title: Safety climate in dialysis centers in Saudi Arabia: a multicenter study.
abstract: OBJECTIVE
  The aim of this study was to assess the safety climate as perceived by nurses and physicians in the dialysis units in Saudi Arabia.
  
  
  METHODS
  This is a cross-sectional survey-based multicenter study using the Safety Climate Scale, which assesses the perception by staff of the prevailing climate of safety. We used 17 items in this survey. These could be further divided into 3 summative categories: (a) handling of errors and safety concerns (9 items), (b) leadership emphasis of safety (7 items), and (c) overall safety recommendation (1 item). The survey uses 5 Likert scale options (1, disagree strongly; 2, disagree slightly; 3, neutral; 4, agree slightly; and 5, agree strongly).
  
  
  RESULTS
  There were 509 respondents--a response rate of 76.6% and 53.3% among nurses and physicians, respectively. The internal consistency using Cronbach α was 0.899. The overall mean (SD) of satisfaction with safety climate was higher among the nurses than the physicians (4.13 [1.1] and 4.05 [1.7], respectively; P = 0.029). The overall agreement rate was 73.8%, with more nurses than physicians agreeing that safety climate prevails the dialysis center (75.4% versus 72.1%, respectively; P = 0.047).The respondents perceived a stronger commitment to safety from their clinical area leaders than from senior leaders in the organization (76.2% and 72.4%, respectively). In addition, the physicians gave lower scores to more questions than the nurses particularly in 3 areas, namely, "leadership is driving us to be a safety-centered institution" (71.5% versus 76.5%; P = 0.037), "I am encouraged by my colleagues to report any patient safety concerns I may have" (67.4% versus 84.7%; P = 0.03), and "I know proper channels to ask questions about safety" (69.6% versus 87.2%; P = 0.002).The scores by the physicians in all the 3 summative categories were again less than the scores by the nurses, but this did not reach a statistical significance.
  
  
  CONCLUSIONS
  The nurses had higher perceptions of a prevailing safety climate than the physicians. There was a perception of a stronger commitment to safety from their clinical area leaders than from senior leaders in the organization. Senior management needs to relay their commitments to safety more effectively especially to physicians and to open clear and easily accessible channels for communication for safety issues.
authors.affiliation: From the *Medical Services, King Abdulaziz Medical City; †King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; ‡Department of Nephrology, Kanoo Kidney Center, Dammam Medical Complex, Dammam, Saudi Arabia; §Jeddah Kidney Center, King Fahd Hospital, Jeddah, Saudi Arabia; ∥Prince Salman Center for Kidney Diseases; and ¶Department of Nephrology, Riyadh Armed Forces Hospital, Riyadh, Saudi Arabia.
authors.forename: Saadi
authors.initials: S
authors.lastname: Taher
authors.forename: Fayez
authors.initials: F
authors.lastname: Hejaili
authors.forename: Ayman
authors.initials: A
authors.lastname: Karkar
authors.forename: Faissal
authors.initials: F
authors.lastname: Shaheen
authors.forename: Majdah
authors.initials: M
authors.lastname: Barahmien
authors.forename: Khalid
authors.initials: K
authors.lastname: Al Saran
authors.forename: Mohamed
authors.initials: M
authors.lastname: Jondeby
authors.forename: Mohamed
authors.initials: M
authors.lastname: Suleiman
authors.forename: Abdulla Ahmed
authors.initials: AA
authors.lastname: Al Sayyari
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007857:Leadership; D008297:Male; D019300:Medical Errors; D009726:Nurses; D015279:Organizational Culture; D061214:Patient Safety; D010820:Physicians; D006435:Renal Dialysis; D017751:Safety Management / Q000458:organization & administration / Q000592:standards; D012529:Saudi Arabia