Designing and Validating a Questionnaire for Assessing the Safety Climate among Nurses

Safety climate has been recognized as a powerful tool for predicting occupational accidents. However this has been ignored in some working environments. The aim of the present study was to develop a questionnaire for assessing safety climate among nurses. Using relevant literature, a pool of questions was drafted. Content validity of questions was assessed using the content validity index (CVI) and content validity ratio (CVR). Then, the questions were distributed among nurses with at least three months of experiences from several hospitals in Tehran, Iran, during the summer of 2017. The completed questionnaires were divided into two datasets: the first was used for exploratory factor analysis, and the second for confirmatory factor analysis. The reliability of questionnaire was assessed using Cronbach's alpha coefficient. The effects of safety climate dimensions on safety performance were assessed using the structural equation modeling (SEM) approach. A total of 273 nurses (41 males and 232 females) participated in the study. Most of these nurses had work experience of one to five years and ranged from 25 to 30 years of age. The final questionnaire contained 19 questions and the exploratory factor analysis (EFA) revealed four dimensions; management commitment to safety; supportive environment; safety training; and perceived work pressure. The structure was confirmed to be acceptable by the following confirmatory factor analysis (CFA) (Chi-square/df=1.01, RMSEA: 0.018, TLI: 0.993, and IFI: 0.994). Supportive environment and management commitment to safety were rated as the two dimensions with the highest effects on the safety performance of nurses in hospitals. The management commitment to safety, supportive environment, safety training, and perceived work pressure were the main dimensions of safety climate in hospitals. Management commitment to safety and supportive environment were the best predictors of safety performance of nurses in hospitals.