Preventing Surgical Site Infections: Are Safety Climate Level and Its Strength Associated With Self-reported Commitment To, Subjective Norms Toward, and Knowledge About Preventive Measures? : Journal of Patient Safety

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Preventing Surgical Site Infections: Are Safety Climate Level and Its Strength Associated With Self-reported Commitment To, Subjective Norms Toward, and Knowledge About Preventive Measures?

Pfeiffer, Yvonne PhD∗; Atkinson, Andrew PhD†; Maag, Judith MSc, MA, MPH†,‡; Lane, Michael A. MD, MPHS, MSc§,∥; Schwappach, David L. B. PhD, MPH; Marschall, Jonas MD†,‡,§

Author Information

From the ∗Swiss Patient Safety Foundation, Zurich

†Department of Infectious Diseases, Bern University Hospital, Inselspital, University of Bern

‡Swissnoso, National Center for Infection Prevention, Bern, Switzerland

§Division of Infectious Diseases, Washington University School of Medicine

∥Center for Clinical Excellence, BJC HealthCare, St Louis, Missouri

Institute of Social and Preventive Medicine (ISPM), University of Bern, Switzerland

Correspondence: Yvonne Pfeiffer, PhD, Swiss Patient Safety Foundation, Asylstr. 77, 8032 Zurich, Switzerland (e-mail: [email protected]).

The authors disclose no conflict of interest.

This study was supported by a research grant from the Swiss National Science Foundation (Nr.: 32003B_179500; Project “Understanding the drivers of surgical site infection: Investigating and modelling the Swissnoso surveillance data (Watussi)”).

D.L.B.S. and J.M. contributed equally to this study.

Ethical approval: The Cantonal Ethics Committee (Bern, Project ID 2019-00294) approved the study.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (www.journalpatientsafety.com).

Journal of Patient Safety 19(4):p 264-270, June 2023. | DOI: 10.1097/PTS.0000000000001111

Abstract

Objectives 

Surgical site infections (SSIs) represent a major source of preventable patient harm. Safety climate in the operating room personnel is assumed to be an important factor, with scattered supporting evidence for the association between safety climate and infection outcome so far. This study investigated perceptions and knowledge specific to infection prevention measures and their associations with general assessments of safety climate level and strength.

Methods 

We invited operating room personnel of hospitals participating in the Swiss SSI surveillance program to take a survey (response rate, 38%). A total of 2769 responses from 54 hospitals were analyzed. Two regression analyses were performed to identify associations between subjective norms toward, commitment to, as well as knowledge about prevention measures and safety climate level and strength, taking into account professional background and number of responses per hospital.

Results 

Commitment to perform prevention measures even when situational pressures exist, as well as subjective norm of perceiving the expectation of others to perform prevention measures were significantly (P < 0.05) related to safety climate level, while for knowledge about preventative measures this was not the case. None of the assessed factors was significantly associated with safety climate strength.

Conclusions 

While pertinent knowledge did not have a significant impact, the commitment and the social norms to maintain SSI prevention activities even in the face of other situational demands showed a strong influence on safety climate. Assessing the knowledge about measures to prevent SSIs in operating room personnel opens up opportunities for designing intervention efforts in reducing SSIs.

Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

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