title: Hospital unit safety climate: relationship with nurses' adherence to recommended use of facial protective equipment.
abstract: BACKGROUND
  Despite the existence of formal guidelines for the acute health care sector, nurses' adherence to recommended use of facial protective equipment (FPE) to prevent occupational transmission of communicable respiratory disease remains suboptimal. In addition to individual factors such as knowledge and education, group factors such as shared perceptions of organizational support for safety may influence adherence. These group safety climate perceptions can differ depending on the pace and type of work, local leadership, and organizational structure of each unit.
  
  
  METHODS
  An analysis of a data set from a cross-sectional survey of 1,074 nurses in 45 units of 6 acute care hospitals was conducted. Variance components analysis was performed to examine the variance in perceptions of safety climate and adherence between units. Hierarchical linear modeling using unit-level safety climate dimensions was conducted to determine if unit-level safety climate dimensions were predictors of nurses' adherence to FPE.
  
  
  RESULTS
  Findings revealed statistically significant unit variances in adherence and 5 of the 6 unit-level safety climate dimensions (P < .05). Furthermore, a hierarchical model suggested that tenure and unit-level communication were significantly associated with increased adherence to FPE (P < .05).
  
  
  CONCLUSIONS
  Unit-level safety climate measures varied significantly between units. Strategies to improve unit-level communication regarding safety should assist in improving adherence to FPE.
authors.affiliation: Department of Occupational and Environmental Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada. Electronic address: michael.rozenbojm@mail.utoronto.ca.
authors.forename: Michael Diamant
authors.initials: MD
authors.lastname: Rozenbojm
authors.affiliation: Department of Occupational and Environmental Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Collaborative Academic Practice, University Health Network, Toronto, Ontario, Canada; Centre for Research Expertise in Occupational Disease, Toronto, Ontario, Canada.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Nichol
authors.affiliation: Department of Psychology, Wayne State University, Detroit, MI.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Spielmann
authors.affiliation: Centre for Research Expertise in Occupational Disease, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Occupational and Environmental Health, St Michael Hospital, Toronto, Ontario, Canada; Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada.
authors.forename: D Linn
authors.initials: DL
authors.lastname: Holness
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D005260:Female; D019983:Guideline Adherence; D006757:Hospital Units / Q000458:organization & administration*; D006801:Humans; D017053:Infection Control / Q000379:methods*; D008297:Male; D008397:Masks; D008875:Middle Aged; D009726:Nurses / Q000523:psychology*; D016017:Odds Ratio; D015279:Organizational Culture; D055815:Young Adult
keywords: Communication; Front-line managers; Health care workers; Infection control; Organizational culture; Respiratory infection; Respiratory protection