The work environment and empowerment as predictors of patient safety culture in Turkey

Nurses' burnout and patient safety culture: The moderating effect of structural empowerment

AIMS

To identify correlations among job burnout, structural empowerment, and patient safety culture (PSC), and to explore the potential moderating effect of structural empowerment on the associations between burnout and PSC.

DESIGN

The study used a cross-sectional survey design.

METHODS

Convenient sampling was employed. We conducted an anonymous online survey in January 2024 among nurses employed at hospitals in three regions of China. Job burnout, structural empowerment, and perceptions of PSC were assessed. A total of 1026 useable surveys were included in the analyses. Descriptive statistics were performed using SPSS software. A latent structural equation modeling approach using Mplus software was used to analyze the moderating effect.

RESULTS

The proposed hypothetical model was supported. Job burnout had a strong direct negative effect on structural empowerment and PSC. Structural empowerment had a significant moderating effect on the relationship between job burnout and PSC.

CONCLUSION

The empirically validated moderation model and study results suggest that managers of healthcare organisations can improve patient safety and care quality by fostering empowerment and providing sufficient support to clinical nurses.

IMPLICATION

The findings of this study suggest that providing more support, resources, and information is likely to be effective in weakening the detrimental impact of job burnout on PSC. This study provides insights into the possible approaches that may improve patient safety. To control the impact of nurses' burnout on care quality, nurse managers should increase empowerment as well as staff nurse engagement.

REPORTING METHOD

We have adhered to relevant EQUATOR guidelines and conducted an observational study, following the STROBE checklist.

PUBLIC CONTRIBUTION

During the data collection phase of this study, clinical caregivers participated in completing the online survey.

An authentic leadership training programme to increase nurse empowerment and patient safety: A quasi-experimental study

BACKGROUND

Authentic leadership and empowered nurses are necessary if a healthy work environment is to be created and patient safety maintained; however, few studies have examined the impact of authentic leadership, on nurse empowerment and the patient safety climate.

PURPOSE

The aim of the study was to investigate the impact of an educational intervention delivered through a multi-faceted training programme on nurses' perceptions of authentic leadership, nurse empowerment (both structural and psychological) and the patient safety climate.

DESIGN

A quasi-experimental study using a one-group pretest-posttest design consistent with TREND guidelines.

METHODS

The study was conducted in a university hospital between December 2018 and January 2020. Participants were followed for 6 months. The programme involved 36 head nurses (leaders) and 153 nurses (followers). The effectiveness of the programme was evaluated using repeated measures of analysis of variance, dependent sample t-tests and hierarchical regression analysis.

RESULTS

Following the intervention, safety climate and authentic leadership scores increased among both leaders and followers. Structural and psychological empowerment scores also increased among followers. We found that authentic leadership and structural empowerment were predictors of safety climate.

CONCLUSION

The implementation of the education programme resulted in positive changes in participants' perceptions of authentic leadership and empowerment, which can enhance patient safety.

IMPLICATIONS

Healthcare organizations can implement similar multi-faceted training programmes focused on authentic leadership, and nurse empowerment to increase patient safety. Achieving effective results in such programmes can be facilitated by motivating participants with the support of the top management.

PATIENT OR PUBLIC CONTRIBUTION

The study included nurses in the intervention and the data collection processes.

IMPACT

Patient safety is a global concern, and improving patient safety culture/climate is a key strategy in preventing harm. Authentic leadership and nurse empowerment are essential in creating healthy work environments and delivering safe, high-quality care. Training programmes addressing these issues can help bring about improvements in healthcare organizations.

Association between the Nursing Practice Environment and Safety Perception with Patient Safety Culture during COVID-19

AIMS

In this study, we aimed to identify the relationship between nursing practice environments (NPEs) and safety perceptions with patient safety culture (PSC) during COVID-19.

DESIGN

We conducted a quantitative, non-experimental, correlational, and cross-sectional study. We interviewed 211 nurses from Peru using two scales: PES-NWI and HSOPSC. We used the Shapiro-Wilk test and Spearman's coefficient and estimated two regression models.

RESULTS

NPE was reported as favorable by 45.5% of the participants, and PSC was reported as neutral by 61.1%. Safety perception, the workplace, and NPE predict PSC. All NPE factors were correlated with PSC. However, safety perception, support of nurses subscale, the nurse manager's ability, and leadership were predictors of PSC.

CONCLUSION

To promote a safe work culture, health institutions should foster leadership that prioritizes safety, strengthens managers' abilities, encourages interprofessional collaboration, and considers nurses' feedback for constant improvement.

Retaining nurses via organizational support and pay during COVID-19 pandemic: The moderating effect between intrinsic and extrinsic incentives

AIM

There has been growing concern about the nurses' turnover intention as well as life satisfaction during COVID-19 pandemic in Iran. The past research has provided evidence on the effect of organizational support on nurses' job satisfaction and turnover intention. However, little is known about the underlying mechanism behind these associations.

DESIGN

A cross-sectional survey was undertaken.

METHODS

An online survey was conducted in Iran from May to June 2020 through Google Docs Forms. In total, 305 nurses were participated and completed the online survey. Data were analysed using structural equation modelling through (AMOS). This study was checked with the STROBE checklist.

RESULT

The results showed that nurses' perception of organizational support was positively related to their job satisfaction which in turn decreases the turnover intention. Likewise, the job satisfaction partially mediated the relationship between organizational support and nurses' life satisfaction.

Safety Competency: Exploring the Impact of Environmental and Personal Factors on the Nurse's Ability to Deliver Safe Care

BACKGROUND

Patient safety is a priority in health care systems. Nurses' safety competence along with environmental and personal factors plays a role in patient safety.

PURPOSE

The purpose of this study was to explore the relationships among safety competency, structural empowerment, systems thinking, level of education, and certification.

METHODS

A cross-sectional exploratory design was used to collect data from nurses (n = 163) practicing in a large Midwestern hospital system.

RESULTS

There were significant positive correlations between safety competency and ( a ) structural empowerment, ( b ) systems thinking, and ( c ) certification. Systems thinking explained 12.9% of the variance in the knowledge component of safety competency and 6.8% of the variance in the skill component of safety competency. Certification explained 2.4% of the variance in the skill component of safety competency.

CONCLUSIONS

Understanding factors that affect safety competency supports the development of effective interventions that may improve safety.

Exploring the relationship between nursing work environment and medical error reporting among Jordanian nurses: a cross-sectional study

Objectives

This study was conducted to explore the relationship between the nursing work environment and medical error reporting practices among Jordanian nurses.

Methods

This study was a cross-sectional survey of 334 participants who were conveniently selected from three types of hospitals (private, teaching and public) in Amman city, Jordan. The data were collected using a standardized questionnaire which was adopted from previous studies and consisted of three main sections including demographics, nursing work environment (The Practice Environment Scale-Nursing Work Index) and medical error reporting practices (incident reporting practice scale). SPSS version 26 was used for data analysis.

Key findings

The study findings detected a strong positive relationship between the nursing work environment and medical error reporting practices. ‘Nurse’s participation in hospital affairs’ showed the highest impact on medical error reporting practices among nurses. Based on the regression model, the nursing work environment explained 65.1% of variations in nurses’ medical error reporting practices. It was found that medical error reporting practices were statistically different across marital status and hospital type.

Conclusions

Based on data analysis findings, the nursing work environment was statistically strongly correlated to medical error reporting practices. To improve medical error reporting practices among nurses, decision-makers and hospital administrators should redesign their nursing work environment to create a more positive and favourable work environment.

The correlation between work environment and patient safety in a general hospital in Indonesia

Patient safety is an important for health care services in the hospital setting. The most difficult obstacle in ensuring patient safety is creating a safety. The objective of this study was to determine the correlation between the hospital work environment, nurses' characteristics, and patient safety. The method was a descriptive correlative study with a cross-sectional approach. The data were obtained from 123 ward nurses through using valid and reliable questionnaires. The results showed a significant relationship between hospital work environment and nurses' characteristics (education level, length of service, and training concerning patient safety) (p<.05). In contrast, nurses' age and marital status were not related to patient safety in the hospital (p>.05). Findings indicate that the hospital work environment and nurses' characteristics are related to patient safety. The study recommended to build a model of patient's safety culture that includes all aspects that influence patients' safety culture.

Comparative Studies on Patient Safety Culture to Strengthen Health Systems Among Southeast Asian Countries

Patient safety is an important issue in health systems worldwide. A systematic review of previous studies on patient safety culture in Southeast Asian countries is necessary for South Korea's partnership with these countries, especially given South Korea's assistance in strengthening the health systems of these developing countries. Studies on patient safety culture in Southeast Asian countries, published in English and Thai languages, were retrieved from computerized databases using keywords through a manual search. Data extraction, quality assessment, and analyses were performed using several tools. The review included 21 studies conducted in Indonesia (n = 8), Thailand (n = 5), Malaysia (n = 3), Vietnam (n = 2), Singapore (n = 1), and the Philippines (n = 1). They were analyzed and categorized into 12 dimensions of safety culture, and differences in response rate or scores were identified compared to the mean of the dimensions. The heterogeneous of safety culture's situation among Southeast Asian countries, both in practice and in research, can be explained since patient safety policy and its application are not prioritized as much as they are in developed countries in the priority compared to the developed countries. However, Vietnam, Cambodia, Myanmar, and Laos are the priority countries for South Korea's official healthcare development assistance in the Southeast Asia region. Vietnam, for instance, is an economically transitioning country; therefore, consolidated patient safety improvement by inducing patient safety culture in the provincial and central health system as well as strengthening project formulation to contribute to health policy formation are needed for sustainable development of the partner countries' health systems. It is recommended that more evidence-based proactive project planning and implementation be conducted to integrate patient safety culture into the health systems of developing countries, toward health policy on patient safety and quality service for the attainment of sustainable development goals in South Korea's development cooperation.

Factors associated with patient safety in neonatal intensive care units: A multicenter study using ordinal logistic regression

AIM

This study aimed to identify nurses' staffing levels, neonatal infection experience, infection control knowledge, and infection control performance, as well as levels of patient safety, and to verify the factors influencing patient safety related to infection control in multi-centered neonatal intensive care units (NICUs).

METHODS

A self-administered questionnaire was completed by 251 NICU nurses working in seven hospitals throughout South Korea. The data were collected in February 2019 and analyzed using generalized ordinal logistic regression.

RESULTS

The distribution of patient safety was as follows: level 1 (very poor) 0%, level 2 (poor) 6.8%, level 3 (fair) 29.7%, level 4 (good) 35.0%, level 5 (very good) 21.5%, and level 6 (excellent) 7.2%. The factors influencing patient safety differed across the different levels of patient safety. Comparing patient safety level 2 with the other levels (3, 4, 5, 6), the nurse staffing level (b = 1.12) was a significant influencing factor. Comparing patient safety levels 2, 3, 4 and 5 with level 6, the influencing factors were neonatal infection experience (b = -1.18) and infection control performance (b = 5.77).

CONCLUSION

The nurse staffing level was a factor when patient safety levels were low, and nurses' neonatal infection experience and infection control performance were factors when patient safety levels were high. Institutional policy efforts are required to identify patient safety levels in NICUs to develop comprehensive strategies to ensure appropriate nurse staffing and enhance neonatal infection control performance to prevent infections.

Predictors of patient-centered care provision among nurses in acute care setting

AIM

The study was conducted to assess the predictors of patient-centred care provision among nurses working in an acute care setting. We hypothesized that higher structural empowerment and compassion satisfaction and lower burnout would predict the provision of patient-centred care.

BACKGROUND

Patient-centred care is a crucial aspect of quality health care and the heart of nursing care. Although previous studies have highlighted some determinants of patient-centred care provision among nurses, there remains a gap in understanding the factors that predict the provision of patient-centred care.

METHODS

A cross-sectional predictive design was used. Through random sampling, 255 nurses were recruited from five hospitals providing acute care services in Saudi Arabia.

RESULTS

Multiple linear regression revealed that compassion satisfaction (β = 0.260 [95% CI: 0.201-0.645]), burnout (β = -0.266 [95% CI: -0.998 to -0.403]) and structural empowerment (β = 0.273 [95% CI: 0.462-1.427]) jointly explained significant variance (27.5%) in the provision of patient-centred care by nurses.

CONCLUSIONS

The study findings reveal that lower burnout, higher compassion satisfaction and structural empowerment increase nurses' provision of patient-centred care.

IMPLICATIONS FOR NURSING MANAGEMENT

Leadership and managerial strategies that not only address compassion satisfaction and burnout but also empower nurses are crucial for the provision of patient-centred care by nurses.

Multilevel Analysis of Individual, Organizational, and Regional Factors Associated With Patient Safety Culture: A Cross-Sectional Study of Maternal and Child Health Institutions in China

Supplemental digital content is available in the text.

The aim of this study was to assess patient safety culture (PSC) in maternal and child health (MCH) institutions in China and its individual, organizational, and regional variations.

Exploring, defining, and illustrating a concept: Structural and psychological empowerment in the workplace

AIM

The aim of this concept analysis is to clarify the meaning and relationship of psychological and structural empowerment.

BACKGROUND

Empowerment is linked to positive organizational and individual constructs and outcomes. Improving the work environment may assist in sustaining a fragile and essential workforce.

DESIGN

Walker and Avant's method was used to guide an analysis of this concept.

DATA SOURCE

Resources published from 1970 to 2018 were identified via electronic databases, empirical works, and modern operational usage of the terms.

REVIEW METHODS

A literature review and search for concept maps were completed and analyzed to identify uses and definitions of the concept: attributes, antecedents, consequences, and empirical referents. It also includes identifying model, borderline, and contrary cases to differentiate empowerment from other related concepts.

RESULTS

A comprehensive, inclusive review of empowerment must include both constructs, structural and psychological. A conceptual map of these akin constructs illustrates their syndication.

CONCLUSIONS

The concept of examining empowerment from both constructs, structural and psychological, is necessary to develop evidence-based practice strategies and improve the work environment and workforce.

Sustainable and Healthy Organizations Promote Employee Well-Being: The Moderating Role of Selection, Optimization, and Compensation Strategies

The psychology of sustainability claims for a new kind of organization that promotes employee well-being as well as the search firm’s performance. In sustainable and healthy organizations, tasks are characterized by their significance, variety, autonomy, and feedback from the job. This way of organizing employees’ activities motivates them and can affect their well-being. However, due to a series of age-related physical and cognitive changes, older workers must constantly adapt to task demands to continue working and maintain their productivity. This research explores the moderating role of selection, optimization, and compensation strategies in the relationship between task characteristics (significance, variety, autonomy, and feedback from the job) on the one hand, and job satisfaction and organizational citizenship behaviors on the other. This study was carried out using a lagged design over a three-month interval. Participants were 183 Spanish workers aged between 45–55 years who completed two questionnaires (Time 1 and Time 2). The results support the moderating role of the optimization and compensation in the relationship between task characteristics and employee well-being. Elective selection and loss-based selection strategies do not moderate the relationship. These findings underscore that people who are actively involved in optimization and compensation strategies can age successfully at work. The implications of this study to improve the orientation practices of older workers are discussed.

Defining the patient safety attitudes and influencing factors of health professionals working at maternity hospitals

AIM

To determine patient safety attitudes of midwives, nurses and physicians and to examine the difference or correlation in patient safety attitudes of midwives, nurses and physicians working in maternity hospitals.

BACKGROUND

It has been suggested that it is necessary to define the factors affecting patient safety attitudes of health professionals working in maternity hospitals.

METHODS

A descriptive and correlational design was employed.The sample comprised 58 midwives, 134 nurses and 63 physicians (255) in two maternity hospitals in Istanbul, Turkey. The data were collected using an 'information form' and a 'Patient Safety Attitude Questionnaire'.

RESULTS

The safety attitudes of participants were generally found to be negative. However, midwives had more positive patient safety attitudes and the age, unit, adequacy of patient safety training and the importance of patient safety were the most effective variables.

CONCLUSIONS

As health professionals working in maternity hospitals generally have negative patient safety attitudes and because patient safety training provided better attitudes among the participants, these training programmes should be developed and implemented considering the differences among age groups and units.

IMPLICATIONS FOR PRACTICE

Health professionals have different views on the patient safety culture; therefore, training needs to involve everyone to create a shared vision for patient safety.