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Learning Objective 1: Identify the characteristics associated with a culture of safety operationalized as work unit and organization support
Learning Objective 2: Describe the relationships between work unit and organization support on patient safety indicators
Framework: High Reliability Organization Theory was used as a framework for the study. HROT originated from studies conducted in non-healthcare settings identified as high risk but relatively error-free. Helathcare leaders have suggested HROT may provide a useful framework for evaluating healthcare settings.
Methodology: OS and WS were operationalized using the National Database for Nursing Quality Indicators® (NDNQI®) RN Survey with Job Satisfaction Scales. Patient Safety was operationalized using four Agency for Healthcare Research and Quality (AHRQ) Patient Safety Indicators: Decubitus Ulcer, Selected Infections due to Medical Care, Failure to Rescue (FTR), and Deep Vein Thrombosis. A structural equation model was developed with adequate fit indices (χ2 = 40.811, df= 27, p= 0.234; CFI= 0.930; RMSEA= 0.065; SRMR= 0.074).
Results: Unexpectedly, increased OS was associated significantly (p= .030) with increase Patient Safety events. A promising, though non-significant finding, was increased WS and OS were associated with decreased Patient Safety events and FTR rates. Increased Teamwork, a component of WS was associated with decreased rates of FTR and Patient Safety events.
Discussion: Nurses perceptions of care were used to operationalize the consturct of a culture of safety and the relationships between work unit and organization support and occurence of adverse outcomes was evaluated. Continued study is needed particularly of the impact of teamwork on adverse patient outcomes and overall work unit support.