Staff In Busy Lobby Area Of Modern Hospital

Hospitals reporting high levels of psychological safety are more likely to have comprehensive infection prevention and control programs, according to the results of a survey recently published in the American Journal of Infection Control.

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 acquired infections (HAIs) result in tens of thousands of deaths, costing the U.S. 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 U.S. 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 American acute care hospitals in 2017 to identify hospital and infection prevention and control 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,” say the study authors in a press release. “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, particularly for prevention of catheter-associated urinary tract infections and ventilator associated pneumonia, according to the authors.

“With the increasing threat of antibiotic resistance, prevention of infection is more important than ever before,” says Karen Hoffman, Association for Professionals in Infection Control and Epidemiology president. “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.”