Hospital safety climate and its relationship with safe work practices and workplace exposure incidents

Background: In the industrial setting, employee perceptions regarding their organization's commitment to safety (ie, safety climate) have been shown t o be important correlates to both the adoption and maintenance of safe work practices and to workplace injury rates. However, safety climate measures specific to the hospital setting have rarely been evaluated. This study was designed to develop a short and effective tool to measure hospital safety climate with respect to institutional commitment to bloodborne pathogen ris k management programs and to assess the relationship between hospital safet y climate and (1) employee compliance with safe work practices and (2) inci dents of workplace exposure to blood and other body fluids. Methods: A questionnaire, which included 46 safety climate items, was devel oped and tested on a sample of 789 hospital-based health care workers at ri sk for bloodborne pathogen exposure incidents. Results: A 20-item hospital safety climate scale that measures hospitals' c ommitment to bloodborne pathogen risk management programs was extracted thr ough factor analysis from the 46 safety climate items. This new hospital sa fety climate scale subfactored into 6 different organizational dimensions: (1) senior management support for safety programs, (2) absence of workplace barriers to safe work practices, (3) cleanliness and orderliness of the wo rk site, (4) minimal conflict and good communication among staff members, ( 5) frequent safety-related feedback/training by supervisors, and (6) availa bility of personal protective equipment and engineering controls. Of these, senior management support for safety programs, absence of workplace barrie rs to safe work practices, and cleanliness/orderliness of the work site wer e significantly related to compliance (P < .05). In addition, both senior m anagement support for safety programs and frequent safety-related feedback/ training were significantly related to workplace exposure incidents (P < .0 5). Thus the most significant finding in terms of enhancing compliance and reducing exposure incidents was the importance of the perception that senio r management was supportive of the bloodborne pathogen safety program. Conclusions: Hospital safety climate with regards to bloodborne pathogens c an be measured by using a short, 20-question scale that measures 6 separate dimensions. Whereas all 6 dimensions are essential elements of overall saf ety climate, 3 dimensions are significantly correlated with compliance, and 1 dimension (senior management support) is especially significant with reg ard to both compliance and exposure incidents. This shea safety climate sca le can be a useful tool for evaluating hospital employees' perceptions rega rding their organization's bloodborne pathogens management program. In addi tion, because this scale measures specific dimensions of the safety climate , it can be used to target problem areas and guide the development of inter vention strategies to reduce occupational exposure incidents to blood and o ther body fluids.