Title:
Interprofessional confidence, patient safety culture and CPR preparedness among pediatric health
care providers at a primary care hospital
Authors / Address of institution:
Ulmer FF 1, Bieri R 1, Studer D 1, Bartenstein A 2
1 Department of Pediatrics, University Hospital Bern, Switzerland
2 Department of Pediatric Surgery, University Hospital Bern, Switzerland
Background / Introduction:
The safety culture practiced by health care professionals (HCP) is influenced by a
variety of factors including safety climate, interprofessional morale, teamwork,
supervision, peer support and medical education. We seek to assess safety skill and
attitude, specifically CPR preparedness, interprofessional confidence and failure
management culture among nurses and physicians in pediatrics in Switzerland.
Methods:
During the last quarter of 2016 we conducted a cross-sectional anonymous survey to
measure confidence and safety attitudes among clinically active staff of all 3 pediatric
departments at Bern’s University Hospital.
Results:
We report a 55% response rate stemming from 1007 distributed and 550 returned surveys. Roughly
1/3 of respondents were physicians and about 2/3 were nurses. Half of those polled report
encountering life threatening situations at least once a month. Threequarters believe they recognize
clinical deterioration early in a child and two thirds believe they are in theory well prepared to deal with
resuscitation. Less than half feel they possess the practical skills required for resuscitation. Nurses
rank their emergency preparedness significantly higher (p=0.008) than physicians and close to two
thirds of residents express concern regarding their resuscitation preparedness. Patient safety
education is deemed sufficient by 48% of respondents with nurses rendering a significantly higher
approval rating than physicians (p=0.001) and junior staff physicians disapproving at the highest rate
(75%). Seventy-seven percent view nursephysician collaboration as collegial rather than hierarchical
but nursing’s assessment was significantly less optimistic (p=0.001) compared to physicians’
assessment. When dealing with life-threatening situations, nurses are also significantly more likely to
voice uncertainty (p=0.001).
Conclusion:
Despite encountering life threatening situations relatively often, a majority of physicians do not feel
sufficiently prepared to deal with them. Patient safety education appears to fall short of HCP staff
expectations. Interprofessional and intraprofessional collaboration enjoys broad support, but
differences in assessment are paralleled by the hierarchical slopes of the respective professions.
Practical education surrounding interprofessional confidence, patient failure management and CPR
preparedness warrants improvement in the eyes of both physicians and nurses in pediatrics.
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