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The relationship between safety climate and injury/exposure in an acute care hospital.

Gershon-RRM; Karkashian-C; Martin-LS; Grosch-J; Murphy-L
NOIRS 1997 Abstracts of the National Occupational Injury Research Symposium 1997. Washington, DC: National Institute for Occupational Safety and Health, 1997 Oct; :5
We have previously identified organizational commitment to safety (i.e., "safety climate") as an important correlate to safe work practices within the hospital workplace. To further advance our understanding of the complex relationship between safety climate and safe work practices and to clarify the role safety climate plays with respect to workplace injuries, such as needlestick injuries, we conducted a cross-sectional survey of employees at a large, 1000 bed, tertiary care hospital. A questionnaire was designed to assess and characterize specific aspects of safety climate and to determine the relationship, if any, between these aspects and injury rates among hospital-based health care workers. The resulting five-page questionnaire was psychometrically analyzed and validated. Employee perception of safety climate was measured using a fifty-item safety climate scale, which factored into three distinct constructs: (1) facility-wide safety climate, (2) departmental-based safety climate, and (3) environmental safety climate. The questionnaire also contained items on injuries employees had experienced within the previous six months and these were further subdivided into categories of injuries and exposures, including exposures to bloodborne pathogens. Employees’ compliance with safe work practices was measured using a 13 item compliance scale, and the questionnaires also included standard sociodemographic items. Most responses were based upon a five-point Likert scale (from strongly disagree to strongly agree). The confidential self-administered questionnaires were sent to a stratified random sample of clinical health care workers (i.e., those with direct patient or patient specimen contact) employed at a large, regional medical center. Responses were obtained from over 750 employees (60% response rate). Eighty-five percent of the respondents were female, the median age was 37 years, and the median tenure was 4.5 years. A total of 186 injuries (which occurred within the previous six months) were reported by 116 respondents. The respondents also reported 330 bloodborne pathogens exposures; 53 respondents reported a total of 74 needlesticks, 81 respondents reported 97 splashes to the mucosa, 52 respondents reported 81 cuts with sharp objects and 27 respondents reported 107 contacts with open wounds. Ninety-three (42%) of these exposures involved blood from a patient known to be infected with the human immunodeficiency virus and/or hepatitis B virus. Injuries were found to be highly correlated with two out of the three safety climate constructs. For example, low rates of injuries/exposures were correlated with strong facility-wide safety climate (p<.01) and departmental safety climate (p<.001). Employees who perceived a strong safety climate were significantly less likely to report workplace injuries. Safety climate was also significantly associated with high levels of selfreported compliance with safe work practices, and this was the case for all three safety climate constructs (p<.001). Two safety climate constructs (facility-wide and departmental- based) were found to be significantly correlated with injuries and exposures; employees who perceived a strong safety climate at work were significantly less likely to report workplace injuries and exposures. Since these data are cross-sectional, we cannot determine causality - i.e., employees with fewer injuries may perceive their workplace to be safer, and this can only be determined from prospective studies. Nevertheless, these results inform us and help to identify the important determinants of safety climate. This will help us to appropriately focus our resources in our efforts to minimize the risk of injury/exposure among hospitalbased health care workers.
Safety-climate; Injuries; Exposure-levels; Health-care-facilities; Work-practices; Needlestick-injuries; Employees; Employee-exposure; Questionnaires; Occupational-exposure; Bloodborne-pathogens; Safety-practices; Health-care-personnel; Demographic-characteristics; Age-factors; Sex-factors; Viral-diseases; Workplace-monitoring; Risk-analysis; Risk-factors
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Conference/Symposia Proceedings; Abstract
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NOIRS 1997 Abstracts of the National Occupational Injury Research Symposium