Validity and reliability on three European language versions of the Safety Organizing Scale.

BACKGROUND The Safety Organizing Scale (SOS) offers a reliable snapshot of nurses' engagement in unit-level safety behaviors in hospitals. As no comparable questionnaire exists in German, French and Italian, we explored the psychometric properties of SOS translations into each of those languages. DESIGN AND METHODS The psychometric properties of the nine-item SOS were tested according to American Educational Research Association guidelines. SUBJECTS AND SETTING Between October 2009 and June 2010, 1633 registered medical and/or surgical nurses in 35 Swiss hospitals completed translated SOS questionnaires. RESULTS For each translation, psychometric evaluation revealed evidence based on content (scale-content validity index >0.89), response patterns (e.g. average of missing values across all items = 0.80%), internal structure (e.g. comparative fit indices >0.90, root mean square error of approximation <0.08) and reliability (Cronbach's alpha >0.79). We differentiated the scale regarding one related concept (implicit rationing of nursing care). Higher SOS scores correlated with supportive leadership and lower nurse-reported medication errors, but not with nurse-reported patient falls. CONCLUSIONS The SOS offers a valuable measurement of engagement in safety practices that might influence patient outcomes. Initial evidence regarding the validity and reliability of the translated versions supports their use in German, French and Italian. Concurrent validity will require confirmation via further analysis using more reliable outcome measures (e.g. mortality rates). The translated versions' predictive validity needs to be established in prospective studies.

[1]  Emmanuel Lesaffre,et al.  Levels and correlates of implicit rationing of nursing care in Swiss acute care hospitals--a cross sectional study. , 2013, International journal of nursing studies.

[2]  D. Eignor.  The standards for educational and psychological testing. , 2013 .

[3]  M. Chassin,et al.  The ongoing quality improvement journey: next stop, high reliability. , 2011, Health affairs.

[4]  Aleksandra Zecevic,et al.  Safety culture in healthcare: a review of concepts, dimensions, measures and progress , 2011, Quality and Safety in Health Care.

[5]  Timothy J. Vogus,et al.  The Impact of Safety Organizing, Trusted Leadership, and Care Pathways on Reported Medication Errors in Hospital Nursing Units , 2007, The Journal of nursing administration.

[6]  D. Conen,et al.  Maßnahmen zur Verbesserung der Patientensicherheit , 2011, Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz.

[7]  M. Blegen,et al.  COMPETENCE AND CERTIFICATION OF REGISTERED NURSES AND SAFETY OF PATIENTS IN INTENSIVE CARE UNITS , 2010, The Journal of nursing administration.

[8]  J. Sorra,et al.  Multilevel psychometric properties of the AHRQ hospital survey on patient safety culture , 2010, BMC health services research.

[9]  D. Hofoss,et al.  Patient safety culture lives in departments and wards: Multilevel partitioning of variance in patient safety culture , 2010, BMC health services research.

[10]  B. Gajewski,et al.  A Multilevel Confirmatory Factor Analysis of the Practice Environment Scale: A Case Study , 2010, Nursing research.

[11]  Ngaire Kerse,et al.  Interventions for preventing falls in older people in nursing care facilities and hospitals. , 2010, The Cochrane database of systematic reviews.

[12]  W. Mckinley.  Organizational Theory Development: Displacement of Ends? , 2010 .

[13]  J. Vitaller-Burillo,et al.  Impact and preventability of adverse events in Spanish public hospitals: results of the Spanish National Study of Adverse Events (ENEAS). , 2009, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[14]  May-Kuen Wong,et al.  Professional commitment, patient safety, and patient-perceived care quality. , 2009, Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing.

[15]  M. Soop,et al.  The incidence of adverse events in Swedish hospitals: a retrospective medical record review study , 2009, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[16]  Jennifer Hayes,et al.  Patient Safety Climate in 92 US Hospitals: Differences by Work Area and Discipline , 2009, Medical care.

[17]  Sara Singer,et al.  Relationship of safety climate and safety performance in hospitals. , 2007, Health services research.

[18]  K. Moorthy,et al.  Is health care getting safer? , 2008, BMJ : British Medical Journal.

[19]  L. Aiken,et al.  Rationing of nursing care and its relationship to patient outcomes: the Swiss extension of the International Hospital Outcomes Study. , 2008, International Journal for Quality in Health Care.

[20]  Kathleen L. Bobay,et al.  Patient safety culture in nursing: a dimensional concept analysis. , 2008, Journal of advanced nursing.

[21]  E. D. de Vries,et al.  The incidence and nature of in-hospital adverse events: a systematic review , 2008, Quality & Safety in Health Care.

[22]  S. Clarke,et al.  Validation of the Basel Extent of Rationing of Nursing Care Instrument , 2007, Nursing research.

[23]  Karl E. Weick,et al.  Managing the unexpected: resilient performance in an age of uncertainty, second edition , 2007 .

[24]  Cheryl Tatano Beck,et al.  Is the CVI an acceptable indicator of content validity? Appraisal and recommendations. , 2007, Research in nursing & health.

[25]  Timothy J. Vogus,et al.  The Safety Organizing Scale: Development and Validation of a Behavioral Measure of Safety Culture in Hospital Nursing Units , 2007, Medical care.

[26]  Torsten B Neilands,et al.  The Safety Attitudes Questionnaire: psychometric properties, benchmarking data, and emerging research , 2006, BMC Health Services Research.

[27]  Alija Kulenović,et al.  Standards for Educational and Psychological Testing , 1999 .

[28]  A. Sperber.  Translation and validation of study instruments for cross-cultural research. , 2004, Gastroenterology.

[29]  P. Aspden.  Patient Safety: Achieving a New Standard for Care , 2004 .

[30]  V. Nieva,et al.  Safety culture assessment: a tool for improving patient safety in healthcare organizations , 2003, Quality & safety in health care.

[31]  L. Aiken,et al.  Educational levels of hospital nurses and surgical patient mortality. , 2003, JAMA.

[32]  N. Lackey,et al.  Making Sense of Factor Analysis: The Use of Factor Analysis for Instrument Development in Health Care Research , 2003 .

[33]  Eileen T Lake,et al.  Practice Environment Scale of the Nursing Work Index , 2018 .

[34]  L. Aiken,et al.  Hospital staffing, organization, and quality of care: Cross-national findings. , 2002, Nursing outlook.

[35]  Patricia S. Jones,et al.  An Adaptation of Brislin’s Translation Model for Cross-cultural Research , 2001, Nursing research.

[36]  F. Guldenmund.  The nature of safety culture: a review of theory and research , 2000 .

[37]  Kathryn Mearns,et al.  Measuring safety climate: identifying the common features☆ , 2000 .

[38]  Rex B. Kline,et al.  Principles and Practice of Structural Equation Modeling , 1998 .