Rozenbojm Michael Diamant, Nichol Kathryn, Spielmann Stephanie, Holness D Linn
Department of Occupational and Environmental Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
Department of Occupational and Environmental Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Collaborative Academic Practice, University Health Network, Toronto, Ontario, Canada; Centre for Research Expertise in Occupational Disease, Toronto, Ontario, Canada.
Am J Infect Control. 2015 Feb;43(2):115-20. doi: 10.1016/j.ajic.2014.10.027. Epub 2014 Dec 16.
Despite the existence of formal guidelines for the acute health care sector, nurses' adherence to recommended use of facial protective equipment (FPE) to prevent occupational transmission of communicable respiratory disease remains suboptimal. In addition to individual factors such as knowledge and education, group factors such as shared perceptions of organizational support for safety may influence adherence. These group safety climate perceptions can differ depending on the pace and type of work, local leadership, and organizational structure of each unit.
An analysis of a data set from a cross-sectional survey of 1,074 nurses in 45 units of 6 acute care hospitals was conducted. Variance components analysis was performed to examine the variance in perceptions of safety climate and adherence between units. Hierarchical linear modeling using unit-level safety climate dimensions was conducted to determine if unit-level safety climate dimensions were predictors of nurses' adherence to FPE.
Findings revealed statistically significant unit variances in adherence and 5 of the 6 unit-level safety climate dimensions (P < .05). Furthermore, a hierarchical model suggested that tenure and unit-level communication were significantly associated with increased adherence to FPE (P < .05).
Unit-level safety climate measures varied significantly between units. Strategies to improve unit-level communication regarding safety should assist in improving adherence to FPE.
尽管急性医疗保健部门存在正式指南，但护士在预防呼吸道传染病职业传播方面对推荐使用面部防护设备（FPE）的依从性仍不理想。除了知识和教育等个体因素外，诸如对组织安全支持的共同认知等群体因素也可能影响依从性。这些群体安全氛围认知可能因每个单位的工作节奏和类型、当地领导以及组织结构的不同而有所差异。
对6家急性护理医院中45个单位的1074名护士进行横断面调查所获得的数据进行分析。进行方差成分分析以检验各单位之间安全氛围认知和依从性的差异。使用单位层面的安全氛围维度进行分层线性建模，以确定单位层面的安全氛围维度是否是护士对FPE依从性的预测因素。
研究结果显示，在依从性以及6个单位层面安全氛围维度中的5个维度上，各单位之间存在统计学上的显著差异（P < 0.05）。此外，一个分层模型表明，任期和单位层面的沟通与对FPE依从性的提高显著相关（P < 0.05）。
各单位之间单位层面的安全氛围措施差异显著。改善单位层面关于安全的沟通的策略应有助于提高对FPE的依从性。
