Patient safety climate in Maltese intensive care units

Abstract

The World Health Organization (2016a) defines patient safety as the absence of preventable harm to a patient during the delivery of healthcare. Evidence from several reports and research studies reflect the high incidence and subsequent high cost of patient harm in general and within Intensive Care Units. Against this background, the present research study tests a theoretical framework addressing relationships among patient safety climate dimensions and their impact on safety performance in Maltese Intensive Care Units. The dimensions refer to safety in terms of procedure suitability and information flow, managerial safety practices and priority of safety. A retrospective cross-sectional descriptive and analytical research study was conducted. The target population was recruited from the three Intensive Care Units in the main tertiary level hospital in Malta: the Intensive Therapy Unit, the Cardiac Intensive Care Unit and the Neonatal Paediatric Intensive Care Unit. A sample of 215 healthcare professionals, who fit the eligibility criteria, participated in this research study, achieving a response rate of 82.7%. The ‘Survey on Patient Safety Climate’ (Appendix B) was adopted from Naveh, Katz-Navon and Stern (2005) and utilised to elicit perceptions from healthcare professionals on patient safety climate. Overall, findings from the present research study support the theoretical framework. Findings support the hypothesis: the higher the extent to which safety procedures are perceived as suitable to the Intensive Care Units’ daily work demands and processes, the lower the Intensive Care Units’ clinical incidents (r = -0.269, p ≤ 0.01). Findings also support the hypothesis: the higher the extent to which safety information flow is perceived as clear and unambiguous to the Intensive Care Units’ daily work demands and processes, the lower the Intensive Care Units’ clinical incidents (r = -0.295, p ≤ 0.01). Furthermore, findings also partially support the hypotheses that managerial safety practices mediate the relationship between safety procedure suitability, safety information flow, and clinical incidents (p = 0.009, p = 0.014 respectively). Moreover, findings partially support the hypotheses that priority of safety mediates the relationship between safety procedure suitability, safety information flow, managerial safety practices and clinical incidents (p = 0.002, p = 0.002, p = 0.042 respectively).