[Perception of safety culture in Spanish intensive care units].
OBJECTIVE
Promoting a safety culture in intensive care units (ICUs) is a basic strategy to improve patient safety. The aim of this study was to measure the safety culture in Spanish ICUs.


METHODS
We drafted a questionnaire based on the Safety Climate Survey (SCS) and the Safety Attitude Questionnaire-ICU model (SAQ-ICU). A translation-back translation method was employed together with focus group discussions. A questionnaire was designed that analyzed six dimensions: teamwork climate, safety climate, perceptions of management, job satisfaction, working conditions, and stress recognition. The survey was delivered to 22 Spanish ICUs. The results were analyzed to detect strengths and weaknesses in the ICU safety culture.


RESULTS
The internal consistency of the survey was 0.92. The response rate was 29.8%. The distribution of positive responses by dimension was as follows: job satisfaction: 65.2%, teamwork climate: 62.1%, safety climate: 50.7%, perceptions of management: 30.3%, working conditions: 43.3%, and stress recognition: 68.8%. Some strengths were detected, such as the percentages who responded affirmatively to the statements "I like my job" (95.1%) and "briefings are important for patient safety" (86.8%). We found significant differences by hospital size: attitudes were better in ICU staff in smaller hospitals than in large hospitals.


CONCLUSIONS
The safety culture is poor in Spanish ICUs, but awareness is greater in smaller hospitals. Nevertheless, some strengths were identified, such as communication. Tools to promote free reporting of errors and incident reports should be provided.
Gutiérrez-Cía
Isabel
I
Servicio de Medicina Intensiva, Hospital Clínico Universitario, Zaragoza, Spain. igutierrcia@hotmail.com
de Cos
Paz Merino
PM
Juan
Aina Yáñez
AY
Obón-Azuara
Blanca
B
Alonso-Ovies
Ángela
Á
Martin-Delgado
María Cruz
MC
Álvarez-Rodríguez
Joaquín
J
Aibar-Remón
Carlos
C
D001291:Attitude of Health Personnel; D006801:Humans; D007362:Intensive Care Units / Q000592:standards*; D017751:Safety Management; D013030:Spain; D011795:Surveys and Questionnaires