Table 2 Survey composites and items’ positive scores (N = 310)

  Supervisor/manager expectations and promoting patient safety (Cronbach’s α = 0.68)

 My supervisor/manager praises staff when a job is done according to established patient safety procedures

 My supervisor/manager seriously considers staff suggestions for improving patient safety

 Whenever pressure builds, my supervisor/manager wants us to work faster, even if it means taking shortcuts(R)

 My supervisor/manager overlooks patient safety problems that recur(R)

  Organizational learning/continuous improvement (Cronbach’s α = 0.41)

 We are actively improving patient safety

 Mistakes have led to positive changes here

 After we make changes to improve patient safety, we evaluate their effectiveness

  Teamwork within units (Cronbach’s α = 0.53)

 People support each other in terms of work in this unit

 When a lot of work needs to be done quickly, we work together as a team to get it done

 In this unit, people treat each other with respect

 When one area in this unit gets really busy, others help out

  Nonpunitive response to errors (Cronbach’s α = 0.22)

 Staff feel like their mistakes are held against them(R)

 When an event is reported, it feels like the person is being reported, not the problem(R)

 Staff worry that mistakes are recorded in their file

 Staffing (Cronbach’s α = 0.38)

 We have enough staff to handle the workload

 Staff in this unit work long hours, which might affect patient care

 We use more agency/temporary staff than is best patient care

 When work is in “crisis mode,” we try to do too much, too quickly

 Communication openness (Cronbach’s α = 0.63)

 Staff freely speak up if they see something that may negatively affect patient care

 Staff feel free to question the decisions or actions of those with more authority

 Staff are afraid to ask questions when something does not feel right(R)

 Feedback and communications about errors (Cronbach’s α = 0.68)

 We are given feedback about changes made on the basis of event reports

 We are informed about errors that happen in this unit

 We discuss ways to prevent errors from recurring in this unit

 Management support for patient safety (Cronbach’s α = 0.56)

 Hospital management provides a work climate that promotes patient safety

 Hospital management show that patient safety is a top priority

 Hospital management is interested in patient safety only after an adverse event (R)

 Teamwork across hospital units (Cronbach’s α = 0.55)

 People support one another in terms of work in this unit(R)

 When a lot of work needs to be done quickly, we work together as a team to get it done

 In this unit, people treat each other with respect(R)

 When one area in this unit gets really busy, others help out

 Handoffs and transitions (Cronbach’s α = 0.74)

 Important patient care information is often lost during shift changes(R)

 Problems often occur in the exchange of information across hospital units(R)

 Shift changes are problematic for patients in this hospital(R)

 Overall perception of safety (Cronbach’s α = 0.54)

 It is just a matter of luck that more serious mistakes do not occur around here(R)

 Patient safety is never compromised to get more work done

 We have patient safety problems in this unit(R)

 Our procedures and systems are effective in preventing errors

 Frequency of events reported (Cronbach’s α = 0.85)

 Events caught and corrected before it can affect the patient

 Events with no potential to harm the patient

 Events that could harm the patient but did not

 Hospital patient safety grade (1 item)