Assessing the Impact of Regulations on Radiation Safety Culture and Practices in Radiology Departments

Background: The need to establish a strong culture around radiation safety is derived from the assertion that medical practitioners, patients, and third parties should not be exposed to unnecessary radiation. Authorities have endeavored to enact policies to protect all employers and patients in radiology departments. Objectives: To assess the impact of radiation safety practices and regulations on the ongoing improvements in radiation safety culture and practices in radiology departments. This will be achieved through a subjective assessment of national and international rules and regulations by healthcare professionals. Materials and Methods: We conducted a questionnaire survey in the radiology departments of three JCI-accredited hospitals in the Riyadh region to identify and assess the impact of national radiation regulations and the accompanying processes on the improvement of radiation safety culture and practices in radiology departments. Results: There were statistically significant differences in the grading system results among various groups of respondents, based on their educational level. Also, there are statistically significant differences between the assessments of safety level results in the answers provided by various groups of respondents according to education level in favor of the master’s degree. Conclusion: The study concludes that technicians with a diploma degree require stricter regulation. Furthermore, the results of this study suggest that an exposure tracking system and a regulatory action supporting it may be useful in the ongoing task of improving patients’ radiation safety.

Translation, Cultural Adaption and Validation of Hospital Survey on Patient Safety Culture in Kosovo

Background: An essential condition to improve patient safety is considered to ensure a supportive patient safety culture. Measuring the culture of patient safety in all health care institutions may be a first step to target improvements. Creating a culture of safety requires eliminating the culture of blame. In order to formulate actions for improvement, it is important for hospitals to assess their baseline scores for the existing safety culture and to determine the areas of priority. Aim: The aim of this study was first to measure the use, translation in Albanian and adaptation of the Hospital Survey on Patient Safety Culture (HSOPSC) assessment as a tool for improving patient safety in Kosovo Hospitals. The second aim was to measure the level of patient safety culture in Kosovo, in seven hospitals and one University Clinical Center (hospitals with over 50 beds, including psychiatric hospitals). Method: The questionnaire (HSOPSC) was translated into Albanian for use in the Kosovo. It was used forward-backward translation: the questions were translated into Albanian by one translator and then translated back into English by an independent translator who was blinded to the original questionnaire. Results: In the eight-factor model, the internal consistency of the factors and the construct validity of the HSOPSC questionnaire were mostly satisfactory. The construct validity was sufficient for all subscales, except for the 4 other subscale regarding intention to report incidents which correlated poorly with other subscales. In total, HSOPSC has 12 dimensions. Cronbach’s α showed that in Kosovarian society, we could use only 8 dimensions model. Conclusion: The hypothesis that HSOPSC would be a suitable instrument to provide important indicators for the improvement of patient safety culture was tested and it was confirmed, that HSOPSC could be used as 8 dimension model. HSOPSC is suitable to improve patient safety culture and provide each hospital with a basic profile on patient safety culture and recommendations for an oriented intervention plan.

Organization：A new focus on mine safety improvement in a complex operational and business environment

The daily operations in the mining industry are still a significant source of risk with regard to occupational safety and health(OS & H). Various research studies and statistical data world-wide show that the number of serious injuries and fatalities still remains high despite substantial efforts the industry has put in recent years in decreasing those numbers. This paper argues that the next level of safety performance will have to consider a transition from coping solely with workplace dangers, to a more systemic model taking organizational risks in consideration. In this aspect, lessons learned from the nuclear industry may be useful, as organizational learning processes are believed to be more universal than the technologies in which they are used. With the notable exception of major accidents, organizational performance has not received all the attention it deserves. A key element for reaching the next level of performance is to include organizational factors in low level events analyses, and approach the management as a risk control system. These factors will then appear not only in the event analysis,but in supervision activities, audits, change management and the like. Many recent event analyses across various industries have shown that organizational factors play a key role in creating conditions for triggering major accidents(aviation, railway transportation, nuclear industry, oil exploitation, mining, etc.).In this paper, a perspective that may be used in supervisory activities, self-assessments and minor events investigations, is presented. When ingrained in an organizational culture, such perspective has the highest potential for continuous safety improvement.

Hospital management priorities and key factors affecting overall perception of patient safety: a cross-sectional study

Objective:Evaluating a staff’s perception of safety culture is a critical factor in hospital management,and the knowledge of value and efficiency in hospitals is still inadequate.This study aimed to investigate the perceptions of safety culture among medical staffs and determine priorities for clear and better management.Methods:A cross-sectional survey of 595 medical staff members was conducted at 2 ter tiary hospitals in Western China using a hospital survey on patient safety culture(HSOPSC)and its value and efficiency in the hospital.Results:The dimensions with a disadvantaged positive response were nonpunitive response to error(44.6%)and staffing(42.0%).Five dimensions can explain 37.7%of the variation in the overall perception of patient safety,and handoffs and transitions are the most important dimensions(standardized coefficients 0.295).Conclusions:Hospital managers should pay more attention to nonpunitive management and staffing.Handoffs and transitions are the most important areas of potential improvement in patient safety in hospitals.

Health care staffs’ perception of patient safety culture in hospital settings and factors of importance for this

Many hospital patients are affected by adverse events. Managers are important when improving safety. The perception of patient safety culture varies among health care staff. Health care staff (n = 1023) working in medical, surgical or mixed medical-surgical health care divisions answered the 51 items (14 dimensions) Swedish Hospital Survey on Patient Safety Culture (S-HSOPSC). Respondents with a managerial function scored higher than non-managers for 11 of 14 dimensions, indicating patient safety culture strengths for a majority of dimensions. Enrolled nurses and staff with experience > 10 years also scored high for several dimensions. The 12 dimensions and sample characteristics explained 49% and 26% of the variance for the outcome dimensions Overall Perceptions of Safety and Frequency of Incident Reporting, respectively. RNs, ENs and physicians have different views on patient safety culture. Hospital Management Support and Organisational Learning is some important factors influencing patient safety culture. Bridging the gap in health care staff’s perceptions of safety in order to improve patient safety is of utmost importance. Managers have the responsibility to foster patient safety culture at their workplace and can thus benefit from results when improving safety for patients.

Nurses Burnout, Resilience and Its Association with Safety Culture: A Cross Sectional Study

Background: The focus of this study was on burnout, resilience and its effect on safety culture. The study maintained that healthcare organizations lag behind in the race to address burnout because they focus more on dealing with the already-existing burnout other than focusing on the source. Aims: To assess burnout, resilience and its association to safety culture in nurses working in mental health institutions with psychiatric patients in Jazan, Saudi Arabia. Method: The study design was a cross sectional survey using convenience sampling, and 119 participants from Al-Amal and psychiatric hospital in Jazan in the period between June and August 2018. A self-administered questionnaire was used to assess burnout, resilience and its association to safety culture. Results: A large percentage of nurses feel that the appropriate information about performance is not presented to them. They feel that they are deprived of a great working day and environment and plan to leave their current workplaces to get better opportunities where their career opportunities are more appreciated. Findings: A significant percentage of nurses feel that appropriate feedback about performance is not offered to them. They feel their careers are unappreciated and are burned out on a typical workday and plan to leave their current workplaces for better opportunities. Conclusion: This study supported the adoption of healthcare mechanisms to address the source of nurse’s burnout than addressing this issue when it emerges. The focus on the source can prove effective in building resilience and supporting safety culture.

Swedish Hospital Survey on Patient Safety Culture— Psychometric properties and health care staff’s perception

This study examined the psychometric properties of the Swedish and the original version of the Hospital Survey on Patient Safety Culture within a Swedish hospital setting and described health care staff’s perceptions of patient safety culture. A web-survey was used to obtain data from registered nurses, enrolled nurses and physicians (N = 1023). Psychometric properties were tested using Confirmatory Factor Analysis and internal consistency using Cronbach’s alpha coefficient. Root mean square error of approximation and other fit indices indicated psychoFmetric properties for both versions to be acceptable. Internal consistency for the dimensions varied between 0.60 and 0.87. Staff scored the dimension “Teamwork Within Units” highest and the dimension “Hospital Management Support” the lowest. The safety was graded as very good or excellent by 58.9% of the respondents and one third had reported more than one event in the past 12 months. The questionnaire is considered to be useful for measuring patient safety culture in Swedish hospital settings. Managers have a great responsibility to work with improving patient safety culture.

Patient safety culture regarding intravenous therapy in Guangzhou, China: a cross-sectional survey

Objective: To investigate the patient safety culture regarding intravenous therapy in parts of tertiary hospitals in Guangzhou, China.Methods: A cross-sectional survey was conducted. A total of 333 medical staffs members from eight hospitals in Guangzhou were included in our study using convenience sampling. An evaluation about the patient safety culture regarding intravenous therapy was conducted.Results: The summarized results show that the total and level one items' scores are greater than 4.3 points(the full mark is 5 points). The lowest scoring of the five level one items is for the hospital's security resources(4.53±0.526), and the highest is for the hospital's safety management commitment(4.65±0.445). Among the 25 secondary entries, the four lowest-scoring entries are "doctors who can master the knowledge of drug efficacy and adverse reactions"(4.44±0.622), "doctors who can master the knowledge of the choice of medicine"(4.45±0.621), "a guarantee of sufficient human resources"(4.46±0.647), and "doctors who can master the knowledge related to the observation and complications with the treatment of intravenous therapy operation"(4.435±0.634).Conclusions: The patient safety culture regarding intravenous treatment in parts of tertiary hospitals in Guangzhou is promising, but there are still shortcomings, including the need to increase relevant resources, such as equipment facilities, training resources, and especially human input.

Medication Safety Climate Questionnaire： Development and Psychometric Analysis

Medication safety improvement strategies require a better understanding of the safety culture specifically related to medicines. In healthcare, safety climate questionnaires are often used as a proxy measure of the underlying safety culture. However, there are currently not known instruments to assess medication safety climate. The study therefore aimed to develop and evaluate a medication safety climate questionnaire for healthcare staff in UK hospitals. Two validated patient safety climate instruments were adapted to develop a Medication Safety Climate （MSC） questionnaire. Data was collected from 510 healthcare professionals （response rate 9.4%）; routinely involved with prescribing, dispensing, administering and monitoring medication; in two acute NHS hospitals in London. Confirmatory factor analysis and reliability analyses were conducted to determine the psychometric properties of the MSC questionnaire. Results showed that the 50-item MSC questionnaire contained nine factors--teamwork climate, safety climate, job satisfaction, stress recognition, perceptions of management, working conditions, organisational learning, feedback and communication about error and management support for medication safety. Internal consistency reliability scores for eight of the nine factors were 〉 0.7 and ranged from 0.64 to 0.9. Correlations between eight factors showed a moderate relationship between the factors; ranging from 0.232 to 0.669. One factor, Stress recognition, had a weak and negative correlation with all other factors. Confirmatory factor analysis achieved an almost adequate model fit （x2/df ratio 2.572; root mean square error of approximation （RMSEA） 0.069; comparative fit index （CFI） 0.791）. The MSC questionnaire demonstrated reasonable psychometric properties. Further refinement using exploratory factor analysis is, however, required to improve the questionnaire＇s validity. This is the first known instrument to measure mediation safety climate in the UK and could be used to inform medication safety improvement strategies and monitor change in healthcare staff perceptions, related to medication safety, over time.

Implementing the Safety Culture Improves the Autonomous Ships Prosperity

Since that a lot of studies and conventions take a look at the explanations of marine accidents within the maritime sectors,and also the position of the human elements that shoulder the high ratio of accidents reasons.They englobed how we learning and measuring the security culture to the human factors to mitigated the motives of incidents and accidents.the International Safety Management(ISM)Code used to be adopted by the International Maritime Organization(IMO)in order to establish a protection lifestyle inside the global maritime community,the ISM Code states that one of its key goals is to set up a“safety culture”in delivery companies,it does not without a doubt outline the that means and measuring of the term.However,a safety way of life may additionally be described as the values,practices and studying that administration and personnel share to ensure that risks are constantly minimized and mitigated to the best degree possible.The ship management structures are nearly completely computerized and any automation failure may additionally cause accidents with damages to human life,to the environment,to the ships,to the port facilities and so the products transported,Safety administration in transport pursuits to stay removed from or mitigate the implications of any incidents bemused.The lookup is based on a descriptive approach,the qualitative methodology,as this methodology is the most capable of providing a comprehensive image of the effectivity of getting to know and measuring the protection culture.The lookup aimed to existing the amendment that ought to take area in the ISM code and use a new science for monitoring the performance and effectiveness of the code as a guide line and to create a spirit of credibility amongst the our bodies supervising the implementation of the Code to cope the self sufficient ship technology.

Patient Safety Culture Post Covid-19 Pandemic: In Perspective of Millennials Human Capital Issues

Background: Patient safety is the core task of any healthcare business. As medical harm caused by hospitalisation is still on the rise and patient safety culture is a struggle. We aim to determine the nature of patient safety culture in a private hospital and explore some unique human resource problems in Malaysia. Methods: In our case study, we use the Hospital Survey on Patient Safety Culture (HSOPSC) questionnaire to measure the 12 dimensions of patient safety culture. The survey received 281 respondents (76% response rate) from all the millennial frontline healthcare providers, including doctors, nurses and allied healthcare providers. The result of the survey was used as the basis to further explore the problems in this hospital. In-depth interviews, observation and document reviews were conducted in relation to human resource problems. This study used IBM SPSS 26 for Windows for statistical analysis and Atlas ti.8 for qualitative analysis of open comments. We used Interpretive Phenomenological Interpretation for analysis of data after triangulation. Results: The overall average positive response rate for the 12 patient safety culture dimensions of the HSOPSC survey was 64%. The result showed that the staff feels positively toward patient safety culture in this hospital. The dimension that received good performance is “Manager expectation”, “Management support for patient safety” and “Organisational learning”. The dimension with the poor performance was “Staffing”, “Frequency of error reporting”, “Teamwork across units”, and “Handoff and transitions”. The open comments indicated inadequate staffing and nursing retention issues. Interviews, observation and document reviews related to staffing reveal high turnover rates among millennial nurses, high overtime and on-call rates, chaotic units with procedures, doctors’ round, admission and discharges mainly in medical and surgical units causing distraction. Poor shared governance is the biggest challenges that need immediate attention post Covid-19 pandemic. Conclusions: The HSOPSC measurement gave valuable insights on patient safety culture in a private hospital in Malaysia. The overall perception of patient safety culture was satisfactory. The poor positive response rate for “Staffing” dimension and the open comments suggests a need for an urgent need for retention and human resource management strategies to prevent brain drain due to high turnover rates, especially among millennial nurses. The key factors causing dissatisfaction and brain drain among nurses are the lack of shared governance.

Enterprise Safety： Basic Factors and Its Construction

Scientific enterprise safety management and its execution are the prerequisite of the business efficiency. Without a safety business system, there will not be an effective communication. So, safety management is always the key point and the difficult point in business management. The author proposes a systematic concept of enterprise safety and researches about the construction on safety enterprise in the paper in view of business running.

Patient Safety Culture Change over Time-Health Care Staffs’Perceptions

Rationale and Aim: Patient safety is of great interest in health care organisations, worldwide. In Sweden, a national patient safety initiative was launched in 2011. The aim of this study was to examine and compare patient safety culture change over time from health care staffs’ perspective. A further aim was to examine factors that have had an effect on patient safety culture. Methods: Patient safety culture was assessed in 2009, 2011 and 2013 using the Swedish version of the Hospital Survey of Patient Safety Culture. Respondents in this study were registered nurses (n = 2149), enrolled nurses (n = 959), physicians (n = 355) and managers (n = 159) working in three health care divisions in a Swedish county council. Results: Patient safety culture decreased significantly over time for all but two dimensions. The dimension “Information to Patients/Relatives” was the only dimension to increase significantly over time. Health care staffs’ profession and health care division belonging had significant main effects on 14 and 8 dimensions, respectively. Managers and enrolled nurses scored patient safety culture significantly higher than registered nurses and physicians. Health care staff working in a mixed medical-surgical health care division scored significantly higher than those working in medical or surgical divisions did. Conclusions: Despite efforts for patient safety work in the county council, health care staffs’ perceptions of patient safety culture decreased over time. To improve hospital patient safety culture, managers and staff groups must meet and communicate with each other in order to create a common view of patient safety.

Survey and analysis of patient safety culture in a county hospital

Objective:This study aimed to survey patient safety culture in a county hospital and to pro-vide evidence for strategies to improve patient safety culture.Methods:Nine hundred and thirty-two medical staff in a county hospital were surveyed with use of the Hospital Survey on Patient Safety Culture.Information was analyzed by one-way ANO-VA and multiple linear regression analysis.Results:Nine hundred and thirty-two questionnaires were distributed,of which 661 of those returned were valid.The subscale-level results showed that the positive response rate for“team-work across units”was higher than 75.0%,indicating it was an area of strength.Five areas-“non-punitive response to error,”“staffing,”“communication openness,”“overall perceptions of patient safety,”and“frequency of event reporting”-had potential for improvement,with a positive re-sponsive rate lower than 50%.Twenty-nine percent of respondents gave their work area a patient safety grade of“excellent”or“very good.”Further,60.1%of respondents had reported no event in the previous 12 months.Multiple linear regression analysis indicated that position and number of years working in this hospital were the factors influencing patient safety culture.Conclusion:Patient safety culture in the county hospital has potential for improvement,especially in the areas of“nonpunitive response to error,”“staffing,”“overall perceptions of patient safety,”“communication openness,”and“frequency of event reporting.”

Exploring traffic safety climate with driving condition and driving behaviour:a random parameter structural equation model approach

This study aimed to explore traffic safety climate by quantifying driving conditions and driving behaviour.To achieve the objective,the random parameter structural equation model was proposed so that driver action and driving condition can address the safety climate by integrating crash features,vehicle profiles,roadway conditions and environment conditions.The geo-localized crash open data of Las Vegas metropolitan area were collected from 2014 to 2016,including 27 arterials with 16827 injury samples.By quantifying the driving conditions and driving actions,the random parameter structural equation model was built up with measurement variables and latent variables.Results revealed that the random parameter structural equation model can address traffic safety climate quantitatively,while driving conditions and driving actions were quantified and reflected by vehicles,road environment and crash features correspondingly.The findings provide potential insights for practitioners and policy makers to improve the driving environment and traffic safety culture.

Reflections on nuclear safety culture from the perspective of traditional Chinese culture

Nuclear safety is a major concern given the rapid development of nuclear power in the modern era.Fostering a nuclear safety culture is an important means of ensuring nuclear safety.In China,a country with a rich historical and cultural heritage,traditional culture will influence the development of a nuclear safety culture.This study explored the origin and levels of nuclear safety culture and reflected on nuclear safety culture from the perspective of traditional Chinese culture.The purpose of this study is to integrate the essence of traditional culture into the nuclear safety culture and foster a nuclear safety culture with Chinese characteristics.

Schools' Flood Emergency Preparedness in Khyber Pakhtunkhwa Province, Pakistan

Pakistan is highly exposed to climate-induced disasters, especially floods. Flooding history shows that educational establishments have been disproportionately hard-hit by flooding events. In Pakistan, school safety and preparedness is still a choice, rather than a mandatory requirement for all schools. But schools in Pakistan do have a responsibility to keep safe the students in their care,especially during and after the catastrophic events. This implies the need to maintain the environment in and around school property, so as to minimize the impacts of floods and to have the mechanisms in place to maximize a school's resilience. This study examined the emergency preparedness activities of 20 schools in four districts of Khyber Pakhtunkhwa Province that had recently been severely affected by floods. Through face to face interviews and a structured questionnaire(n = 100) we collected data on the four pillars of emergency preparedness:emergency planning, preparation measures, safe school facilities, and hazard education and training. The study revealed that the majority of the sample schools hadexperienced more than one natural hazard-induced disaster,predominantly flooding, yet despite this had not undertaken adequate emergency preparedness activities. There are particular gaps with regard to plans for students with disabilities, the continuity of school operations after a disaster,the presence of maps to identify evacuation routes, the availability of emergency equipment and resources, disaster preparedness guidelines, and psychological first aid and crisis counseling. The strengths, weaknesses, opportunities,and threats analysis that our researchers carried out indicates that, although schools in the survey have taken many steps towards flood preparedness, many weaknesses still exist and there remain significant opportunities to strengthen the preparedness level of many schools. The goal of this study is to inform policy decisions that improve school safety in Pakistan and to suggest the priority areas for future school disaster preparedness and management efforts.