Organizational Culture, Team Climate, and Quality Management in an Important Patient Safety Issue: Nosocomial Pressure Ulcers

Marije Bosch*, Ruud J. G. Halfens, Trudy van der Weijden, Michel Wensing, Reinier Akkermans, Richard P. Grol

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Background: Increasingly, policy reform in health care is discussed in terms of changing organizational culture, creating practice teams, and organizational quality management. Yet, the evidence for these suggested determinants of high-quality care is inconsistent. Aims: To determine if the type of organizational culture (Competing Values Framework), team climate (Team Climate Inventory), and preventive pressure ulcer quality management at ward level were related to the prevalence of pressure ulcers. Also, we wanted to determine if the type of organizational culture, team climate, or the institutional quality management related to preventive quality management at the ward level. Methods: In this cross-sectional observational study multivariate (logistic) regression analyses were performed, adjusting for potential confounders and institution-level clustering. Data from 1,274 patients and 460 health care professionals in 37 general hospital wards and 67 nursing home wards in the Netherlands were analyzed. The main outcome measures were nosocomial pressure ulcers in patients at risk for pressure ulcers (Braden score
Original languageEnglish
Pages (from-to)4-14
JournalWorldviews on Evidence-Based Nursing
Issue number1
Publication statusPublished - 2011


  • organizational culture
  • pressure ulcer
  • prevalence
  • quality of health care
  • institutional policies
  • team climate

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