In the U.S., construction accidents remain a significant economic and social problem. Despite recent improvement, the Construction industry, generally, has lagged behind other industries in implementing safety as a total management process for achieving zero accidents and developing a high-performance safety culture. One aspect of this total approach to safety that has frustrated the construction industry the most has been “measurement”, which involves identifying and quantifying the factors that critically influence safe work behaviors. The basic problem attributed is the difficulty in assessing what to measure and how to measure it – particularly the intangible aspects of safety. Without measurement, the notion of continuous improvement is hard to follow. This research was undertaken to develop a strategic framework for the measurement and continuous improvement of total safety in order to achieve and sustain the goal of zero accidents, while improving the quality, productivity and the competitiveness of the construction industry as it moves forward. The research based itself on an integral model of total safety that allowed decomposition of safety into interior and exterior characteristics using a multiattribute analysis technique. Statistical relationships between total safety dimensions and safety performance (measured by safe work behavior) were revealed through a series of latent variables (factors) that describe the total safety environment of a construction organization. A structural equation model (SEM) was estimated for the latent variables to quantify relationships among them and between these total safety determinants and safety performance of a construction organization. The developed SEM constituted a strategic framework for identifying, measuring, and continuously improving safety as a total concern for achieving and sustaining the goal of zero accidents.

Submitted by Nadir Basilio (nadirsb@uninove.br) on 2018-08-10T13:00:10Z No. of bitstreams: 1 Marco Aurelio Araujo dos Santos.pdf: 17624457 bytes, checksum: a39f334c6d3e733c0e16c8355eb7e4a3 (MD5) / Made available in DSpace on 2018-08-10T13:00:10Z (GMT). No. of bitstreams: 1 Marco Aurelio Araujo dos Santos.pdf: 17624457 bytes, checksum: a39f334c6d3e733c0e16c8355eb7e4a3 (MD5) Previous issue date: 2018-02-23 / Every year, fires in public educational institutions and other public properties cause a substantial number of civilian deaths and injuries and significant property damage in the Brazil. This research is about Education and Fire Safety Management, linking it to the culture and occupational health and safety in an educational institution. This is a case study research in Fire Safety Awareness of audiovisual installations at federal educational institution. Fire Safety Management failures in public schools or colleges & universities to focus on prevention and control methods of fire suppression interfere with the efficient fire suppression, for educational institutions where there might be limited resources or high risk in case of fire to extinguish or prevent the spread of fire. The aim of this research is to promote the Fire Safety Awareness, Safety Culture, to identify future safety failures leads to improved planning, and raising environmental awareness and providing information through education to employees and students. The following culture types were then analyzed: school culture, organizational culture and safety culture. Implications of these three theoretical perspectives for the ways sociologists think about the theoretical contributions of Critical Theory in the research was Adorno and Horkheimer’s concepts of culture and awareness, discussing the barriers to awareness and education. Finally, the research propose recommendations to improve the Fire Safety Management at federal educational institution. / Todos los años se registran diversos casos de incendios en edificios públicos en Brasil, muchas de estas ocurrencias se registran en las instituciones educativas públicas, causando diversos accidentes, muertes y daños materiales. Esta investigación tuvo como tema la educación y la gestión de la seguridad en caso de incendio, fue realizada en una institución federal educativa y presenta como problema la cuestión de la concientización de la comunidad de la institución para la implantación de una cultura de seguridad, partiendo de la hipótesis de que es posible un plan de gestión que considere un Programa de Prevención de Riesgos Ambientales e incentive la concientización de la comunidade de la seguridad en caso de incendio, a través de medidas educativas y culturales, buscando la prevención con base en las informaciones presentadas en la legislación vigente. El objetivo general de esta investigación es desarrollar el proceso de concientización y de implementación de un sistema de seguridad em caso de incendio en la institución, basado en la implantación de la cultura de la seguridad y en la legislación vigente, los objetivos específicos son: identificar y describir las principales fallas del sistema de la seguridad contra incendios en la institución de esta investigación, analizar cómo tales fallas interfieren en la gestión del sistema contra incendios de la institución y señalar interferencias necesarias de la administración sobre la concientización y la gestión del sistema de seguridad em caso de incêndio de la institución. En la investigación fueron evaluados, como muestreo, los ambientes audiovisuales y sus accesos, los sujetos de la investigación fueron servidores de la institución y alumnos. La metodología adoptada en este trabajo fue una investigación de naturaleza cualitativa, utilizando el método de un estudio de caso, realizado en la institución, por medio de recolección de datos, combinando el uso de técnicas de observación participante y entrevistas personales, en las cuales los instrumentos de observación recolección fueron los guiones de entrevistas y el grupo focal, que sirvieron al análisis de los resultados. El referencial teórico crítico fue la Teoría Crítica, por medio de los autores Horkheimer y Adorno para el fundamento teórico de los conceptos de cultura y concientización. Finalizando, la investigación trató de una recomendación de propuesta de intervención de la Gestión de la seguridad en caso de incendio. / Todos os anos são registrados diversos casos de incêndios em edificações públicas no Brasil, muitas destas ocorrências são registradas em instituições de ensino públicas, causando diversos acidentes, mortes e danos materiais. Este trabalho tem como tema a Educação e a Gestão da Segurança Contra Incêndio, foi realizado em uma instituição federal de ensino e apresenta como problema a questão da conscientização da comunidade do campus para a implantação de uma cultura de segurança, que possa gerir de forma eficiente a segurança contra incêndio, partindo da hipótese de que é possível um plano de gestão que considere um Programa de Prevenção de Riscos Ambientais e incentive a conscientização da comunidade, por meio de medidas educativas e culturais, visando a prevenção com base nas informações apresentadas na legislação vigente. O objetivo geral desta pesquisa é desenvolver o processo de conscientização e de implementação de um sistema de segurança contra incêndios no campus, baseado na implantação da cultura de segurança e na legislação vigente, os objetivos específicos são: identificar e descrever as principais falhas do sistema de segurança contra incêndio na instituição desta pesquisa, analisar como tais falhas interferem na gestão do sistema contra incêndios do campus e apontar interferências necessárias da administração sobre a conscientização e a gestão do sistema de segurança contra incêndio. Na pesquisa foram avaliados, como amostragem, os ambientes audiovisuais e seus acessos, os sujeitos da pesquisa foram servidores da instituição e alunos. A metodologia adotada neste trabalho foi uma pesquisa de natureza qualitativa, utilizando o método de um estudo de caso, realizado na instituição, por meio de coleta de dados, combinando o uso de técnicas de observação participante e entrevistas pessoais, nas quais os instrumentos de coleta foram os roteiros de entrevistas e o grupo focal, que serviram à análise dos resultados. O referencial teórico crítico é a Teoria Crítica, por meio dos autores Horkheimer e Adorno para o embasamento teórico dos conceitos de cultura e conscientização. Finalizando, a investigação recomendou uma proposta de intervenção na Segurança Contra Incêndio do campus.

Ämnesområdet säkerhet har kommit att få mer utrymme inom verksamhetsområden som ett resultat av det omvärldsläge som förefaller idag, där kriser och olyckor tycks bli en del av det vardagliga sammanhanget snarare än extraordinära händelser som inträffar då och då. Samhället är en dynamisk plats som ständigt utvecklas, vilket innebär att såväl förebyggande arbete som åtgärder inte kommer att vara detsamma för alltid. Begränsad forskning på hur systematiskt säkerhetsarbete bedrivs och förstås utifrån teoretiska utgångspunkter utgör ett incitament att undersöka detta vidare. Universitetet kan likställas med mindre samhällen, sett till exponering och omfång och kräver således ett gediget systematiskt säkerhetsarbete för att säkerställa en trygg och säker tillvaro där risker såväl bedöms som värderas och åtgärdas. Studien syftar till att undersöka hur systematiskt säkerhetsarbete bedrivs och ter sig vid universitet i Sverige och genom detta skapa en uppfattning om såväl framgångsfaktorer som hinder. För att ge svar på studiens syfte har styrdokument samlats in från tre mellanstora universitet i Sverige, för att skapa en kunskapsöversikt och förståelse för hur säkerhetsarbetet bedrivs. I tillägg till detta har yrkesverksamma inom säkerhetsområdet vid samma tre universitet intervjuats. Studiens resultat visar på såväl hinder som framgångsfaktorer vid ett framgångsrikt säkerhetsarbete. Komplexitet föreligger i att nå ut till den stora skalan, och studenter tycks vara den målgrupp som är svårast att nå. Ett intressant fynd i kontrast till detta är att riskmedvetenheten förefaller sig vara lika hög hos studenter som anställda, om än högre. Vidare visar studien att lagar och förordningar sätter ramen för hur det systematiska säkerhetsarbetet bedrivs vid universitet, utöver de universitetens egna ambitioner, och bidrar till en ökad riskmedvetenhet. / Safety has come to gain more attention in operational areas as a result of the current state of the world, whereas crises and accidents seem to have become part of the everyday context rather than extraordinary events that occur every now and then. Society is a dynamic place that is constantly evolving, which means that both prevention work and measures will have to evolve along with society. Limited research on how systematic safety work is conducted and understood based on theoretical starting points constitutes an incentive to investigate this subject area further. The university can be compared to smaller communities, due to risk exposure and scope, that requires systematic safety work to ensure a safe and secure environment where risks are assessed as well as valued with relevant measures being taken. The study aims to investigate how systematic safety work is conducted at universities in Sweden, and by doing so create an understanding of successful factors as well as obstacles and challenges of conducting a successful safety work. To provide answers to the purpose of the study, documents from three middle sized universities in Sweden have been collected to gain knowledge of how the systematic safety work is being conducted. In addition to this, professionals in the security field at the same three universities have been interviewed. The results of the study show both obstacles and success factors in conducting a successful safety work. Complexity appears in reaching out to the large scale, and students seem to be the most difficult target group to reach. An interesting finding in contrast to this is that risk awareness appears to be just as high among students as employees, if not higher. Furthermore, the study shows that laws and regulations set the framework for how the systematic safety work is conducted at universities, in addition to the universities' own ambitions, and contribute to an increased risk awareness.

Human related accidents in high-risk industries amount to a significant economic hazard and incur tremendous damages, causing excessive operational costs and loss of life. The aviation industry now observes human-related accidents more frequently than in the past, an upswing attributable to cutting-edge technology usage and the complex systems employed by aviation organizations. Historically, aviation accidents have been attributed to individual unsafe behavior. However, contemporary accident causation models suggest that organizational-level factors influence individual safety performance, as human-related accidents take place in an organizational context. The present study examines the formation of organizational safety culture and influence on individuals' safety behavior in a police aviation environment. The theory of planned behavior guides the study model in explaining individual variability in safety behavior via organizational safety culture. The study conceptualized organizational safety culture and individual safety behavior as multidimensional constructs. Confirmatory factor analysis was conducted for each latent construct to validate the construct validity for each measurement model. Organizational safety culture was observed via safety climate facets, which contained four subcomponents including individual attitude, group norms, management attitude, and workplace pressures. Individual safety behavior contained violation and error components observed by self-reported statements. Structural equation modeling was conducted to test the study hypotheses. Utilizing a sample of 210 employees from the Turkish National Police Aviation Department, a 53-item survey was conducted to measure individuals' safety culture perceptions and self-reported safety behaviors. The results suggest that individual safety behavior is significantly influenced by organizational safety culture. Except for the relation between workplace pressures and intention, all suggested relations and correlations were statistically significant. The four-factor measurement model of organizational safety climate fit reasonably well to the data, and most correlations between the safety climate components were significant at the .05 level. Individuals' self-reported error behavior is positively associated with age, and individuals' self-reported violation behavior is positively associated with years of service. Overall, along with organizational safety culture, age and service-year variables accounted for 65% of the variance in intention, 55% of the variance in violation behavior, and 68% of the variance in error behavior. Lastly, no significant difference manifested among pilots, maintenance personnel, and office staff according to their self-related safety behaviors. The findings have theoretical, policy, and managerial implications. First, the theory of planned behavior was tested, and its usefulness in explaining individuals' safety behavior was demonstrated. The survey instrument of the study, and multi-dimensional measurement models for organizational safety climate and individual safety behavior were theoretical contributions of the study. Second, the emergence of informal organizational structures and their effects on individuals indicated several policy implications. The study also revealed the importance of informal structures in organizations performing in high-risk environments, especially in designing safety systems, safety policies, and regulations. Policy modification was suggested to overcome anticipated obstacles and the perceived difficulty of working with safety procedures. The influences of age on error behavior and years of service on violation behavior point to the need for several policy modifications regarding task assignment, personnel recruitment, health reports, and violation assessment policies. As well, managerial implications were suggested, including changing individuals' perceptions of management and group attitudes toward safety. The negative influence of anticipated obstacles and the perceived difficulties of safety procedures on individual safety behavior pointed out management's role in reducing risks and accidents by designing intervention programs to improve safety performance, and formulating proactive solutions for problems typically leading to accidents and injuries.

Background: The status of Safety Management is highly relevant to evaluate an organization’s ability to deal with unexpected events or errors, especially in times of crisis. However, it remains unclear to what extent Safety Management was developed and suffciently implemented within the healthcare system during the COVID-19 pandemic. Providing insights of potential for improvement is expected to be directional for ongoing Safety Management efforts, in times of crisis and beyond. Method: A nationwide survey study was conducted among healthcare professionals and auxiliary staff on German Intensive Care Units (ICUs) evaluating their experiences during the first wave of the COVID-19 pandemic. Error Management and Patient Safety Culture (PSC) measures served to operationalize Safety Management. Data were analyzed descriptively and by using quantitative content analysis (QCA). Results: Results for n = 588 participants from 53 hospitals show that there is a gap between errors occurred, reported, documented, and addressed. QCA revealed that low quality of safety culture (27.8%) was the most mentioned reason for errors not being addressed. Overall, ratings of PSC ranged from 26.7 to 57.9% positive response with Staffng being the worst and Teamwork Within Units being the best rated dimension. While assessments showed a similar pattern, medical staff rated PSC on ICUs more positively in comparison to nursing staff. Conclusion: The status-analysis of Safety Management in times of crisis revealed relevant potential for improvement. Human Factor plays a crucial role in the occurrence and the way errors are dealt with on ICUs, but systemic factors should not be underestimated. Further intensified efforts specifically in the fields of staffng and error reporting, documentation and communication are needed to improve Safety Management on ICUs. These findingsmight also be applicable across nations and sectors beyond the medical field.

Dagens avverkningsindustri har under de senaste årtionden mekaniserat med tyngre maskiner som ökar effektiviteten och precisionen av arbetsprocessen. Det är viktigt att konstant anpassa arbetsrutiner och säkerhetsarbetet till den snabbt utvecklande arbetsmiljön. Organisationens säkerhetskultur är en bra indikator på hur väl säkerhetsarbetet genomförs och ger en god insikt på hur säkerheten hanteras på individ- och organisationsnivå. En metod för att undersöka säkerhetsmognaden är att analysera företagets anställda på olika nivåer inom verksamheten och se hur de olika rollerna arbetar med ett antal viktiga aspekter för säkerhetsarbete. Därför har rapporten som syfte att svara på följande forskningsfrågor: (1) Är digitala enkäter lämpliga verktyg för att samla in relevant data för att bedöma säkerhetskulturen hos ett företag? (2) Kan den nuvarande säkerhetskulturen hos Stora Enso bedömas med hjälp av Bradley Curve och i så fall vad är mognadsgraden? (3) Vad för förbättringsförslag kan vi ge på Stora Ensos nuvarande riskhanteringssystem? Genom att skicka ut enkäter till anställda, kunde information om deras bemötande i viktiga säkerhetsfrågor kvantifieras med hjälp av ett numeriskt poängsystem. Enkätverktyget samlade in ett bra antal svar som visade en god tillförlitlighet, vilket innebär att enkäter är ett lämpligt verktyg för relevant datainsamling. Stora Ensos säkerhetskultur kan bedömas med hjälp av Bradley Curve, som visar att verksamheten har nått independent-nivån på kurvan. Genom att uppmuntra anställda till att rapportera flera incidenter och tillbud och använda sig av tillgängliga säkerhetsverktyg, kan man förbättra kommunikationen och därmed säkerhetskulturen och utvecklingsarbetet inom företaget. / The logging industry today has mechanized with heavier machinery over the past decades, increasing the efficiency and precision of the work process. It is important to constantly adapt work routines and safety practices to the rapidly evolving work environment. The organization's safety culture is a good indicator of how well safety practices are implemented and provides good insight into how safety is managed at both the individual and organizational levels. A method to investigate safety maturity is to analyze the company's employees at various levels within the organization and see how the different roles work with several important aspects of safety work. Therefore, the report aims to answer the following research questions: (1) Are digital surveys suitable tools for collecting relevant data to assess a company's safety culture? (2) Can the current safety culture at Stora Enso be assessed using the Bradley Curve and, if so, what is the maturity level? (3) What improvement suggestions can we provide for Stora Enso's current risk management system? By sending out surveys to employees, information about their responses to important safety issues could be quantified using a numerical scoring system. The survey tool collected a good number of responses that showed good reliability, indicating that surveys are a suitable tool for relevant data collection. Stora Enso's safety culture can be assessed using the Bradley Curve, which shows that the company has reached the independent level on the curve. By encouraging employees to report more incidents and near-misses and to use available safety tools, communication can be improved, thereby enhancing the safety culture and development work within the company.

Dricksvatten utgör en förutsättning för liv, det är därmed viktigt att goda tillgångar till säkert dricksvatten upprätthålls. Människors kontinuerliga behov av rent dricksvatten skapar en sårbarhet för smittspridningar i dricksvattenförsörjningen. Cryptosporidiumutbrotten i Östersund och Skellefteå kommun år 2010–2011 belyste dricksvattenförsörjningens bristande beredskap och behovet av säkerhetsåtgärder. Utmaningarna med att upprätthålla rent dricksvatten förväntas förvärras på grund av klimatförändringar, ökad urbanisering, befolkningstillväxt och förändrade världsförhållanden. Dessa utmaningar kan leda till en högre risk för spridningar av patogener i dricksvattenförsörjningen, vilket potentiellt kan orsaka hälsorisker om beredskapen och medvetenheten är otillräcklig. Syftet med studien är att utforska kommuners riskuppfattningar, riskprioriteringar och beredskap inför framtida utbrott. Studien syftar också till att identifiera skillnader i uppfattningar, prioriteringar och beredskap mellan kommuner som tidigare har, respektive inte har drabbats av ett kritiskt dricksvattenburet smittutbrott. Tre kommuner, Östersund, Piteå och Sandviken har inkluderats i studien. Totalt fem personer intervjuades. Dessa intervjuer har bearbetats och analyserats med hjälp av en kvalitativ innehållsanalys. Studiens resultat belyser hur riskuppfattningar formas genom osäkra framtidsförhållanden, riskfaktorer och tidigare händelser. Utbrotten av cryptosporidium i Östersund och Skellefteå 2010–2011 ökade medvetenheten om mikrobiologiska dricksvattenutbrott. Som ett resultat av detta förbättrades kommunernas beredskap genom investeringar, ökad provtagning och förbättrad vattenbehandling. Utbrottet i Östersund ledde till ett förlorat konsumentförtroende, vilket arbetas med att åtgärda. Trots detta anses utbrottet ha lett till en ökad förståelse för detaljer inom framtidens krisberedskap, vilket utgör en osäkerhetsfaktor bland icke drabbade kommuner. Kommunerna säkerställer en säker dricksvattenförsörjning genom lagkrav. De utvecklar och implementerar dokument för beredskapshantering och säkerhetsåtgärder baserat på dessa lagbestämmelser. Det framgår att prioriteringar och ekonomiska begränsningar påverkar beredskapen inför kritiska dricksvattenburna utbrott, vilket påverkar möjligheten till att rusta dricksvattensäkerheten. / Drinking water is a prerequisite for life, it is therefore important that good supplies of safe drinking water are maintained. People's continuous need for clean drinking water creates a vulnerability to the spread of infection in the drinking water supply. The cryptosporidium outbreaks in Östersund and Skellefteå in 2010–2011 highlighted the lack of preparedness and the need for safety measures. The challenges of maintaining clean drinking water are expected to worsen due to climate change, increased urbanization, population growth, and changing world conditions. These challenges could lead to a higher risk of pathogen spread in drinking water supplies, potentially causing health risks in case of insufficient preparedness and awareness. The study aims to explore municipalities' perception of risks, prioritization of risks, and preparedness for future outbreaks. The study also seeks to identify differences in perceptions, prioritization and preparedness between municipalities that have and have not experienced a previous critical drinking water outbreak. Three municipalities, Östersund, Piteå, and Sandviken, were included in the study. Five people were interviewed. These interviews were processed and analysed using a qualitative content analysis The study's results highlight how risk perceptions are shaped by uncertain future conditions, risk factors and past events. Specifically, the cryptosporidium outbreaks in Östersund and Skellefteå in 2010-2011 increased awareness of microbiological drinking water outbreaks. As a result, municipal preparedness improved through investments, increased sampling, and improved water treatment. The outbreak in Östersund resulted in a loss of consumer confidence, which is still being addressed. Despite this, the outbreak is considered to have led to an increased understanding of the details of emergency management for the future, which is an uncertainty among unaffected municipalities. Municipalities ensure a safe drinking water supply through legal requirements. They develop and implement preparedness management documents and safety measures based on these legal provisions. It appears that priorities and financial constraints affect preparedness for critical drinking water outbreaks, which affects the ability to equip for drinking water safety.

國內企業在行銷活動上時常展現積極的作為，因為行銷活動往往和利潤有關，在生產面上較少系統化推動安全管理，始終想得多、做得少，對於建立安全管理機制亦無法如推動行銷活動般積極；反觀有的企業卻能夠兼顧安全與營業利潤，持續成長壯大；推究原因，影響因素有很多，但重點關鍵在於是否充分認識安全文化，並掌握推動安全管理文化的進程及方法。 企業文化是企業成功的關鍵因素(Key Success Factor) ，但是非常抽象、含糊，難以定義。而建立企業文化相較於擬定營運計畫或行銷計畫更加困難，因為營業利潤具有量化數字而企業文化較難量化，因此常被企業經營者忽略；企業文化始終無法有效建立。 綜合以上，有鑑於國內企業對建立安全文化的方法較為陌生，但是對於行銷方法卻運用嫻熟，本研究運用企業管理者所熟知的行銷策略架構，以內部行銷的角度歸納企業在不同的安全文化階段可執行的實務方法，協助管理者有效地與員工進行價值交換，塑造企業安全管理文化。 本研究擬以邱志聖教授著作之策略行銷分析 (2006) 一書中所探討的內隱交易成本作為組織內部行銷策略之基礎，配合 Ahmed & Rafiq 二位學者所著內部行銷 (2002) 一書為輔，結合杜邦公司二百年來的安全管理實務作為個案分析，以了解、評估及探索在不同的安全文化階段下，企業可以採取哪些內部行銷方法促使員工改變觀念與行為，並驗證不同的安全文化階段所使用之內部行銷策略也將不同。 本研究結合專家訪談及問卷調查進行實證研究，研究發現如下：『利用內部行銷策略可以提升員工對於安全文化的認識，減少個人對不安全行為的僥倖心理，進而融入企業安全文化，展現安全行為。』

Une préoccupation grandissante face aux risques biologiques reliés aux maladies infectieuses est palpable tant au niveau international que national ou provincial. Des maladies émergentes telles que le SRAS ou la grippe A/H1N1 ont amené une prise en charge des risques pandémiques et à l’élaboration de mesures d’urgence pour maîtriser ces risques : développer une culture de sécurité est devenu une priorité de recherche de l’OMS. Malgré tout, peu d’écrits existent face à cette volonté de sécuriser la santé et le bien-être par toute une série de dispositifs au sein desquels les discours occupent une place importante en matière de culture de sécurité face aux risques biologiques. Une réflexion sociopolitique était nécessaire pour les infirmières qui sont aux premières loges en dispensant des soins à la population dans une perspective de prévention et de contrôle des infections (PCI) dans laquelle elles se spécialisent. Dès lors, ce projet avait pour buts d’explorer la perception du risque et de la sécurité face aux maladies infectieuses auprès des infirmières cliniciennes et gestionnaires québécoises; d’explorer plus spécifiquement l'existence ou l'absence de culture de sécurité dans un centre de santé et de services sociaux québécois (CSSS); et d’explorer les discours en présence dans le CSSS en matière de sécurité et de risques biologiques face aux maladies infectieuses et comment ces discours de sécurité face aux risques biologiques se traduisent dans le quotidien des infirmières. Les risques biologiques sont perçus comme identifiables, mesurables et évitables dans la mesure où les infirmières appliquent les mesures de préventions et contrôle des infections, ce qui s’inscrit dans une perspective positiviste du risque (Lupton, 1999). La gestion de ces risques se décline au travers de rituels de purification et de protection afin de se protéger de toute maladie infectieuse. Face à ces risques, une culture de sécurité unique est en émergence dans le CSSS dans une perspective de prévention de la maladie. Toutefois, cette culture de sécurité désirée est confrontée à une mosaïque de cultures qui couvrent différentes façons d’appliquer ou non les mesures de PCI selon les participants. La contribution de cette recherche est pertinente dans ce nouveau domaine de spécialité que constituent la prévention et le contrôle des infections pour les infirmières québécoises. Une analyse critique des relations de pouvoir tel qu’entendu par Foucault a permis de soulever les questions de surveillance infirmière, de politique de l’aveu valorisée, de punition de tout écart à l’application rigoureuse des normes de PCI, de contrôle de la part des cadres infirmiers et d’assujettissement des corps relevant des mécanismes disciplinaires. Elle a permis également de documenter la présence de dispositifs de sécurité en lien avec la tenue de statistiques sur les patients qui sont répertoriés en tant que cas infectieux, mais également en termes de circulation des personnes au sein de l’établissement. La présence d’un pouvoir pastoral est perceptible dans la traduction du rôle d’infirmière gestionnaire qui doit s’assurer que ses équipes agissent de la bonne façon et appliquent les normes de PCI privilégiées au sein du CSSS afin de réguler les taux d’infections nosocomiales présents dans l’établissement. En cas de non-respect des mesures de PCI touchant à l’hygiène des mains ou à la vaccination, l’infirmière s’expose à des mesures disciplinaires passant de l’avertissement, la relocalisation, l’exclusion ou la suspension de l’emploi. Une culture du blâme a été décrite par la recherche d’un coupable au sein de l’institution, particulièrement en temps de pandémie. Au CSSS, l’Autre est perçu comme étant à l’origine de la contamination, tandis que le Soi est perçu comme à l’abri de tout risque à partir du moment où l’infirmière respecte les normes d’hygiène de vie en termes de saines habitudes alimentaires et d’activité physique. Par ailleurs, les infirmières se doivent de respecter des normes de PCI qu’elles connaissent peu, puisque les participantes à la recherche ont souligné le manque de formation académique et continue quant aux maladies infectieuses, aux risques biologiques et à la culture de sécurité qu’elles considèrent pourtant comme des sujets priorisés par leur établissement de santé. Le pouvoir produit des effets sur les corps en les modifiant. Cette étude ethnographique critique a permis de soulever les enjeux sociopolitiques reliés aux discours en présence et de mettre en lumière ce que Foucault a appelé le gouvernement des corps et ses effets qui se capillarisent dans le quotidien des infirmières. Des recherches ultérieures sont nécessaires afin d’approfondir ce champ de spécialité de notre discipline infirmière et de mieux arrimer la formation académique et continue aux réalités infectieuses cliniques. / At an international, national or provincial level, there is a growing concern related to biological risks and infectious disease. Emerging diseases such as SARS or influenza A/H1N1 brought a pandemic risk management and the development of emergency measures to control these risks: developing a safety culture has become a research priority for the WHO. However, few writings exist about the desire to secure health and well-being through a variety of devices in which the discourses takes a predominant place as regards of security against biological risks. From the perspective of prevention and infection control (PCI), in which the nurses specialize, a socio-political reflexion was necessary since they are at the forefront in providing care to the population. Therefore, the purpose of this project was to explore the discourses surrounding the safety culture against biological risks in the context of a Quebec healthcare facility “Centre de santé et de services sociaux” (CSSS). Biological hazards are perceived as identifiable, measurable and avoidable if the nurses apply the preventive and infection control measures, which is part of a positivist perspective of risk (Lupton, 1999). Managing these risks is declined through a purification and protection rituals in order to protect themselves from any infectious disease. Faced with these risks, a unique safety culture is emerging in the CSSS following a disease prevention perspective. However, the desired safety culture is faced with a mosaic of cultures that cover different ways to apply or not the prevention and infection control (PIC) measures according to participants. The contribution of this research is important within the prevention and control of infection field for Quebecois nurses. Critical analysis of power relations has raised questions about nursing surveillance, valorized confession policy, punishment for any deviation from the normative application of the PCI standards, monitoring by the nursing managers and subjugation of bodies within disciplinary mechanisms. It made it possible to document the presence of safety devices in conjunction with maintaining statistics on patients who are listed as infectious cases, but also in terms of flux of person’s movements within the institution. The presence of a pastoral power is perceptible in the translation of the administrative role of nurse who must ensure that its teams act in the right way and apply the preferred CSSS PIC standards to regulate the rate of nosocomial infections present within the establishment. In case of non-compliance with PIC related measures to hand hygiene or vaccination, the nurse may be subject to disciplinary action from the warning, the relocation, the exclusion or suspension of the employment. A culture of blame has been described by the search for a culprit in the institution. Within the CSSS, the Other is perceived as being the source of contamination, while the Self is seen as free from any risk from the moment the nurse respects the standards of hygiene of life in terms of healthy dietary habits and physical activity. In addition, nurses must respect the PIC standards they know little, since the research participants noted the lack of academic and continuous training concerning infectious diseases, biological hazards and safety culture that they consider prioritized by their health institution. Power produces effects on the bodies by modifying them. This ethnographic study criticizes, made it possible to raise the sociopolitic stakes connected to the involved speeches and to clarify what Foucault called the government of the bodies and his effects which are capillaries in the nurse’s daily normalities. Further researches are necessary to explore this nursing speciality and to link academic and continuous training to clinical infectious realities.

Föreliggande avhandlings centrala syfte är att undersöka säkerhetskultur ombord i fartyg vilka trafikerar Östersjön. Genomgående för fartyg i Östersjöfart är täta hamnanlöp, kustnära resor, trafik i tätt trafikerade områden samt små besättningar. Tidigare forskning antyder att det kan finnas ett systemfel i sjöfarten. Charles Perrow beskriver, till exempel, sjöfarten som ett felskapande system och menar att orsaken till detta är hur sjöfarten bedrivs. James Reason menar att värdering, attityd, kompetens och beteendemönster är fyra viktiga parametrar som definierar en säkerhetskultur. Sjöfartens säkerhetsstyrningssystem, International Safety Management Code (ISM) syftar till att en proaktiv och utvecklande säkerhetskultur skapas och upprätthålls inom sjöfarten. Resultaten av den här studien visar att sjöfarten saknar en framförhållning, ”failure of foresight”, där det proaktiva arbetssättet syftar till att incidenter och olyckor kan förutses. Studien har ett etnografiskt perspektiv vilket syftar till att skapa en så fullödig beskrivning över den kultur som studeras. Totalt ingår elva olika fartyg i studien, där besöken ombord varierat från någon timme till ett par dagar. Insamlad data har via en egenutvecklad analysmodell bearbetats för att försöka förklara säkerhetskulturen. I fokus i analysmodellen står hur information, feedback, ansvar, samarbete, uppföljning samt utveckling hanteras. Studien visar att det finns behov av att diskutera och förändra säkerhetskulturen i sjöfarten, både i stort som enskilt i fartygen. Det finns ett behov av vidare studier av hur säkerhetskulturen kan förbättras, samt ett behov av riktade utbildningsinsatser inom systemtänkande, organisationsteori och säkerhetskultur. / The main purpose of this thesis is to explore the safety culture onboard vessels trading in the Baltic Sea. The common denominator for vessels trading in the Baltic Sea is frequent port visits, coastal voyages, voyages in dense trafficked areas and small crews. Earlier research shows that there may be a system fault in the shipping industry. Charles Perrow describes the maritime industry as an error inducing system. He means that the cause for that is the way shipping is carried out. In a safety culture values, attitudes, competence and behavioral patterns are four important factors that define the safety culture. The maritime safety management system, International Safety Management Code (ISM) aims towards a proactive and evolutionally safety culture in the shipping industry. The results show that shipping today lacks a foresight, “failure of foresight”, where the proactive way of work leads to incidents and accidents being anticipated. This study has an ethnographic perspective, which aims to create a thick and substantial description of the culture that is being studied. Totally a number of eleven vessels participated in the study. The visits onboard reach from a couple of hours up to a few days. Collected data has been analysed through a self-developed model in an ambition to try to explain the safety culture. The model focuses on how information, feedback, responsibility, co-operation, follow-up and development are being handled. The study reveals that there is a need to discuss and change the safety culture in the shipping industry, in large as on the single vessel. As well as a need for further studies of how the safety culture can be improved and a need for education aimed towards system thinking, organizational theory and safety culture.