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  • Publication # 14-RA003

Staff perception of infection prevention safety culture varies among hospitals

Patient Safety and Quality of Care

A hospital's perceived commitment to safety and quality improvements is its safety culture. Improving safety culture is complicated, as it involves individual and group values. A new study reveals that frontline health care technicians perceive they are not as engaged in hospital infection improvement efforts compared to other staff. Similarly, frontline technicians had lower perceptions of the adequacy of staffing and resources than administration. Nevertheless, most safety culture items did not vary by staff role or experience. Instead, the safety culture related to infection control varies more by the hospital than by any particular staff position or the experience of individual employees. Therefore, the researchers conclude that safety education and interventions need to be tailored to the needs of individual hospitals rather than the professional role or experience level for individual staff. 

The researchers surveyed staff, clinicians, and managers at 5 hospitals about their perceptions of their hospital's safety culture related to preventing infections. The 5 hospitals included four urban hospitals and one rural hospital across New England, the South and Middle Atlantic, and West North Central parts of the country. Staff perceptions of safety related to infection prevention were scored from 1 (strongly disagree) to 5 (strongly agree).

On average, each hospital completed 63 questionnaires. The majority who responded were nurses (38 percent), although about 10 percent were health care technicians (aides, medical technologists, and phlebotomists). Eleven of 14 mean scores were above 4.0. There were high scores for such things as practical things staff could do to prevent infections, washing hands before and after patient contact, and hospital monitoring of infections for quality improvement. 

The lowest scores centered on staffing coverage, inadequate resources to support patient safety, and better continuing education programs on infection control. Administrators and quality leaders agreed more strongly than nurses and technicians that the hospital monitors infections to improve patient safety. However, nurses kept better posted on advances in patient safety compared to residents and interns. Staff with shorter tenure at their facilities agreed more strongly that there are practical things they can do to prevent infections compared to those staff with 20 years of more of employment. The study was supported by AHRQ (Contract No. 290-06-00015). 

See "Does health care role and experience influence perception of safety culture related to preventing infections?", by Barbara I. Braun, Ph.D., Anthony D. Harris, M.D., M.P.H., Cheryl L. Richards, B.S., R.H.I.A., and others in the American Journal of Infection Control 41, pp. 638-641, 2013.


Page last reviewed January 2014
Internet Citation: Staff perception of infection prevention safety culture varies among hospitals: Patient Safety and Quality of Care. January 2014. Agency for Healthcare Research and Quality, Rockville, MD.


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