Survey shows link between psychological safety and use of infection prevention practices
Arlington, Va., December 16, 2019
Hospitals reporting high levels of psychological safety are more likely to have comprehensive infection prevention and control (IPC) programs, according to the results of a survey appearing in the American Journal of Infection Control (AJIC), the journal of the Association for Professionals in Infection Control and Epidemiology (APIC), published by Elsevier.
Psychological safety refers to the shared belief that team members will not be reprimanded, punished, or embarrassed for speaking up, sharing ideas, posing questions, raising concerns, or making mistakes.
Healthcare-associated infections (HAI) result in tens of thousands of deaths, costing the US healthcare system billions of dollars each year. Despite the presence of evidence-based guidelines focused on HAI prevention and the proliferation of large-scale HAI implementation initiatives, variation in the use of recommended infection prevention practices across US hospitals remains an issue.
Researchers at University of Michigan Medical School and the VA Ann Arbor Healthcare System conducted a survey of infection preventionists in a random sample of nearly 900 US acute care hospitals in 2017 to identify hospital and IPC program characteristics, organizational factors, and the use of practices to prevent common HAIs. Hospitals were also ranked based on seven psychological safety questions. Their analysis showed a positive link between high psychological safety and the adoption of infection prevention practices that require staff to speak up and challenge deep-rooted customs. Only 38 percent of responding hospitals were deemed to have a high level of psychological safety.
“It is not surprising that high levels of psychological safety are associated with frequent use of socioadaptive safety interventions – those requiring personnel to speak up, ask for help, or provide feedback,” stated the study authors. “Multiple studies have shown that organizational efforts to prevent HAIs require both technical and socioadaptive interventions. Ensuring that infection prevention programs are well supported may enhance safety climates and provide a platform for organizations to build a culture of psychological safety to improve patient safety.”
Although the use of some practices to prevent device-related HAIs has increased in recent years, several socioadaptive prevention practices are still not used as frequently as they could be, according to the study authors, particularly for prevention of catheter-associated urinary tract infections and ventilator-associated pneumonia.
“With the increasing threat of antibiotic resistance, prevention of infection is more important than ever before,” said 2019 APIC President, Karen Hoffmann, RN, MS, CIC, FSHEA, FAPIC. “In order to effectively prevent HAIs and protect patients, healthcare facilities must cultivate environments that are psychologically safe and fully supported by leadership, so that comprehensive IPC programs can be fully implemented.”
Notes for editors
The article is “Psychological safety and infection prevention practices: Results from a national survey,” by M. Todd Greene, Heather M. Gilmartin, and Sanjay Saint (https://doi.org/10.1016/j.ajic.2019.09.027). It appears in the American Journal of Infection Control published by Elsevier.
It will appear in the print edition in January 2020 (Volume 48, Issue 1) and is openly available at https://www.ajicjournal.org/article/S0196-6553(19)30889-2/fulltext.
About AJIC: American Journal of Infection Control
AJIC: American Journal of Infection Control covers key topics and issues in infection control and epidemiology. Infection preventionists, including physicians, nurses, and epidemiologists, rely on AJIC for peer-reviewed articles covering clinical topics as well as original research. As the official publication of APIC, AJICis the foremost resource on infection control, epidemiology, infectious diseases, quality management, occupational health, and disease prevention. AJIC also publishes infection control guidelines from APIC and the CDC. Published by Elsevier, AJIC is included in MEDLINE and CINAHL. www.ajicjournal.org
The Association for Professionals in Infection Control and Epidemiology (APIC) is creating a safer world through the prevention of infection. APIC’s nearly 16,000 members develop and direct infection prevention and control programs that save lives and improve the bottom line for healthcare facilities. APIC advances its mission through patient safety, education, implementation science, competencies and certification, advocacy, and data standardization. Visit us at apic.org.
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