Bakgrund: Skador orsakade av vården medför både ett lidande för patienten menäven en stor kostnad för samhället. Operationsavdelningen är en högriskmiljö som ställer krav på både ett personlig riskmedvetet engagemang och ett väl fungerande teamarbete. WHO:s checklista ska förbättra teamets samarbete men även en god säkerhetskultur kan stärka upp teamets prestation. Säkerhetskultur handlar omindividens synsätt, attityderna gentemot varandra och de gemensamma uppfattningarna om risker. Syfte: Syftet med studien var att undersöka attityder till säkerhetskulturen påoperationsavdelning och WHO:s checklista. Studiens frågeställning var: skiljer sigattityder till säkerhetskulturen mellan professioner och sjukhus? Metod: Studien utfördes utifrån en kvantitativ forskningsansats, data har inhämtatsmed hjälp av en webbenkät med avsikten att mäta och därefter analysera ochsammanställa olika gruppers attityder till säkerhetskulturen och WHO:s checklista på operationssal. Safety Attitudes Questionnaire (SAQ-OR) är anpassad till operationssjukvård och ger en ögonblicksbild av säkerhetskulturen. Frågeformuläret bestod av 30 frågor indelade i sex faktorer och tre egenkonstruerade frågor om WHO:s checklista. Urvalet var ett bekvämlighetsurval och inkluderadeoperationssjuksköterskor och operatörer som arbetar på centraloperation, tvåsjukhus ingick i studien. Resultat: Resultat visade på varierade positiva attityder inom säkerhetskulturen. Arbetstillfredsställelse och attityder till WHO:s checklista var de faktorer som skattades högst medan uppfattning om ledning skattades lägst. Studien visade ingaskillnader mellan operationssjuksköterskor och operatörer. Vid jämförelsen avsjukhus upptäcktes skillnader i medvetenhet till stress och uppfattning av ledning. Slutsats: Det krävs förbättringar i dialogen och relationen mellan chefer och personal. Vidare måste personalen ges rätt förutsättningar från organistationen föratt bedriva en säker vård. / Background: Injury caused by healthcare causes both a suffering for the patient but also a great cost to society. The operation department is a high-risk environment that demands both personal risk-consciousness and well-functioning team work. WHO:s checklist can improve the team's cooperation but also a good safety culture can strengthen the team's performance. Safety culture is the individual's attitudes towards each other and the common perceptions of risks. Aim: The aim of the study was to investigate attitudes to the safety culture and the WHO:s checklist. The question of the study was: do attitudes differ to the safety culture between professions and hospitals? Methods: The study was based on a quantitative research approach, data has been obtained using a web survey with the intention of measuring and then analyzing different groups' attitudes to the safety culture and the WHO:s checklist. Safety Attitudes Questionnaire (SAQ-OR) is adapted to operating care and provides a snapshot of the safety culture. The questionnaire consisted of 30 questions divided into six factors, three self-constructed questions were also included. The selection was based on a convenience sample which included operating theatre nurses and surgeons that works on a central unit, two hospitals were included in the study.Result: Results showed varied positive attitudes within the safety culture. Work satisfaction and attitudes to the WHO:s checklist hade the highest scores while the perception of management was the lowest. The study showed no differences between the professions. In the comparison of hospitals, differences in awareness of stress and perception of management were discovered. Conclusion: Improvements are needed in the dialogue and relationship between managers and staff. Furthermore, the staff must be given the right conditions from the organization to conduct a safe care.

Il est préconisé de développer le climat de sécurité (CS) pour améliorer la sécurité des soins. Dans cette thèse, nous essaierons de préciser l’utilisation du concept de CS pour l’évaluation d'interventions d’amélioration de la sécurité des soins.Les objectifs des travaux présentés étaient d’élaborer un questionnaire de CS en français et d’évaluer l’impact de l’analyse de vignettes d’événements indésirables associés aux soins (EIAS) sur le CS d’unités de soins en milieu hospitalier.Ces travaux ont montré la faisabilité de mesurer le CS avec une version française du questionnaire américain, le Hospital Survey On Patient Safety Culture (HSOPSC). Ils ont permis de proposer une version française aux performances psychométriques suffisantes. Ils ont montré l’importance du rôle de l’encadrement, de l’organisation apprenante et du travail d’équipe entre services. La version française de l’HSOPSC a été utilisée pour évaluer l’effet de l’analyse de vignettes d’EIAS. Testée dans un essai contrôlé randomisé en clusters, cette intervention a amélioré les perceptions des professionnels sur l’organisation apprenante et l’amélioration continue, sans modifier les autres dimensions.Face à la difficulté de modifier dans un temps court l’ensemble des dimensions, le CS devrait être utilisé pour caractériser le contexte d'implémentation des interventions afin de les adapter et de mieux en comprendre l’impact, plutôt que pour servir de critère de résultat.Les pistes de recherche sont d’étudier la pérennité d’une intervention au-delà de son évaluation initiale au travers du maintien ou du développement de la culture de sécurité ; et d’étudier les perceptions des patients en matière de sécurité de soins / It is recommended to develop the safety climate (SC) to improve patient safety. In this thesis, we will try to clarify the use of the CS concept for the evaluation of interventions aiming to improve patient safety.The objectives of the articles presented were to develop a French version of a SC questionnaire and to assess the impact of a vignette-based analysis of adverse events (AEs) on the SC of care units.The studies demonstrated the feasibility of measuring the SC with a French version of the American questionnaire, the Hospital Survey On Patient Safety Culture (HSOPSC). They made it possible to propose a French version with sufficient psychometric performance. They showed the importance of the role of supervision, the organisational learning and teamwork between units. The French version of the HSOPSC was used to evaluate the effect of the vignette-based analysis of AEs. Tested in a randomized controlled cluster trial, this intervention improved professionals' perceptions of the organisational learning and continuous improvement, without modifying other dimensions.Given the difficulty of modifying all dimensions in a short period of time, SC should be used to characterize the context in which interventions are implemented in order to adapt them and better understand their impact, rather than being used as an outcome criterion.The research areas are to study the sustainability of an intervention beyond its initial evaluation through the maintenance or development of a safety culture; and to study patients' perceptions of care safety

Cette thèse étudie la notion de culture de sûreté, nouveau « mantra » des organisations à haut risque (Silbey, 2009). Apparue à la fin des années 1980 afin de mieux prendre en compte l’organisation dans la gestion de la sécurité nucléaire, elle est aujourd'hui très utilisée dans les discours comme dans les politiques managériales des entreprises à haut risque. L’enquête ethnographique, menée par observations de situations de travail, d’entretiens et de l’analyse de documents, permet d’étudier la construction sociale de la notion de culture de sûreté, ses représentations, ses usages et son influence sur l’organisation du travail dans les centrales nucléaires. La thèse appréhende la culture de sûreté comme un objet hybride entre un discours qui serait diffusé dans les industries à risque et un outil de gestion de la sécurité. Elle analyse comment la notion de culture de sûreté s’est installée dans différents espaces sociaux de l’industrie nucléaire grâce à sa flexibilité interprétative : experts internationaux de la sécurité nucléaire, chercheurs des sciences de la sécurité industrielle, dirigeants de la division production nucléaire d’EDF et managers de proximité des centrales nucléaires. La comparaison des systèmes d’action de trois centrales nucléaires montre que dans un univers hautement normé et procéduralisé, la culture de sûreté est devenue un outil, de nature essentiellement discursive. Les managers s’en saisissent pour agir sur les contraintes qui pèsent sur eux et les rapports de pouvoir dans lesquels ils inscrivent leur action, de manière à rendre leur travail plus efficace. La thèse met ainsi en avant la capacité des discours à agir concrètement sur le travail. / This thesis examines the concept of safety culture, new 'mantra' of high risk organizations (Silbey, 2009). It appeared in the late 1980s in order to better reflect the organization in the management of nuclear safety, and it is now widely used in the discourse as in the managerial policies of high-risk industry companies. The ethnographic investigation, based on observations, interviews and document analysis, analyzes the social construction of the concept of safety culture, its representations, its uses and its influence on the organization of work in nuclear power plants. The thesis reveals safety culture as a hybrid object between a speech that would be broadcast in high-risk industries and a security management tool. It analyzes how the notion of safety culture has settled in different social spaces of the nuclear industry thanks to its interpretative flexibility: international experts on nuclear safety, “safety science” researchers, EDF’s central administration and team managers in nuclear power plants. The comparison of three nuclear power plants’ local orders shows that in a highly standardized and proceduralized universe, safety culture has essentially become a discursive tool. Managers seize it to act on the constraints laid upon them and power relations in which they act, so as to make their work more effective. Thus, the thesis puts forward the ability of speech to act concretely on the organization of work.

Many obstacles still exist toward improving safety standards, practices, and culture in the ready-made garment (RMG) industry in Bangladesh. Workers' beliefs and habits, employers' level of involvement, and gaps in the regulatory framework necessitate an examination of safety practices to build a foundation for safety culture in the workplace. The focus of this study was to contribute to regulatory reform aimed at creating a safe work environment by exploring the perceptions of workers, employers, and government regulators through the lens of the theory on reciprocal determinism. A total of 41 participants, categorized into three groups of workers, employers, and government regulators, consented to face-to-face interviews. The study provided individual and group perspectives of requirements for safe factories and development of safety culture. Interview data were inductively coded and subjected to a thematic analysis procedure. The results showed the groups collectively prioritized the need for training, collaboration, health, and safety, and they raised concern over civil unrest. The groups differed on the importance placed in areas such as protection of workers, profit, and legal enforcement. The study results can serve to contribute to effective government reform by developing self-efficacy of workers and improve collaboration between workers, employers, and government in the RMG industry of Bangladesh.

Patient safety is of particular importance within intensive care units (ICUs), where critically ill, vulnerable patients receive complex multidisciplinary care. Prior research has indicated that improving patient safety and reducing errors within healthcare requires a focus on systems and organisational culture issues. This thesis was concerned with three studies. One focused on assessing the patient safety culture and two on quality improvement initiatives within an intensive care unit (ICU) of a large teaching hospital. The first study involved a survey of ICU consultant, registrar and nursing staff regarding aspects of safety culture. This was conducted using an existing Hospital Survey on Patient Safety Culture. Of the twelve patient safety culture composites assessed, eight had scores lower than 50%, highlighting these as areas for improvement. Overall, while the survey results revealed that teamwork within the ICU was considered a strength, event reporting and patient care handovers and transitions were both considered areas with potential for improvement. The second study focused on the evaluation of a change initiative designed to improve the handover of patient clinical information in the ICU. This study involved a survey and interviews with consultant, registrar and nursing staff before and after the introduction of a Patient Management, Plan and Progress (PMPP) document. Examination of the survey responses involved both quantitative and qualitative analysis; respondent interview transcripts were analysed using thematic analysis. The results of this study revealed resistance to, and criticisms of, the introduction of the PMPP document; the initiative failed and use of the document was discontinued. The second initiative concerned an evaluation of the impact of a hospital-wide document on improving documentation of withdrawal of patient treatment within the ICU. This involved both quantitative and qualitative analysis, with a patient medical record audit of decisions to withdraw patient treatment within the ICU before and after the introduction of an Advance Care Plan (ACP) document. ICU consultant, registrar and nursing staff were interviewed regarding the process of withdrawal of patient treatment within the ICU. Interview transcripts were analysed using a modified grounded theory approach. Results revealed that the attempt to improve the documentation of withdrawal of treatment within the ICU failed, with the ACP document remaining unused in 89% of cases and incomplete in the remaining 11%. Also, documentation of decision-making and of the process within the medical records did not improve. Before-introduction findings revealed that only 26% of medical records met the pre-existing requirements for treatment withdrawal in the ICU, and after-introduction findings revealed that only 19% of medical records audited met the requirements of the ACP document. After-audit findings also revealed significant and inappropriate increases in the involvement of an ICU registrar both as primary and secondary decision-makers. In spite of an increased awareness of ICU staff concerning the importance of improving documentation, the medical record audit revealed less compliance with the standards required for documentation. Possible reasons for the document remaining essentially unused, as revealed from interviews with staff, included: previous criticisms by the coroner when they failed to complete a similar formalised document properly; perceived logistical issues associated with obtaining required staff signatures; disagreement concerning who should be involved in documenting the withdrawal of treatment process; and the existence of an ICU subculture of practice that, in one particular aspect of documentation, was not consistent with established hospital and ICU protocol and documentation requirements. The final chapter of this thesis considered implications of the results of the studies for the planning, development, implementation and evaluation of improvement programs within the ICU setting. The results were considered within the context of organisational change management theory and research, including factors that have been found to be critical in the success or failure of change programs, such as resistance to change, the involvement of key stakeholders in the change process, leadership, communication and organisational culture. It is suggested that management consultants with organisational change expertise in the planning, development, implementation and evaluation of such programs should be involved in future quality improvement initiatives. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1297608 / Thesis (Ph.D.) -- University of Adelaide, School of Psychology, 2007

<p>Att framföra ett utryckningsfordon skiljer sig från att framföra en vanlig bil bland annat för de större friheter gällande trafikregler utryckningsförarna har. Dessa inkluderar både rätten att köra i högre hastigheter än annan trafik, men även möjligheten att kräva fri väg från andra trafikanter. Detta skapar en speciell interaktion mellan trafikanterna i trafiken där utryckningsfordonet kan ses som en lagligt olaglig agent. Avsaknaden på restriktioner gör dock körningen helt beroende på de enskilda utryckningsförarnas bedömning kring körbeteende. Trots det finns det inga nationella riktlinjer i Sverige fällande utbildning av utryckningsförare.</p><p>Den här studien undersökte normer och värderingar kring trafiksäkerhet hos operativ personal inom en ambulansorganisation. Semistrukturerade intervjuer genomfördes vilka var fokuserade på ett antal faktorer som förväntades kunna påverka trafiksäkerheten.</p><p>En tendens att se andra trafikanter som skyldiga för farliga situationer observerades, så väl som effekten olika uppdrag har på körningen, ett fenomen tidigare identifierat som ”red mist” (Dorn & Brown, 2003). Körningen ansågs vara ett känsligt ämne att kritisera och kollegors körstil sågs delvis bero på individuella skillnader. En påverkan på körningen av SOS Alarm påvisas samt att förarutbildningar nedprioriterats inom organisationen. En positiv attityd mot nationella riktlinjer som ett sätt att garantera förarutbildning observerades. Studien öppnar upp för ett flertal framtida studier vilka diskuteras.</p> / <p>Drivers of emergency vehicles (EV) are agents in the traffic system that by law are permitted to perform actions which are illegal for other road users. Not only can EV drivers legally drive above the speed limit, but they can also demand right of way by the use of warning lights and sirens. The lack of restrictions leaves the driving solely dependent on the judgment of each EV driver. Thus, the drivers should be well trained not just in driving skills but specifically in terms of risk assessment and self-assessment. However, there are no national guidelines in Sweden on training of EV drivers.</p><p>This study investigated the traffic safety norms among some ambulance drivers in Sweden. Semi-structured interviews were conducted focused on factors deemed important for traffic safety.</p><p>A tendency to attribute the reasons for risky situation to other drivers was found, as well as the presence of the condition dubbed “red mist” (Dorn & Brown, 2003). Driving was considered a sensitive matter in terms of critiquing and driving behaviour is partly attributed to individual differences. A positive attitude towards national guidelines was observed, as a way to ensure the sufficient EV driver training quality. A broader view of patient safety during pre-hospital health care is proposed to include EV transportation requirements.</p>

Background: The Alliance for Patient Medication Safety (APMS) helps community pharmacies comply with continuous quality improvement requirements of many states and third party payment contracts through use of their Pharmacy Quality Commitment (PQC) program. Aims: To assess changes in the incidence of prescription Quality Related Events (QREs) and adoption of patient safety culture attitudes after guided PQC implementation. Methods: Twenty-one pharmacies were randomized to standard PQC practices (control) or guided PQC implementation (treatment). Pharmacy staff completed retrospective pre and post safety culture questionnaires. Negative binomial mixed and linear regression analyses were employed to examine changes in QREs rates and attitudes, respectively. Rasch analysis was used to assess questionnaire validity and reliability. Results: During the 2-month study period 3,343 QREs were reported to the online PQC system. At baseline, no difference in the average QRE reporting rate was identified between groups. Treatment group QRE reporting rates differed in one category post treatment (more incorrect safety caps QREs reported in treatment group, p<0.034). Seventy-one employees completed the questionnaire (70% response). Attitude improvement in the treatment group was 36% greater than in control (p<0.0001). The questionnaire demonstrated acceptable reliability and validity evidence. Conclusions: Guided PQC implementation increased reporting of certain QREs and increased the adoption of patient safety culture attitudes among staff pharmacy.

The aim was to psychometrically test the S-HSOPSC and HSOPSC, investigate health care staff’s perceptions of patient safety culture and their suggestions for improvement. Methods: A three-time cross-sectional study with data from health care staff (N= 3721) in a Swedish county council was conducted in 2009 (N = 1,023), 2011 (N = 1,228) and 2013 (N =1,470) using the S-HSOPSC (I, II, III). Health care staff’s suggestions for improvement were analyzed in a qualitative content analysis study (IV). Results: The S-HSOPSC (14 dimensions, 51 items) is acceptable for measuring patient safety culture (I). Health care staff held a positive attitude towards their own unit’s teamwork, and a less favorable attitude towards hospital managers’ support for patient safety work (I). Managers held a more positive attitude towards patient safety than others and enrolled nurses held a more positive attitude than registered nurses and physicians (II, III). Positive attitudes towards learning, nonpunitive response and staffing was associated with positive attitudes towards overall safety (II). Health care staff’s attitudes towards patient safety decreased between 2009- 2013 for 12 dimensions (III). A diversity of approaches, nuanced in relation to the informant’s profession was suggested to improve patient safety, for example ‘Increased staffing’ ‘Teamwork and collaboration’ and ‘Committed management' (IV). Conclusions: The S-HSOPSC is suitable for measuring patient safety culture. Supporting and committed managers, teamwork and collaboration are important for patient safety improvement. RNs have an important coordinating position in patient safety work, since they work in close proximity to the patients, and strategically in teams, where decisions of importance for patient safety are made. Health care staff attitudes towards communication, nonpunitive approach, feedback and learning from mistakes have deteriorated. To prevent from organizational fatigue, actions are needed. / Baksidestext: In health care, many patients are being harmed, with leads to suffering and financial costs. Health care staff’s patient safety culture reflects their attitudes towards safety for patients. The overall aim was to psychometrically test the questionnaires S-HSOPSC and HSOPSC for measuring patient safety culture, investigate health care staff’s perceptions of patient safety culture and their suggestions for improvement. In this thesis, respondents in the most common health care staff groups participated. Health care staff held a positive attitude towards patient safety culture within their own unit’s work. The perception of patient safety culture differed between professions and managers had a more positive attitude towards patient safety culture than others. Health care staff’s attitudes towards patient safety decreased during the measurement period for almost all aspects and they suggested many approaches to improve patient safety. Patient safety needs to be a responsibility for everyone. Supporting, committed managers, teamwork and collaboration are important for patient safety improvement. RNs have an important coordinating position in patient safety work. / Syftet var att psykometriskt testa frågeformulären S-HSOPSC och HSOPSC och undersöka sjukvårdspersonals attityder till patientsäkerhet samt förslag till förbättringar. Metod: Tre tvärsnittsundersökningar genomfördes. Sjukhuspersonal (N = 3 721) i ett landsting besvarade enkäten Hospital Survey on Patient Safety Culture om patientsäkerhetskultur år 2009 (n = 1 023), 2011 (n = 1 228) och 2013 (n = 1 470) (I, II, III). Sjukvårdspersonalens förslag på förbättring av patientsäkerhet studerades med kvalitativ innehållsanalys (IV). Resultatet visade att den svenska versionen S-HSOPSC (14 dimensioner, 51 frågor) är acceptabel för att mäta patientsäkerhetskultur (I). Sjukvårdspersonalen hade en positiv attityd till aspekter av patientsäkerhet som handlade om arbete på den egna vårdenheten, men en mindre positiv attityd till högsta ledningens stöd för patientsäkerhetsarbetet (I). Chefer hade en mer positiv attityd till patientsäkerhet än andra och undersköterskor hade en mer positiv attityd än sjuksköterskor och läkare (II, III). Förmågan att dra lärdom av misstag, en icke-skuldbeläggande attityd vid misstag samt bemanning var positivt associerad till en positiv attityd till generell patientsäkerhet (II). Sjukvårdspersonalens attityder till patientsäkerheten försämrades under mätperioden för 12 av 14 dimensioner. (III). Sjukvårdspersonalen föreslog en mängd förbättringar av patientsäkerheten. Förslagen var nyanserade i relation till informanternas egen profession (IV). Konklusioner: Engagerade chefer är viktigt för patientsäkerheten. Teamwork och förståelse för varandras arbete är gynnsamt för patientsäkerheten. Sjuksköterskor är viktiga i patientsäkerhetsarbetet, då de både arbetar nära patienterna och i team där beslut fattas som rör patientsäkerheten. Personalens attityd till kommunikation, icke- bestraffande synsätt, återkoppling och lärande i samband med misstag har försämrats. Detta kan indikera en organisatorisk utmattning och kräver åtgärder.

Darbo tikslas: ištirti palaikomojo gydymo ir slaugos ligoninės sveikatos priežiūros specialistų požiūrį į saugos kultūrą. Uždaviniai: ištirti palaikomojo gydymo ir slaugos ligoninės sveikatos priežiūros specialistų požiūrį į saugos kultūros sritis; išanalizuoti palaikomojo gydymo ir slaugos ligoninės sveikatos priežiūros specialistų požiūrį į saugos kultūrą, atsižvelgiant į sociodemografinius ir profesinius veiksnius; nustatyti palaikomojo gydymo ir slaugos ligoninės sveikatos priežiūros specialistų požiūrio į saugos kultūrą skirtumus, atsižvelgiant į gydymo įstaigos charakteristikas. Tyrimo metodika. 2013 metų kovo – gegužės mėnesiais atlikta vienmomentinė kiekybinė apklausa, naudojant JAV Pitsburgo universitete sukurtą Požiūrio į saugą klausimyną (The Emergency Medical Services Safety Attitudes Questionnaire – EMS-SAQ). Tyrime dalyvavo 138 sveikatos priežiūros specialistai, dirbantys penkiose palaikomojo gydymo ir slaugos ligoninėse (atsako dažnis – 80,8 proc.). Tyrimui atlikti gautas LSMU Bioetikos centro leidimas. Rezultatai. Vyriausieji respondentai (>49 m.), lyginant su 30–39 m. grupe, reikšmingai didesniais įverčiais vertino pasitenkinimo darbu, komandinio darbo ir saugos klimato sritis (atitinkamai p<0.05). Sveikatos specialistai reikšmingai dažniau pasitenkinimo darbu ir komandinio darbo sričiai skyrė teigiamo vertinimo balus, t.y. ≥75, kai jų darbo stažas dabartinėjė ligoninėje buvo >11 metų, lyginant su tais, kurie dirbo trumpiau. Komandinio darbo sritis vertinta... [toliau žr. visą tekstą] / Aim of the study. To analyse the attitudes of health care professionals towards safety culture in nursing and supportive treatment hospital. Objectives: to explore the attitudes of health care professionals in nursing and supportive treatment hospital towards safety culture; to analyse the attitudes of health care professionals towards safety culture in relation to their socio-demographic and professional characteristics; to determine the differences in attitudes towards safety culture among health care professionals in relation to institutional characteristics of the hospitals. Methods. The cross-sectional quantitative survey was conducted from March to May, 2013, using the Emergency Medical Services Safety Attitudes Questionnaire (EMS-SAQ) that was developed in Pittsburgh University, USA. The study included 138 health care professionals from five nursing and supportive treatment hospitals with the response rate of 80.8 %. Permition to perform this study was issued by the LUHS Bioethics Centre. Results. The attitudes towards the job satisfaction, teamwork and safety climate was evaluated significantly higher by the oldest respondents (> 49 y.), compared with the group of 30-39 y., p<0.05. Health care professionals significantly more often have got positive attitudes towards the job satisfaction and teamwork, i.e. ≥ 75, when their work experience in the current hospital was over 11 years, compared with those who have been employed for shorter periods of time. The teamwork... [to full text]

Saugos kultūra – pacientų saugos elementas nukreiptas sumažinti žalą pacientui, kuri gali būti padaryta teikiant jam sveikatos priežiūros paslaugas. Tikslas – Įvertinti Kauno regiono greitosios medicinos pagalbos tarnybų darbo vietos saugos kultūrą. Tyrimo metodas: 2012 metų kovo–gegužės mėnesiais atlikta vienmomentinė anoniminė apklausa. Tyrime dalyvavo aštuonių Kauno regiono greitosios medicinos pagalbos tarnybų darbuotojai (N=325, atsako dažnis 82,9 proc.). Tyrimui naudotas Požiūrio į saugą klausimynas (The Emergency Medical Services Safety Attitudes Questionnaire – EMS–SAQ). Nustatyta GMP Požiūrio į saugą klausimyno pakankamai aukštas vidinis nuoseklumas (α=0,822). Rezultatai: Kauno regiono greitosios medicinos pagalbos tarnybų specialistai, vertindami septynias saugos kultūros sritis, aukščiausiais teigiamais įverčiais vertino komandinio darbo (76,34 balai), pasitenkinimo darbu (76,49 balai) ir vadovų požiūrio į saugą sritis (75,98 balai). Žemiausiais balais darbuotojai vertino streso pripažinimo ir nepageidaujamų įvykių raiškos sritis, atitinkamai – 49,62 ir 37,24 balai. Komandinį darbą ir vadovų požiūrį į saugą dažniau teigiamai vertino slaugytojai, lyginant su GMP vairuotojais, o paramedikai labiau teigiamai vertino pasitenkinimą darbu, lyginant su gydytojais (p<0,05). Gydytojai ir paramedikai dažniau pripažino stresą, lyginant su slaugytojais ir vairuotojais (p<0,01). Daugiau kvietimų per metus atliekantys darbuotojai dažniau teigiamai vertino saugos klimato... [toliau žr. visą tekstą] / Safety culture is the element of patient safety that purposes to decrease the damage to the patient that may be done during provision of health care service. The purpose of this study was to investigate the safety culture at the workplace of emergency medical service at Kaunas region. Material and methods: Anonymous survey was conducted on March-May in 2012. The staff from eight emergency medical service institutions at Kaunas region took part in the survey (N=325 with response rate of 82.9 %). The Emergency Medical Services Safety Attitudes Questionnaire – EMS–SAQ was used after the permission by the authors was issued. The internal consistency of translated and adapted instrument was sufficiently high (Cronbach α=0,822). Results: The staff of emergency medical service of Kaunas region evaluated six dimensions of safety culture rating team work (76.34 scores), work satisfaction (76.49 scores) and perceptions of management at the highest level (75.98 scores). The lowest ratings were related to stress recognition and present of adverse events, respectively – 49.62 and 37.24 scores. Nurses scored the team work and perceptions of management more positive in comparison to drivers; paramedics have had more positive attitudes towards work satisfaction than physicians. Physicians and paramedics recognised stress more often in comparison to nurses and drivers. The attitudes towards a safety climate, perceptions of management and work satisfaction were more positive in... [to full text]