Measuring the safety climate in an Australian emergency department.


Journal

International emergency nursing
ISSN: 1878-013X
Titre abrégé: Int Emerg Nurs
Pays: England
ID NLM: 101472191

Informations de publication

Date de publication:
Sep 2021
Historique:
received: 10 09 2020
revised: 14 06 2021
accepted: 23 06 2021
pubmed: 5 9 2021
medline: 9 11 2021
entrez: 4 9 2021
Statut: ppublish

Résumé

There are numerous intricate human, system and cultural factors that can impact upon the safe and effective implementation of patient safety systems (e.g. rapid response systems). Safety climate is one of these factors and is a measure of frontline healthcare workers' shared perceptions, behaviours, beliefs and attitudes towards the organisation's culture of safety. Safety climate scores are also associated with the frequency of errors and adverse events in the healthcare setting. However, there is little evidence regarding the relationships between attitudes to patient safety and staff characteristics such as emergency care expertise and experience. The aims of this study were to measure perceptions of the safety climate in an Australian metropolitan Emergency Department and examine relationships between safety climate perceptions and staff characteristics. The Victorian Managed Insurance Authority Safety Climate Survey was administered to all doctors (n = 44) and nurses (n = 119) at an Australian emergency department. Completed surveys were received from 127 (78%) respondents, 25 (52%) doctors and 100 (84%) nurses. Reliability analysis showed very good internal consistency of all 43-items of the survey (α = 0.94). With the exception of stress recognition, nurses rated the organisation's commitment to patient safety higher than doctors in all remaining attitudinal domains (p < 0.05). Both groups acknowledge that fatigue, increased workload and stress recognition negatively impacts upon patient safety. There was a significant trend for declining safety climate ratings related to participants' clinical competence level and experience across all domains except stress recognition (p < 0.05). The Safety Climate Survey appears to be a reliable measure of patient safety climate for use in Emergency Departments. Emergency doctors and nurses did not perceive there to be a strong organisational commitment to patient safety in an Australian Emergency Department. Emergency Departments can provide a safer environment through genuine commitment to safety culture improvement which capitalises on the insights, intrinsic strengths and behaviours characteristic of the ED team's expertise and experience. This kind of commitment can positively influence the effectiveness of actions taken to minimise risk to patient safety and improve ED staff job satisfaction and effectiveness.

Sections du résumé

BACKGROUND BACKGROUND
There are numerous intricate human, system and cultural factors that can impact upon the safe and effective implementation of patient safety systems (e.g. rapid response systems). Safety climate is one of these factors and is a measure of frontline healthcare workers' shared perceptions, behaviours, beliefs and attitudes towards the organisation's culture of safety. Safety climate scores are also associated with the frequency of errors and adverse events in the healthcare setting. However, there is little evidence regarding the relationships between attitudes to patient safety and staff characteristics such as emergency care expertise and experience. The aims of this study were to measure perceptions of the safety climate in an Australian metropolitan Emergency Department and examine relationships between safety climate perceptions and staff characteristics.
METHODS METHODS
The Victorian Managed Insurance Authority Safety Climate Survey was administered to all doctors (n = 44) and nurses (n = 119) at an Australian emergency department.
RESULTS RESULTS
Completed surveys were received from 127 (78%) respondents, 25 (52%) doctors and 100 (84%) nurses. Reliability analysis showed very good internal consistency of all 43-items of the survey (α = 0.94). With the exception of stress recognition, nurses rated the organisation's commitment to patient safety higher than doctors in all remaining attitudinal domains (p < 0.05). Both groups acknowledge that fatigue, increased workload and stress recognition negatively impacts upon patient safety. There was a significant trend for declining safety climate ratings related to participants' clinical competence level and experience across all domains except stress recognition (p < 0.05).
CONCLUSIONS CONCLUSIONS
The Safety Climate Survey appears to be a reliable measure of patient safety climate for use in Emergency Departments. Emergency doctors and nurses did not perceive there to be a strong organisational commitment to patient safety in an Australian Emergency Department. Emergency Departments can provide a safer environment through genuine commitment to safety culture improvement which capitalises on the insights, intrinsic strengths and behaviours characteristic of the ED team's expertise and experience. This kind of commitment can positively influence the effectiveness of actions taken to minimise risk to patient safety and improve ED staff job satisfaction and effectiveness.

Identifiants

pubmed: 34481382
pii: S1755-599X(21)00086-0
doi: 10.1016/j.ienj.2021.101048
pii:
doi:

Types de publication

Journal Article

Langues

eng

Pagination

101048

Informations de copyright

Copyright © 2021 Elsevier Ltd. All rights reserved.

Auteurs

Clifford J Connell (CJ)

Monash Nursing and Midwifery, Monash University, PO Box 527, Frankston, VIC 3199, Australia. Electronic address: clifford.connell@monash.edu.

Simon Cooper (S)

School of Nursing and Health Professions, Federation University, Gippsland Campus, Churchill, VIC 3842, Australia. Electronic address: s.cooper@federation.edu.au.

Ruth Endacott (R)

Monash Nursing and Midwifery, Monash University, PO Box 527, Frankston, VIC 3199, Australia; School of Nursing and Midwifery, University of Plymouth, Drake Circus, Plymouth PL4 8AA, United Kingdom. Electronic address: ruth.endacott@monash.edu.

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