ABSTRACT
Preventing work injuries requires a clear understanding of how they occur, how they are recorded, and the accuracy of injury surveillance. Our innovation was to examine how psychosocial safety climate (PSC) influences the development of reported and unreported physical and psychological workplace injuries beyond (physical) safety climate, via the erosion of psychological health (emotional exhaustion). Self-report data (T2, 2013) from 214 hospital employees (18 teams) were linked at the team level to the hospital workplace injury register (T1, 2012; T2, 2013; and T3, 2014). Concordance between survey-reported and registered injury rates was low (36%), indicating that many injuries go unreported. Safety climate was the strongest predictor of T2 registered injury rates (controlling for T1); PSC and emotional exhaustion also played a role. Emotional exhaustion was the strongest predictor of survey-reported total injuries and underreporting. Multilevel analysis showed that low PSC, emanating from senior managers and transmitted through teams, was the origin of psychological health erosion (i.e., low emotional exhaustion), which culminated in greater self-reported work injuries and injury underreporting (both physical and psychological). These results underscore the need to consider, in theory and practice, a dual physical-psychosocial safety explanation of injury events and a psychosocial explanation of injury underreporting.
Subject(s)
Accidents, Occupational/psychology , Burnout, Professional/psychology , Disclosure , Occupational Injuries/psychology , Organizational Culture , Personnel, Hospital/psychology , Workplace/psychology , Accidents, Occupational/statistics & numerical data , Adult , Disclosure/statistics & numerical data , Female , Follow-Up Studies , Humans , Male , Middle Aged , SafetyABSTRACT
Current patient safety policy focuses nursing on patient care goals, often overriding nurses' safety. Without understanding how nurses construct work health and safety (WHS), patient and nurse safety cannot be reconciled. Using ethnography, we examine social contexts of safety, studying 72 nurses across five Australian hospitals making decisions during patient encounters. In enacting safe practice, nurses used "frames" built from their contextual experiences to guide their behavior. Frames are produced by nurses, and they structure how nurses make sense of their work. Using thematic analysis, we identify four frames that inform nurses' decisions about WHS: (a) communicating builds knowledge, (b) experiencing situations guides decisions, (c) adapting procedures streamlines work, and (d) team working promotes safe working. Nurses' frames question current policy and practice by challenging how nurses' safety is positioned relative to patient safety. Recognizing these frames can assist the design and implementation of effective WHS management.
ABSTRACT
The authors examined how a crime schema influenced the types of details witnesses recalled over multiple interviews that varied in delay before the initial interview and between subsequent interviews. Accuracy data showed that, in general, schema-irrelevant traces experienced greater decay than schema-consistent and schema-inconsistent traces after the initial interview and that delaying the initial interview negatively affected recall at the initial interview but led to less decay over subsequent interviews. Ambiguity of the crime stimulus was also manipulated. Witnesses used their schema to interpret ambiguous information and, as a result, made more schema-consistent intrusions and less correct responses and were more likely to report false memories that involved conscious recollection (using the remember-know paradigm).
