Relationship between patient safety climate and adherence to standard precautions

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Abstract

Background:

Standard precautions (SPs) are designed to limit bloodborne pathogen exposures among health care workers (HCWs) and health care–associated infections. SP adherence is globally suboptimal; however, reasons are underexplored. This study aim was to explore the relationships among safety climate factors and SP adherence by HCWs in hospitals using newly developed survey and observational tools.

Methods:

Cross-sectional data from 11 units in 5 hospitals were collected between March and September 2015. A patient safety and standard precaution survey was administered to nurses and pooled with data from observations of HCW-patient interactions using defined SP indications. Descriptive statistics of distributions, frequencies, and Pearson correlation coefficients were calculated to determine the unit-level relationships among dimensions of the patient safety climate and unit percentages of SP adherence (P < .05).

Results:

There were 540 HCW-patient encounters with 1,713 SP indications and 140 surveys collected. Although most nurses (94%) reported always or often adhering to SPs and generally reported positive scores on unit safety climate, observed SP adherence was 62% (unit range, 31%-80%). Only 30% of nurses rated staffing positively, and this was inversely related to observed SP adherence.

Conclusions:

Adherence to the full complement of observed SP behaviors by HCWs of all types was suboptimal. The relationship between safety climate, particularly staffing, and adherence to SPs warrants further testing.

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