BACKGROUND: The Rhode Island (RI) Intensive Care Unit (ICU) Collaborative was designed to improve patient safety and clinical outcomes in adult ICUs through a unit-based patient safety program and evidenced-based practices. Few studies have shown how to draw on a strong safety culture to improve clinical outcomes. A study was conducted to (1) examine the impact of a Safety Attitudes Questionnaire Action Plan (SAQAP) on the 2008 Safety Attitudes Questionnaire (SAQ) and (2) determine the impact of an SAQAP on ICU central line-associated blood stream infections (CLABSIs) and ventilator-associated pneumonia (VAP) rates. METHODS: The SAQ was administered at 23 ICUs in 11 hospitals in fall 2007 and 2008. Units were surveyed as to whether they completed an SAQAP on the basis of 2007 SAQ results. Annual rates of infection were submitted as unadjusted monthly CLABSI infections per 1,000 line days and VAP infections per 1,000 ventilator days for 2007 and 2008. RESULTS: SAQAPs were completed on 9 (39%) of the 23 units. Units that developed SAQAPs demonstrated higher improvement rates in all domains of the SAQ except working conditions. Improvements were close to statistical significance for teamwork climate (+18.4% in SAQAP units versus -6.4%, p = .07) and job satisfaction (+25.9% increase in SAQAP units versus +7.3%, p = .07). Units with SAQAPs decreased the CLABSI rates by 10.2% in 2008 compared with 2007, while those without SAQAP had a 2.2% decrease in rates (p = .59). Similarly, VAP rates decreased by 15.2% in SAQAP units, while VAP rates increased by 4.8% in units without SAQAP (p = .39). CONCLUSIONS: Teams that developed SAQAPs improved their unit culture and clinical outcomes. An active, targeted intervention in culture can translate into improved outcomes for patients.
BACKGROUND: The Rhode Island (RI) Intensive Care Unit (ICU) Collaborative was designed to improve patient safety and clinical outcomes in adult ICUs through a unit-based patient safety program and evidenced-based practices. Few studies have shown how to draw on a strong safety culture to improve clinical outcomes. A study was conducted to (1) examine the impact of a Safety Attitudes Questionnaire Action Plan (SAQAP) on the 2008 Safety Attitudes Questionnaire (SAQ) and (2) determine the impact of an SAQAP on ICU central line-associated blood stream infections (CLABSIs) and ventilator-associated pneumonia (VAP) rates. METHODS: The SAQ was administered at 23 ICUs in 11 hospitals in fall 2007 and 2008. Units were surveyed as to whether they completed an SAQAP on the basis of 2007 SAQ results. Annual rates of infection were submitted as unadjusted monthly CLABSI infections per 1,000 line days and VAP infections per 1,000 ventilator days for 2007 and 2008. RESULTS:SAQAPs were completed on 9 (39%) of the 23 units. Units that developed SAQAPs demonstrated higher improvement rates in all domains of the SAQ except working conditions. Improvements were close to statistical significance for teamwork climate (+18.4% in SAQAP units versus -6.4%, p = .07) and job satisfaction (+25.9% increase in SAQAP units versus +7.3%, p = .07). Units with SAQAPs decreased the CLABSI rates by 10.2% in 2008 compared with 2007, while those without SAQAP had a 2.2% decrease in rates (p = .59). Similarly, VAP rates decreased by 15.2% in SAQAP units, while VAP rates increased by 4.8% in units without SAQAP (p = .39). CONCLUSIONS: Teams that developed SAQAPs improved their unit culture and clinical outcomes. An active, targeted intervention in culture can translate into improved outcomes for patients.
Authors: Nishi Rawat; Ting Yang; Kisha J Ali; Mary Catanzaro; Mariah D Cohen; Donna O Farley; Lisa H Lubomski; David A Thompson; Bradford D Winters; Sara E Cosgrove; Michael Klompas; Kathleen A Speck; Sean M Berenholtz Journal: Crit Care Med Date: 2017-07 Impact factor: 7.598
Authors: Gitte Y Larsen; Michelle Schober; Anthony Fabio; Stephen R Wisniewski; Mary Jo C Grant; Nadeem Shafi; Tellen D Bennett; Deborah Hirtz; Michael J Bell Journal: Neurocrit Care Date: 2016-06 Impact factor: 3.210
Authors: Alexandre Tran; Shannon M Fernando; Daniel I McIsaac; Bram Rochwerg; Garrick Mok; Andrew J E Seely; Dalibor Kubelik; Kenji Inaba; Dennis Y Kim; Peter M Reardon; Jennifer Shen; Peter Tanuseputro; Kednapa Thavorn; Kwadwo Kyeremanteng Journal: Can J Surg Date: 2020-12-09 Impact factor: 2.089
Authors: Sallie J Weaver; Lisa H Lubomksi; Renee F Wilson; Elizabeth R Pfoh; Kathryn A Martinez; Sydney M Dy Journal: Ann Intern Med Date: 2013-03-05 Impact factor: 25.391
Authors: Raymond M Khan; Maha Aljuaid; Hanan Aqeel; Mohammed M Aboudeif; Shaimaa Elatwey; Rajeh Shehab; Yasser Mandourah; Khalid Maghrabi; Hassan Hawa; Imran Khalid; Ismael Qushmaq; Asad Latif; Bickey Chang; Sean M Berenholtz; Sultan Tayar; Khloud Al-Harbi; Amin Yousef; Anas A Amr; Yaseen M Arabi Journal: Ann Thorac Med Date: 2017 Jan-Mar Impact factor: 2.219
Authors: Ellen Catharina Tveter Deilkås; Dag Hofoss; Elisabeth Holm Hansen; Gunnar Tschudi Bondevik Journal: PLoS One Date: 2019-04-10 Impact factor: 3.240
Authors: Mats Hedsköld; Karin Pukk-Härenstam; Elisabeth Berg; Marion Lindh; Michael Soop; John Øvretveit; Magna Andreen Sachs Journal: BMC Health Serv Res Date: 2013-08-22 Impact factor: 2.655