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Am J Infect Control. 2014 Oct;42(10 Suppl):S203-8. doi: 10.1016/j.ajic.2014.05.020.

On the CUSP: Stop BSI: evaluating the relationship between central line-associated bloodstream infection rate and patient safety climate profile.

Author information

1
Armstrong Institute for Patient Safety and Quality and Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Johns Hopkins Carey School of Business, Baltimore, MD. Electronic address: sjweaver@jhu.edu.
2
Armstrong Institute for Patient Safety and Quality and Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
3
Armstrong Institute for Patient Safety and Quality and Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Armstrong Institute for Patient Safety and Quality, and Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
4
Armstrong Institute for Patient Safety and Quality and Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD.

Abstract

BACKGROUND:

Central line-associated bloodstream infection (CLABSI) remains one of the most common and deadly hospital acquired infections in the United States. Creating a culture of safety is an important part of healthcare-associated infection improvement efforts; however, few studies have robustly examined the role of safety climate in patient safety outcomes. We applied a pattern-based approach to measuring safety climate to investigate the relationship between intensive care unit (ICU) patient safety climate profiles and CLABSI rates.

METHODS:

Secondary analyses of data collected from 237 adult ICUs participating in the On the CUSP: Stop BSI project. Unit-level baseline scores on the Hospital Survey on Patient Safety, a survey designed to assess patient safety climate, and CLABSI rates, were investigated. Three climate profile characteristics were examined: profile elevation, variability, and shape.

RESULTS:

Zero-inflated Poisson analyses suggested an association between the relative incidence of CLABSI and safety climate profile shape. K-means cluster analysis revealed 5 climate profile shapes. ICUs with conflicting climates and nonpunitive climates had a significantly higher CLABSI risk compared with ICUs with generative leadership climates.

CONCLUSIONS:

Relative CLABSI risk was related to safety climate profile shape. None of the climate profile shapes was related to the odds of reporting zero CLABSI. Our findings support using pattern-based methods for examining safety climate rather than examining the relationships between each narrow dimension of safety climate and broader safety outcomes like CLABSI.

KEYWORDS:

Central line–associated bloodstream infection; Organizational culture; Patient safety

PMID:
25239711
PMCID:
PMC4491500
DOI:
10.1016/j.ajic.2014.05.020
[Indexed for MEDLINE]
Free PMC Article

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