A safety climate evaluation tool for primary care dental practice in Scotland

A Safety Climate Evaluation Tool for Primary Care Dental Practice in Scotland

Background

The World Health Organisation defines patient safety as “the prevention of errors and adverse effects to patients associated with health care”. In Europe, around 10% of hospital patients are unintentionally harmed. Information about the incidence of preventable harm in primary care dentistry is limited but reported events include:

• Adverse reactions to materials and drugs (including latex)
• Local anaesthetic injections causing nerve damage
• Damaging intraoral soft tissues with overheating handpieces
• Unintentional inhalation or ingestion of drugs, burs, crowns and materials
• Clerical errors
• Incorrect site surgery (mainly wrong tooth extraction)
• Equipment failures (Bailey, Tickle & Campbell, 2014)

In Scotland, improving patient safety is a key objective of the Healthcare Quality Strategy  A key aspect of this is the development of a strong and positive safety culture in primary care practice.

NHS Education for Scotland has developed and validated a safety climate questionnaire to support primary care medical teams measure and improve the safety culture in their practice (de Wet et al, 2010). Implemented through the Scottish Patient Safety Programme in Primary Care, the GP SafeQuest survey is completed in more than 90% of general medical practices in Scotland.

Summary

The aim of this study is to adapt and validate the GP SafeQuest safety climate questionnaire for use by dental teams in primary care dental practice in Scotland.

The study comprises two key stages.

1. Content validity index (CVI) exercise – SDPBRN REPs and their teams were invited to rate the relevance of all items in the GP SafeQuest questionnaire on a scale of 1 = not relevant to 4 = highly relevant to general dental practice. An expert group of Dental Practice Advisers was also invited to participate in a CVI exercise. In addition to rating each item, participants were asked for feedback on the questionnaire’s acceptability and clarity and to suggest additional items for inclusion.
   Following the CVI exercises two additional items were added to the questionnaire. No items were removed.
2. Questionnaire pilot – The revised safety climate questionnaire was piloted with the participation of dentists and their teams in SDPBRN REP and Dental Vocational Training practices.
   In each practice all members of staff were invited to complete the dental safety climate questionnaire. Practices then received a summary of their results before holding a meeting to discuss findings and agree action plans for improvement.
   Construct validity of the dental safety climate questionnaire will be evaluated using data gathered from pilot practices.

Current status

All data collection complete. Data analysis ongoing

Study resources

• Practice results summary (Example) (PDF)
• Practice meeting guidance (PDF)

Related publications and web resources

• Bailey, E., Tickle, M. & Campbell, S (2014). ‘Patient safety in primary care dentistry: where are we now?’ Br Dent J, 217(7), 339-44.
• de Wet, C., Spence, W., Mash, R., Johnson, P., Bowie, P. (2010). ‘The development and psychometric evaluation of a safety climate measure for primary care.’ Qual Saf Health Care, 19: 578-584 (PDF)
• NHS Education for Scotland: Patient Safety and Clinical Skills
• Scottish Patient Safety Programme in Primary Care

Joint chief investigators

Dr Linda Young, SDPBRN, NHS Education for Scotland
Irene Black, Dental Directorate, NHS Education for Scotland