Table 3 Positive response rate of each item and Cronbach’s α for dimensions
Dimension/items (internal consistency and test-retest reliability coefficient) | Internal consistency (N = 1013, Cronbach’s α) | Test-retest Reliability (n = 200, ICC) | McDonald’s hierarchical dimensions omega(ω) | M ± SD | Positive responses rate (PPRs) | |||
|---|---|---|---|---|---|---|---|---|
US | China | US | China | |||||
DD1. | Teamwork | 0.76 | 0.75 | 0.95，p<0.001 | 0.86 | 4.39 ± 0.60 | 82.0 | 93.0 |
A1. | In this unit, we work together as an effective team. | 88.0 | 95.0 | |||||
A8. | During busy times, staff in this unit help each other. | 87.0 | 94.0 | |||||
A9r. | There is a problem with disrespectful behavior by those working in this unit. | 70.0 | 91.0 | |||||
DD2. | Staffing and Work Pace | 0.67 | 0.75 | 0.87，p<0.001 | 0.84 | 3.21 ± 0.92 | 58.0 | 51.0 |
A2. | In this unit, we have enough staff to handle the workload. | 53.0 | 52.0 | |||||
A3r. | Staff in this unit work longer hours than is best for patient care. | 54.0 | 30.0 | |||||
A5ra. | This unit relies too much on temporary staff. | 62.0 | 57.0 | |||||
A11r. | The work pace in this unit is so rushed that it negatively affects patient safety. | 61.0 | 65.0 | |||||
DD3. | Organizational Learning – Continuous Improvement | 0.76 | 0.87 | 0.78，p<0.001 | 0.92 | 3.71 ± 0.96 | 72.0 | 61.0 |
A4. | This unit regularly reviews work processes to determine if changes are needed to improve patient safety. | 74.0 | 61.0 | |||||
A12. | In this unit, changes to improve patient safety are evaluated to see how well they worked. | 68.0 | 64.0 | |||||
A14r. | This unit lets the same patient safety problems keep happening. | 74.0 | 58.0 | |||||
DD4. | Response to Error | 0.83 | 0.82 | 0.92，p<0.001 | 0.89 | 3.07 ± 0.94 | 64.0 | 44.0 |
A6r. | In this unit, staff feel like their mistakes are held against them. | 71.0 | 40.0 | |||||
A7r. | When an event is reported in this unit, it feels like the person is being written up, not the problem. | 62.0 | 59.0 | |||||
A10. | When staff make errors, this unit focuses on learning rather than blaming individuals. | 58.0 | 22.0 | |||||
A13r. | In this unit, there is a lack of support for staff involved in patient safety errors. | 65.0 | 53.0 | |||||
DD5b. | Supervisor or Clinical Leader Support for Patient Safety | 0.77 | 0.68 | 0.85，p<0.001 | 0.84 | 4.24 ± 0.53 | 80.0 | 91.0 |
B1b. | My supervisor or clinical leader seriously considers staff suggestions for improving patient safety. | 79.0 | 92.0 | |||||
B2rb. | My supervisor or clinical leader wants us to work faster during busy times, even if it means taking shortcuts. | 84.0 | 87.0 | |||||
B3b. | My supervisor or clinical leader takes action to address patient safety concerns that are brought to their attention. | 78.0 | 95.0 | |||||
DD6. | Communication About Error | 0.89 | 0.83 | 0.80，p<0.001 | 0.96 | 4.38 ± 0.73 | 71.0 | 87.0 |
C1. | We are informed about errors that happen in this unit. | 70.0 | 98.0 | |||||
C2. | When errors happen in this unit, we discuss ways to prevent them from happening again. | 74.0 | 99.0 | |||||
C3. | In this unit, we are informed about changes that are made based on event reports. | 69.0 | 63.0 | |||||
DD7. | Communication Openness | 0.83 | 0.75 | 0.78，p<0.001 | 0.84 | 3.09 ± 0.92 | 75.0 | 51.7 |
C4. | In this unit, staff speak up if they see something that may negatively affect patient care. | 83.0 | 59.0 | |||||
C5. | When staff in this unit see someone with more authority doing something unsafe for patients, they speak up. | 72.0 | 56.0 | |||||
C6. | When staff in this unit speak up, those with more authority are open to their patient safety concerns. | 75.0 | 55.0 | |||||
C7r. | In this unit, staff are afraid to ask questions when something does not seem right | 71.0 | 36.6 | |||||
DD8. | Reporting Patient Safety Events | 0.75 | 0.82 | 0.90，p<0.001 | 0.92 | 3.45 ± 1.13 | 74.0 | 46.0 |
D1. | When a mistake is caught and corrected before reaching the patient, how often is this reported? | 65.0 | 44.0 | |||||
D2. | When a mistake reaches the patient and could have harmed the patient, but did not, how often is this reported? | 83.0 | 48.0 | |||||
DD9. | Hospital Management Support for Patient Safety | 0.77 | 0.87 | 0.78，p<0.001 | 0.92 | 4.09 ± 0.80 | 67.0 | 80.0 |
F1. | The actions of hospital management show that patient safety is a top priority. | 79.0 | 86.0 | |||||
F2. | Hospital management provides adequate resources to improve patient safety. | 73.0 | 86.0 | |||||
F3r. | Hospital management seems interested in patient safety only after an adverse event happens. | 49.0 | 67.0 | |||||
DD10. | Handoffs and Information Exchange | 0.72 | 0.93 | 0.84，p<0.001 | 0.96 | 3.71 ± 1.06 | 64.0 | 72.0 |
F4r. | When transferring patients from one unit to another, important information is often left out. | 73.0 | 73.0 | |||||
F5r. | During shift changes, important patient care information is often left out. | 56.0 | 73.0 | |||||
F6. | During shift changes, there is adequate time to exchange all key patient care information. | 63.0 | 69.0 | |||||