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What Has Been the Impact of Covid-19 on Safety Culture? A Case Study from a Large Metropolitan Healthcare Trust.

ABSTRACT: Covid-19 has placed an unprecedented demand on healthcare systems worldwide. A positive safety culture is associated with improved patient safety and, in turn, with patient outcomes. To date, no study has evaluated the impact of Covid-19 on safety culture. The Safety Attitudes Questionnaire (SAQ) was used to investigate safety culture at a large UK healthcare trust during Covid-19. Findings were compared with baseline data from 2017. Incident reporting from the year preceding the pandemic was also examined. SAQ scores of doctors and "other clinical staff", were relatively higher than the nursing group. During Covid-19, on univariate regression analysis, female gender, age 40-49 years, non-White ethnicity, and nursing job role were all associated with lower SAQ scores. Training and support for redeployment were associated with higher SAQ scores. On multivariate analysis, non-disclosed gender (-0.13), non-disclosed ethnicity (-0.11), nursing role (-0.15), and support (0.29) persisted to a level of significance. A significant decrease (p < 0.003) was seen in error reporting after the onset of the Covid-19 pandemic. This is the first study to investigate SAQ during Covid-19. Differences in SAQ scores were observed during Covid-19 between professional groups when compared to baseline. Reductions in incident reporting were also seen. These changes may reflect perception of risk, changes in volume or nature of work. High-quality support for redeployed staff may be associated with improved safety perception during future pandemics.

SUBMITTER: Denning M

PROVIDER: S-EPMC7579589 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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What Has Been the Impact of Covid-19 on Safety Culture? A Case Study from a Large Metropolitan Healthcare Trust.

Denning Max M Goh Ee Teng ET Scott Alasdair A Martin Guy G Markar Sheraz S Flott Kelsey K Mason Sam S Przybylowicz Jan J Almonte Melanie M Clarke Jonathan J Winter Beatty Jasmine J Chidambaram Swathikan S Yalamanchili Seema S Tan Benjamin Yong-Qiang BY Kanneganti Abhiram A Sounderajah Viknesh V Wells Mary M Purkayastha Sanjay S Kinross James J

International journal of environmental research and public health 20200925 19

Covid-19 has placed an unprecedented demand on healthcare systems worldwide. A positive safety culture is associated with improved patient safety and, in turn, with patient outcomes. To date, no study has evaluated the impact of Covid-19 on safety culture. The Safety Attitudes Questionnaire (SAQ) was used to investigate safety culture at a large UK healthcare trust during Covid-19. Findings were compared with baseline data from 2017. Incident reporting from the year preceding the pandemic was al ...[more]

PMID: 32993013

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Project description:AimsLongitudinal data on the mental health impact of the coronavirus disease 2019 (Covid-19) pandemic in healthcare workers is limited. We estimated prevalence, incidence and persistence of probable mental disorders in a cohort of Spanish healthcare workers (Covid-19 waves 1 and 2) -and identified associated risk factors.Methods8996 healthcare workers evaluated on 5 May-7 September 2020 (baseline) were invited to a second web-based survey (October-December 2020). Major depressive disorder (PHQ-8 ≥ 10), generalised anxiety disorder (GAD-7 ≥ 10), panic attacks, post-traumatic stress disorder (PCL-5 ≥ 7), and alcohol use disorder (CAGE-AID ≥ 2) were assessed. Distal (pre-pandemic) and proximal (pandemic) risk factors were included. We estimated the incidence of probable mental disorders (among those without disorders at baseline) and persistence (among those with disorders at baseline). Logistic regression of individual-level [odds ratios (OR)] and population-level (population attributable risk proportions) associations were estimated, adjusting by all distal risk factors, health care centre and time of baseline interview.Results4809 healthcare workers participated at four months follow-up (cooperation rate = 65.7%; mean = 120 days s.d. = 22 days from baseline assessment). Follow-up prevalence of any disorder was 41.5%, (v. 45.4% at baseline, p < 0.001); incidence, 19.7% (s.e. = 1.6) and persistence, 67.7% (s.e. = 2.3). Proximal factors showing significant bivariate-adjusted associations with incidence included: work-related factors [prioritising Covid-19 patients (OR = 1.62)], stress factors [personal health-related stress (OR = 1.61)], interpersonal stress (OR = 1.53) and financial factors [significant income loss (OR = 1.37)]. Risk factors associated with persistence were largely similar.ConclusionsOur study indicates that the prevalence of probable mental disorders among Spanish healthcare workers during the second wave of the Covid-19 pandemic was similarly high to that after the first wave. This was in good part due to the persistence of mental disorders detected at the baseline, but with a relevant incidence of about 1 in 5 of HCWs without mental disorders during the first wave of the Covid-19 pandemic. Health-related factors, work-related factors and interpersonal stress are important risks of persistence of mental disorders and of incidence of mental disorders. Adequately addressing these factors might have prevented a considerable amount of mental health impact of the pandemic among this vulnerable population. Addressing health-related stress, work-related factors and interpersonal stress might reduce the prevalence of these disorders substantially. Study registration number: NCT04556565.

Project description:BackgroundLack of trust in institutional control measures during Coronavirus disease 2019 (COVID-19) outbreaks may affect healthcare workers' (HCWs) levels of stress and wellbeing, and as a consequence, may influence their trust and confidence in their organization. This study aims to understand factors associated with healthcare workers perceptions of trust in organizational preparedness, communication, and infection risk during the COVID-19 pandemic.MethodsA cross-sectional study was conducted among HCWs (n = 876) in 16 COVID 19 healthcare facilities between October and December 2020 in Palestine (Gaza Strip, West Bank and East Jerusalem). A stratified purposive sample using an online self-administered Arabic version of a questionnaire was used for data collection. The questionnaire used for this study was adapted from the World Health Organization Blueprint Novel Coronavirus Perceptions of healthcare workers regarding local infection prevention and control procedures for a COVID-19 research protocol.Data were analyzed using Statistical Package for Social Sciences software version 23. In the bivariate analysis, T-test, one-way ANOVA and χ2 test were used at a significant p-value < 0.05. In the multivariable logistic regression analyses, the adjusted odds ratios and its 95% confidence intervals are presented.ResultsFindings showed that confidence in the systems' ability to manage COVID-19 cases, encouragement and support from senior medical/nursing staff to apply recommended IPC measures, and good levels of mental health increased trust in the organization. Additionally, receiving proper training on IPC procedures for other communicable diseases, having access to clear policies and procedures related to IPC procedures for COVID-19, and providing PPE during the previous clinical shift also increased trust. However, the intention to use recommended PPE when treating patients with suspected or confirmed COVID-19 when having access to it and feeling emotional was negatively correlated with this trust.ConclusionsHCWs should be provided with clear, accessible communications about policies and protocols, as well as training about infection prevention and control, personal protective equipment, and support during pandemics to increase their trust in the healthcare system. Additionally, the improvement in HCWs' wellbeing can be attributed to a greater sense of trust in institutions.

Dataset Information

What Has Been the Impact of Covid-19 on Safety Culture? A Case Study from a Large Metropolitan Healthcare Trust.

Publications

What Has Been the Impact of Covid-19 on Safety Culture? A Case Study from a Large Metropolitan Healthcare Trust.

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