Adaptation of the Safety Climate Survey: A Contribution to Improving Patient Safety

Aims. The aim of this study was to adapt the Safety Climate Survey and examine its validity and reliability for use in the Turkish healthcare context. Background. Maintaining patient safety is a challenge for healthcare systems world-wide, and healthcare professionals need valid and reliable tools to measure improvements in safety. Methods. The Safety Climate Survey is unidimensional and contains 19 items, which are all five-point Likert-type scales as follows: 1 (totally disagree), 2 (disagree), 3 (neither agree nor disagree), 4 (agree), and 5 (totally agree). Language adaptation of the Safety Climate Survey conducted in accordance with the International Society for Pharma economics and Outcome Research (ISPOR) and expert assessments to calculate the content validity indices was undertaken in the first phase of the study. In phase two, a survey of 434 nurses employed in three hospitals in İzmir (Turkey) was conducted to test the construct validity with confirmatory factor analysis and internal consistency with Cronbach’s alpha, split-half reliability, and item-total correlation. The intraclass correlation coefficient was also checked via test-retest reliability for stability. Results. The content validity index score was 0.97 for the scale and above 0.90 for the items, confirming excellent validity. The confirmatory factor analysis showed an adequate fit, and all the factor loadings were positive and greater than 0.30. Cronbach’s alpha was 0.90, and Spearman̶–Brown coefficient 0.83, indicating good internal consistency. The item-total correlation coefficients were between 0.33 and 0.70, exceeding the acceptable level. The intraclass correlation coefficient value obtained was 0.84, reflecting a good level for time stability. Conclusion. The Turkish version of the Safety Climate Survey is a valid, reliable, and practical tool which can provide essential data on safety issues for healthcare professionals and administrators. Implications for Nursing Management. The instrument can be used in hospital settings to measure the safety climate among nurses, and the results obtained can be used to inform the development of safety improvement strategies.