Healthcare Workers Perceive “Cooler” Safety Climate 1


As winter approaches and cooler temperatures hit most of the nation, workers unpack coats and boots, and workplaces adjust thermostats. However, one climate that should stay the same year-round, no matter where a workplace is located geographically, is the safety climate. Safety climate—defined as the perception among workers about the value of safety—correlates to improved health and safety in the workplace.

Depending on whom you ask, however, this perception may differ.

Although important in all industries, a strong safety climate is especially critical in high-risk occupations such as healthcare. The rate of reportable non-fatal injury and illness in healthcare is almost double that of all private sector occupations, according to 2014 data from the Bureau of Labor statistics. One of the main causes of this high rate is respiratory illness stemming from exposure to airborne bacteria and viruses, and hazardous chemicals in various cleaning and sterilization products.

To compare perceptions about the safety climate for respiratory protection in healthcare, the National Institute for Occupational Safety and Health (NIOSH), in collaboration with university researchers and state health departments, analyzed survey data collected in 2011 and 2012 for a national study.

The Respirator Use Evaluation in Acute Care Hospitals (REACH) study evaluated how acute care hospitals implemented respiratory protection program requirements from the Occupational Safety and Health Administration and infection control guidance from the Centers for Disease Control and Prevention.

Survey respondents included 215 hospital managers, 245 unit managers, and 1,105 healthcare workers in 98 acute care hospitals in six states, including California, Illinois, Michigan, Minnesota, New York, and North Carolina. Each survey included 10 questions designed to measure five key components of safety climate:

  1. Managerial commitment to safety
  2. Management feedback on safety procedures
  3. Coworkers’ safety norms
  4. Worker involvement
  5. Worker safety training

The investigators found that perceptions varied significantly among the three groups. Overall, healthcare workers reported less positive perceptions of their workplace safety climate than both hospital managers and unit managers. In comparison, unit managers viewed management’s supervision of healthcare workers’ respiratory protection practices more favorably than both hospital managers and healthcare workers.

According to the investigators, the findings indicate the need for frontline healthcare workers’ inclusion to better support effective respiratory protection programs and practices. Hospital management should ensure that they create formal opportunities for frontline healthcare workers to provide feedback to management about their individual respiratory protection programs, training, and ways to improve safe respiratory protection practices at the point of care, according to the study published in the journal Workplace Health & Safety. To understand why perceptions about safety climate differ, further research is necessary.


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