title: Safety culture in long-term care: a cross-sectional analysis of the Safety Attitudes Questionnaire in nursing and residential homes in the Netherlands.
abstract: The first objective was to investigate if the Safety Attitudes Questionnaire (SAQ) is appropriate to measure the safety attitude of caregivers in nursing and residential homes, and second, to compare safety attitude of these caregivers with available data of caregivers in other settings (ie, inpatients, intensive care unit (ICU) and ambulatory care).
  
  
  
  Using a cross-sectional survey methodology, we obtained completed SAQ surveys from 521 caregivers (response rate of 53%) working in nine units in nine different nursing and residential homes in The Netherlands. Exploratory factor and Cronbach's alpha measures were used to analyse the psychometric properties of the SAQ. A correlation matrix was performed to study the relationship among the SAQ dimensions. A t test was performed to test significant differences between our sample and the benchmark settings.
  
  
  
  The factor analyses and calculated Cronbach's alphas (α=0.56-0.80) for this sample confirmed the robustness of the SAQ scales. There was a high positive correlation between teamwork climate, job satisfaction, perceptions of management, safety climate and working conditions (r=0.31 to 63), but stress recognition had a negative correlation with each of the other dimensions (r=-0.13 to -0.18). Overall, the scores from the nursing and residential homes differed significantly from the benchmark settings.
  
  
  
  The findings in this study confirmed that the SAQ could also be used in the nursing and residential homes setting. However, stress recognition in nursing and residential homes setting does not seem to be one of the dimensions of the safety attitude construct. Furthermore, Dutch nursing and residential homes have significantly higher scores on most dimensions of the SAQ compared with US inpatient units and comparable scores to ICUs (Dutch and US) and ambulatory services.
authors.affiliation: Erasmus University Rotterdam, Institute of Health Policy and Management, Rotterdam, The Netherlands.
authors.forename: Martina
authors.initials: M
authors.lastname: Buljac-Samardzic
authors.affiliation: Erasmus University Rotterdam, Institute of Health Policy and Management, Rotterdam, The Netherlands.
authors.forename: Jeroen Dh
authors.initials: JD
authors.lastname: van Wijngaarden
authors.affiliation: University of Applied Sciences Rotterdam, Research Centre Innovations in Care, Rotterdam, The Netherlands.
authors.forename: Connie M
authors.initials: CM
authors.lastname: Dekker-van Doorn
mesh_terms: D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D005260:Female; D006282:Health Personnel / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D008134:Long-Term Care / Q000458:organization & administration / Q000592:standards* / Q000706:statistics & numerical data; D008297:Male; D009426:Netherlands; D009735:Nursing Homes / Q000458:organization & administration / Q000592:standards* / Q000706:statistics & numerical data; D015279:Organizational Culture; D061214:Patient Safety; D012112:Residential Facilities / Q000458:organization & administration / Q000592:standards* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires
keywords: Nursing homes; Patient safety; Safety culture