Safety culture in long-term care: a cross-sectional analysis of the Safety Attitudes Questionnaire in nursing and residential homes in the Netherlands

• Published in: BMJ quality & safety Vol. 25; no. 6; p. 424
• Main Authors: Buljac-Samardzic, Martina, van Wijngaarden, Jeroen Dh, Dekker-van Doorn, Connie M
• Format: Journal Article
• Language: English
• Published: England 01-06-2016
• Subjects: Attitude of Health Personnel; Cross-Sectional Studies; Female; Health Personnel - psychology; Health Personnel - statistics & numerical data; Humans; Long-Term Care - organization & administration; Long-Term Care - standards; Long-Term Care - statistics & numerical data; Male; Netherlands; Nursing Homes - organization & administration; Nursing Homes - standards; Nursing Homes - statistics & numerical data; Organizational Culture; Patient Safety; Residential Facilities - organization & administration; Residential Facilities - standards; Residential Facilities - statistics & numerical data; Surveys and Questionnaires; Patient safety; Nursing homes; Safety culture
• ISSN: 2044-5423
• DOI: 10.1136/bmjqs-2014-003397

The first objective was to investigate if the Safety Attitudes Questionnaire (SAQ) is appropriate to measure the safety attitude of caregivers in nursing and residential homes, and second, to compare safety attitude of these caregivers with available data of caregivers in other settings (ie, inpatients, intensive care unit (ICU) and ambulatory care).
Using a cross-sectional survey methodology, we obtained completed SAQ surveys from 521 caregivers (response rate of 53%) working in nine units in nine different nursing and residential homes in The Netherlands. Exploratory factor and Cronbach's alpha measures were used to analyse the psychometric properties of the SAQ. A correlation matrix was performed to study the relationship among the SAQ dimensions. A t test was performed to test significant differences between our sample and the benchmark settings.
The factor analyses and calculated Cronbach's alphas (α=0.56-0.80) for this sample confirmed the robustness of the SAQ scales. There was a high positive correlation between teamwork climate, job satisfaction, perceptions of management, safety climate and working conditions (r=0.31 to 63), but stress recognition had a negative correlation with each of the other dimensions (r=-0.13 to -0.18). Overall, the scores from the nursing and residential homes differed significantly from the benchmark settings.
The findings in this study confirmed that the SAQ could also be used in the nursing and residential homes setting. However, stress recognition in nursing and residential homes setting does not seem to be one of the dimensions of the safety attitude construct. Furthermore, Dutch nursing and residential homes have significantly higher scores on most dimensions of the SAQ compared with US inpatient units and comparable scores to ICUs (Dutch and US) and ambulatory services.