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Table 5 Characteristics of the review included safety culture

From: Evidence from facility level inputs to improve quality of care for maternal and newborn health: interventions and findings

Reviews (n=9) Description of included interventions Type of studies included (no) Targeted health care providers Outcome reported Pooled data (Y/N) Results
     Other outcomes MNCH specific outcomes   
Burls 2006[44] Influenza vaccination cRCT: 3
RCT: 03
Before/after studies: 05Surveys: 07
Health care workers in hospitals, nursing homes or the community in contact with high-risk individuals in HIC Vaccination uptake   No Range 5% - 45%
     Effectiveness    Narrative
Gould 2011[48] Hand hygiene ITS: 02
RCT: 01
CBA: 01
Nurses, doctors and other allied health professionals (except operating theatre staff) in any hospital or community setting, (HIC) Effectiveness   No Multifaceted campaigns with social marketing or staff involvement appear to have an effect
Hollmeyer 2009[45] Identify self-reported reasons among HCW for vaccine acceptance or non-acceptance and to identify predictive factors that are statistically associated with influenza vaccine acceptance. 13 studies Physicians, nurses or both and not support staff or para/non-medical personnel Self-reported reasons   No If HCW get immunized against influenza, they do so primarily for their own benefit and not for the benefit to their patients
     Predictive factors    
Morello 2013[50] There were a number of different safety culture strategies tested, including leadership walk rounds, structured educational programs, team-based strategies, simulation-based training programs, multi-faceted unit-based programs and multi-component organizational interventions. cRCT: 1
Pre-Post: 7
Historically controlled studies: 13
Any study on with health care workers within a hospital, hospital department or clinical unit Leadership walk rounds   No 2/2 studies some to moderate effect
     Multi-faceted unit-based programs    6/7 studies some to moderate effect
     Multi-component organizational strategies    1 study showed no effect
     Structured educational programs    1/2 studies some to moderate effect
     Simulation-based training programs    1/4 studies some to moderate effect
     Team based strategies    1/3 studies some to moderate effect
     Other patient safety culture strategies    1/2 studies some to moderate effect
Nascimanto 2009[64] Safety culture and patient safety 48 references General health care environment    No Narrative
Ng 2011[46] Influenza vaccination RCT: 03   Mean number of working days lost   Yes 0.08 (0.19 to 0.02)
     Days with ILI symptoms    0.12 ( 0.3 to 0.06)
     RR of ILI episodes    1.14 ( 0.15 to 8.52)
Royal 2006[49] Interventions applied in primary care which aimed to reduce drug-related morbidity, hospitalization or death resulting from medication overuse or misuse. 38 studies Pharmacist, Nurses, healthcare professionals in HIC Hospital admission in pharmacist led intervention   Yes 0.64 (0.43- 0.96)
     Complex interventions to reduce fall in elderly    0.91 (0.68-1.21)
Seale 2011[47] Any study examining seasonal influenza vaccination (uptake, attitudes and/or programs) among Australian hospital Health care workers was included. 10 studies Health care workers in Australia Policies and implementation of vaccine protocols   No 16 to 77% coverage of vaccination after intervention compared to 8 to 50% coverage before intervention
Weaver 2013[51] 20 studies explicitly included team training or tools to improve team communication processes, 8 explicitly included some form of executive walk rounds or interdisciplinary rounding, and 8 explicitly used comprehensive unit based safety program (CUSP). Pre–post studies: 27
RCT: 4
Observational: 3
Any health care professionals or paraprofessionals practicing in adult or pediatric inpatient settings CUSP
Staff perceptions of safety culture
  No 6/8 studies reported statistically significant improvements in
     Safety culture score    23/32 studies reported improvement
     Patient outcomes    6/11 studies reported improvement