Data from: An exploratory study of staff perceptions of shift safety in the critical care unit and routinely available data on workforce, patient and organisational factors

Objectives To explore: bedside professional reported (BPR) perceptions of
safety in intensive care staff; and the relationships between BPR safety,
staffing, patient and work environment characteristics. Design An
exploratory study of self-recorded staff perceptions of shift safety and
routinely collected data. Setting A large teaching hospital comprising 70
critical care beds. Participants All clinical staff working in adult
critical care. Interventions Staff recorded whether their shift felt
“safe, unsafe or very unsafe” for 29 consecutive days. We explored these
perceptions and relationships between these and routine data on staffing,
patient and environmental characteristics. Outcome measures Relationships
between BPR safety and staffing, patient and work environment
characteristics. Results 2836 BPR scores were recorded over 29 consecutive
days (response rate 57.7%). Perceptions of safety varied between staff,
including within the same shift. There was no correlation between
perceptions of safety and two measures of staffing; care hours per patient
day (r= 0.13 p=0.108) and Safecare Allocate (r= -0.19 p=0.013). We found a
significant, positive relationship between perceptions of safety and the
percentage of Level 3 (most severely ill) patients (r=0.32, p=0.0001).
There was a significant inverse relationship between perceptions of safety
and the percentage of Level 1 patients on a shift (r= -0.42,
p=<0.0001). Perceptions of safety correlated negatively with
increased numbers of patients (r= -0.44, p=0.0006) and higher percentage
of patients located side rooms (r=0.63, p<0.0001). We found a
significant relationship between perceptions of safety and the percentage
of staff with a specialist critical care course (r=0.42. p=0.0001).
Conclusion Existing staffing models, which are primarily influenced by
staff:patient ratios may not be sensitive to patient need. Other factors
may be important drivers of staff perceptions of safety and should be
explored further. Trial registration- UK Health Research Authority
approval was obtained (ID249248).