Soh Sze-Ee, Morello Renata, Rifat Sheral, Brand Caroline, Barker Anna
Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 99 Commercial Road, Melbourne, Vic. 3004, Australia. Email: ; ;
Aust Health Rev. 2018 Apr;42(2):203-209. doi: 10.1071/AH16172.
Objectives The aim of the present study was to explore nurse perceptions of safety climate in acute Australian hospitals. Methods Participants included 420 nurses who have worked on 24 acute wards from six Australian hospitals. The Safety Attitudes Questionnaire (SAQ) Short Form was used to quantify nurse perceptions of safety climate and benchmarked against international data. Generalised linear mixed models were used to explore factors that may influence safety climate. Results On average, 53.5% of nurses held positive attitudes towards job satisfaction followed by teamwork climate (50.5%). There was variability in SAQ domain scores across hospitals. The safety climate and perceptions of hospital management domains also varied across wards within a hospital. Nurses who had worked longer at a hospital were more likely to have poorer perceptions of hospital management (β=-5.2; P=0.014). Overall, nurse perceptions of safety climate appeared higher than international data. Conclusions The perceptions of nurses working in acute Victorian and New South Wales hospitals varied between hospitals as well as across wards within each hospital. This highlights the importance of surveying all hospital wards and examining the results at the ward level when implementing strategies to improve patient safety and the culture of safety in organisations. What is known about the topic? Prior studies in American nursing samples have shown that hospitals with higher levels of safety climate have a lower relative incidence of preventable patient complications and adverse events. Developing a culture of safety in hospitals may be useful in targeting efforts to improve patient safety. What does this paper add? This paper has shown that the perceptions of safety climate among nurses working in acute Australian hospitals varied between hospitals and across wards within a hospital. Only half the nurses also reported positive attitudes towards job satisfaction and teamwork climate. What are the implications for practitioners? Programs or strategies that aim to enhance teamwork performance and skills may be beneficial to improving the culture of safety in hospitals. Wards may also have their own safety 'subculture' that is distinct from the overall hospital safety culture. This highlights the importance of tailoring and targeting quality improvement initiatives at the ward level.
目标 本研究旨在探究澳大利亚急症医院护士对安全氛围的认知。方法 参与者包括来自澳大利亚六家医院24个急症病房的420名护士。使用安全态度问卷（SAQ）简表来量化护士对安全氛围的认知，并与国际数据进行对比。采用广义线性混合模型来探究可能影响安全氛围的因素。结果 平均而言，53.5%的护士对工作满意度持积极态度，其次是团队合作氛围（50.5%）。各医院间SAQ领域得分存在差异。医院管理领域的安全氛围和认知在医院内各病房间也有所不同。在医院工作时间较长的护士对医院管理的认知更可能较差（β=-5.2；P=0.014）。总体而言，护士对安全氛围的认知似乎高于国际数据。结论 在维多利亚州和新南威尔士州急症医院工作的护士的认知在不同医院以及各医院内的不同病房间存在差异。这凸显了在实施提高患者安全和组织安全文化的策略时，对所有医院病房进行调查并在病房层面检查结果的重要性。关于该主题已知的情况是什么？此前针对美国护士样本的研究表明，安全氛围水平较高的医院可预防患者并发症和不良事件的相对发生率较低。在医院营造安全文化可能有助于针对性地努力提高患者安全。本文补充了什么？本文表明，澳大利亚急症医院护士对安全氛围的认知在不同医院以及医院内各病房间存在差异。只有一半的护士对工作满意度和团队合作氛围也持积极态度。对从业者有何启示？旨在提高团队合作绩效和技能的项目或策略可能有助于改善医院的安全文化。病房可能也有其自身与整体医院安全文化不同的安全“亚文化”。这凸显了在病房层面定制和针对性开展质量改进举措的重要性。
