Predictors of safe behaviour and holistic framework for promoting proactive safety culture in healthcare and nursing homes
Tallinn Health Care College, Academic and International Affairs Office, Kännu 67, EE13418 Tallinn, Estonia
Correspondence: jaana.sepp@ttk.ee
Abstract:
The poor safety culture in nursing homes is attributed to the lack of professional and safety competencies, management commitment, and limited empirical data. The purpose of this study is to identify potential predictors of safe behaviour among care workers and establish a holistic framework for a proactive safety culture in healthcare and nursing homes. The study was conducted in 25 care institutions between September 2014 to December 2017 using mixed-methods with quantitative (NOSACQ-50; CCQ, COPSOQ II) and qualitative (focus-group interview) components. Results revealed challenges with safety systems and management, lack of resources and time, and the importance of leadership and psychosocial well-being. The study identified subcultures of proactive safety culture, including professional competence culture and psychosocial well-being culture. These subcultures aid in identifying weaknesses and improving quality, emphasizing the need for a holistic approach to safety culture in healthcare institutions, particularly in nursing homes. The author’s proposition on positive safety culture, based on the theory of situated cognition, highlights the significance of subcultures such as professional competence culture and psychosocial well-being culture in influencing care workers’ professional identity and safety behaviour. In conclusion, the importance of these subcultures can be emphasised due to ensuring adequate understanding and positive attitudes towards safety. Adequate care worker training and a culture that supports professional competence are crucial for patient safety and organizational outcomes. Addressing psychosocial risks and promoting a culture of psychosocial well-being can create a safer workplace culture and improve employee performance, job satisfaction, and overall organizational outcomes.
Key words:
nursing homes, professional competence culture, psychosocial well-being culture, safety climate, safety culture, safety management.