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Neonatal intensive care unit safety culture varies widely.

TitleNeonatal intensive care unit safety culture varies widely.
Publication TypeJournal Article
Year of Publication2012
AuthorsProfit J, Etchegaray J, Petersen LA, J Sexton B, Hysong SJ, Mei M, Thomas EJ
JournalArch Dis Child Fetal Neonatal Ed
Date Published2012 Mar
KeywordsAttitude of Health Personnel, Clinical Competence, Female, Health Services Research, Humans, Infant, Newborn, Intensive Care Units, Neonatal, Job Satisfaction, Male, Occupational Diseases, Occupational Health, Organizational Culture, Patient Care Team, Personnel, Hospital, Safety Management, Stress, Psychological, United States

BACKGROUND: Variation in healthcare delivery and outcomes in neonatal intensive care units (NICUs) may be partly explained by differences in safety culture.

OBJECTIVE: To describe NICU care giver assessments of safety culture, explore variability within and between NICUs on safety culture domains, and test for association with care giver characteristics.

METHODS: NICU care givers in 12 hospitals were surveyed using the Safety Attitudes Questionnaire (SAQ), which has six scales: teamwork climate, safety climate, job satisfaction, stress recognition, perception of management and working conditions. Scale means, SDs and percent positives (percent agreement) were calculated for each NICU.

RESULTS: There was substantial variation in safety culture domains among NICUs. Composite mean score across the six domains ranged from 56.3 to 77.8 on a 100-point scale and NICUs in the top four NICUs were significantly different from the bottom four (p<0.001). Across the six domains, respondent assessments varied widely, but were least positive on perceptions of management (3%-80% positive; mean 33.3%) and stress recognition (18%-61% positive; mean 41.3%). Comparisons of SAQ scale scores between NICUs and a previously published adult ICU cohort generally revealed higher scores for NICUs. Composite scores for physicians were 8.2 (p=0.04) and 9.5 (p=0.02) points higher than for nurses and ancillary personnel.

CONCLUSION: There is significant variation and scope for improvement in safety culture among these NICUs. The NICU variation was similar to variation in adult ICUs, but NICU scores were generally higher. Future studies should validate whether safety culture measured with the SAQ correlates with clinical and operational outcomes in NICUs.

Alternate JournalArch. Dis. Child. Fetal Neonatal Ed.
PubMed ID21930691
PubMed Central IDPMC3845658
Grant ListK02 HS017145 / HS / AHRQ HHS / United States
1UC1HS014246 / HS / AHRQ HHS / United States
1 K02 HS017145-02 / HS / AHRQ HHS / United States
K23 HD056298 / HD / NICHD NIH HHS / United States
K24 HD053771 / HD / NICHD NIH HHS / United States
1 K24 HD053771-01 / HD / NICHD NIH HHS / United States
1 K23 HD056298-01 / HD / NICHD NIH HHS / United States
1 PO1 HS1154401 / HS / AHRQ HHS / United States
UC1 HS014246 / HS / AHRQ HHS / United States