
Affiliation(s)
| | - Ritesh Pandey
- Assistant Professor, Finance Area, IMT Ghaziabad, India
| | - Amit Gupta
- IIM Amritsar, PTU Capmus, 143105, Amritsar, Punjab, India
| |
Collapse
|
32
|
Alrowely Z, Ghazi Baker O. Assessing Building Blocks for Patient Safety Culture-a Quantitative Assessment of Saudi Arabia. Risk Manag Healthc Policy 2019; 12:275-285. [PMID: 31827340 PMCID: PMC6902844 DOI: 10.2147/rmhp.s223097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Accepted: 11/09/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose The study analyzes staffs' perception of a safety culture and their knowledge of safety measures in the hospitals of Saudi Arabia. Patients and methods A cross-sectional study was conducted by considering six different public hospitals from Arar city, and by recruiting 503 nurses. Building blocks of patient safety culture were measured through survey questions. Results The highest positive rating (81%) was received by both "people support one another in this unit" and "in this unit, people treat each other with respect." Supervisor/manager expectations and actions promoting patient safety was rated neutrally (n = 283; 56%) with an average mean score of 3.17±0.50, which suggested a neutral response by participants. Organizational learning, along with continuous improvement, was positively rated (n = 406; 81%) with an average mean score of 3.93±0.61. Conclusion It demonstrated that participant nurses neither disagree nor agree on the level of patient safety culture prevailing in their hospital setting.
Collapse
Affiliation(s)
- Zeid Alrowely
- Health Investment Development Administration, Directorate of Health Affairs, Aljouf, Saudi Arabia
| | | |
Collapse
|
33
|
Lim JH, Ahn JW, Son YJ. Association between Hospital Nurses' Perception of Patient Safety Management and Standard Precaution Adherence: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16234744. [PMID: 31783559 PMCID: PMC6926684 DOI: 10.3390/ijerph16234744] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 11/23/2019] [Accepted: 11/25/2019] [Indexed: 02/07/2023]
Abstract
Standard precautions should be applied to prevent health care-associated infections during every nursing activity. However, adherence to standard precautions was reported to be inadequate. Therefore, this study aimed to identify the rates of standard precaution adherence and the association between perception of patient safety management and standard precaution adherence. In this cross-sectional descriptive study, a convenience sample of nurses was recruited from a university-affiliated teaching hospital in Seoul, Korea. Data were collected using a structured self-report questionnaire. Among the 332 questionnaires returned (response rate: 94.9%), a total of 329 nurses were analyzed. In the present study, the overall standard precaution adherence rate was approximately 53.5%. The multiple linear regression results revealed that participants’ perceptions of patient safety management were only significantly associated with standard precaution adherence after adjusting other covariates (β = 0.412, p < 0.001). Nurse supervisors should focus more on raising awareness about nurses’ perception of patient safety management based on the specific work environment, such as the total number of nurses working together and the nurse-to-patient ratio. Nurse educators should develop integrated curricula to help graduate nurses transition smoothly into professional practice and enhance adherence to standard precautions in diverse health care settings.
Collapse
Affiliation(s)
- Ji-Hye Lim
- Division of Nursing, Chung-Ang University Hospital, Seoul 06974, Korea;
| | - Jung-Won Ahn
- Red Cross College of Nursing, Chung-Ang University, Seoul 06974, Korea;
| | - Youn-Jung Son
- Red Cross College of Nursing, Chung-Ang University, Seoul 06974, Korea;
- Correspondence: ; Tel.: +82-2-820-5198
| |
Collapse
|
34
|
Donati D, Biagioli V, Cianfrocca C, Marano T, Tartaglini D, De Marinis MG. Experiences of compliance with standard precautions during emergencies: A qualitative study of nurses working in intensive care units. Appl Nurs Res 2019; 49:35-40. [PMID: 31495417 DOI: 10.1016/j.apnr.2019.07.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 06/17/2019] [Accepted: 07/27/2019] [Indexed: 01/05/2023]
Abstract
Aim To explore factors that influence intensive care nurses' experiences of being compliant with standard precautions (SP) during emergencies. BACKGROUND Intensive care nurses can be exposed to a greater risk of biohazardous exposure during an emergency. The primary strategy to address the complex variety of biological hazards in clinical practice is represented by the implementation of SP guidelines. Previous research has indicated that nurses' compliance rates with SPs are suboptimal, but no study has focused on the factors influencing compliance during an emergency. DESIGN A descriptive qualitative study was conducted in an Italian university hospital with 19 intensive care nurses who had at least two years of work experience in critical care. The nurses were interviewed in four focus groups and were asked about their experiences of being compliant with SPs during an emergency. Data were analyzed using conventional content analysis. RESULTS Three themes emerged: conflict, competencies, and context. Conflict was reported regarding the need to save the patient and the need for self-protection through the use of SPs. In particular, nurses had to manage the pressure of limited time. Competencies were identified by nurses' knowledge, attitude, skills, training, and experience. Context was related to the work and organizational conditions during the emergency, including overcrowding. CONCLUSION To support intensive care nurses' compliance with SPs during emergencies, conflict, competencies, and context should be audited regularly in clinical practice. The findings of this study could inform infection control programs and training that targets intensive care nurses.
Collapse
Affiliation(s)
- Daniele Donati
- Department of Biomedicine and Prevention, Tor Vergata University of Rome, via Montpellier 1, 00133 Rome, Italy.
| | - Valentina Biagioli
- Research Unit Nursing Science, Campus Bio-Medico University of Rome, via Álvaro del Portillo 21, 00128 Rome, Italy.
| | - Claudia Cianfrocca
- Department of Biomedicine and Prevention, Tor Vergata University of Rome, via Montpellier 1, 00133 Rome, Italy.
| | - Tiziana Marano
- Research Unit Nursing Science, Campus Bio-Medico University of Rome, via Álvaro del Portillo 21, 00128 Rome, Italy.
| | - Daniela Tartaglini
- Research Unit Nursing Science, Campus Bio-Medico University of Rome, via Álvaro del Portillo 21, 00128 Rome, Italy.
| | - Maria Grazia De Marinis
- Research Unit Nursing Science, Campus Bio-Medico University of Rome, via Álvaro del Portillo 21, 00128 Rome, Italy.
| |
Collapse
|
35
|
Teamwork and safety climate affect antimicrobial stewardship for asymptomatic bacteriuria. Infect Control Hosp Epidemiol 2019; 40:963-967. [PMID: 31339085 DOI: 10.1017/ice.2019.176] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE In preparation for a multisite antibiotic stewardship intervention, we assessed knowledge and attitudes toward management of asymptomatic bacteriuria (ASB) plus teamwork and safety climate among providers, nurses, and clinical nurse assistants (CNAs). DESIGN Prospective surveys during January-June 2018. SETTING All acute and long-term care units of 4 Veterans' Affairs facilities. METHODS The survey instrument included 2 previously tested subcomponents: the Kicking CAUTI survey (ASB knowledge and attitudes) and the Safety Attitudes Questionnaire (SAQ). RESULTS A total of 534 surveys were completed, with an overall response rate of 65%. Cognitive biases impacting management of ASB were identified. For example, providers presented with a case scenario of an asymptomatic patient with a positive urine culture were more likely to give antibiotics if the organism was resistant to antibiotics. Additionally, more than 80% of both nurses and CNAs indicated that foul smell is an appropriate indication for a urine culture. We found significant interprofessional differences in teamwork and safety climate (defined as attitudes about issues relevant to patient safety), with CNAs having highest scores and resident physicians having the lowest scores on self-reported perceptions of teamwork and safety climates (P < .001). Among providers, higher safety-climate scores were significantly associated with appropriate risk perceptions related to ASB, whereas social norms concerning ASB management were correlated with higher teamwork climate ratings. CONCLUSIONS Our survey revealed substantial misunderstanding regarding management of ASB among providers, nurses, and CNAs. Educating and empowering these professionals to discourage unnecessary urine culturing and inappropriate antibiotic use will be key components of antibiotic stewardship efforts.
Collapse
|
36
|
Alshehry AS. Culture of quality in infection prevention of a hospital as perceived by health care workers. J Nurs Manag 2019; 27:1131-1139. [PMID: 31034680 DOI: 10.1111/jonm.12783] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 04/17/2019] [Accepted: 04/24/2019] [Indexed: 01/27/2023]
Abstract
AIM This research aimed to assess the culture of quality in infection prevention (CQIP) of a university hospital as perceived by health care workers (HCWs). BACKGROUND Health care-associated infections are serious concerns in hospitals in Saudi Arabia. Hence, assessing their CQIP is necessary. METHOD An investigation employing a descriptive and cross-sectional design was carried out among 623 HCWs (doctors, nurses and nursing assistants) in a university hospital in Saudi Arabia by using the Leading a Culture of Quality in Infection Prevention (LCQ-IP) scale. RESULTS The overall mean in the LCQ-IP was 3.86 (SD = 0.62). The subscale "prioritization of quality" (M = 4.11, SD = 0.79) was rated the highest dimension, whereas "supportive work environment" was perceived as the poorest dimension (M = 3.56, SD = 0.54). Gender, nationality, highest education and job title affected the four factors of the HCWs' perceptions of the hospital's CQIP. CONCLUSION HCWs modestly perceived their hospital's CQIP. The study highlighted the need for improving CQIP based on the four dimensions. IMPLICATIONS FOR NURSING AND HOSPITAL MANAGEMENT This study provided valuable implications for hospital and nursing management to ensure high-quality culture of infection prevention.
Collapse
|
37
|
Freedman D, Woods GW. The developing significance of context and function: Neuroscience and law. BEHAVIORAL SCIENCES & THE LAW 2018; 36:411-425. [PMID: 30033592 DOI: 10.1002/bsl.2351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 11/21/2017] [Accepted: 11/27/2017] [Indexed: 06/08/2023]
Abstract
Neuroscience has already changed the understanding of how intent forms and is acted upon, how an individual's cognitive processes shape behavior, and how bio-psychosocial history and neurodevelopmental approaches provide information that has been largely missing from the assessment of intent. In this paper, we first review the state of forensic assessment of mental condition and intent, focused primarily on the weaknesses of the current approach. In Section 2, we discuss neurobehavioral forensic assessment, which is a neuroscience-based approach. Section 3 focuses on the changing understanding of mental illness and how neuroscience is pushing law towards a functional capacity-and-ability model and away from a diagnostic cut-off model. Finally, in Sections 4 and 5, we turn to the role of social and environmental context in shaping behavior and propose a model of behavioral intent in line with the scientific evidence.
Collapse
|
38
|
Suliman M, Aloush S, Aljezawi M, AlBashtawy M. Knowledge and practices of isolation precautions among nurses in Jordan. Am J Infect Control 2018; 46:680-684. [PMID: 29103636 PMCID: PMC7132704 DOI: 10.1016/j.ajic.2017.09.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 09/20/2017] [Accepted: 09/21/2017] [Indexed: 12/27/2022]
Abstract
Background Implementation of isolation precautions from the Centers for Disease Control and Prevention (CDC) has been justified through research and clinical evidence. However, nurses' understanding and compliance with these precautions is still unknown. The aim of this study was to assess nurses' knowledge and practices in relation to isolation precautions in Jordan. Methods A cross-sectional, descriptive design was used. The study took place in 8 hospitals in Jordan. A self-reported questionnaire and an observational checklist were developed based on the CDC (2007) isolation precautions guidelines. Results A total of 247 questionnaires were returned out of 400, for a response rate of 61.7%. The results show that most nurses (90%) have good knowledge of isolation precautions. However, only 65% of nurses reported good compliance with isolation precautions. The results of a t test revealed that nurses with Bachelor's degrees perform better in knowledge examinations than nurses with 2-year diplomas (P < .001). However, there was no significant difference in knowledge and self-report practices scores based on nurses' previous training and existence of isolation guidelines in their units or wards (P > .05). The results of the checklists confirm that there is a low compliance with standard isolation practice. In addition, the checklist shows that a high percentage of units and wards do not use isolation signs (46.4%) and posters (34.5%). Conclusions This study revealed that educating nurses about isolation is not enough strategy to improve their compliance. It is important to adapt other strategies, such as supporting nurses by giving them a manageable workload, and providing more supplies and reminders of isolation precautions in the hospitals.
Collapse
|
39
|
Patient Safety Climate: A Study of Southern California Healthcare Organizations. J Healthc Manag 2018; 63:175-192. [PMID: 29734279 DOI: 10.1097/jhm-d-16-00004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
EXECUTIVE SUMMARY Human error remains the most important factor in unnecessary deaths and suffering in U.S. hospitals. Human error results from healthcare providers' attitudes and behaviors toward patients in different settings. Therefore, taking periodic snapshots of the attitudes and behaviors prevalent in an organization and manifested in its patient safety climate (PSC) is essential.We developed and tested a short survey instrument intended as an organization-level measure of PSC with good psychometric properties that can be used in hospitals, clinics, or other healthcare provider settings. Analysis of data from 61 Southern California healthcare organizations resulted in a PSC model with four distinct, reliable factors: (1) Assistance From Others and the Organization, (2) Leadership Messages of Support in Policy and Behavior, (3) Resources and Work Environment, and (4) Error Reporting Behavior. A PSC score, ranging from 0 to 100, was generated for each organization.For a subsample of hospitals in our study, preliminary results indicate a predictive quality of the model. The higher the PSC score, the lower the number of violations detected by the Centers for Medicare & Medicaid Services in complaint inspections, and the fewer the safety problems reported by The Leapfrog Group.Given the association between PSC and health outcomes, we urge healthcare leaders to use various means, such as our survey, to monitor the degree to which their organizations maintain a climate that fosters patient safety and use such data to pinpoint areas for improvement.
Collapse
|
40
|
Yıldız A, Kaya S, Teleş M, Korku C. The effect of nurses' empowerment perceptions on job safety behaviours: a research study in Turkey. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2018; 26:489-496. [PMID: 29595097 DOI: 10.1080/10803548.2018.1459079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Objective. This study aimed to investigate the effect of nurses' empowerment perceptions on job safety behaviours. Methods. A survey of 377 nurses working in five hospitals in Turkey was conducted using the conditions of work effectiveness questionnaire, psychological empowerment instrument, universal precautions compliance scale and occupational health and safety obligations compliance scale. Relations between variables were tested using Pearson's correlation and path analysis. Results. There was a moderate and statistically significant relationship between psychological and structural empowerment and complying with universal safety measures and meeting occupational health and safety obligations. Also, an increase of 1 unit on the level of psychological empowerment was found to correspond to an increase of 0.37 units on the level of universal precautions compliance and to an increase of 0.46 units on the level of occupational health and safety obligations compliance. As such, an increase of 1 unit in structural empowerment corresponds to an increase of 0.53 units on the level of universal precautions compliance and to an increase of 0.36 units (total effect) on the level of occupational health and safety obligations compliance. Conclusions. The findings reveal that empowerment is a valuable tool for nurses' positive job safety behaviours.
Collapse
Affiliation(s)
- Ahmet Yıldız
- Management of Health Institutions, Batman University, Turkey
| | - Sıdıka Kaya
- Faculty of Economics and Administrative Sciences, Hacettepe University, Turkey
| | - Mesut Teleş
- Faculty of Economics and Administrative Sciences, Hacettepe University, Turkey
| | - Cahit Korku
- Faculty of Economics and Administrative Sciences, Hacettepe University, Turkey
| |
Collapse
|
41
|
Moralejo D, El Dib R, Prata RA, Barretti P, Corrêa I. Improving adherence to Standard Precautions for the control of health care-associated infections. Cochrane Database Syst Rev 2018; 2:CD010768. [PMID: 29481693 PMCID: PMC6491237 DOI: 10.1002/14651858.cd010768.pub2] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND 'Standard Precautions' refers to a system of actions, such as using personal protective equipment or adhering to safe handling of needles, that healthcare workers take to reduce the spread of germs in healthcare settings such as hospitals and nursing homes. OBJECTIVES To assess the effectiveness of interventions that target healthcare workers to improve adherence to Standard Precautions in patient care. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, CINAHL, LILACS, two other databases, and two trials registers. We applied no language restrictions. The date of the most recent search was 14 February 2017. SELECTION CRITERIA We included randomised trials of individuals, cluster-randomised trials, non-randomised trials, controlled before-after studies, and interrupted time-series studies that evaluated any intervention to improve adherence to Standard Precautions by any healthcare worker with responsibility for patient care in any hospital, long-term care or community setting, or artificial setting, such as a classroom or a learning laboratory. DATA COLLECTION AND ANALYSIS Two review authors independently screened search results, extracted data from eligible trials, and assessed risk of bias for each included study, using standard methodological procedures expected by Cochrane. Because of substantial heterogeneity among interventions and outcome measures, meta-analysis was not warranted. We used the GRADE approach to assess certainty of evidence and have presented results narratively in 'Summary of findings' tables. MAIN RESULTS We included eight studies with a total of 673 participants; three studies were conducted in Asia, two in Europe, two in North America, and one in Australia. Five studies were randomised trials, two were cluster-randomised trials, and one was a non-randomised trial. Three studies compared different educational approaches versus no education, one study compared education with visualisation of respiratory particle dispersion versus education alone, two studies compared education with additional infection control support versus no intervention, one study compared peer evaluation versus no intervention, and one study evaluated use of a checklist and coloured cues. We considered all studies to be at high risk of bias with different risks. All eight studies used different measures to assess healthcare workers' adherence to Standard Precautions. Three studies also assessed healthcare workers' knowledge, and one measured rates of colonisation with methicillin-resistant Staphylococcus aureus (MRSA) among residents and staff of long-term care facilities. Because of heterogeneity in interventions and outcome measures, we did not conduct a meta-analysis.Education may slightly improve both healthcare workers' adherence to Standard Precautions (three studies; four centres) and their level of knowledge (two studies; three centres; low certainty of evidence for both outcomes).Education with visualisation of respiratory particle dispersion probably improves healthcare workers' use of facial protection but probably leads to little or no difference in knowledge (one study; 20 nurses; moderate certainty of evidence for both outcomes).Education with additional infection control support may slightly improve healthcare workers' adherence to Standard Precautions (two studies; 44 long-term care facilities; low certainty of evidence) but probably leads to little or no difference in rates of health care-associated colonisation with MRSA (one study; 32 long-term care facilities; moderate certainty of evidence).Peer evaluation probably improves healthcare workers' adherence to Standard Precautions (one study; one hospital; moderate certainty of evidence).Checklists and coloured cues probably improve healthcare workers' adherence to Standard Precautions (one study; one hospital; moderate certainty of evidence). AUTHORS' CONCLUSIONS Considerable variation in interventions and in outcome measures used, along with high risk of bias and variability in the certainty of evidence, makes it difficult to draw conclusions about effectiveness of the interventions. This review underlines the need to conduct more robust studies evaluating similar types of interventions and using similar outcome measures.
Collapse
Affiliation(s)
- Donna Moralejo
- Memorial UniversitySchool of NursingH2916, Health Sciences Centre300 Prince Philip DriveSt. John'sNewfoundlandCanadaA1B 3V6
| | - Regina El Dib
- Institute of Science and Technology, UNESP ‐ Univ Estadual PaulistaDepartment of Biosciences and Oral DiagnosisSão José dos CamposSPBrazil
| | - Rafaela A Prata
- Department of Nursing, UNESP ‐ Univ Estadual PaulistaBotucatuBrazil
| | - Pasqual Barretti
- Botucatu Medical School, UNESP ‐ Univ Estadual PaulistaClinical MedicineDistrito de Rubião Junior, s/nBotucatuSão PauloBrazil18618‐900
| | - Ione Corrêa
- Department of Nursing, UNESP ‐ Univ Estadual PaulistaBotucatuBrazil
| | | |
Collapse
|
42
|
Sholomovich L, Magnezi R. Tell me how pleased you are with your workplace, and I will tell you how often you wash your hands. Am J Infect Control 2017; 45:677-681. [PMID: 28161003 DOI: 10.1016/j.ajic.2016.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 12/07/2016] [Accepted: 12/07/2016] [Indexed: 11/25/2022]
Abstract
Hospital-acquired infections are the most common complication of treatment and the primary patient safety hazard. Hand hygiene (HH) is the most important tool for preventing these infections. Although thousands of research projects have been conducted, many articles written, and numerous therapeutic recommendations made, the goal has not yet been reached. The professional literature emphasizes that the reasons HH strategies fail are still only partially understood. The aim of this study was to examine the correlation between the psychological safety of an organization's nursing staff and its sense of personal responsibility for avoiding transmission of infections. Questionnaires were distributed to the 400 nurses in a children's hospital. Nurses' psychological safety and sense of responsibility for transmitting infections were positively correlated (r = 0.425; P < .001). In addition, 209 respondents (95.7%) believe that transmission of resistant infections between patients is preventable and 74% agree that transmission of infections is the responsibility of the care staff, but only 40% were willing to take personal responsibility in the department in which they were employed. There is a correlation between nurses' psychological safety and sense of responsibility for transmitting infections. To increase workers' sense of personal responsibility regarding infections as a way to increase the response to HH, hospital management must work toward increasing workers' psychological safety.
Collapse
|
43
|
Lin YS, Lin YC, Lou MF. Concept analysis of safety climate in healthcare providers. J Clin Nurs 2017; 26:1737-1747. [PMID: 27862495 DOI: 10.1111/jocn.13641] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2016] [Indexed: 12/12/2022]
Abstract
AIM AND OBJECTIVE To report an analysis of the concept of safety climate in healthcare providers. BACKGROUND Compliance with safe work practices is essential to patient safety and care outcomes. Analysing the concept of safety climate from the perspective of healthcare providers could improve understanding of the correlations between safety climate and healthcare provider compliance with safe work practices, thus enhancing quality of patient care. DESIGN Concept analysis. DATA SOURCES The electronic databases of CINAHL, MEDLINE, PubMed and Web of Science were searched for literature published between 1995-2015. Searches used the keywords 'safety climate' or 'safety culture' with 'hospital' or 'healthcare'. METHOD The concept analysis method of Walker and Avant analysed safety climate from the perspective of healthcare providers. RESULTS Three attributes defined how healthcare providers define safety climate: (1) creation of safe working environment by senior management in healthcare organisations; (2) shared perception of healthcare providers about safety of their work environment; and (3) the effective dissemination of safety information. Antecedents included the characteristics of healthcare providers and healthcare organisations as a whole, and the types of work in which they are engaged. Consequences consisted of safety performance and safety outcomes. Most studies developed and assessed the survey tools of safety climate or safety culture, with a minority consisting of interventional measures for improving safety climate. CONCLUSION More prospective studies are needed to create interventional measures for improving safety climate of healthcare providers. This study is provided as a reference for use in developing multidimensional safety climate assessment tools and interventional measures. RELEVANCE TO CLINICAL PRACTICE The values healthcare teams emphasise with regard to safety can serve to improve safety performance. Having an understanding of the concept of and interventional measures for safety climate allows healthcare providers to ensure the safety of their operations and their patients.
Collapse
Affiliation(s)
- Ying-Siou Lin
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan.,Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan
| | - Yen-Chun Lin
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Meei-Fang Lou
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| |
Collapse
|
44
|
Exploring the context for effective clinical governance in infection control. Am J Infect Control 2017; 45:278-283. [PMID: 27916342 DOI: 10.1016/j.ajic.2016.10.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 10/16/2016] [Accepted: 10/17/2016] [Indexed: 11/21/2022]
Abstract
BACKGROUND Effective clinical governance is necessary to support improvements in infection control. Historically, the focus has been on ensuring that infection control practice and policy is based on evidence, and that there is use of surveillance and auditing for self-regulation and performance feedback. There has been less exploration of how contextual and organizational factors mediate an infection preventionists (IP's) ability to engage with evidence-based practice and enact good clinical governance. METHODS A cross sectional Web-based survey of IPs in Australia and New Zealand was undertaken. Questions focused on engagement in evidence-based practice and perceptions about the context, culture, and leadership within the infection control team and organization. Responses were mapped against dimensions of Scally and Donaldson's clinical governance framework. RESULTS Three hundred surveys were returned. IPs appear well equipped at an individual level to undertake evidence-based practice. The most serious set of perceived challenges to good clinical governance related to a lack of leadership or active resistance to infection control within the organization. Additional challenges included lack of information technology solutions and poor access to specialist expertise and financial resources. CONCLUSIONS Focusing on strengthening contextual factors at the organizational level that otherwise undermine capacity to implement evidence-based practice is key to sustaining current infection control successes and promoting further practice improvements.
Collapse
|
45
|
Hessels AJ, Genovese-Schek V, Agarwal M, Wurmser T, Larson EL. Relationship between patient safety climate and adherence to standard precautions. Am J Infect Control 2016; 44:1128-1132. [PMID: 27318523 DOI: 10.1016/j.ajic.2016.03.060] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 03/12/2016] [Accepted: 03/14/2016] [Indexed: 12/21/2022]
Abstract
BACKGROUND Standard precautions (SPs) are designed to limit bloodborne pathogen exposures among health care workers (HCWs) and health care-associated infections. SP adherence is globally suboptimal; however, reasons are underexplored. This study aim was to explore the relationships among safety climate factors and SP adherence by HCWs in hospitals using newly developed survey and observational tools. METHODS Cross-sectional data from 11 units in 5 hospitals were collected between March and September 2015. A patient safety and standard precaution survey was administered to nurses and pooled with data from observations of HCW-patient interactions using defined SP indications. Descriptive statistics of distributions, frequencies, and Pearson correlation coefficients were calculated to determine the unit-level relationships among dimensions of the patient safety climate and unit percentages of SP adherence (P < .05). RESULTS There were 540 HCW-patient encounters with 1,713 SP indications and 140 surveys collected. Although most nurses (94%) reported always or often adhering to SPs and generally reported positive scores on unit safety climate, observed SP adherence was 62% (unit range, 31%-80%). Only 30% of nurses rated staffing positively, and this was inversely related to observed SP adherence. CONCLUSIONS Adherence to the full complement of observed SP behaviors by HCWs of all types was suboptimal. The relationship between safety climate, particularly staffing, and adherence to SPs warrants further testing.
Collapse
|
46
|
Tad-y D, Wald HL. The evolution of morbidity and mortality conferences. BMJ Qual Saf 2016; 26:433-435. [DOI: 10.1136/bmjqs-2016-005817] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2016] [Indexed: 11/03/2022]
|