CNE Article: Safety Culture In Australian Intensive Care Units: Establishing A Baseline For Quality Improvement

Author:

Chaboyer Wendy1,Chamberlain Di2,Hewson-Conroy Karena3,Grealy Bernadette4,Elderkin Tania5,Brittin Maureen6,McCutcheon Catherine7,Longbottom Paula8,Thalib Lukman9

Affiliation:

1. Wendy Chaboyer is a faculty member and director of the National Health and Medical Research Council Centre of Research Excellence in Nursing Interventions for Hospitalised Patients, Research Centre for Clinical and Community Practice Innovation, Griffith Health Institute, Griffith University, Queensland, Australia.

2. Di Chamberlain is a senior lecturer and coordinator of critical care studies, Flinders University, Adelaide, South Australia.

3. Karena Hewson-Conroy is research and quality manager, New South Wales Intensive Care Coordination and Monitoring Unit, and honorary associate, Faculty of Nursing, Midwifery and Health, University of Technology, Sydney, Australia.

4. Bernadette Grealy is a clinical nurse manager in the intensive care department, Queen Elizabeth Hospital, Adelaide, South Australia.

5. Tania Elderkin is a clinical nurse educator and a clinical research nurse in the intensive care unit, Barwon Health, Victoria, Australia.

6. Maureen Brittin is codirector of maternal and child health, Royal Darwin Hospital, Darwin, Northern Territory, Australia.

7. Catherine McCutcheon is an intensive care liaison nurse practitioner, Calvary Health Care, Canberra, Australia.

8. Paula Longbottom is a research assistant, Research Centre for Clinical and Community Practice Innovation, Griffith University.

9. Lukman Thalib is an associate professor in the Faculty of Medicine, University of Kuwait, Safat, Kuwait.

Abstract

Background Workplace safety culture is a crucial ingredient in patients’ outcomes and is increasingly being explored as a guide for quality improvement efforts. Objectives To establish a baseline understanding of the safety culture in Australian intensive care units. Methods In a nationwide study of physicians and nurses in 10 Australian intensive care units, the Safety Attitudes Questionnaire intensive care unit version was used to measure safety culture. Descriptive statistics were used to summarize the mean scores for the 6 subscales of the questionnaire, and generalized-estimation-equations models were used to test the hypotheses that safety culture differed between physicians and nurses and between nurse leaders and bedside nurses. Results A total of 672 responses (50.6% response rate) were received: 513 (76.3%) from nurses, 89 (13.2%) from physicians, and 70 (10.4%) from respondents who did not specify their professional group. Ratings were highest for teamwork climate and lowest for perceptions of hospital management and working conditions. Four subscales, job satisfaction, teamwork climate, safety climate, and working conditions, were rated significantly higher by physicians than by nurses. Two subscales, working conditions and perceptions of hospital management, were rated significantly lower by nurse leaders than by bedside nurses. Conclusions Measuring the baseline safety culture of an intensive care unit allows leaders to implement targeted strategies to improve specific dimensions of safety culture. These strategies ultimately may improve the working conditions of staff and the care that patients receive. (American Journal of Critical Care. 2013;22:93–103)

Publisher

AACN Publishing

Subject

Critical Care,General Medicine

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