Gershon R R, Karkashian C D, Grosch J W, Murphy L R, Escamilla-Cejudo A, Flanagan P A, Bernacki E, Kasting C, Martin L
Department of Environmental Health Sciences, School of Public Health, The Johns Hopkins University, Baltimore, MD 21205, USA.
Am J Infect Control. 2000 Jun;28(3):211-21. doi: 10.1067/mic.2000.105288.
In the industrial setting, employee perceptions regarding their organization's commitment to safety (i.e., safety climate) have been shown to be important correlates to both the adoption and maintenance of safe work practices and to workplace injury rates. However, safety climate measures specific to the hospital setting have rarely been evaluated. This study was designed to develop a short and effective tool to measure hospital safety climate with respect to institutional commitment to bloodborne pathogen risk management programs and to assess the relationship between hospital safety climate and (1) employee compliance with safe work practices and (2) incidents of workplace exposure to blood and other body fluids.
A questionnaire, which included 46 safety climate items, was developed and tested on a sample of 789 hospital-based health care workers at risk for bloodborne pathogen exposure incidents.
A 20-item hospital safety climate scale that measures hospitals' commitment to bloodborne pathogen risk management programs was extracted through factor analysis from the 46 safety climate items. This new hospital safety climate scale subfactored into 6 different organizational dimensions: (1) senior management support for safety programs, (2) absence of workplace barriers to safe work practices, (3) cleanliness and orderliness of the work site, (4) minimal conflict and good communication among staff members, (5) frequent safety-related feedback/training by supervisors, and (6) availability of personal protective equipment and engineering controls. Of these, senior management support for safety programs, absence of workplace barriers to safe work practices, and cleanliness/orderliness of the work site were significantly related to compliance (P<.05). In addition, both senior management support for safety programs and frequent safety-related feedback/training were significantly related to workplace exposure incidents (P<.05). Thus the most significant finding in terms of enhancing compliance and reducing exposure incidents was the importance of the perception that senior management was supportive of the bloodborne pathogen safety program.
Hospital safety climate with regards to bloodborne pathogens can be measured by using a short, 20-question scale that measures 6 separate dimensions. Whereas all 6 dimensions are essential elements of overall safety climate, 3 dimensions are significantly correlated with compliance, and 1 dimension (senior management support) is especially significant with regard to both compliance and exposure incidents. This short safety climate scale can be a useful tool for evaluating hospital employees' perceptions regarding their organization's bloodborne pathogens management program. In addition, because this scale measures specific dimensions of the safety climate, it can be used to target problem areas and guide the development of intervention strategies to reduce occupational exposure incidents to blood and other body fluids.
在工业环境中，员工对其组织安全承诺（即安全氛围）的认知已被证明与安全工作实践的采用和维持以及工伤发生率密切相关。然而，针对医院环境的安全氛围测量方法却很少得到评估。本研究旨在开发一种简短有效的工具，用于衡量医院在血源性病原体风险管理计划方面的机构承诺所形成的安全氛围，并评估医院安全氛围与（1）员工对安全工作实践的遵守情况以及（2）工作场所血液和其他体液暴露事件之间的关系。
编制了一份包含46个安全氛围项目的问卷，并在789名有血源性病原体暴露事件风险的医院医护人员样本中进行了测试。
通过对46个安全氛围项目进行因子分析，提取出了一个包含20个项目的医院安全氛围量表，该量表用于衡量医院对血源性病原体风险管理计划的承诺。这个新的医院安全氛围量表细分为6个不同的组织维度：（1）高级管理层对安全计划的支持；（2）安全工作实践不存在工作场所障碍；（3）工作场所的清洁与有序；（4）员工之间冲突最小且沟通良好；（5）主管频繁提供与安全相关的反馈/培训；（6）个人防护设备和工程控制措施的可用性。其中，高级管理层对安全计划的支持、安全工作实践不存在工作场所障碍以及工作场所的清洁/有序与遵守情况显著相关（P<0.05）。此外，高级管理层对安全计划的支持和频繁的安全相关反馈/培训均与工作场所暴露事件显著相关（P<0.05）。因此，就提高遵守情况和减少暴露事件而言，最显著的发现是员工认为高级管理层支持血源性病原体安全计划的重要性。
可以使用一个简短的、包含20个问题的量表来测量医院在血源性病原体方面的安全氛围，该量表涵盖6个不同维度。虽然所有6个维度都是整体安全氛围的重要组成部分，但其中3个维度与遵守情况显著相关，1个维度（高级管理层支持）在遵守情况和暴露事件方面尤为显著。这个简短的安全氛围量表可作为一个有用的工具，用于评估医院员工对其组织血源性病原体管理计划的认知。此外，由于该量表测量了安全氛围的特定维度，它可用于确定问题领域，并指导制定干预策略以减少工作场所血液和其他体液的暴露事件。
