A multi-university assessment of patient safety competence during clinical training among baccalaureate nursing students: A cross-sectional study

Preregistration nursing students' motivation for speaking up for patient safety: An integrated literature review

AIM

The aim of this review was to uncover what motivates preregistration nursing students to speak up for patient safety during work integrated learning (WIL) and to develop an evidence-based safety motivation framework for use by educators, clinicians, and preregistration nursing students.

DESIGN

This study used an integrative literature review design guided by Whittemore and Knafl's methodological framework.

DATA SOURCES

Five research databases, CINAHL, MEDLINE, PubMed, Scopus, and Web of Science, were searched for relevant peer reviewed research literature published in English between January 2011 and January 2024. The use of MeSH terms "undergraduate nursing student," or "preregistration nursing student" and "speaking up," "patient safety," and "motivation," resulted in 489 search returns. Following application of filters and inclusion criteria fifty-four (n = 54) studies were identified as being relevant to the research aim.

REVIEW METHODS

The fifty-four (n = 54) research studies were reviewed using the JBI Critical Appraisal tool relevant to the study methodology. The JBI critical appraisal tools are checklists used to determine research quality, validity, results, and meaning. Following appraisal, 27 studies were included in the integrative literature review.

RESULTS

Authentic learning, view of self as a nurse, and positive work integrated learning experiences were found to be the primary motivators for preregistration nursing students to speak up for patient safety during work integrated learning. These three motivators provided the foundation for an evidence-based framework, underpinned by self-determination theory, that can be used to enhance preregistration nursing students' motivation to speak up for patient safety.

CONCLUSIONS

The integrative review design enabled the development of the evidence-based Safety Motivation Framework to support preregistration nursing students' during work integrated learning however missing from the literature was information about the lived experience of this group of students when speaking up for patient safety.

Nursing students' perspectives on patients' safety competencies: a cross-sectional survey

BACKGROUND

Nurses constitute the largest body of healthcare professionals globally, positioning them at the forefront of enhancing patient safety. Despite their crucial role, there is a notable gap in the literature regarding the comprehension and competency of nursing students in patient safety within Egypt. This gap underscores the urgent need for research to explore how nursing students perceive patient safety and the extent to which these competencies are integrated into their clinical and educational experiences. Understanding these perspectives is essential for developing targeted interventions that can significantly improve patient safety outcomes. The objective of this study was to fill this gap by assessing the perspectives of nursing intern students on patient safety competencies, thereby contributing to the global efforts in enhancing patient safety education and practice.

METHODS

In this research, a cross-sectional study design was employed to investigate the topic at hand. A purposive sample of 266 nursing intern students was enrolled from the Faculty of Nursing at Mansoura University. The data were collected using a patient safety survey. Subsequently, the collected data underwent analysis through the application of descriptive and inferential statistical techniques using SPSS-20 software.

RESULTS

Among the studied intern nursing students, we found that 55.3% and 59.4% of the involved students agreed that they could understand the concept of patient safety and the burden of medical errors. Regarding clinical safety issues, 51.1% and 54.9% of the participating students agreed that they felt confident in what they had learned about identifying patients correctly and avoiding surgical errors, respectively. Concerning error reporting issues, 40.2% and 37.2% of the involved students agreed that they were aware of error reports and enumerated the barriers to incident reporting, respectively. There was a statistically significant difference between the nursing student patient safety overview domain and their age (p = 0.025).

CONCLUSIONS

Our study's compelling data demonstrated that intern students who took part in the patient safety survey scored higher overall in all patient safety-related categories. However, problems with error reporting showed the lowest percentage. The intern students would benefit from additional educational and training workshops to increase their perspectives on patients' safety competencies.

The patient safety curriculum: An interventional study on the effectiveness of patient safety education for Jordanian nursing students

INTRODUCTION

The purpose of the study was to assess the effectiveness of the World Health Organization's (WHO) patient safety curriculum (PSC) in improving the patient safety education for nursing students in Jordanian higher education programmes.

METHODS

An interventional design adopting a pre-test and post-test was used. A questionnaire survey was administered to 373 nursing students before and after the curriculum. Students were asked to complete pre-test and post-test questionnaires on self-awareness of patient safety.

RESULTS

Students had moderate knowledge of factors that influence patient safety and scored as the highest, (mean 3.45, SD 0.94). The greatest improvement was in the role of the health organisation in error reporting (the mean difference was 0.97, P = 0.001). Taking into consideration the essential measurements, the results obtained after the post-test regarding the two patient safety topics showed a significant increase after completing the training, demonstrating that the patient safety course was effective.

CONCLUSION

The study highlights the importance of developing a curriculum in nursing schools that incorporates patient safety education. The WHO PSC guide can be a great start in this domain.

Identifying predictors of patient safety competency based on sleep quality in student faculty of nursing and midwifery during the internship period: a multidisciplinary study

BACKGROUND

Ensuring patient safety is of paramount importance in healthcare services. Sleep disorders not only have detrimental effects on the health of healthcare students but also significantly impair their performance, leading to an increased risk of medication errors. These errors can pose a grave threat to the safety and well-being of patients. It is crucial to address and mitigate sleep disorders among internship healthcare students to safeguard the quality of care and minimize potential patient harm.

OBJECTIVES

This study aimed to investigate the predictors of Patient Safety Competency (PSC) based on the sleep quality of internship healthcare students.

METHODS

A study was conducted on 331 students from the Ardabil School of Nursing and Midwifery at Ardabil University of Medical Sciences in northwest Iran from August to December 2022. The participants were selected by stratified random sampling. Data were collected using a demographic information form, the Pittsburgh Sleep Quality Index (PSQI), and the Health Professional Education in Patient Safety Survey (H-PEPSS). The collected data were analyzed using SPSS software version 22.0. Person correlation coefficients were used to examine the relationship between PSC level, its dimensions, and sleep quality, while multiple linear regression was conducted to identify the predictors of PSC.

RESULTS

The competency of nurses in patient safety was average in both classroom and clinical settings. However, their ability to work as a team with other healthcare professionals scored the lowest. In addition, the quality of sleep was found to be a predictor of patient safety competency among healthcare students during their internships.

CONCLUSIONS

It is important to note that healthcare students tend to have moderate patient safety competence (PSC), which is positively correlated with their sleep quality. Therefore, it is vital to identify the key factors that directly affect PSC. This would enable nursing and midwifery faculty administrators to take preventive measures to enhance patient safety competence in both classroom and clinical settings. Additionally, organizing educational workshops that engage students and improve their sleep quality could improve patient care. Practical courses are recommended for health professionals and students in clinical settings to enhance patient safety competencies. Additionally, student internships should receive hands-on training to improve teamwork and rest conditions.

Nursing students' evaluation of patient safety culture in three central European countries: a cross-sectional study

OBJECTIVES

This cross-sectional study aimed to investigate and compare the perceptions of nursing students regarding patient safety culture (PSC) during the COVID-19 pandemic in three Central European countries.

METHODS

Data were collected from 624 nursing students between April and September 2021 using the Hospital Survey on Patient Safety Culture.

RESULTS

The evaluation of the PSC dimensions did not reach the expected level of 75 %. Significant associations were found between the perception of the dimensions of the individual PSC and age, student status, study year, and clinical placement. The overall patient safety grade, the number of events reported, and the number of events reported by nursing students were significantly predicted by several dimensions of the PSC (p<0.05).

CONCLUSIONS

The evaluation of patient safety culture by nursing students offers a unique perspective. Students come with 'fresh eyes' and provide different perspectives that can provide healthcare leaders with a practical opportunity to identify blind spots, review and improve safety protocols, and foster a more inclusive culture that prioritizes patient safety.

Health professionals' perceptions of patient safety competencies: psychometric properties of the French version of the H-PEPSS in France and Switzerland

BACKGROUND

Several initiatives have been implemented to develop, manage, and assess patient safety (PS) competencies, which are considered as a serious public health issue across the world. The Health Professional Education in Patient Safety Survey (H-PEPSS) is widely used as a psychometric scale for evaluating perceived PS competencies but has not been validated in French. The purpose of the study was to investigate the main psychometric properties of the French version of the H-PEPSS.

METHODS

A total of 449 students enrolled in nursing and physiotherapy schools in France and French-speaking Switzerland completed a self-administered questionnaire. The 38 items of the H-PEPSS were translated into French following a committee approach. The scale's construct validity was assessed using confirmatory factor analysis. Reliability of the six factors of the H-PEPSS was evaluated using Cronbach α and McDonald's ω. Measurement invariance across countries and academic majors as well as discriminant validity were also investigated.

RESULTS

After we removed one item, the H-PEPSS 6-factor model demonstrated adequate goodness-of-fit statistics (χ2[194] = 316.633, χ2/df = 1.632, p < 0.001, CFI = 0.934, TLI = 0.922, RMSEA = 0.041 [0.033, 0.049], SRMR = 0.044). The total score can be also used as an overall measure of PS competence (χ2[203] = 342.251, χ2/df = 1.686, p < 0.001, CFI = 0.925, TLI = 0.915, RMSEA = 0.043 [0.035, 0.051], SRMR = 0.047). One item was removed because of its high multicollinearity with other items. The reliability was deemed satisfactory (Cronbach α ≥ 0.60), except for the "Understanding human and environmental factors" subscale. Consistently, this subscale was often reported with the lowest reliability in previous studies. We confirmed scalar invariance between countries and partial scalar invariance between majors (ΔCFI ≤ 0.01). The heterotrait-monotrait ratio of correlations ranged from 0.63 to 0.91. In our results, country, academic year, and academic satisfaction were frequently the main predictors of self-reported PS competencies.

CONCLUSION

Perceived PS competencies can be assessed and fairly compared across France and Switzerland and across nursing and physiotherapy students. We discuss the relevance of the introduction of the H-PEPSS in the training pathway of health professions degree courses and the fallout in clinical contexts.

Senior nursing student's confidence in learnt competencies and perceptions of patient safety competency: a multisite cross-sectional study

OBJECTIVE

Nursing students' attainment of patient safety (PS) competency has always been a global concern among health and educational organisations. Therefore, this study was conducted to determine senior nursing students' confidence of their PS competencies, and associated predictive factors.

DESIGN

Cross-sectional study.

SETTING

Four faculties from the nursing faculties of East Azerbaijan province.

PARTICIPANTS

253 senior nursing students in Iran.

PRIMARY AND SECONDARY OUTCOME MEASURES

Using the modified version of the Health Professional Education Patient Safety Survey, data related to the level of confidence of nursing students in acquired competencies in seven sociocultural dimensions of PS in classroom learning and clinical settings were collected. In addition, the predictors of the patient's safety competencies were identified by linear regression statistics.

RESULTS

Mean scores of all dimensions of PS competencies both in the classroom and in clinical settings were higher than 3.11 (out of 5). The nursing students were most confident in their learning of 'understanding human and environmental factors' in the classroom and the clinical setting. Nursing students displayed the least confidence in learning 'work in teams with other health professionals' in both the classroom and the clinical settings. Type of university, prior experience with PS competencies education, and coverage of PS competency issues in the curriculum predicted the students' perceived competency scores in the classroom (R2=0.53, p<0.001). Also, perceived competence in the clinical settings was predicted by the variables of reporting errors to personnel and peers and the type of university (R2=0.65, p<0.001).

CONCLUSION

Study findings emphasise the role of learning environments and educational experiences of nursing students especially the clinical environment, clinical instructors and the hidden curriculum in improving safety competence. Nursing educators can use this information to revise and develop the undergraduate nursing curriculum, paying close attention to lesson plans and content in relation to teaching safety issues.

Prehospital nursing students' experiences of patient safety culture in emergency medical services-A qualitative study

AIMS AND OBJECTIVES

To describe prehospital nursing students' experiences of patient safety culture in emergency medical services during their internship.

BACKGROUND

Patient safety culture in the emergency medical services is a complex phenomenon including more than organisational policies and practices and professionals' technical skills.

DESIGN

The descriptive qualitative approach used the Sharing Learning from Practice to improve Patient Safety Learning Event Recording Tool, which includes both open-ended and structured questions.

METHODS

Purposeful sampling was used, and data were collected from graduating prehospital nursing students (n = 17) from three Finnish Universities of Applied Sciences. Open-ended questions were reviewed using thematic analysis, and frequencies and percentages were derived from structured questions. COREQ guidelines were used to guide this study.

RESULTS

Four themes were identified during the thematic analysis: environmental and other unexpected factors in emergency medical services, working practices and professionalism in emergency medical services, teamwork in emergency medical services and feelings related to patient safety events in emergency medical services. Patient safety events described by students were seldom reported in the healthcare system or patient files. According to the students, such events were most likely related to communication, checking/verification and/or teamwork.

CONCLUSIONS

This study shows that prehospital nursing students can produce important information about patient safety events and the reasons that contributed to those events. Therefore, emergency medical services organisations and managers should use students' observations to develop a patient safety culture in emergency medical services.

RELEVANCE TO CLINICAL PRACTICE

Understanding how prehospital nursing students have experienced patient safety culture during their internships on ambulances can support educational institutions, together with emergency medical services organisations and managers, to improve policies for students to express patient safety concerns as well as patient safety successes.

The effect of community of practice in improving the role of clinical instructor in patient safety implementation by prelicensure nursing students

Introduction: Patient safety problems caused by students leads to different adverse event, hence clinical instructor plays a role in guiding them in the implementation of patient safety programs. Furthermore, the community of practice is considered to improve the role of clinical instructors in patient safety problems. This study is then conducted to measure the impact of community of practice toward the role of clinical instructors in patient safety problems. Design and methods: This is a pre-experimental design for one group and a pre-post test design without a control group. In addition, the sample includes 36 prelicensure nursing students. Result: The results showed that the score of clinical instructors’ role before and after intervention with community of practice implementation was 58 (34-67) and 79.33 with SD of 10,960, respectively, with a significant increase of 24.27. Also, the statistic analysis depicted that the role had a significant effect after implementation, with a p-value of < 0,000. Conclusions: Based on the results, the community of practice had a significant impact in increasing the role of clinical instructors in the implementation of patient safety problems by prelicensure nursing students.  

Association between nurses' experiences of workplace incivility and the culture of safety of hospitals: A cross-sectional Study

AIM AND OBJECTIVES

This article examined the association between workplace incivility experiences of nurses and patient safety (PS) culture in hospitals.

BACKGROUND

Workplace incivility, which is characterised by low-intensity behaviours with unclear intention to harm and disruption of workplace ambiance of mutual respect, may threaten the work environment, resulting in an unhealthy and unsafe workplace.

DESIGN

Cross-sectional study.

METHOD

This study surveyed 261 nurses in Saudi Arabia from June 2019 to August 2019 using the 'Hospital Survey of Patients' Safety Culture' and the 'Nurse Incivility Scale'. A multiple linear regression was performed with unit- and hospital-level PS culture as the dependent variables.

RESULTS

'Organizational learning-continuous improvement' and 'Teamwork within units' were recognised as PS culture strengths. The nurses reported workplace incivility from patient/visitor as the most frequently experienced (mean = 2.27, standard deviation = 0.88). Working in Hospital B (ß = 0.24, p < .001, 95%CI = 0.15, 0.33) and having a baccalaureate degree in nursing (ß = 0.13, p = .014, 95%CI = 0.03, 0.23) were associated with better perceptions of unit-level PS, whereas working in medical-surgical wards (ß = -0.16, p = .002, 95%CI = -0.26, -0.06) and in intensive care units (ß = -0.19, p = .002, 95%CI = -0.32, -0.07) and experiencing patient/visitor incivility (ß = -0.09, p = .004, 95%CI = -0.15, -0.03) were associated with poor unit-level PS culture perceptions. Experiences of general incivility (ß = -0.24, p < .001, 95%CI = -0.35, -0.13) and supervisor incivility (ß = -0.26, p = .011, 95%CI = -0.46, -0.06) were associated with poor hospital-level PS culture perceptions.

CONCLUSIONS

Workplace incivility from patients/visitors had a negative association with unit-level PS culture perceptions, whereas experiences on general and supervisor incivilities had an adverse relationship with hospital-level PS culture perceptions.

RELEVANCE TO CLINICAL PRACTICE

The study emphasises the call to eradicate any form of incivility in healthcare settings to guarantee a PS culture. Hospital and nursing managers should prioritise the creation and implementation of policies aimed at eliminating uncivil behaviours in clinical settings to ensure that unit- and hospital-level PS culture are above standards.

Predictors of Self-Assessed and Actual Knowledge about Diabetes among Nursing Students in Saudi Arabia

The aim of this study was to investigate the predictors of self-assessed and actual knowledge of diabetes among undergraduate nursing students. Nursing education plays an important role in preparing future nurses and ensuring that they are knowledgeable and competent in diabetes care. A descriptive, cross-sectional study was conducted with a convenience sample of 330 undergraduate Saudi student nurses. We collected data from October to December 2019 using the Diabetes Self-report Tool (DSRT) and Diabetes Basic Knowledge Tool (DBKT). We performed a multiple regression analysis to identify the predictors of self-reported and actual knowledge of diabetes. The students' overall mean (SD) scores in the DSRT and DBKT were 48.31 (5.71), which is equivalent to 80.52% of the total score and 22.54 (8.57), respectively. The students' university, gender, year level and experience in providing direct care to diabetic patients were the significant predictors of self-reported knowledge, whereas their university, age and perceived diabetes knowledge were the significant predictors of actual diabetes knowledge. The findings underscore the necessity to improve student nurses' actual knowledge of diabetes and its management. Our findings provide a solid basis for planning and implementing educational interventions with diabetes-related information to ensure adequate diabetes knowledge among nursing students.

Nurses' Perception of Patient Safety Culture in Primary Care During the COVID-19 Pandemic: A Preliminary Results

Investigation of nurses' perceptions of patient safety culture (PSC) might be beneficial in identifying safety areas that need improvement, especially during the COVID-19 pandemic. The study reports on the PSC in primary care from the nurses' perspective during the pandemic. Nurses (n = 117) evaluated teamwork (87.3%) and staff training (80.9%) positively but work pressure and pace (26.1%) and patient care tracking (45.3%) concerning PSC dimensions negatively. Limited care coordination and continuity lead to patient hospitalizations and care fragmentation. However, regular assessment of PSC can lead to adopting the necessary strategies to reinforce weaknesses and thus improve patient safety in primary care.

Nurse–Patient/Relatives Conflict and Patient Safety Competence Among Nurses

Nurse–patient/relatives conflicts may adversely impact the well-being and work performance of nurses, which could prelude to the possibility of unwanted errors thereby threatening patient safety. This descriptive and cross-sectional study aimed to examine the association between nurses’ perceived nurse–patient/family conflicts and their perceived patient safety (PS) competence. Nurse–patient/relatives conflicts are critical issues that may adversely impact the nurses’ well-being, which could prelude to unwanted errors, thereby threatening PS. The study surveyed 320 nurses in Saudi Arabia using the “Healthcare Conflict Scale” and “Health Professional Education in Patient Safety Survey” from December 2019 to January 2020. The subscale “mistrust of motivations” was perceived to have the greatest conflict, whereas “contradictory communication” was rated as the lowest conflict. A significant difference was observed between the perceived conflict and the different hospital units where nurses worked. Saudi nurses reported higher nurse–patient/family conflicts than Filipino and Indian nurses. The highest PS competence was reported in “communicating effectively,” whereas “working in teams with other health professionals” had the poorest safety competence. The nurses’ perceived “mistrust of motivations” and “contradictory communication” were associated with poorer self-reported PS competence. Perceived conflicts between nurses and their patients/relatives had negative association with the perceived confidence of nurses in the difference patient safety competencies. The results can become the basis for formulating hospital policies geared toward the elimination of healthcare conflicts to help ensure the patient safety competence of nurses. Policies on mitigating conflicts between healthcare workers and patients/relatives must be created and implemented.

Clinical nursing competency assessment: a scoping review

Objective

To ensure that only competent graduates are licensed to practice nursing, councils conduct licensing examinations, which may include among others clinical competency assessment. This review explored current practices in clinical competency assessment of nursing students as part of a larger study aimed at developing an evidence-based, context-specific framework for clinical competency assessment in a sub-Saharan African (SSA) country.

Methods

A scoping guided by the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) was conducted.

Results

Findings from 28 out of 1151 studies identified from Scopus, PubMed, CINAHL, Wiley Online Library, and ProQuest were included and synthesized. Results show that a good assessment system must be valid, reliable, transparent, feasible, fair, objective, and must provide feedback and continually improve to have an educational impact. Clinical competency assessment systems must be developed on sound empirical evidence, pilot tested, and involve thorough training and evaluation of the examiners. Continuous evaluation of the assessment system is also essential to ensure the quality and relevance of the assessment system. Only one of the included studies was conducted in Africa.

Conclusions

The paucity of clinical competency assessment research in sub-Saharan Africa may lead to benchmarking assessment systems on research conducted outside the context. Sub-Saharan Africa has a set of circumstances that demand a context-specific clinical competency assessment framework to guide clinical competency assessment.

Patient safety education for undergraduate nursing students: a scoping review protocol

OBJECTIVE

The objective of the review is to examine the literature on patient safety and the teaching and learning strategies required to help students learn about patient safety in undergraduate nursing curricula in prelicensure nursing education programs.

INTRODUCTION

Patient safety is a global concern, and health care professionals, including nurses who are on the frontline of health care delivery, should be equipped with the knowledge to enhance patient safety. Undergraduate nursing curricula should include the relevant patient safety content and supply nurse educators with teaching and learning strategies to help students acquire these skills.

INCLUSION CRITERIA

Based on the Participants, Concept, and Context (PCC) framework, the eligible population will include nursing students who are enrolled in undergraduate nursing programs and nurse educators who teach in undergraduate nursing programs. The concept of interest is patient safety education, namely, the curricular content and teaching and learning strategies used to help nursing students learn the content. The context is prelicensure nursing education programs at college or university level. Eligible studies will include, but not be limited to, quantitative studies, observational, qualitative, and mixed-methods studies, systematic reviews, and opinion papers.

METHODS

Online databases will be searched across MEDLINE, CINAHL, and Web of Science. JBI methodology for scoping reviews will be used to conduct the review. Pre-determined inclusion and exclusion criteria will be used to select relevant studies. Data will be extracted and synthesized from studies that describe patient safety content and teaching and learning strategies in prelicensure nursing education.

The knowledge about patient safety among undergraduate nurse students in Cyprus and Greece: a comparative study

BACKGROUND

The Patient safety movement contributed to the reduction of preventable adverse events associated with health care. Although patient safety issues have received the attention of educators in the health care studies, there is evidence that in nursing education and the associated curricula it is not well-incorporated. This may not allow students to acquire scientific knowledge and develop strong competencies to assure patient safety throughout their professional life. The aım of the study was the exploration of the undergraduate nursing student perspectives regarding knowledge received during their training about patient safety-related issues.

METHODS

A descriptive comparative study was conducted with three and four-year undergraduate nursing students from the Cyprus Republic (n = 243) and Greece (n = 367). All students were surveyed using the Health Professional Education Patient Safety Survey (H-PEPSS) to describe students' knowledge in the classroom and clinical setting.

RESULTS

Students' Knowledge about patient safety was expressed significantly higher (p < 0.001) in the classroom (mean = 4.0) than the clinical setting (3.7) (1-5 scale). The knowledge in the dimension "clinical aspects" received the highest score and "working in teams" received the lowest. Also, differences were recorded between countries wıth Cypriot students reporting hıgher level of knowledge than the Greek students in most of the dimensions. CONCLUSıON: The findings revealed the gap between theory and practice and the need for collaboration between the two settings. Also, students reported relatively higher knowledge with regards to the technical aspects of patient safety. Still, they were less knowledgable about the sociocultural aspects of the patient, such as working in teams.

Nursing students' experience of risk assessment, prevention and management: a systematic review

Introduction

As a fundamental dimension of quality, the patient safety and healthcare workers safety in the healthcare environment depend on the ability of each healthcare workers (whether administrators or technicians) to reduce the probability of error. This review focused on nursing students. The aim was to assess level and determinants of knowledge about risk assessment, risk prevention and risk management of nursing students.

Methods

A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Two reviewers searched the bibliographic databases Pubmed, Scopus and Cinahl to collect all the available articles in English and Italian issued between 2015 and August 2019. To obtain an exhaustive query of search, the following keywords were combined through Boolean operators AND and OR: Clinical Risk Assessment, Nursing Education, Nursing Student*, Patient Safety. The authors assessed the quality of the evidence by using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) method.

Results

Twelve papers are included. Although the literature on the nursing student’s error is limited, their frequencies are worrying. Some authors have created a model of prevention of clinical error based on three level. However, the majority of nursing students don’t feel confident with a patient safety. Many authors shown that patient safety education was delivery by lecture, laboratory or simulation sessions.

Conclusions

This review underlines the need to revise the nursing curriculum on patient safety and the need to think what educational methodology is the better for the student to create a safe care.

Psychometric analysis of the Nurses' Professional Values Scale-3 Arabic version among student nurses

AIMS

We sought to establish the psychometric properties of the Nurses' Professional Values Scale-3 Arabic version among student nurses.

BACKGROUND

Nurses' professional values are central in the nursing profession; it encompasses principles such as respecting people rights and dignity, compassion, and caring without prejudice.

INTRODUCTION

The professional values of student nurses, most specifically in Saudi Arabia and other Arab countries, can hardly be studied due of the lack of a valid and reliable measure that is linguistically and culturally acceptable.

METHODS

In this cross-sectional study, we came up with the Arabic version of the tool and tested its psychometric properties among 350 student nurses from two universities in Saudi Arabia.

RESULTS

The principal component analysis revealed three distinct factors with eigenvalues above 1.00 and with an explained variance of 70.5%. The computed Cronbach's alpha of the tool was 0.967, while 0.964, 0.960, and 0.886 were computed for activism, caring, and professionalism, respectively. The test-retest scores (n = 85) revealed an Intraclass Correlation Coefficient of 0.827 for the entire scale, 0.826 for the subscale activism, 0.792 for caring, and 0.870 for professionalism.

CONCLUSIONS

The Nurses' Professional Values Scale-3 Arabic version had sound psychometric properties when used among Saudi student nurses.

IMPLICATION FOR NURSING

The tool can provide an accurate assessment of the professional values of Saudi nursing students and other Arabic-speaking student nurses.

IMPLICATION FOR NURSING POLICY

The tool can be utilized by nursing and nursing education policymakers in Saudi Arabia and in other Arab countries in guiding the creation of practice and education policies that gears towards improving nurses' professional values in this part of the world.

Can anxiety in undergraduate students in a high-fidelity clinical simulation be predicted? A randomized, sham-controlled, blinded trial

INTRODUCTION

High-fidelity clinical simulation has implied a revolution in health science training. Despite its benefits, some drawbacks could hinder the learning process, especially the anxiety produced during such scenarios.

OBJECTIVES

The aim of the present work is to develop a predictive model capable of determining which students will present high levels of anxiety.

DESIGN

We performed a randomized, sham-controlled, blinded trial in which students were randomly assigned to four scenarios and played one of two possible roles.

METHODS

Before and after the simulation we assessed the anxiety level along with physiological and analytical parameters. The main analyzed outcome was an increase of ≥25% in anxiety compared with baseline.

RESULTS

The type of scenario or the role played had no effect on anxiety. The predictive model presented an Area Under the Receiver Operating Characteristics of 0.798 (95% CI: 0.69-0.90; p < 0.001), with age and systolic blood pressure being protective factors against anxiety.

CONCLUSIONS

Our results showed that the anxiety level developed during simulation could be predicted. The application of this predictive model when associated to appropriate techniques to deal with increased anxiety levels could improve the learning process of medical students during simulations.

Assessment and analysis of patient safety competency of Chinese nurses with associate degrees: A cross-sectional study

Aim

To analyse the patient safety competency (PSC) of Chinese nurses with associate degrees (ADNs) and explore factors.

Design

A cross-sectional study.

Methods

A convenience sample of 451 ADNs working in 18 hospitals located in Chongqing city of China was investigated using the Patient Safety Competency Nurse Evaluation Scale (PSCNES). Descriptive and inferential statistics were used to analyse the data.

Results

ADNs had a moderate level of PSC. In terms of the six dimensions of PSC, ADNs performed well in clinical practice and safety risk management, while they performed poorly in patient-centred care and patient safety culture. Statistically significant differences were reported in two items. Firstly, ADNs who have participated in patient safety training had a higher level in all dimensions of PSC than those who have not participated in related training. Secondly, ADNs without professional titles had a higher level of patient safety culture than those with professional titles.

Nursing Students' Perceptions, Knowledge, and Preventive Behaviors Toward COVID-19: A Multi-University Study

Background: Knowledge, perception, and preventive behavior should be considered in the planning of effective educational interventions for the coronavirus disease of 2019 (COVID-19) pandemic and in increasing awareness about the health risks brought about by this disease. This research aimed to assess knowledge, perceptions, and preventive behavior toward the COVID-19 infection among student nurses.

Methods: The study has quantitative, descriptive, and cross-sectional design. A convenience sample of 1,226 student nurses from seven universities in Saudi Arabia was surveyed from March 22 to April 4, 2020. A four-part online survey on demographic characteristics, perceptions, knowledge, and preventive behavior of Saudi student nurses was carried out.

Results: Nearly all students were aware of the outbreak (99.2%), and most of them received information on COVID-19 primarily from social media (71.0%). Over three-fourths of the students were confident that the government (89.1%) and Ministry of Health (MOH) (86.5%) were doing a good job responding to the COVID-19 outbreak in the country. The overall average score in the knowledge questionnaire was 9.85 (SD = 1.62, range = 0–12), which is equivalent to 82.1%. The majority of the students always performed most of the preventive behavior identified in the survey, except “washing hands with soap and water for at least 20 s after blowing my nose, coughing, or sneezing” (39.2%) and “daily cleaning and disinfecting frequently touched surfaces” (41.6%). Being female, being in the fourth year, and gaining good perceived knowledge were associated with high actual COVID-19 knowledge. University, gender, age, academic level, and perceived COVID-19 knowledge were the associated factors.

Conclusions: The findings of this study have provided baseline information on the current state of Saudi nursing students' perceptions, knowledge, and preventive behavior toward COVID-19 as the crisis is happening. The findings revealed some areas that should be focused on by nursing education, as well as health agencies, to ensure that the students have adequate knowledge and correct preventive behavior.

Nursing Students' Knowledge, Competence and Attitudes towards Vital Signs Monitoring during Clinical Practice

AIM AND OBJECTIVE

This study assessed the perceived knowledge and competence, and the attitude of Saudi nursing students towards vital signs monitoring for detecting patient deterioration during clinical rotation. It also examined the predictors of students' attitudes.

BACKGROUND

One of the most important uses of vital signs monitoring is the early detection of deterioration. Vital signs monitoring is one of the most frequently assigned tasks to students during clinical rotation. However, the attitudes of nursing students towards vital signs monitoring for detecting clinical deterioration remain unexplored.

DESIGN

Quantitative, cross-sectional design.

METHOD

A convenience sample of 529 baccalaureate nursing students in two universities in Saudi Arabia was surveyed using the V-scale from October 2019-December 2019. A multivariate multiple regression was implemented to examine the multivariate effect of the predictor variables on the five subscales of the V-scale. This study adhered to the STROBE checklist.

RESULTS

The overall attitudes of the students towards VS monitoring can be interpreted as poor to modest. The highest mean was reported in the subscale 'communication'. The subscales 'workload', 'key indicators' and 'technology' received low mean scores. The university, age, gender, academic year level and perceived knowledge had significant multivariate effects on the five subscales of the V-scale.

CONCLUSIONS

The Saudi nursing students had poor attitudes towards vital signs monitoring, specifically towards the use of technology in vital signs monitoring, the workload associated with vital signs monitoring and vital signs as key indicators of patient deterioration.

RELEVANCE TO CLINICAL PRACTICE

The findings reveal the need to improve the curricular content and training of nursing students regarding vital signs and the physiological indicators of clinical deterioration. This study also identified areas that require improvement to ensure positive attitudes among students.

The Self-Compassion Scale Arabic version for baccalaureate nursing students: A validation study

BACKGROUND

The Self-Compassion Scale is an extensively used tool to measure self-compassion among different groups of population, including nurses. The tool has been translated and tested for its psychometric properties in previous studies. Assessing self-compassion among Saudi nursing students is critical as self-compassion is suggested to create a positive effect on one's wellbeing, coping, emotions, and other personal outcomes.

OBJECTIVES

This study determined the validity and reliability of the Self-Compassion Scale Arabic version (SCS-A) for nursing students. It also identified the demographic factors associated with the students' self-compassion.

DESIGN

A quantitative, cross-sectional design.

SETTINGS

The investigation was carried-out in two government universities in Saudi Arabia.

PARTICIPANTS

A sample of 322 Saudi nursing students in the 2nd to 4th year, as well as nurse interns was surveyed (mean age = 21.27, range = 18-27).

METHODS

The Self-Compassion Scale was culturally adapted to come up with the SCS-A. Content validity was established. Exploratory Factor Analysis (EFA) was used to establish the construct validity; whereas for reliability, internal consistency and test-retest reliability were established. Pearson's product correlation, t-test, and One-way Analysis of Variance were used to examine the demographic factors associated with self-compassion, accordingly.

RESULTS

A panel of experts rated content validity as excellent. The EFA revealed six dimensions namely "self-judgment," "self-kindness," "common humanity," "mindfulness," "isolation," and "over-identification", with total variance of 64.1%. Cronbach's alpha values for the six factors were from 0.76 to 0.85, with an overall α of the whole scale at 0.86. Computation revealed ICC values ranging from 0.84 to 0.92, whereas the ICC for the entire SCS-A was 0.81.

CONCLUSION

SCS-A shown satisfactory validity as well as good reliability. SCS-A can be used to collect baseline data on self-compassion, which could be used in developing policies in the universities and training hospitals to ensure that nurse interns and nursing students have compassion toward self. The study also opens opportunities for multi-country and cross-cultural studies on self-compassion among nursing students.

Examining the Influence of Workplace Incivility on Nurses' Patient Safety Competence

PURPOSE

This study assessed clinical nurses' workplace incivility experiences and determined the effects of workplace incivility experiences on nurses' patient safety competence.

DESIGN

This quantitative study surveyed 261 clinical nurses in two acute healthcare facilities in Saudi Arabia from June to August 2019.

METHODS

A self-administered survey, including the Nurse Incivility Scale and the Health Professional Education in Patient Safety Survey, was employed to assess the variables workplace incivility and patient safety competence. The association between incivility and patient safety competence was analysed using multivariate multiple regression.

RESULTS

The highest mean score was recorded for patient or visitor incivility, whereas the lowest score was recorded for supervisor incivility. Regarding patient safety competence, the dimension "communicating effectively" received the highest mean score, whereas "working in teams with other health professionals" was rated lowest. General and nurse incivilities had multivariate effects on the six dimensions of patient safety competence.

CONCLUSIONS

Nurses' experiences of uncivil acts from nurses and from general incivility negatively impact nurses' patient safety competence.

CLINICAL RELEVANCE

This investigation could guide the establishment of policies centered on boosting the patient safety competence of nurses by addressing uncivil acts in healthcare settings.

Self-reported confidence in patient safety competencies among Chinese nursing students: a multi-site cross-sectional survey

BACKGROUND

Nursing interns are an important backup force for nursing professionals, so efforts to strengthen their patient safety (PS) competencies are a major priority. To do so requires assessing the strengths and weaknesses of Chinese nursing students' PS competence and identifying the influencing factors.

METHODS

This was a multi-site, cross-sectional, web-based study that was carried out between September 2018 and January 2019. A national online survey was completed by 732 Chinese undergraduate nursing students. Our primary outcome factor was the Health Professional Education in Patient Safety Survey score. We also collected socio-demographic and clinical practice-related characteristics as independent variables. Multiple stepwise linear regression was performed to identify predictors of PS competence.

RESULTS

Chinese undergraduate nursing students were fairly confident in their clinical safety skills but less confident in what they learned about sociocultural or context-dependent aspects of PS and speaking up about PS, including effective communication and understanding human and environmental factors. Less than half of the students felt that they could approach someone engaging in unsafe practice and were reluctant to voice concern about adverse events. We observed significant differences in PS competence between students from different regions, across different PS learning styles (self-study and classroom theoretical study), with different self-assessed PS competence levels, and with experiences of adverse events (p < 0.05). These factors accounted for almost 15% of the total variance in PS competence scores (adjusted R² = 0.15, p = 0.00).

CONCLUSIONS

The results of this study provide a better understanding of PS competence among final-year nursing students in China. Our findings may help nursing educators or healthcare organizations to cultivate and improve PS competence by establishing documented policies or by improving the efficacy of intervention.

Assessment of nursing students perceptions of their training hospital's infection prevention climate: A multi-university study in Saudi Arabia

BACKGROUND

The risk of acquiring and spreading infection must be minimized in nursing students because they are exposed to healthcare-associated infections during clinical training. To achieve this goal, students should be knowledgeable and competent in infection control practice before proceeding to their training hospitals.

OBJECTIVES

This study assessed the nursing students' perception of the infection prevention climate in training hospitals in Saudi Arabia. It also examined the predictors of the students' perceptions.

DESIGN

A quantitative, cross-sectional design was used.

METHODS

This investigation was part of a large study conducted in six Saudi universities. A total of 829 Saudi nursing students were included in this study. Data were collected using the Leading Culture of Quality in Infection Prevention scale and analyzed using descriptive and inferential statistics. Ethical approval was obtained from the King Saud University, and permission was given by the administration of each participating university.

RESULTS

The overall perception of nursing students indicated a modest infection prevention climate. Prioritization of quality and improvement orientation was rated as the highest dimensions, whereas psychological safety and supportive environment were the lowest. The nursing students in University F had the poorest perceptions among the six universities. The predictors of nursing student perception of their training hospitals' infection prevention climates were the university where they studied, their age, and participation in infection prevention seminars.

CONCLUSIONS

This article describes nursing students' perception of the infection prevention climate of their training hospitals in Saudi Arabia. Results may provide a unique theoretical underpinning on the perception and factors that effect an infection prevention climate. Thereby, previous knowledge and literature may be expanded. Results can be used as a guide in establishing clinical policies in efforts toward improving the infection prevention climate.

Clinical practitioners' perception of the dimensions of patient safety culture in a government hospital: A one-sample correlational survey

AIMS AND OBJECTIVES

To assess the perceptions of clinical practitioners regarding the different dimensions of patient safety culture in their hospital and examine the work-related predictors of patient safety culture perceptions.

BACKGROUND

Patient safety is seen as a progressively critical focus in healthcare areas worldwide. Saudi Arabia aims to improve healthcare quality by providing access to healthcare for its increasing population. Hence, constantly assessing the patient safety culture of healthcare facilities in the country is imperative.

DESIGN

One-sample correlational survey design.

METHODS

The Hospital Survey of Patients' Safety Culture was used to survey the total population sample of 181 healthcare practitioners in a Saudi hospital from December 2018-January 2019. Strengths and weaknesses on PS culture were identified as perceived by the clinical practitioners. Regression analysis was performed to identify the work-related predictors of patient safety culture perceptions. The study followed the STROBE guideline.

RESULTS

Nine of the 12 dimensions measured were identified as patient safety culture weaknesses, including 'management support for patient safety' (49.2%), 'teamwork across unit' (44.2%), 'frequency of events reporting' (43.1%), 'communication openness' (41.3%), 'overall perception of patient safety' (38.7%), 'supervisor/manager expectations and actions promoting patient safety' (32.9%), 'staffing' (23.7%), 'hospital handoffs and transitions' (19.6%) and 'non-punitive response to errors' (15.8%). None of the dimensions were identified as strengths by the respondents. Working hours per week and staff position were identified as significant predictors.

CONCLUSIONS

The study underscores the urgent need to improve the patient safety culture of the hospital.

RELEVANCE TO CLINICAL PRACTICE

Hospital administrators should highlight initiatives on positive patient safety impact plan for clinical practitioners and patients, such as monitoring, reporting and strictly adhering to hospital activities that reduce the risks associated with exposure to medical care.

Culture of quality in infection prevention of a hospital as perceived by health care workers

AIM

This research aimed to assess the culture of quality in infection prevention (CQIP) of a university hospital as perceived by health care workers (HCWs).

BACKGROUND

Health care-associated infections are serious concerns in hospitals in Saudi Arabia. Hence, assessing their CQIP is necessary.

METHOD

An investigation employing a descriptive and cross-sectional design was carried out among 623 HCWs (doctors, nurses and nursing assistants) in a university hospital in Saudi Arabia by using the Leading a Culture of Quality in Infection Prevention (LCQ-IP) scale.

RESULTS

The overall mean in the LCQ-IP was 3.86 (SD = 0.62). The subscale "prioritization of quality" (M = 4.11, SD = 0.79) was rated the highest dimension, whereas "supportive work environment" was perceived as the poorest dimension (M = 3.56, SD = 0.54). Gender, nationality, highest education and job title affected the four factors of the HCWs' perceptions of the hospital's CQIP.

CONCLUSION

HCWs modestly perceived their hospital's CQIP. The study highlighted the need for improving CQIP based on the four dimensions.

IMPLICATIONS FOR NURSING AND HOSPITAL MANAGEMENT

This study provided valuable implications for hospital and nursing management to ensure high-quality culture of infection prevention.