Low ratings of workplace safety climate by hospital nurses linked to higher risk of injury

Compared to other groups of healthcare practitioners, nurses may have the poorest perceptions of workplace safety climate and the highest rates of injuries and sick time, suggests a single-hospital study in the May/June issue of the Journal of Healthcare Management, an official publication of the American College of Healthcare Executives (ACHE).

Low ratings of workplace safety may also be associated with increased job stress and decreased job satisfaction for nurses, healthcare aides, and allied healthcare professionals, according to the new research by Gwen E. McGhan, Ph.D., and colleagues of University of Calgary. They write, "Considering the importance of safety climate perceptions for the well-being of care practitioners, healthcare organizations need to prioritize workplace safety to optimize practitioners' perceptions."

Safety Climate Perceptions Affect Job Stress, Turnover, and Satisfaction

The survey study included three groups of healthcare professionals at one Canadian hospital: nurses, healthcare aides, and allied health professionals (for example, physical and occupational therapists). All groups completed a 10-item individual workplace safety climate scale, rating their agreement/disagreement with job descriptions such as "unsafe," "risky," or "could get hurt."

Perceptions of workplace safety climate were compared among groups, and associations with ratings of job stress, job satisfaction, and turnover intentions were assessed. The analysis included 144 responses (survey response rate 28 percent) from three hospital units where all three groups of professionals worked.

Nurses had the lowest ratings of workplace safety climate, followed closely by healthcare aides. In contrast, allied health professionals had significantly higher safety perceptions. "Nurses reported the poorest safety perceptions, lowest job satisfaction, and highest stress, while allied health professionals reported the highest safety perceptions and job satisfaction and the lowest stress," Dr. McGhan and coauthors write. Turnover intentions (for example, "How often do you consider leaving your job?") were also highest for nurses and lowest for allied health professionals.

Workplace safety climate perceptions were also related to reported injuries and illnesses: 68.3 percent of all injuries occurred in nurses, compared to 23.3 percent for healthcare aides and 8.3 percent for allied health professionals. As individual safety perceptions decreased, the odds of being injured at work more than doubled.

The higher injury rates in nurses and aides might reflect their greater involvement in direct, hands-on patient care, the researchers suggest. Nurses accounted for 53.2 percent of all paid sick time, healthcare aides for 42.2 percent, and allied health professionals for 4.6 percent.

"Healthcare organizations are struggling to cope with a growing global shortage of healthcare practitioners," according to the authors. Along with growing caseloads and other factors, rates of injuries and illness in healthcare professionals—among the highest of any occupational group—may affect the ability to retain qualified practitioners.

The new findings suggest that different groups of healthcare practitioners have differing perceptions of workplace safety climate, and that these perceptions affect job stress, job satisfaction, and injury/illness rates. Dr. McGhan and coauthors conclude: "By focusing on position, role, and perceptions of safety climate, healthcare leaders can provide safety processes and training to improve how employees perceive the safety of their workplace."