Pousette Anders, Larsman Pernilla, Eklöf Mats, Törner Marianne
Occupational and Environmental Medicine, The Sahlgrenska Academy, University of Gothenburg, Sweden; Department of Psychology, University of Gothenburg, Sweden.
Occupational and Environmental Medicine, The Sahlgrenska Academy, University of Gothenburg, Sweden.
J Safety Res. 2017 Jun;61:187-198. doi: 10.1016/j.jsr.2017.02.020. Epub 2017 Mar 10.
Patient safety climate/culture is attracting increasing research interest, but there is little research on its relation with organizational climates regarding other target domains. The aim of this study was to investigate the relationship between patient safety climate and occupational safety climate in healthcare.
The climates were assessed using two questionnaires: Hospital Survey on Patient Safety Culture and Nordic Occupational Safety Climate Questionnaire. The final sample consisted of 1154 nurses, 886 assistant nurses, and 324 physicians, organized in 150 work units, within hospitals (117units), primary healthcare (5units) and elderly care (28units) in western Sweden, which represented 56% of the original sample contacted.
Within each type of safety climate, two global dimensions were confirmed in a higher order factor analysis; one with an external focus relative the own unit, and one with an internal focus. Two methods were used to estimate the covariation between the global climate dimensions, in order to minimize the influence of bias from common method variance. First multilevel analysis was used for partitioning variances and covariances in a within unit part (individual level) and a between unit part (unit level). Second, a split sample technique was used to calculate unit level correlations based on aggregated observations from different respondents. Both methods showed associations similar in strength between the patient safety climate and the occupational safety climate domains.
The results indicated that patient safety climate and occupational safety climate are strongly positively related at the unit level, and that the same organizational processes may be important for the development of both types of organizational climate.
Safety improvement interventions should not be separated in different organizational processes, but be planned so that both patient safety and staff safety are considered concomitantly.
患者安全氛围/文化正吸引着越来越多的研究关注，但关于其与其他目标领域的组织氛围之间的关系，研究却很少。本研究的目的是调查医疗保健领域中患者安全氛围与职业安全氛围之间的关系。
使用两份问卷对氛围进行评估：《患者安全文化医院调查问卷》和《北欧职业安全氛围问卷》。最终样本包括1154名护士、886名助理护士和324名医生，他们分布在瑞典西部的150个工作单位中，这些单位包括医院（117个单位）、初级医疗保健机构（5个单位）和老年护理机构（28个单位），占最初联系样本的56%。
在每种安全氛围类型中，高阶因素分析确认了两个全局维度；一个是相对于自身单位的外部关注点，另一个是内部关注点。为了尽量减少共同方法偏差带来的偏倚影响，使用了两种方法来估计全局氛围维度之间的协变。首先，使用多层分析来划分单位内部部分（个体层面）和单位之间部分（单位层面）的方差和协方差。其次，使用拆分样本技术，根据不同受访者的汇总观察结果来计算单位层面的相关性。两种方法都显示患者安全氛围和职业安全氛围领域之间的关联强度相似。
结果表明，在单位层面，患者安全氛围和职业安全氛围呈强正相关，并且相同的组织过程可能对两种组织氛围的发展都很重要。
安全改进干预措施不应在不同的组织过程中分开进行，而应进行规划，以便同时考虑患者安全和工作人员安全。
