Perceptions of Psychological Safety Among Health Care Professionals in a Level III Neonatal Intensive Care Unit: An...

To assess perceptions of psychological safety (PS) among nurses and physicians in a Level III neonatal intensive care unit (NICU) and its association with organizational factors and intention to leave.

PS supports teamwork, open communication, patient safety, and staff well-being, yet evidence from NICUs and its relevance for workforce retention remains limited.

An exploratory cross-sectional survey was conducted between August and September 2025 in a Level III NICU of a German university hospital. Nurses and physicians completed an anonymous online, pretested questionnaire based on validated items. The questionnaire comprised 31 items assessing PS, teamwork, communication, workload, and error management, rated on a six-point Likert scale. Data were analyzed descriptively, including subgroup comparisons by profession, age, experience, and intention to leave.

Overall, 101 health care professionals participated (response rate 89%). Respondents described a respectful and supportive team climate with strong commitment to patient safety. However, challenges were identified in speaking up, conflict resolution, onboarding, and error communication. More than half reported stress-related impairment at work and consideration of leaving the profession within the past year. Physicians rated PS more positively than nurses, while participants with turnover intention reported substantially lower PS.

PS in the NICU was perceived as positive, but vulnerabilities persist regarding communication, inclusivity, and error management culture. Lower PS was associated with intention to leave, underscoring its relevance for workforce retention.

Onboarding, inclusive leadership, feedback, and forums for discussing errors are recommended. Longitudinal studies should examine staff well-being and retention.