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Keeping Patients Safe: The Relationship Between Patient Safety Climate and Patient Outcomes



Roxanne Louise O'Brien

Increasing complexity and use of technology in health care has provided life-saving advances in patient care and also increased risks of medical error. Developing a culture of safety and assessing the safety climate or measurable attitudes of staff, in hospitals has been recommended as approaches to enhancing the safety of hospitalized patients. This study used a cross-sectional, descriptive, model testing design to evaluate the relationship between patient safety climate, patient outcomes, staffing, and hospital performance measures. The sample consisted of multiple patient care units and ancillary departments in 10 hospitals. Secondary databases used in this research included responses to a patient safety attitudes survey, unit level patient falls and hospital acquired pressure ulcers, unit staffing data, and hospital level performance measures. Bivariate correlations, descriptive statistics, ANOVA, and hierarchical linear modeling were used to describe unit and hospital level safety attitudes. Patient safety climate was found to vary significantly across units and among hospitals. There were no relationships found between patient safety climate, falls and hospital acquired pressure ulcers. Higher staffing hours in ICU were a confounder in the analysis of a significant relationship between patient safety climate and nurse staffing. A reduction in the failure rate for the community acquired pneumonia hospital performance measure was associated with staff perception of support from unit managers. Understanding how patient safety climate influences the safety of hospitalized patients is currently evolving. Continuing research in this area is warranted to explore this relationship.

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