Feasibility trial to assess the patient safety culture in the professional group of dietitians

Background

Patient safety culture is determined by the requirement of understanding of values, attitudes, competences and behavioral patterns [1, 2]. Dietitians are health professionals trained to advice on diet, food and nutrition and provide nutrition expertise including nutrition assessment, diet modification and individual or group counselling [3]. Within hospitals, dietitians represent a relatively small professional group. For example, the University Hospital Graz has eleven dietitians and approximately 7,000 employees in total.

The primary aim of this feasibility trial was to assess the perceived patient safety culture solely within the professional group of dietitians. Three hospital organizations from Austria, Germany and Switzerland were invited to participate. To the best of our knowledge this is the first report concerning patient safety culture within the professional group of dietitians.

Material and methods

ETH Zurich, Center for Organizational and Occupational Sciences (PASKI) translated the HSOPSC survey into German [4]. Survey results are separated into three levels:

· Level 1: 9 dimensions concerning the unit-level

· Level 2: 3 dimensions concerning the hospital-level

· Level 3: 3 Outcome measures

The survey contained 48 questions using the 5-point Likert response scale of agreement. In 2014 a paper-pencil feasibility trial was conducted. The questionnaire was sent to 62 nutrition experts (Austria n = 44, Germany n = 16, Switzerland n = 2); the survey was open for one month. The conduct of the online survey was approved by the Medical University Graz Ethics Committee (vote-number: 27-002 ex 14/15).

Survey data were analyzed using descriptive statistics. Internal consistency of the questionnaire and its items was measured by Cronbach's alpha coefficient. Reliability was considered good if values were >0.7 and very good if values were >0.9. All analyses were conducted using SPSS version 21.

Results

The overall response rate was 55% (n = 18 (41%) from Austria, n = 14 (88%) from Germany and n = 2 (100%) from Switzerland). Cronbach alpha coefficient ranged from 0.44 for item "feedback and communication about error" to 0.90 for the item "handoffs and transition across units".

Table 1 Pooled survey results for dietitians from Austria (n = 18), Germany (n = 14) and Switzerland (n = 2).

Conclusions

This feasibility trial was the first attempt to attract the professional group of dietitians in assessing the patient safety culture. So far, the professional group of dietitians had been underrepresented in the literature concerning patient safety culture measurements. The targeted goal to compare three nations was not achieved. As only two dietitians from Switzerland took part, just pooled results are shown. Perceived patient safety culture for almost all items had been good, despite the item of "staffing" and "patient safety in general". This feasibility trial could be supportive to further attract patient safety aspects such as critical incident reporting systems or clinical risk management within the professional group of dietitians.

Acknowledgements

The authors would like to thank all participants who took part in this feasibility trial.