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

Background: In the industrial setting, employee perceptions regarding their organizationʹs commitment to safety (ie, safety climate) have been shown to 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 risk management programs and to assess the relationship between hospital safety climate and (1) employee compliance with safe work practices and (2) incidents of workplace exposure to blood and other body fluids. Methods: A questionnaire, which included 46 safety climate items, was developed and tested on a sample of 789 hospital-based health care workers at risk for bloodborne pathogen exposure incidents. Results: A 20-item hospital safety climate scale that measures hospitalsʹ commitment to bloodborne pathogen risk management programs was extracted through factor analysis from the 46 safety climate items. This new hospital safety 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 work site, (4) minimal conflict and good communication among staff members, (5) frequent safety-related feedback/training by supervisors, and (6) availability of personal protective equipment and engineering controls. Of these, senior management support for safety programs, absence of workplace barriers to safe work practices, and cleanliness/orderliness of the work site were significantly related to compliance (P < .05). In addition, both senior management support for safety programs and frequent safety-related feedback/training were significantly related to workplace exposure incidents (P < .05). Thus the most significant finding in terms of enhancing compliance and reducing exposure incidents was the importance of the perception that senior management was supportive of the bloodborne pathogen safety program. Conclusions: Hospital safety climate with regards to bloodborne pathogens can be measured by using a short, 20-question scale that measures 6 separate dimensions. Whereas all 6 dimensions are essential elements of overall safety climate, 3 dimensions are significantly correlated with compliance, and 1 dimension (senior management support) is especially significant with regard to both compliance and exposure incidents. This short safety climate scale can be a useful tool for evaluating hospital employeesʹ perceptions regarding their organizationʹs bloodborne pathogens management program. In addition, because this scale measures specific dimensions of the safety climate, it can be used to target problem areas and guide the development of intervention strategies to reduce occupational exposure incidents to blood and other body fluids. (AJIC Am J Infect Control 2000;28:211-21)