Measuring and benchmarking safety culture: application of the safety attitudes questionnaire to an acute medical admissions unit

Original Article



To assess the safety culture in an acute medical admissions unit (AMAU) of a teaching hospital in order to benchmark results against international data and guide a unit-based, integrated, risk management strategy.


The safety attitudes questionnaire (SAQ), a validated instrument for the measurement of safety culture was applied to an AMAU. All AMAU healthcare staff (n = 92) were surveyed: doctors, nurses, healthcare assistants (HCAs) and allied healthcare professionals (AHPs). Safety attitude scores for the overall unit and individual caregiver types were assessed across six domains of safety culture.


When compared against an international benchmark, the AMAU scored significantly higher for four of the six safety domains: p < 0.01 for ‘teamwork climate’, ‘safety climate’ and ‘stress recognition’ and p < 0.05 for ‘job satisfaction’. The difference between nurse manager scores and the overall mean for the study group was statistically significant for the domains of ‘teamwork climate’ (p < 0.05) and ‘safety climate’ (p < 0.01). HCAs scored significantly lower relative to staff overall with regard to ‘working conditions’ (p < 0.05) and ‘perceptions of management’ (p < 0.01).


The SAQ was successfully applied to an AMAU setting giving a valuable insight into staff issues of concern across the safety spectrum: employee and environmental safety, clinical risk management and medication safety.


Safety culture Medication safety Patient safety 


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Copyright information

© Royal Academy of Medicine in Ireland 2009

Authors and Affiliations

  • E. Relihan
    • 1
  • S. Glynn
    • 2
  • D. Daly
    • 3
  • B. Silke
    • 4
  • S. Ryder
    • 5
  1. 1.Medication SafetySt. James’s HospitalDublin 8Ireland
  2. 2.Risk ManagementSt. James’s HospitalDublin 8Ireland
  3. 3.Health and SafetySt. James’s HospitalDublin 8Ireland
  4. 4.Acute Medical Admissions UnitSt. James’s HospitalDublin 8Ireland
  5. 5.School of Pharmacy, Trinity CollegeDublinIreland

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