Español Português Nederlandse Deutsch Сервис опросов العربية Français Italiano 日本語 Türkçe Svenska Hebrew IL
+1 800 531 0228 +91 9650778590 +52 55 8421 2884 +49 309 160 7401 +44 20 7081 3228 +61 2 8074 5080 +971 585 998 383
SIGN UP FREE
Survey Templates Surveys Organizational Safety Culture Survey Reliability a

Organizational Safety Culture Survey Reliability a

Organizational Safety Culture Survey Reliability and Validity Study
STUDY INFORMATION
Hello. You are being asked to take part in this research study because researchers at the Duke University School of Nursing would like to learn more about organizational safety culture surveys (workplace safety). Research studies include only people who choose to take part. Please read this consent form carefully and take your time in making a decision. You will not be contacted directly by study staff to discuss this consent form, but you will have access to the study staff to ask him/her to explain any words or information that you do not clearly understand. The nature of the study, risks, inconveniences, and other important information about the study are listed below.

A grant from the National Institute of Health (NIH) will sponsor this study. Portions of Patrick Palmieri’s doctoral pay are provided by this sponsor. The persons responsible for the oversight of this study are Patrick Palmieri and his faculty advisors, Drs. Ruth Anderson and Constance Johnson. The purpose of this study is to learn how best to ask registered nurses about workplace safety. We will assess whether two different safety questionnaires test similar ideas. About 400 graduate nursing students enrolled at the Duke University School of Nursing will be asked to take part in this study.

There are no direct costs associated with this study. You will be asked to complete 9 multiple choice bigoraphical questions and then 73 survey multiple choice questions that should take approximately 15 to 20 minutes to answer. There will be no further follow up. We will email you a link to the survey. Your personal information will not be identifiable when the researchers obtain the survey results. There is, however, always the potential risk for loss of confidentiality. If you agree to take part in this study, there is no direct medical benefit to you. However, the results of this study will be published and disseminated to assist researchers seeking to better study safety in healthcare organizations.

For questions about the study, to request a paper copy of the consent form or any other concern, contact Patrick Palmieri at (919) 684-9198 during regular business hours and at (806) 441-7781 after hours and on weekends and holidays.

STATEMENT OF CONSENT
"The purpose of this study, procedures to be followed, and risks and benefits have been explained to me. I have been provided with contact information to ask questions, and my questions have been answered to my satisfaction. I understand that I may contact the Duke University Health System Institutional Review Board (IRB) Office at (919) 668-5111 if I have questions about my rights as a research subject, to discuss problems, concerns, or suggestions related to the research, or to obtain information or offer input about the research. I have read this consent form and agree to be in this study, with the understanding that I may withdraw at any time. I have been told how to print or obtain a paper copy of this consent document. By accessing the next screen and electing to submit the questionnaire titled, Organizational Safety Culture Survey Study, I agree to participate in this study.”

Thank you very much for your time and support. Please start with the survey now by clicking on the Continue button below or close the browser to exit from the survey.

Do you currently work in a hospital nursing unit?
What is your gender?
What is your age?
What is your ethnicity?
How many years of nursing experience do you have?
How many years of nursing experience do you have in your current specialty area?
On what type of nursing unit do you work(and will answer for this survey)?
How many years have you worked in your current nursing unit?
What is the usual shift that you work?
Please answer the following items with respect to the hosptial and the specific unit or clinical area where you primarily work. Choose your response to each question using the scale below:
Not at all
To a very limited extent
To a limited extent
To a moderate extent
To a considerable extent
To a great extent
To a very great extent
1. We have a good "map" of each other's talents and skills.
2. We talk about mistakes and ways to learn from them.
3. We discuss our unique skills with each other so we know who on the unit has relevant specialized skills and knowledge.
4. We discuss alternatives as to how to go about our normal work activities.
5. When giving report to an oncoming nurse, we usually discuss what to look out for.
6. When attempting to resolve a problem, we take advantage of the unique skills of our colleagues.
7. We spend time identifying activities we do not want to go wrong.
8. When errors happen, we discuss how we could have prevented them.
9. When a patient crisis occurs, we rapidly pool our collective expertise to attempt to resolve it.
For the remaining survey questions, the scale has changed to include five choices.

Please answer the following items with respect to the hosptial and the specific unit or clinical area where you primarily work. Choose your response to each question using the scale below:
Disagree Strongly
Disagree Slightly
Neutral
Agree Slightly
Agree Strongly
1. High levels of workload are common in my unit.
2. I like my job.
3. Nurse input is well received my unit.
4. I would feel safe being treated here as a patient.
5. Medical errors are handled appropriately in my unit.
6. This hospital does a good job of training new personnel.
7. All the necessary information for diagnostic and therapeutic decisions is routinely available to me.
8. Working in this hospital is like being part of a large family.
9. The administration of this hospital is doing a good job.
10. Hospital administration supports my daily efforts.
Disagree Strongly
Disagree Slightly
Neutral
Agree Slightly
Agree Strongly
11. I receive appropriate feedback about my performance.
12. In this unit, it is difficult to discuss errors.
13. Briefings (e.g., patient report at shift change) are important for patient safety.
14. Thorough briefs are common in my unit.
15. This hospital is a good place to work.
Please continue to answer the following items with respect to the hosptial and the specific unit or clinical area where you primarily work. Choose your response to each question using the scale below:
Disagree Strongly
Disagree Slightly
Neutral
Agree Slightly
Agree Strongly
16. When I am interrupted, my patients’ safety is not affected.
17. All personnel in my unit take responsibility for patient safety.
18. Hospital management does not knowingly compromise the safety of patients.
19. The levels of staffing in my unit are sufficient to handle the number of patients.
20. Decision-making in my unit utilizes input from relevant personnel.
21. This hospital encourages teamwork and cooperation among its personnel.
22. I am encouraged by my colleagues to report any patient safety concerns that I may have.
23. The culture in my unit makes it easy to learn from the errors of others.
24. This hospital deals constructively with problem personnel.
25. The medical equipment in my unit is adequate.
Disagree Strongly
Disagree Slightly
Neutral
Agree Slightly
Agree Strongly
26. In my unit, it is difficult to speak up if I perceive a problem with patient care.
27. When my workload becomes excessive, my performance is impaired.
28. I am provided with adequate, timely information about events in the hospital that might affect my work.
29. I have seen others make errors that had the potential to harm patients.
30. I know the proper channels to direct questions regarding patient safety in my unit.
Please continue to answer the following items with respect to the hosptial and the specific unit or clinical area where you primarily work. Choose your response to each question using the scale below:
Disagree Strongly
Disagree Slightly
Neutral
Agree Slightly
Agree Strongly
31. I am proud to work at this hospital.
32. Disagreement in my unit are resolved appropriately (i.e., not who is right but what is best for the patient).
33. I am less effective at work when fatigued
34. I am more likely to make errors in tense or hostile situations.
35. Stress from personal problems adversely affects my performance.
36. I have the support I need from other personnel to care for patients.
37. It is easy for personnel in my unit to ask questions when there is something that they do not understand.
38. Disruptions in the continuity of care (e.g., shift changes, patient transfers, ect.) can be detrimental to patient safety.
39. During emergencies, I can predict what other personnel are going to do next.
40. The physicians and nurses in my unit together as a well coordinated team.
Disagree Strongly
Disagree Slightly
Neutral
Agree Slightly
Agree Strongly
41. I am frequently unable to express disagreement with staff physicians in my unit.
42. Very high levels of workload stimulate and improve my performance.
43. Truly professional personnel can leave personal problems behind when working.
44. Morale is high in my unit.
45. Trainees in my discipline are adequately supervised.
Please continue to answer the following items with respect to the hosptial and the specific unit or clinical area where you primarily work. Choose your response to each question using the scale below:
Disagree Strongly
Disagree Slightly
Neutral
Agree Slightly
Agree Strongly
46. I know the first and last names of all personnel I worked with during my last shift.
47. I have made errors that had the potential to harm patients.
48. Staff physicians in my unit do a good job.
49. Fatigue impairs my performance during emergency situations (e.g., emergency resuscitation, seizures).
50. Fatigue impairs my performance during routine care (e.g., medication review, ventilator checks, transfer orders).
51. If necessary, I know how to report errors that happen in my unit.
52. Patient safety is constantly reinforced as the priority in my unit.
53. Interactions in this ICU are collegial, rather than hierarchical.
54. Important issues are well communicated at shift change.
55. There is wide spread adherence to clinical guidelines and evidence-based criteria in my unit.
Disagree Strongly
Disagree Slightly
Neutral
Agree Slightly
Agree Strongly
56. Personnel are not punished for errors reported through incident reports.
57. Error reporting is rewarded in my unit.
58. Information obtained through incident reports is used to make patient care safer in my unit.
59. During emergency situations (e.g., emergency resuscitation), my performance is not affected by working with inexperienced or less capable personnel.
60. Personnel frequently disregard rules or guidelines (e.g., handwashing, treatment protocols/clinical pathways, sterile field, ect.) that are established in my unit.
61. Communication breakdowns which lead to delays in the delivery of care are common.
62. Communication breakdowns which negatively affect patient care are common.
63. A confidential reporting system that documents medical incidents is helpful to improving patient safety.
64. I may hesitate to use a reporting system for medical incidents because I am concerned about being identified.
use this free template

Related templates and questionnaires

QuestionPro
Help center Live Chat SIGN UP FREE

QuestionPro in your language

Awards & certificates

  • g2-easyset-ent-fall21
  • g2-easybiz-mm-fall21
  • g2-leader-mm-fall21
  • g2-leader-fall21
  • g2-leader-eu-fall21
  • bbb-acredited
The Experience Journal

Find innovative ideas about Experience Management from the experts