Associations of organizational safety practices with workers' perceptions and safety behaviors, and musculoskeletal symptoms among hospital nurses

Background: Organizational safety practices have been linked to workers’ injury outcomes and safety behaviors. The study examined the associations of organizational safety practices with nurses’ perceptions about job and risk of injury, safety behaviors, and work-related musculoskeletal symptoms.  

Methods: This was a cross-sectional statewide survey of a random sample of 2,000 licensed nurses selected from the California Board of Registered Nursing list. Data were collected by both postal and on-line surveys from January to July in 2013. Data analysis included 268 hospital nurses. Organizational safety practices were assessed by safety climate, ergonomic practices and people-oriented culture. Work-related musculoskeletal symptoms were defined as symptoms in the low back, neck, shoulders, or hands experienced in the past 12 months that were caused or worsened by work. 

Results: All three variables of organizational safety practices were significantly correlated with nurses’ safe patient handling behaviors, greater job satisfaction, and lower perceptions of risk of musculoskeletal injury and job strain (p<0.001). Among organizational safety practices variables, stronger correlations were found between safety behavior and safety climate; job satisfaction and people-oriented culture; and risk perception and ergonomic practices. After controlling for demographic and job characteristics, work-related musculoskeletal symptoms were significantly associated with safety climate (OR=0.52, 95% CIs 0.37-0.74), ergonomic practices (OR=0.53, 95% CIs 0.38-0.72) and people-oriented culture (OR=0.55, 95% CIs 0.39-0.76).

Conclusions: The study findings suggest that organizational practices for worker safety may play a pivotal role in promoting nurses’ safety behaviors and positive perceptions about job, and in reducing the risk of work-related musculoskeletal disorders.