title: The climate of patient safety in a Canadian intensive care unit.
abstract: BACKGROUND
  We assessed multidisciplinary team members' perspectives of patient safety climate in a 15-bed, closed medical-surgical intensive care unit through a self-administered questionnaire.
  
  
  METHODS
  We invited all clinicians and nonclinicians to complete a short demographic section and a modified Safety Climate Survey (SCS) in which higher scores represent a better safety climate. We used multivariable regression to examine factors associated with higher safety climate scores. In an open-ended question, we asked all respondents for suggestions to improve patient safety, analyzing text in triplicate, independently.
  
  
  RESULTS
  Our response rate was 93.2% (136/146). Respondents were nurses (49.4%), physicians (16.1%), other clinicians (30.3%), and nonclinical staff (11.8%). The mean (SD) SCS score was 4.0 (0.6) of a maximum of 5. We found no independent predictors of safety climate scores. Qualitative data revealed 3 major safety themes needing solutions: appropriate staffing, medication safety, and improving the bedside care of obese patients.
  
  
  CONCLUSIONS
  Although our baseline safety climate score was encouraging, room for improvement exists. Future research will analyze the responsiveness of the SCS scale to change, following our recently instituted initiatives such as a new graduate integration program, an improved medication dispensing system, newly installed lifting devices, and the critical care response team.
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada. khome@mcmaster.ca
authors.forename: Michelle E
authors.initials: ME
authors.lastname: Kho
authors.forename: Dan
authors.initials: D
authors.lastname: Perri
authors.forename: Ellen
authors.initials: E
authors.lastname: McDonald
authors.forename: Lily
authors.initials: L
authors.lastname: Waugh
authors.forename: Cynthia
authors.initials: C
authors.lastname: Orlicki
authors.forename: Erin
authors.initials: E
authors.lastname: Monaghan
authors.forename: Deborah J
authors.initials: DJ
authors.lastname: Cook