Nurses' perceptions of patient safety climate in intensive care units: a cross-sectional study

To investigate registered nurses' perceptions of the patient safety climate in intensive care units and to explore potential predictors for overall perception of safety and frequency of incident reporting.

A cross-sectional design was conducted, using the questionnaire Hospital Survey on Patient Safety Culture, measuring 12 patient safety climate dimensions: seven at unit and three at hospital level, two outcomes and in addition two outcome items.

Ten intensive care units (ICUs) in six hospitals in one hospital trust in Norway.

In total, 220 registered nurses (RNs) responded (72%). Seven of 12 dimensions achieved a RN proportion of positive scores over 55%. Five achieved a lower proportion. Significant differences in RNs' perceptions of patient safety were found between types of units and between the four hospitals. The total variance in the outcome measure explained by the model as a whole was for the outcome dimensions "overall perception of safety" 32%, and "frequency of incident reporting" 32%. The variables at the unit level made a significant contribution to the outcome.

RNs in ICU are most positive to patient safety climate at unit level, hence improvements are needed concerning incident reporting, feedback and communication about errors and organisational learning and continuous improvement.