• Attilio Di Benedetto, Francesco Pelliccia, Manuela Moretti, Wanda d'Orsi, Fernando Starace, Laura Scatizzi, Maria Teresa Parisotto, and Daniele Marcelli.
• Fresenius Medical Care, NephroCare Italy, Naples, Italy.
• J. Nephrol. 2011 Sep 1;24(5):604-12.

BackgroundClinical staff's safety perception is considered an important indicator of the implementation level of safety climate and safety culture. For this purpose, the Safety Climate Survey Questionnaire was submitted to the dialysis clinics staff of the Fresenius Medical Care (FME) network in Italy. Moreover, to explore how standard procedures implementation influences staff opinion of safety levels, the Universal Hygiene Precautions Questionnaire was also submitted.MethodsSafety Climate Survey and Universal Hygiene Precautions questionnaires were based on 19 and 14 statements, respectively. Staff members (n=346) of 33 dialysis units were involved: 21.4% physicians, 58.1% registered nurses and 20.5% health care assistants (HCAs).ResultsSafety Climate mean total score was 81.9%. Medical directors (91.5%) and quality-responsible head nurses (QHRNs) (87.4%) showed higher scores in comparison with staff physicians (82.4%), nurses responsible for hygiene (81.1%) and HCAs (78.8%). Staff nurses (78.9%) showed a significant difference (p<0.05) compared with medical directors. Universal Hygiene Precautions mean total score was 90.8%, not significantly different among medical directors (92%), staff physicians (91.4%), QHRNs (93.2%), nurses responsible for hygiene (91.7%) and staff nurses (91.4%). Only HCAs reported a significantly (p<0.05) lower score (83.6%) compared with medical directors. As the respondents were asked to complete both questionnaires anonymously, a direct correlation between the 2 questionnaires was not possible.ConclusionA relatively high value for Safety Climate was evaluated within the FME network of Italian dialysis clinics. Management showed higher Safety Climate scores than frontline staff. Fostering communication and implementation of training programs are considered valid tools to improve safety.

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