Patient safety climate in primary care: age matters.

OBJECTIVE: Safety climate, as a measurement in time of safety culture using a survey instrument, has been explored in inpatient units and among hospitals. Differences have been reported among professional groups in these venues. This study sought to determine if comparable differences exist among professional groups in ambulatory care settings. SETTING: Four US Air Force ambulatory care facilities (clinics) from the Midwestern United States. METHODS: The Safety Attitudes Questionnaire was selected as the research tool because of its published utilization in inpatient venues, its sound psychometrics (Cronbach alpha, 0.74-0.93), and its ambulatory care version. RESULTS: All 328 available primary care staff from 4 clinics was surveyed yielding 213 responses for a response rate of 65%. There were no significant differences among the professional groups on the total patient safety score or on 5 of the 6 subscales. There were, however, significant differences on total safety scores based on age, not professional group, with staff members younger than 31 years scoring lower on the overall safety score (mean, 64.8; P < 0.001), as compared with the 32- to 41-year age group (mean, 74.3) and those 42- to 63-year age group (mean, 73.8). The youngest age group also had the lowest scores on the subscales of teamwork climate, safety climate, perception of management, and job satisfaction (all subscales P < 0.03). These differences persisted after controlling for professional group. CONCLUSIONS: Growing attention has been given to the demographic groups known in the popular press as Generation Xers and Nexters, but not within the context of enhancing patient safety. Efforts that address the information, training, and job satisfaction needs of these specific age groups have the potential to strengthen health care teams and contribute to a more positive safety climate.

The intersection of patient safety and nursing research.

The individual and collective discussions of the patient safety issue in the United States have mounted from a low roar to a deafening din in the past 10 years. In this chapter the authors (1) discuss the context of patient safety over the past decade and the federal response to the problem, (2) briefly present Reason's theory of human error, which frames much of the safety research, and (3) provide a glossary of terms.

Research issues in preparedness for mass casualty events, disaster, war, and terrorism.

This article provides a perspective on the types of research questions that might be explored and strategies used in relation to disaster,terrorism, and mass casualty events. Research is addressed in the context of three areas of focus: issues related to the health care provider; issues affecting the patient, individual, family, and community; and issues related to the health care system.