Health and Safety Practices Survey of Healthcare Workers

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Differences in Safety Climate Perceptions by Worker, Workplace and Work Schedule Characteristics

Here you will learn how perceptions of workplace safety differ by healthcare worker, work schedule and workplace characteristics.


Safety climate, defined as shared perceptions of employees about the importance of safety within their organization, is associated with patient and healthcare worker safety and outcomes, and with healthcare worker injuries, exposures, and compliance with safe work practices.1-4

The Health and Safety Practices Survey of Healthcare Workers provided an opportunity to compare differences in safety climate dimensions over a wide range of employee, work schedule, and workplace characteristics. Survey responses were analyzed from 10,168 respondents who completed the core module and one or more of the safety perception questions.  More than half of the respondents were nurses, with increasingly smaller proportions of technologists/technicians, anesthesiologists, dental practitioners, respiratory therapists, other healthcare workers, and pharmacy practitioners. The safety perception questions were grouped into the following safety climate themes: management commitment to health and safety; safety precautions; exposure to risk; and reporting of injuries without fear of reprisal. Multivariable regression analyses were used to examine associations among worker and workplace characteristics and safety climate perception theme scores.

Major Findings:

  • Across safety climate perception themes, mean scores were highest (most positive) for dentists and for healthcare workers who were fee-for-service or salaried, were self-employed, worked day shifts and shifts < 11 hours, spent 1-50% of their time in patient care, were employed in smaller workplaces (<100 workers), and worked in ambulatory care facilities (as compared to hospitals).
  • Safety climate perception scores were lowest (most negative) for contract employees and for employees who worked shifts longer than 12 hours or variable shifts, had mandatory overtime, or worked evening and night shifts.


Overall, the findings suggest that workers in professions lower in the healthcare hierarchy and those working long or unusual work schedules warrant particular attention when designing interventions targeting safety climate.


  1. DeJoy DM, Schaffer BS, Wilson MG, Vandenberg RJ, Butts MM. 2004. Creating safer workplaces: assessing the determinants and role of safety climate. J Safety Res. 35(1):81-90.
  2. Stone PW, Hughes R, Dailey M. 2008. Creating a safe and high-quality health care environment. In: Hughes RG, ed. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville, MD.
  3. Taylor JA, Dominici F, Agnew J, Gerwin D, Morlock L, Miller MR. Do nurse and patient injuries share common antecedents? An analysis of associations with safety climate and working conditions. BMJ Qual Saf. 21(2):101-111.
  4. Grosch JW, Gershon RR, Murphy LR, DeJoy DM. 1999. Safety climate dimensions associated with occupational exposure to blood-borne pathogens in nurses. Am J Ind Med. Suppl 1: 122-124.

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Page last reviewed: November 19, 2018