Patient safety culture: factors that influence clinician involvement in patient safety behaviours

ObjectivesTo develop an understanding of the factors that influence patient safety-related behaviours by nurses, doctors and allied health staff employed by Queensland Health, using a theory-driven behavioural model.DesignCross-sectional survey analysed with multiple logistic regression.SettingMetro...

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Veröffentlicht in:BMJ quality & safety 2010-12, Vol.19 (6), p.585-591
Hauptverfasser: Wakefield, John G, McLaws, Mary-Louise, Whitby, Michael, Patton, Leanne
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container_end_page 591
container_issue 6
container_start_page 585
container_title BMJ quality & safety
container_volume 19
creator Wakefield, John G
McLaws, Mary-Louise
Whitby, Michael
Patton, Leanne
description ObjectivesTo develop an understanding of the factors that influence patient safety-related behaviours by nurses, doctors and allied health staff employed by Queensland Health, using a theory-driven behavioural model.DesignCross-sectional survey analysed with multiple logistic regression.SettingMetropolitan, regional and rural public hospitals in Queensland, Australia.Participants5294 clinical and managerial staff.Main outcome measuresThe Theory of Planned Behaviour was used to develop behavioural models for high-level Patient Safety Behavioural Intent (PSBI) of senior and junior doctors, senior and junior nurses, and allied health professionals. Multiple logistic regression analysis was used to identify factors that significantly influenced PSBI between the five professional groups.ResultsThe factors that influence high-level PSBI give rise to unique predictive models for each professional group. Two factors stand out as influencing high-level PSBI for all healthcare workers (HCWs): (1) Preventive Action Beliefs (adjusted OR 2.38), HCWs' belief that engaging in the target behaviours will lead to improved patient safety; and (2) Professional Peer Behaviour (adjusted OR 1.79), perceptions about the patient safety-related behaviours of one's professional colleagues.ConclusionsProfessional peer-modelling behaviours and individuals' beliefs about the value of those behaviours in improving patient safety are important predictors of HCWs' patient safety behaviour. These findings may help explain the limitations of current knowledge-based educational approaches to patient safety reform. Use of the behavioural models developed in this study when designing future patient safety improvement initiatives may prove more effective in driving the behavioural change necessary for improved patient safety.
doi_str_mv 10.1136/qshc.2008.030700
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Multiple logistic regression analysis was used to identify factors that significantly influenced PSBI between the five professional groups.ResultsThe factors that influence high-level PSBI give rise to unique predictive models for each professional group. Two factors stand out as influencing high-level PSBI for all healthcare workers (HCWs): (1) Preventive Action Beliefs (adjusted OR 2.38), HCWs' belief that engaging in the target behaviours will lead to improved patient safety; and (2) Professional Peer Behaviour (adjusted OR 1.79), perceptions about the patient safety-related behaviours of one's professional colleagues.ConclusionsProfessional peer-modelling behaviours and individuals' beliefs about the value of those behaviours in improving patient safety are important predictors of HCWs' patient safety behaviour. These findings may help explain the limitations of current knowledge-based educational approaches to patient safety reform. Use of the behavioural models developed in this study when designing future patient safety improvement initiatives may prove more effective in driving the behavioural change necessary for improved patient safety.</description><identifier>ISSN: 1475-3898</identifier><identifier>ISSN: 2044-5415</identifier><identifier>EISSN: 1475-3901</identifier><identifier>EISSN: 2044-5423</identifier><identifier>DOI: 10.1136/qshc.2008.030700</identifier><identifier>PMID: 20724390</identifier><language>eng</language><publisher>England: BMJ Publishing Group Ltd</publisher><subject>Attitudes ; Aviation ; Behavior ; behaviour ; Cross-Sectional Studies ; Culture ; Health administration ; Health care policy ; Hospitals, Public ; Humans ; Medical Errors - prevention &amp; control ; Medical personnel ; Organizational Culture ; Patient safety ; Personnel, Hospital ; Professional Role ; Quantitative psychology ; Queensland ; Questionnaires ; safety climate ; safety culture ; Safety Management ; Safety research ; survey ; Theory ; theory of planned behaviour ; Validity</subject><ispartof>BMJ quality &amp; safety, 2010-12, Vol.19 (6), p.585-591</ispartof><rights>2010, Published by the BMJ Publishing Group Limited. 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For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b400t-18779fff6c97c0c263ae860d9e575c5ebab21d8972800e592474b47d8ba5de5e3</citedby><cites>FETCH-LOGICAL-b400t-18779fff6c97c0c263ae860d9e575c5ebab21d8972800e592474b47d8ba5de5e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://qualitysafety.bmj.com/content/19/6/585.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttps://qualitysafety.bmj.com/content/19/6/585.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>114,115,314,780,784,3196,23571,27924,27925,77600,77631</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20724390$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wakefield, John G</creatorcontrib><creatorcontrib>McLaws, Mary-Louise</creatorcontrib><creatorcontrib>Whitby, Michael</creatorcontrib><creatorcontrib>Patton, Leanne</creatorcontrib><title>Patient safety culture: factors that influence clinician involvement in patient safety behaviours</title><title>BMJ quality &amp; safety</title><addtitle>Qual Saf Health Care</addtitle><description>ObjectivesTo develop an understanding of the factors that influence patient safety-related behaviours by nurses, doctors and allied health staff employed by Queensland Health, using a theory-driven behavioural model.DesignCross-sectional survey analysed with multiple logistic regression.SettingMetropolitan, regional and rural public hospitals in Queensland, Australia.Participants5294 clinical and managerial staff.Main outcome measuresThe Theory of Planned Behaviour was used to develop behavioural models for high-level Patient Safety Behavioural Intent (PSBI) of senior and junior doctors, senior and junior nurses, and allied health professionals. Multiple logistic regression analysis was used to identify factors that significantly influenced PSBI between the five professional groups.ResultsThe factors that influence high-level PSBI give rise to unique predictive models for each professional group. Two factors stand out as influencing high-level PSBI for all healthcare workers (HCWs): (1) Preventive Action Beliefs (adjusted OR 2.38), HCWs' belief that engaging in the target behaviours will lead to improved patient safety; and (2) Professional Peer Behaviour (adjusted OR 1.79), perceptions about the patient safety-related behaviours of one's professional colleagues.ConclusionsProfessional peer-modelling behaviours and individuals' beliefs about the value of those behaviours in improving patient safety are important predictors of HCWs' patient safety behaviour. These findings may help explain the limitations of current knowledge-based educational approaches to patient safety reform. Use of the behavioural models developed in this study when designing future patient safety improvement initiatives may prove more effective in driving the behavioural change necessary for improved patient safety.</description><subject>Attitudes</subject><subject>Aviation</subject><subject>Behavior</subject><subject>behaviour</subject><subject>Cross-Sectional Studies</subject><subject>Culture</subject><subject>Health administration</subject><subject>Health care policy</subject><subject>Hospitals, Public</subject><subject>Humans</subject><subject>Medical Errors - prevention &amp; control</subject><subject>Medical personnel</subject><subject>Organizational Culture</subject><subject>Patient safety</subject><subject>Personnel, Hospital</subject><subject>Professional Role</subject><subject>Quantitative psychology</subject><subject>Queensland</subject><subject>Questionnaires</subject><subject>safety climate</subject><subject>safety culture</subject><subject>Safety Management</subject><subject>Safety research</subject><subject>survey</subject><subject>Theory</subject><subject>theory of planned behaviour</subject><subject>Validity</subject><issn>1475-3898</issn><issn>2044-5415</issn><issn>1475-3901</issn><issn>2044-5423</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqFkM9vFCEYhkmjsbV692Qm8eDBzPaDGQbwphvtmrTVRO0eCcN8k2WdH1tgNva_L5tpm9SLJwg878vHQ8gbCgtKi-rsJmzsggHIBRQgAI7ICS0FzwsF9NnDXip5TF6GsAWgiin6ghwzEKxM0AkxP0x0OMQsmBbjbWanLk4eP2atsXH0IYsbEzM3tN2Eg8XMdm5w1pkhne3Hbo_9IeyGbPe0p8aN2btx8uEVed6aLuDr-_WU_P765ddylV98P_-2_HSR1yVAzKkUQrVtW1klLFhWFQZlBY1CLrjlWJua0UYqwSQAcsVKUdalaGRteIMci1Pyfu7d-fFmwhB174LFrjMDjlPQknJVVen_iXz3D7lNgw5pOE2FkLIsK8YTBTNl_RiCx1bvvOuNv9UU9MG-PtjXB_t6tp8ib--Lp7rH5jHwoDsB-Qy4EPHv473xf3QlCsH11fVSX67Xq-X680-9SvyHma_77f-fvwPPmZ59</recordid><startdate>201012</startdate><enddate>201012</enddate><creator>Wakefield, John G</creator><creator>McLaws, Mary-Louise</creator><creator>Whitby, Michael</creator><creator>Patton, Leanne</creator><general>BMJ Publishing Group Ltd</general><general>BMJ Publishing Group LTD</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>201012</creationdate><title>Patient safety culture: factors that influence clinician involvement in patient safety behaviours</title><author>Wakefield, John G ; McLaws, Mary-Louise ; Whitby, Michael ; Patton, Leanne</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b400t-18779fff6c97c0c263ae860d9e575c5ebab21d8972800e592474b47d8ba5de5e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Attitudes</topic><topic>Aviation</topic><topic>Behavior</topic><topic>behaviour</topic><topic>Cross-Sectional Studies</topic><topic>Culture</topic><topic>Health administration</topic><topic>Health care policy</topic><topic>Hospitals, Public</topic><topic>Humans</topic><topic>Medical Errors - prevention &amp; control</topic><topic>Medical personnel</topic><topic>Organizational Culture</topic><topic>Patient safety</topic><topic>Personnel, Hospital</topic><topic>Professional Role</topic><topic>Quantitative psychology</topic><topic>Queensland</topic><topic>Questionnaires</topic><topic>safety climate</topic><topic>safety culture</topic><topic>Safety Management</topic><topic>Safety research</topic><topic>survey</topic><topic>Theory</topic><topic>theory of planned behaviour</topic><topic>Validity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wakefield, John G</creatorcontrib><creatorcontrib>McLaws, Mary-Louise</creatorcontrib><creatorcontrib>Whitby, Michael</creatorcontrib><creatorcontrib>Patton, Leanne</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health &amp; 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safety</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wakefield, John G</au><au>McLaws, Mary-Louise</au><au>Whitby, Michael</au><au>Patton, Leanne</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Patient safety culture: factors that influence clinician involvement in patient safety behaviours</atitle><jtitle>BMJ quality &amp; safety</jtitle><addtitle>Qual Saf Health Care</addtitle><date>2010-12</date><risdate>2010</risdate><volume>19</volume><issue>6</issue><spage>585</spage><epage>591</epage><pages>585-591</pages><issn>1475-3898</issn><issn>2044-5415</issn><eissn>1475-3901</eissn><eissn>2044-5423</eissn><abstract>ObjectivesTo develop an understanding of the factors that influence patient safety-related behaviours by nurses, doctors and allied health staff employed by Queensland Health, using a theory-driven behavioural model.DesignCross-sectional survey analysed with multiple logistic regression.SettingMetropolitan, regional and rural public hospitals in Queensland, Australia.Participants5294 clinical and managerial staff.Main outcome measuresThe Theory of Planned Behaviour was used to develop behavioural models for high-level Patient Safety Behavioural Intent (PSBI) of senior and junior doctors, senior and junior nurses, and allied health professionals. Multiple logistic regression analysis was used to identify factors that significantly influenced PSBI between the five professional groups.ResultsThe factors that influence high-level PSBI give rise to unique predictive models for each professional group. Two factors stand out as influencing high-level PSBI for all healthcare workers (HCWs): (1) Preventive Action Beliefs (adjusted OR 2.38), HCWs' belief that engaging in the target behaviours will lead to improved patient safety; and (2) Professional Peer Behaviour (adjusted OR 1.79), perceptions about the patient safety-related behaviours of one's professional colleagues.ConclusionsProfessional peer-modelling behaviours and individuals' beliefs about the value of those behaviours in improving patient safety are important predictors of HCWs' patient safety behaviour. These findings may help explain the limitations of current knowledge-based educational approaches to patient safety reform. Use of the behavioural models developed in this study when designing future patient safety improvement initiatives may prove more effective in driving the behavioural change necessary for improved patient safety.</abstract><cop>England</cop><pub>BMJ Publishing Group Ltd</pub><pmid>20724390</pmid><doi>10.1136/qshc.2008.030700</doi><tpages>7</tpages></addata></record>
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identifier ISSN: 1475-3898
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source MEDLINE; BMJ Journals - NESLi2
subjects Attitudes
Aviation
Behavior
behaviour
Cross-Sectional Studies
Culture
Health administration
Health care policy
Hospitals, Public
Humans
Medical Errors - prevention & control
Medical personnel
Organizational Culture
Patient safety
Personnel, Hospital
Professional Role
Quantitative psychology
Queensland
Questionnaires
safety climate
safety culture
Safety Management
Safety research
survey
Theory
theory of planned behaviour
Validity
title Patient safety culture: factors that influence clinician involvement in patient safety behaviours
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