The role of demographic, job-related and psychological characteristics on the prevalence of repetitive patient safety incidents among Iranian nurses.

BACKGROUND: Job-related psychosocial factors have a substantial effect on the occurrence of adverse events among healthcare professionals. OBJECTIVE: An analytical and descriptive survey was conducted to evaluate the relationship between the occurrence of patient safety incidents and psychological factors. METHODS: The study sample consisted of 177 nurses who were asked about patient safety events over six months. Repetitive patient safety incidents were selected by examining medical records and interviewing specialists. Also, psychological factors were assessed using job content questionnaire (JCQ). RESULTS: Repetitive patient safety incidents were involved medication administration error, pressure ulcer and skin-muscular injuries, patient falls, inability to CPR patients, blood transfusion reactions, and death due to human error. The findings showed that 92 participants (52%) had at least one case of patient safety incident. Among patient safety incidents, medication administration error and death due to human error had the highest and lowest repletion, respectively. Nurses training, job insecurity and peer support were significant predictors of different aspects of patient safety (p < 0.05). CONCLUSION: Proper collaboration between new and experienced nurses can have a significant impact to reduce patient safety incidents. In addition, nursing training can be a good way to understand risk points in medical errors.

The mediator role of safety motivation and knowledge between safety culture and safety performance: The results of a sociotechnical and macroergonomics approach.

BACKGROUND: Nowadays, although the effect of positive safety culture on improving safety performance has been confirmed, the mechanisms of this effect are somewhat ambiguous. OBJECTIVES: This study aimed to investigate the direct and indirect effects of safety culture on safety performance based on a sociotechnical and macroergonomics approach. METHODS: The participants consisted of 276 workers, supervisors, and managers in an oil and gas refinery complex. The data collection conducted using questionnaires including safety culture in accordance with the organization's sociotechnical characteristics with 12 dimensions (effectiveness of safety management, management's attitude towards safety, training, awareness and safety policy, peer support, work schedule, job demands, confrontation of tasks and safety, behavioural features and commitment to safety, work equipment and tools, personal protective equipment, workplace hazards, and external environmental factors), safety motivation and safety knowledge as mediators between safety culture and safety performance, and safety compliance and safety participation as the components of safety performance. RESULTS: The examination of paths in three structural models indicated that in the presence of the direct effect, the indirect paths were not approved due to the lack of confirmation of safety motivation ⟶ safety performance and safety knowledge ⟶ safety performance. In the model without the direct effect, indirect paths were confirmed; however, a low amount of safety performance variance was explained by safety culture. CONCLUSIONS: The safety culture tool explained the highest value of variance for the direct path due to the use of industry-related factors.

A macroergonomics perspective for exploring safety culture factors: a qualitative content analysis approach.

Objective. Although assessing safety culture is a useful approach in reducing occupational accidents, there are no qualitative examinations of it based on a systems approach. This study was conducted with the aim of explaining the experiences of gas refinement personnel on safety issues and extending safety culture constructs using a macroergonomics approach. Methods. A directed qualitative content analysis was used. Data were collected by 18 semi-structured interviews based on a work subsystems model as a guiding framework. Results. From the interviews, 420 codes were extracted. By placing codes into subsystems, five categories in the organization subsystem, two categories in the job subsystem, one category in the human subsystem, two categories in the technology subsystem and two categories in the environment subsystem emerged. In addition to the common factors in assessment scales, factors such as work schedule, safety standards in new technologies and external factors of the organization like financial conditions were considered effective for workers' attitudes and safety behaviors. Conclusion. Investigating personnel perspectives about safety in the workplace based on a macroergonomics approach developed distinct factors in safety culture. It seems that industry features, environment and technology along with organizational factors are important in assessing safety culture.

Comparison of the work ability index and the work ability score for predicting health-related quality of life.

PURPOSE: To compare the relationship of the 7-item Work Ability Index (WAI) and the single-item Work Ability Score (WAS) with individual and work-related factors, and to investigate the predictive role of these two work ability assessments for health-related quality of life (HRQOL). METHODS: This is a cross-sectional study. 407 of 445 employees working on a construction project in Shiraz, Iran consented to participate in an anonymous survey. 381 surveys were returned completed. Correlation analyses were used to evaluate relationships between WAI and WAS, and the total score and four domains of the WHOQOL-BREF, our measure of HRQOL, and individual and work-related variables. Hierarchical multivariate linear regression analyses were performed to compare WAI and WAS in predicting HRQOL and its four dimensions. RESULTS: WAI and WAS were both significant predictors of HRQOL and its four dimensions and the explained variance was very similar. The WAI and WAS explained 46% and 44% of the variance related to the HRQOL, respectively. WAI and WAS explained 36-38% and 35-37% of the variance related to dimensions of the HRQOL, respectively. There were significant relationships of both WAS and WAI with job type, work schedule, smoking, and exercise habit. CONCLUSIONS: The WAS and WAI showed a very similar relationship with participants' individual and work-related factors and HRQOL. The Work Ability Score is a valid and suitable measure for assessment of work ability among Iranian workers. Use of this simple measure could be advantageous to reduce demands on research participants and in workability assessments.

Psychometric properties of the Persian version of Neal and Griffin's safety performance scale.

Introduction. Neal and Griffin's safety performance scale is an appropriate tool to evaluate safety performance. This article was validated and relied on the Persian version of Neal and Griffin's scale as the widely used tool to assess safety performance. Methods. Neal and Griffin's scale has eight questions and two dimensions - safety compliance and safety participation. A back-forward method was used to translate the original English version into Persian. A total of 161 employees of a petrochemical complex were selected for data collection. Content validity, Cronbach's α and split-half methods, concurrent validity and confirmatory factor analysis were used for psychometric evaluation. Results. The content validity index and content validity ratio were 0.82 and 0.84, respectively. Cronbach's α for total items was 0.9, indicating a high consistency. Additionally, Cronbach's α values for safety compliance and safety participation were 0.87 and 0.83, respectively. Spearman's correlation coefficients indicated a positive correlation between safety performance and safety culture items (r = 0.182-0.852, p < 0.01). Goodness-of-fit indexes in the default model had poor values. Thus, these values were improved in the modified model. Conclusion. The results demonstrated that Neal and Griffin's scale could be a reliable tool to evaluate preventive measures of safety performance among Iranian workers.

The relationship between safety culture and safety climate and safety performance: a systematic review.

Introduction. There is a close relationship between safety culture and safety climate and safety performance. However, the details of this relationship are somewhat unclear, due to different attitudes toward safety culture and safety climate, and the use of various tools for their evaluation, and various measures of safety performance. Methods. In this study, articles published in English from 2005 to 2017 were selected from various databases. Then, certain journals in the field of safety were specifically searched using the keywords 'safety and safety performance', 'safety climate and safety performance', 'safety culture and safety performance', 'safety climate and safety outcome', 'safety culture and safety outcome', 'safety culture and injury and fatalities' and 'safety climate and injuries and fatalities'. Results. In the current article, the role of safety culture and safety climate in improving safety performance was evaluated in 31 selected studies. It seems that reactive criteria and safety compliance is more consistent with safety climate and safety culture. Conclusions. The findings emphasized that increasing the level of safety climate and safety culture could be effective in reducing incidents and improving safety performance indicators.

Comprehensibility of pharmaceutical pictograms: Effect of prospective-user factors and cognitive sign design features.

BACKGROUND: The people's comprehensibility regarding the meaning of internationally recommended pictograms is an important factor in the correct usage of medications. OBJECTIVE: To investigate the relationship between the guessability of the pharmaceutical pictograms, the cognitive sign features, and prospective-user factors. METHODS: A total of 351 Iranian people participated in this study. Two questionnaires were used to measure guessability and cognitive design features regarding the pharmaceutical pictograms. A single-sheet questionnaire was also developed to collect demographic data. RESULTS: According to the 67% correctness criterion suggested by ISO 3864:P3, 18 pictograms were understandable by the participants. Moreover, of the five cognitive features, "semantic closeness" and "meaningfulness" had the most correlation with the guessability score. In terms of personal factors, understanding of the pictograms' meaning was negatively correlated with age, while it had no association with the occupation. CONCLUSIONS: Some pharmaceutical pictograms developed by reliable international organizations can be used in a community only after redesigning and testing among the prospective users. The findings indicated that some pharmaceutical pictograms were not comprehensible for most participants. It is therefore expected that using a combination of pictograms with written messages and training could help in conveying the messages by pharmaceutical pictograms.

Multiple environmental and psychosocial work risk factors and sleep disturbances.

BACKGROUND: This study aimed to investigate the relationship between multiple psychosocial and environmental work risk factors and sleep disturbances. METHODS: This cross-sectional study was conducted among 90 workers in a brick factory in Iran. The health and safety executive (HSE) tool, Epworth Sleepiness Scale (ESS), and Stop-Bang questionnaire were used to determine psychosocial factors, subjective sleepiness, and obstructive sleep apnea (OSA), respectively. Standard objective methods were used to assess the environmental risk factors, including noise, light, heat stress, and respirable particles. RESULTS: Most psychosocial and all environmental work factors were moderately to highly correlated to the ESS score. There were also moderate correlations between the demands (including work load, work patterns, and work environment), role (including a clear understanding of the employees about their role in the organization), and lighting variables and the Stop-Bang score. The results of multivariate logistic regression analysis showed that job control, wet bulb globe temperature (WBGT), and respirable dust were predictive of an ESS score indicating abnormal sleep status and noise was predictive of a Stop-Bang score predictive of OSA. CONCLUSIONS: The results suggest that stressors, especially noise, heat stress, and respirable dust, are related to the employees' indices of sleep disturbance independent of other potential workplace confounding factors. These results can highlight the importance of considering multiple psychosocial and environment work risk factors for implementing occupational health and ergonomics interventional programs to prevent sleep disturbances in the workforce.

The effect of work-related and socio-demographic factors on Work Ability Index (WAI) among Iranian workers.

BACKGROUND: The Work Ability Index (WAI) is a suitable and valid instrument, which provides a general view of workers' abilities and functional capacities. OBJECTIVE: This study aimed to evaluate the effect of work-related and sociodemographic factors on work ability among employees of a company in Iran. METHODS: This cross-sectional study was conducted on 167 employees. Work ability was measured by the Persian version of WAI. A questionnaire was also developed to assess work-related and sociodemographic factors. The data were analyzed using univariate analysis of variance (ANOVA), independent t-test, and Pearson's correlation. RESULTS: The mean (SD) score of WAI was 38.4 (6.4). WAI mean score (p < 0.05) was associated with age, gender, sleep quality, smoking, work schedule, the conflict between the work and individual, family, and social lives, work injuries, and job satisfaction. CONCLUSIONS: To improve the workers' work ability, interventional programs should be concentrated on changing work schedules, improving sleep quality, limiting work hours, and not scheduling sensitive individuals to night shifts, those whose circadian rhythm stability and circadian rhythm amplitude is rigid type and languid type, respectively.

Prevalence of musculoskeletal pains and effect of work-related factors among employees on offshore oil and gas installations in Iran.

BACKGROUND: Work-related musculoskeletal pain is usually caused by poor physical conditions, repetitive motion, and adverse environmental and psychological situations. OBJECTIVE: This study aims to assess the prevalence of musculoskeletal pain and their work-related factors among employees on offshore oil and gas installations in Iran. METHODS: Standardized Nordic Questionnaire was used to collect data. The relationship of musculoskeletal pain with job type, rest breaks, exercise, shift program, and work period was studied among employees on offshore installations. T-test and ANOVA were used for data analysis. RESULTS: Employees on offshore installations were exposed to high levels of risk of musculoskeletal pain in their knees and back. Consequently, they reported the highest level of complaints of pain in the neck and lower back areas. Workers in drilling and tour-scheduling jobs reported the highest level of musculoskeletal pain. In the course of seven days and 12 months, the highest level of significant relationship was observed between the limbs and the work periods (tour scheduling or days-off) of the staff. CONCLUSION: The findings showed that the prevalence of musculoskeletal disorders among employees of offshore facilities was high due to inappropriate working conditions such as repetitive work, lifting heavy loads and limited rest periods. Therefore, strategies must be considered to reduce the effects of disorders.