Observational studyBMC health services research2019
Safety climate, safety climate strength, and length of stay in the NICU.
Observational study in BMC health services research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed.
- Leader behaviors to improve teamwork during interprofessional rounds in the NICU.Journal of perinatology : official journal of the California Perinatal Association · 2026Article
- Development of a machine learning model to identify the predictors of the neonatal intensive care unit admission.Scientific reports · 2025Article
- Elevating the role and professional contributions of the neonatal dietitian for the future: insights from the experts themselves.Frontiers in pediatrics · 2025Article
- An exploration of patient safety culture in NICUs: a convergent parallel mixed-method study.BMC health services research · 2024Article
- Article
- The association between patient safety culture and adverse events - a scoping review.BMC health services research · 2023Article
- Patient safety culture in neonatal intensive care units: A qualitative content analysis.Frontiers in public health · 2023Article
- Characteristics of High Versus Low-Performing Hospitals for Very Preterm Infant Morbidity and Mortality.The journal of pediatrics: X · 2023Article
- NICU Admission for Term Neonates in a Large Single-Center Population: A Comprehensive Assessment of Risk Factors Using a Tandem Analysis Approach.Journal of clinical medicine · 2022Article
- The Incident Feedback Committee (IFC): A Useful Tool to Investigate Errors in Clinical Research.Healthcare (Basel, Switzerland) · 2022Article
- Cost-effectiveness analysis of heart rate characteristics monitoring to improve survival for very low birth weight infants.Frontiers in health services · 2022Article
- Developing patient safety standards for health-care quality promotion in neonatal intensive care units: A mixed-methods Protocol.Journal of education and health promotion · 2022Article
- Changing safety culture.Journal of perinatology : official journal of the California Perinatal Association · 2021Article
- Assessment of Workplace Safety Climate among Healthcare Workers during the COVID-19 Pandemic in Low and Middle Income Countries: A Case Study of Nigeria.Healthcare (Basel, Switzerland) · 2021Article
- Provider burnout: Implications for our perinatal patients.Seminars in perinatology · 2020Review
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
backgroundSafety climate is an important marker of patient safety attitudes within health care units, but the significance of intra-unit variation of safety climate perceptions (safety climate strength) is poorly understood. This study sought to examine the standard safety climate measure (percent positive response (PPR)) and safety climate strength in relation to length of stay (LOS) of very low birth weight (VLBW) infants within California neonatal intensive care units (NICUs).
methodsObservational study of safety climate from 2073 health care providers in 44 NICUs. Consistent perceptions among a NICU's respondents, i.e., safety climate strength, was determined via intra-unit standard deviation of safety climate scores. The relation between safety climate PPR, safety climate strength, and LOS among VLBW (< 1500 g) infants was evaluated using log-linear regression. Secondary outcomes were infections, chronic lung disease, and mortality.
resultsNICUs had safety climate PPRs of 66 ± 12%, intra-unit standard deviations 11 (strongest) to 23 (weakest), and median LOS 60 days. NICUs with stronger climates had LOS 4 days shorter than those with weaker climates. In interaction modeling, NICUs with weak climates and low PPR had the longest LOS, NICUs with strong climates and low PPR had the shortest LOS, and NICUs with high PPR (both strong and weak) had intermediate LOS. Stronger climates were associated with lower odds of infections, but not with other secondary outcomes.
conclusionsSafety climate strength is independently associated with LOS and moderates the association between PPR and LOS among VLBW infants. Strength and PPR together provided better prediction than PPR alone, capturing variance in outcomes missed by PPR. Evaluations of NICU safety climate consider both positivity (PPR) and consistency of responses (strength) across individuals.
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