The relationship between safety climate and nurses’ safe handling of chemotherapy: A partial least squares structural equation modeling analysis

Published:October 06, 2022DOI:


      • Safety climate plays a critical role in nurses' safety behaviors.
      • Few know the sub-dimensions of the safety climate related to safety behavior.
      • Managers should allow nurses to share their views on workplace safety.
      • Managers can purchase PPE that can be used easily and comfortably.



      Safety climate plays a critical role in nurses' safety behaviors. However, few are aware of the safety climate sub-dimensions associated with safety behavior. This study aimed to investigate the relationship between nurses’ perception of the workplace safety climate and their safety behavior regarding the handling of chemotherapy upon intravenous administration.


      This study included a cross-sectional survey of nurses recruited by purposive sampling at three hospitals in Taiwan. A total of 484 self-administered questionnaires were returned. Each participant had to complete the questionnaire that was developed by the authors, including the Taiwanese Safety Climate Instrument and Chemotherapy Safety Precautions Questionnaire. Exploratory factor analysis and Confirmatory factor analysis was conducted to verify the psychometric properties. We used the samples (N = 247) for confirmatory factor analysis to verify the model using partial least squares structural equation modeling.


      We found that nurses’ perceptions of workplace safety climate can explain and predict their safety behavior regarding administration chemotherapy, particularly the dimension of “perception of interaction with colleagues,” “experience of clinical jobs hindering the use of personal protective equipment,” “perception of comfort using personal protective equipment,” and “easy usage of personal protective equipment.” The study further revealed that the dimensions of the Taiwanese Safety Climate Instrument were moderate predictors of the Chemotherapy Safety Precautions.


      Nurses have a positive perception of the workplace safety climate and frequently implement behaviors regarding the safe handling of chemotherapy. Organizational managers should enable nurses to share their perceptions of workplace safety with their colleagues and purchase easy-to-use and comfortable personal protective equipment.


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