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. 2016 Apr;92(4):349-62.
doi: 10.1016/j.jhin.2015.08.023. Epub 2015 Sep 25.

Relationship between patient safety climate and standard precaution adherence: a systematic review of the literature

A J Hessels  1 , E L Larson  2
Affiliations

Relationship between patient safety climate and standard precaution adherence: a systematic review of the literature

A J Hessels et al. J Hosp Infect. 2016 Apr.

Abstract

Standard precaution (SP) adherence is universally suboptimal, despite being a core component of healthcare-associated infection (HCAI) prevention and healthcare worker (HCW) safety. Emerging evidence suggests that patient safety climate (PSC) factors may improve HCW behaviours. Our aim was to examine the relationship between PSC and SP adherence by HCWs in acute care hospitals. A systematic review was conducted as guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. Three electronic databases were comprehensively searched for literature published or available in English between 2000 and 2014. Seven of 888 articles identified were eligible for final inclusion in the review. Two reviewers independently assessed study quality using a validated quality tool. The seven articles were assigned quality scores ranging from 7 to 10 of 10 possible points. Five measured all aspects of SP and two solely measured needlestick and sharps handling. Three included a secondary outcome of HCW exposure; none included HCAIs. All reported a statistically significant relationship between better PSC and greater SP adherence and used data from self-report surveys including validated PSC measures or measures of management support and leadership. Although limited in number, studies were of high quality and confirmed that PSC and SP adherence were correlated, suggesting that efforts to improve PSC may enhance adherence to a core component of HCAI prevention and HCW safety. More clearly evident is the need for additional high-quality research.

Keywords: Healthcare-associated infection; Infection prevention; Safety climate; Standard precautions.

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Conflict of interest statement

Conflict of interest statement

None declared.

Figures

Figure 1
Figure 1
Analytic Framework for Patient Safety Climate and Standard Precaution Adherence. Boxes represent the population, exposure, and outcomes examined to address the question: ‘Do healthcare workers in acute hospital settings with a high rating of patient safety climate adhere more to standard precautions than healthcare professionals in acute hospital settings with a low rating of patient safety climate?’ HCW, healthcare worker; HCAI, healthcare-associated infection.
Figure 2
Figure 2
PRISMA flow diagram: relationship between patient safety climate (PSC) and standard precautions (SPs). Boxes on the left represent each stage of search strategy; boxes on the right represent the number of articles retained and excluded by stage of analysis. Records identified through database
See this image and copyright information in PMC

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