Section of Neonatology, Houston Center for Quality of Care and Utilization Studies, Baylor College of Medicine, VA HSR&D, 2002 Holcombe Boulevard, Houston, TX 77030, USA.
Arch Dis Child Fetal Neonatal Ed. 2012 Mar;97(2):F127-32. doi: 10.1136/archdischild-2011-300612.
Neonatal intensive care unit (NICU) safety culture, as measured by the Safety Attitudes Questionnaire (SAQ), varies widely. Associations with clinical outcomes in the adult intensive care unit setting make the SAQ an attractive tool for comparing clinical performance between hospitals. Little information is available on the use of the SAQ for this purpose in the NICU setting.
To determine whether the dimensions of safety culture measured by the SAQ give consistent results when used as a NICU performance measure.
Cross-sectional survey of caregivers in 12 NICUs, using the six scales of the SAQ: teamwork climate, safety climate, job satisfaction, stress recognition, perceptions of management and working conditions. NICUs were ranked by quantifying their contribution to overall risk-adjusted variation across the scales. Spearman rank correlation coefficients were used to test for consistency in scale performance. The authors then examined whether performance in the top four NICUs in one scale predicted top four performance in others.
There were 547 respondents in 12 NICUs. Of 15 NICU-level correlations in performance ranking, two were >0.7, seven were between 0.4 and 0.69, and the six remaining were <0.4. The authors found a trend towards significance in comparing the distribution of performance in the top four NICUs across domains with a binomial distribution p=0.051, indicating generally consistent performance across dimensions of safety culture.
A culture of safety permeates many aspects of patient care and organisational functioning. The SAQ may be a useful tool for comparative performance assessments among NICUs.
新生儿重症监护病房（NICU）的安全文化，通过安全态度问卷（SAQ）进行衡量，差异很大。在成人重症监护病房环境中，与临床结果的关联使得 SAQ 成为比较医院之间临床绩效的有吸引力的工具。关于在 NICU 环境中出于此目的使用 SAQ 的信息很少。
确定使用 SAQ 作为 NICU 绩效衡量标准时，安全文化的维度是否给出一致的结果。
对 12 个 NICU 的护理人员进行横断面调查，使用 SAQ 的六个量表：团队合作氛围、安全氛围、工作满意度、压力识别、管理层看法和工作条件。通过量化每个 NICU 在各量表中的总体风险调整变异的贡献来对 NICU 进行排名。使用 Spearman 秩相关系数来检验量表表现的一致性。然后，作者检查了在一个量表中排名前四的 NICU 的表现是否可以预测其他量表中排名前四的表现。
在 12 个 NICU 中有 547 名受访者。在 15 个 NICU 级别的绩效排名相关性中，有两个大于 0.7，七个在 0.4 到 0.69 之间，其余六个小于 0.4。作者发现，在比较各领域中排名前四的 NICU 的表现分布与二项分布之间存在趋势，p=0.051，表明安全文化的各个维度的表现通常一致。
安全文化渗透到患者护理和组织运作的许多方面。SAQ 可能是 NICU 之间进行比较绩效评估的有用工具。
