Thesis Questionnaire

4 April 2017

SAFETY CULTURE QUESTIONNAIRE (Health Care Personnel) I work in the (clinical area or patient care area where you typically spend your time): This is the Department of:| * Encircle the number which corresponds to your answer. | Please answer the following items with respect to your specific unit or clinical area. Choose your responses using the scale below. 5| 4| 3| 2| 1| Agree Strongly| Agree Slightly| Neutral| Disagree Strongly| Disagree Slightly| I. Safety Climate| 1. I would feel safe being treated here as a patient. | 5| 4| 3| 2| 1| | 2.

The health personnel implement rules and guidelines (e. g. hand washing, treatment protocols, clean area, etc) sincerely and religiously| 5| 4| 3| 2| 1| | 3. The health personnel take responsibility for patient safety by administering medications and treatments accurately. | 5| 4| 3| 2| 1| | 4. Jewelry such as earrings, necklaces or bracelets is worn while on duty. | 5| 4| 3| 2| 1| | 5. This institution respect for patients’ rights when rendering care such as cultural and religious beliefs, privacy and confidentiality of information. | 5| 4| 3| 2| 1| | 6.

Thesis Questionnaire Essay Example

This institution ensure that patients’ records are available only to those who are professionally directly involved in their case. | 5| 4| 3| 2| 1| | 7. The health personnel acquire the necessary competence (knowledge, attitudes & skills) to effectively render proper services to patients. | 5| 4| 3| 2| 1| | 8. When conflict arises regarding management of patient care, patients’ rights are upheld. | 5| 4| 3| 2| 1| | II. Teamwork| 1. In this clinical area, it is difficult to speak up if I perceive a problem with patient care. | 5| 4| 3| 2| 1| | 2.

It is easy for personnel here to ask questions when there is something that they do not understand. | 5| 4| 3| 2| 1| | 3. The physicians and nurses here work together as a well-coordinated team. | 5| 4| 3| 2| 1| | 4. I know the first and last names of all personnel I worked with during my last shift. | 5| 4| 3| 2| 1| | 5. Briefings/Endorsements are common in this clinical area. | 5| 4| 3| 2| 1| | 6. I experience good collaboration with nurses in this clinical area. | 5| 4| 3| 2| 1| | 7. I experience good collaboration with staff physicians in this clinical area. | 5| 4| 3| 2| 1| | 8.

I experience good collaboration with pharmacists and laboratory technicians in this clinical area. | 5| 4| 3| 2| 1| | III. Job Satisfaction| 1. I receive appropriate feedback about my performance. | 5| 4| 3| 2| 1| | 2. I like my job. | 5| 4| 3| 2| 1| | 3. Working here is like being a part of a large family. | 5| 4| 3| 2| 1| | 4. This is a good place to work. | 5| 4| 3| 2| 1| | 5. I am proud to work in this clinical area. | 5| 4| 3| 2| 1| | 6. Morale in this clinical area is high. | 5| 4| 3| 2| 1| | IV. Perception of Management| 1. My suggestions about patient’s safety are being acted upon. | 5| 4| 3| 2| 1| | 2.

The health personnel support my daily efforts to improve my patient’s condition. | 5| 4| 3| 2| 1| | 3. The health personnel don’t knowingly compromise patient care. | 5| 4| 3| 2| 1| | 4. The health personnel maintain a safe, sanitary & healthful environment for the patient. | 5| 4| 3| 2| 1| | 5. The health personnel work with the patient & patients’ family so that they gain understanding of his/her illness and cooperate towards promoting early recovery of the patient. | 5| 4| 3| 2| 1| | 6. The health personnel take responsibility for patient’s welfare- physically, mentally & spiritually. | 5| 4| 3| 2| 1| | 7.

The levels of staffing in this clinical area are sufficient to handle the number of patients. | 5| 4| 3| 2| 1| | V. Stress Recognition | 1. When my workload becomes excessive, my performance is impaired. | 5| 4| 3| 2| 1| | 2. I am less effective at work when fatigued. | 5| 4| 3| 2| 1| | 3. I am more likely to commit errors in tense or hostile situations. | 5| 4| 3| 2| 1| | 4. My performance in the clinical area is affected when I have personal problems. | 5| 4| 3| 2| 1| | 5. Understaffing affects my performance. | 5| 4| 3| 2| 1| | VI. Working Conditions| 1. This institution does a good job of training new personnel. 5| 4| 3| 2| 1| | 2. All the necessary information for diagnostic and therapeutic decisions is routinely available to me. | 5| 4| 3| 2| 1| | 3. Trainees in my discipline are adequately supervised. | 5| 4| 3| 2| 1| | 4. This institution provides continuing learning educations to staffs nurses and other members of the health care team. | 5| 4| 3| 2| 1| | DEMOGRAPHIC DATA| Age: Sex: Religion: Civil Status:Address: Date:| Have you completed this survey before?

Yes No Don’t knowPosition: (Mark only one)Attending Physician/Staff PhysicianRegistered NurseFellow PhysicianPharmacistResident PhysicianNutritionist/DieticianPhysician Assistant/Nurse PractitionerTechnologist/TechnicianNurse Manager/Charge NurseNursing AttendantMidwifeGender: Male FemaleYears in practice/specialty: less than 6 months 6-11 mos. 1-2 yrs. 3-4 yrs. 5-10 yrs. 11-20 yrs. 21 yrs. or more| | | Thank you for completing the survey-your time and participation are greatly appreciated. |

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