Safety culture in two metropolitan Australian tertiary hospital intensive care units: A cross-sectional survey.


Journal

Australian critical care : official journal of the Confederation of Australian Critical Care Nurses
ISSN: 1036-7314
Titre abrégé: Aust Crit Care
Pays: Australia
ID NLM: 9207852

Informations de publication

Date de publication:
01 2020
Historique:
received: 25 06 2018
revised: 28 11 2018
accepted: 28 11 2018
pubmed: 21 1 2019
medline: 24 11 2020
entrez: 21 1 2019
Statut: ppublish

Résumé

Safety culture is significant in the complex intensive care environment, where the consequences of human error can be catastrophic. Research within Australian intensive care units has been limited and little is understood about the safety culture of intensive care units in Queensland. The aim was to evaluate and compare safety culture in the intensive care units of two metropolitan tertiary hospitals in Queensland. A cross-sectional survey, Safety Attitudes Questionnaire, was administered to all medical, nursing and allied health professionals in the research sites (A and B) during January and February 2016. Data were collated into six safety culture domains of teamwork climate, safety climate, job satisfaction, stress recognition, working conditions and perceptions of management. Comparison was made using t-tests and between demographic groups using generalising estimating equations. In total, 206 surveys were returned from 522 staff (39.5% response rate). The majority of respondents were nurses (80.6%). Site B scored all domains of the safety attitudes questionnaire significantly higher than Site A (p < 0.001). The scores for both site A and B were significantly higher in all domains (p < 0.001) than a previous Australian study conducted in 2013. Both sites returned low scores in the stress recognition domain. Medical staff perceived the teamwork climate as more positive than nursing staff (mean difference 16.6 [Wald χ Despite similar governance and external structures, differences were found in safety culture between the two research sites. This finding emphasises the importance of local, unit-level assessment of safety culture and planning of improvement strategies. This study adds to the evidence and implications for critical care clinical practice that these interventions need to be unit focused, supported by management and multidisciplinary in approach.

Sections du résumé

BACKGROUND
Safety culture is significant in the complex intensive care environment, where the consequences of human error can be catastrophic. Research within Australian intensive care units has been limited and little is understood about the safety culture of intensive care units in Queensland.
AIM
The aim was to evaluate and compare safety culture in the intensive care units of two metropolitan tertiary hospitals in Queensland.
METHOD
A cross-sectional survey, Safety Attitudes Questionnaire, was administered to all medical, nursing and allied health professionals in the research sites (A and B) during January and February 2016. Data were collated into six safety culture domains of teamwork climate, safety climate, job satisfaction, stress recognition, working conditions and perceptions of management. Comparison was made using t-tests and between demographic groups using generalising estimating equations.
RESULTS
In total, 206 surveys were returned from 522 staff (39.5% response rate). The majority of respondents were nurses (80.6%). Site B scored all domains of the safety attitudes questionnaire significantly higher than Site A (p < 0.001). The scores for both site A and B were significantly higher in all domains (p < 0.001) than a previous Australian study conducted in 2013. Both sites returned low scores in the stress recognition domain. Medical staff perceived the teamwork climate as more positive than nursing staff (mean difference 16.6 [Wald χ
CONCLUSION
Despite similar governance and external structures, differences were found in safety culture between the two research sites. This finding emphasises the importance of local, unit-level assessment of safety culture and planning of improvement strategies. This study adds to the evidence and implications for critical care clinical practice that these interventions need to be unit focused, supported by management and multidisciplinary in approach.

Identifiants

pubmed: 30660433
pii: S1036-7314(18)30170-X
doi: 10.1016/j.aucc.2018.11.069
pii:
doi:

Types de publication

Journal Article Multicenter Study

Langues

eng

Pagination

4-11

Informations de copyright

Copyright © 2018 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

Auteurs

Elspeth Dunstan (E)

Clinical Nurse, Intensive Care Unit, Princess Alexandra Hospital, Ipswich Rd, Woolloongabba, QLD, Australia. Electronic address: Elspeth.dunstan@health.qld.gov.au.

Fiona Coyer (F)

School of Nursing, Queensland University of Technology and Intensive Care Services, Royal Brisbane and Women's Hospital, Metro North Health Service District, Queensland, Australia; Institute for Skin Integrity and Infection Prevention, University of Huddersfield, United Kingdom. Electronic address: f.coyer@qut.edu.au.

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