From the *Medical Services, King Abdulaziz Medical City; †King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; ‡Department of Nephrology, Kanoo Kidney Center, Dammam Medical Complex, Dammam, Saudi Arabia; §Jeddah Kidney Center, King Fahd Hospital, Jeddah, Saudi Arabia; ∥Prince Salman Center for Kidney Diseases; and ¶Department of Nephrology, Riyadh Armed Forces Hospital, Riyadh, Saudi Arabia.
J Patient Saf. 2014 Jun;10(2):101-4. doi: 10.1097/PTS.0000000000000111.
The aim of this study was to assess the safety climate as perceived by nurses and physicians in the dialysis units in Saudi Arabia.
This is a cross-sectional survey-based multicenter study using the Safety Climate Scale, which assesses the perception by staff of the prevailing climate of safety. We used 17 items in this survey. These could be further divided into 3 summative categories: (a) handling of errors and safety concerns (9 items), (b) leadership emphasis of safety (7 items), and (c) overall safety recommendation (1 item). The survey uses 5 Likert scale options (1, disagree strongly; 2, disagree slightly; 3, neutral; 4, agree slightly; and 5, agree strongly).
There were 509 respondents--a response rate of 76.6% and 53.3% among nurses and physicians, respectively. The internal consistency using Cronbach α was 0.899. The overall mean (SD) of satisfaction with safety climate was higher among the nurses than the physicians (4.13 [1.1] and 4.05 [1.7], respectively; P = 0.029). The overall agreement rate was 73.8%, with more nurses than physicians agreeing that safety climate prevails the dialysis center (75.4% versus 72.1%, respectively; P = 0.047).The respondents perceived a stronger commitment to safety from their clinical area leaders than from senior leaders in the organization (76.2% and 72.4%, respectively). In addition, the physicians gave lower scores to more questions than the nurses particularly in 3 areas, namely, "leadership is driving us to be a safety-centered institution" (71.5% versus 76.5%; P = 0.037), "I am encouraged by my colleagues to report any patient safety concerns I may have" (67.4% versus 84.7%; P = 0.03), and "I know proper channels to ask questions about safety" (69.6% versus 87.2%; P = 0.002).The scores by the physicians in all the 3 summative categories were again less than the scores by the nurses, but this did not reach a statistical significance.
The nurses had higher perceptions of a prevailing safety climate than the physicians. There was a perception of a stronger commitment to safety from their clinical area leaders than from senior leaders in the organization. Senior management needs to relay their commitments to safety more effectively especially to physicians and to open clear and easily accessible channels for communication for safety issues.
本研究旨在评估沙特阿拉伯透析单位护士和医生对安全氛围的看法。
这是一项基于横断面调查的多中心研究，使用安全氛围量表评估员工对普遍安全氛围的看法。我们在这项调查中使用了 17 个项目。这些项目可以进一步分为 3 个总结性类别：(a)处理错误和安全问题(9 项)，(b)领导对安全的重视(7 项)，(c)总体安全建议(1 项)。该调查使用 5 点李克特量表选项(1，强烈不同意；2，略有不同意；3，中立；4，略有同意；5，强烈同意)。
共有 509 名受访者应答，护士和医生的应答率分别为 76.6%和 53.3%。使用 Cronbach α 的内部一致性为 0.899。护士对安全氛围的总体满意度(4.13 [1.1])高于医生(4.05 [1.7]；P=0.029)。总体一致率为 73.8%，护士比医生更同意安全氛围在透析中心占主导地位(分别为 75.4%和 72.1%；P=0.047)。受访者认为临床领导对安全的承诺比组织内的高级领导更强(分别为 76.2%和 72.4%)。此外，医生对更多问题的评分低于护士，尤其是在 3 个领域，即“领导正在推动我们成为以安全为中心的机构”(分别为 71.5%和 76.5%；P=0.037)，“鼓励我报告我可能遇到的任何患者安全问题”(分别为 67.4%和 84.7%；P=0.03)，“我知道正确的渠道来询问有关安全的问题”(分别为 69.6%和 87.2%；P=0.002)。在所有 3 个总结性类别中，医生的得分再次低于护士，但未达到统计学意义。
护士对普遍安全氛围的看法高于医生。他们对来自临床领导的安全承诺的看法强于来自组织内高级领导的安全承诺。高级管理层需要更有效地传达对安全的承诺，特别是对医生，并为安全问题建立清晰和易于访问的沟通渠道。
