Table 3.
Facilitating and inhibiting factors for implementing interventions to enhance safety culture.
| Facilitating | Inhibiting |
|---|---|
| Staff | |
| Empower to implement change (Damery et al., 2019; Smith et al., 2018) | Time pressure and heavy workloads and, therefore, competing demands and project fatigue or reduced willingness to complete surveys (Agency for Healthcare Research and Quality (AHRQ), 2017; Mai, 2015; Marshall et al., 2018) |
| Responsibility to specific areas of safety (Damery et al., 2019) | High staff turnover and staff shortage (Marshall et al., 2018; Storm et al., 2018) |
| Good connections and trust between staff and managers (Damery et al., 2019) | Feeling of patronage and surveillance (Mai, 2015), mistrust, and skepticism towards the participation (Damery et al., 2019) |
| Management | |
| Backing and active support of the project goals (Ganaden and Mitchell, 2018; Marshall et al., 2018; Smith et al., 2018) | Fluctuation of managers (Damery et al., 2019; Marshall et al., 2018; Storm et al., 2018) |
| Program organization | |
| Target achievable ideas considering time and resources available (Ganaden and Mitchell, 2018), flexible intervention approach so facilities can adapt materials to their needs (Agency for Healthcare Research and Quality (AHRQ), 2017) | High preparation effort in relation to the benefit (Mai, 2015) |
| Integrate changes into the workflow and organizational culture (Damery et al., 2019) | Organizational changes like restructuring of the facility taking place simultaneously with the intervention (Storm et al., 2018) |
| Offer tailored training to fit nurses' schedules and learning styles, use relevant language and examples (Damery et al., 2019), point out transfer options in strategies learned from other areas of practice (Agency for Healthcare Research and Quality (AHRQ), 2017) | |
| Bring in external expertise and network with other nursing homes (Damery et al., 2019; Marshall et al., 2018), good relationships between organizational leads and facilities (Agency for Healthcare Research and Quality (AHRQ), 2017) | |
| Support through program moderators (Damery et al., 2019; Marshall et al., 2018), ongoing coaching in the desired practices (Agency for Healthcare Research and Quality (AHRQ), 2017) |
Inconsistency of the team facilitating the program (Marshall et al., 2018) |
| Non-judgmental feedback on changes, utilizing own data (Agency for Healthcare Research and Quality (AHRQ), 2017; Damery et al., 2019; Marshall et al., 2018) | |
| In-person meetings (where possible) to forge stronger connections (Agency for Healthcare Research and Quality (AHRQ), 2017) | |
| Transparent processes regarding occurrence reporting and the option of reporting anonymously (Ganaden and Mitchell, 2018) | Technical difficulties like lack of computers with internet (Agency for Healthcare Research and Quality (AHRQ), 2017) |
| Insufficient submission of assessments, so that feedback is only possible to a limited extent (Agency for Healthcare Research and Quality (AHRQ), 2017) | |