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Wang X, Liu M, Xu T, Wang K, Huang L, Zhang X. New nurses' practice environment, job stress, and patient safety attitudes: a cross-sectional study based on the job demands-resources model. BMC Nurs 2024; 23:473. [PMID: 38997677 PMCID: PMC11241995 DOI: 10.1186/s12912-024-02135-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 06/28/2024] [Indexed: 07/14/2024] Open
Abstract
BACKGROUND Patient safety is paramount for all healthcare agencies. Health professionals' lack of patient safety competencies threaten patients' lives, and increase patients, families, hospitals, and social burdens. The new nurse-related patient safety issues have particularly attracted much attention. The aim of this study was to examine the impacts of practice environment and job stress on new nurses' patient safety attitudes by employing the job demands-resources model. METHODS The study used a cross-sectional structural equation modeling (SEM). A convenience sample of 370 new nurses was recruited from seven tertiary hospitals in Anhui province, China, from April 2022 to August 2022. Data were collected using self-report questionnaires including the Chinese version of the Nurse Job Stressors Scale, the Practice Environment Scale, and the Safety Attitudes Questionnaire. RESULTS New nurses' patient safety attitudes scores were moderate (126.99 ± 14.39). Practice environment had a significant direct effect on job stress (β = -0.337, t = 6.120), patient safety attitudes (β = 0.604, t = 13.766), practice environment had an indirect effect on patient safety attitudes through job stress (β = 0.066, t = 3.690), and the indirect effect accounted for 9.9% of the total effect. This model was able to explain 48.3% of patient safety attitudes with moderate prediction accuracy. CONCLUSIONS This study emphasizes the importance of improving new nurses' attitudes toward patient safety. Hospital administrators should develop policies and strategies to address job characteristics, and establish a favorable work environment to reduce new nurses' job stress as well as to improve patient safety.
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Affiliation(s)
- Xin Wang
- Faculty of Health Sciences and Sports, Macao Polytechnic University, Macao, China
| | - Ming Liu
- Peking University Health Science Center - Macao Polytechnic University Nursing Academy, Macao Polytechnic University, Macao, China
| | - Tao Xu
- School of Nursing, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Kangyue Wang
- Faculty of Health Sciences and Sports, Macao Polytechnic University, Macao, China
| | - Liebin Huang
- Faculty of Health Sciences and Sports, Macao Polytechnic University, Macao, China
| | - Xiancui Zhang
- Health Management Center, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China.
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He H, Chen X, Tian L, Long Y, Li L, Yang N, Tang S. Perceived patient safety culture and its associated factors among clinical managers of tertiary hospitals: a cross-sectional survey. BMC Nurs 2023; 22:329. [PMID: 37749580 PMCID: PMC10518958 DOI: 10.1186/s12912-023-01494-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 09/11/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND Patient safety is a global challenge influenced by perceived patient safety culture. However, limited knowledge exists regarding the patient safety culture perceived by hospital clinical managers and its associated factors. This study aims to investigate the perceptions of patient safety culture and associated factors among clinical managers of tertiary hospitals in China. METHODS A cross-sectional survey was conducted from June 19 to July 16, 2021, involving 539 clinical managers from four tertiary hospitals in Changsha City of Hunan Province. The Hospital Survey on Patient Safety Culture (HSOPSC) was utilized to assess perceived patient safety culture. Bivariate, multivariable linear regression, and logistic regression analyses were performed. RESULTS The mean score for the total HSOPSC was 72.5 ± 7.6, with dimensional scores ranging from 62.1 (14.9) to 86.6 (11.7). Three dimensions exhibited positive response rates (PRRs) < 50%, indicating areas that need to be improved: "nonpunitive response to errors" (40.5%), "staffing" (41.9%), and "frequency of events reported" (47.4%). Specialized hospitals (β = 1.744, P = 0.037), female gender (β = 2.496, P = 0.003), higher professional title (β = 1.413, P = 0.049), a higher education level (β = 1.316, P = 0.001), and shorter time delays per shift (β=-1.13, P < 0.001) were correlated with higher perceived patient safety culture. Education level, work department, "teamwork within a unit", "management support for patient safety", "communication openness", and "staffing" dimensions were associated with patient safety grades (all P < 0.05). Years worked in hospitals, occupation, education level, work department, hospital nature, professional title, "communication openness", and "handoffs & transitions" were associated with the number of adverse events reported (all P < 0.05). CONCLUSIONS Our study revealed a generally low level of patient safety culture perceived by clinical managers and identified priority areas requiring urgent improvement. The associated factors of patient safety culture provide important guidance for the development of targeted interventions in the future. Promoting patient safety by optimizing the patient safety culture perceived by clinical managers should be prioritized.
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Affiliation(s)
- Haiyan He
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Xi Chen
- School of Nursing, Hong Kong Polytechnic University, Hongkong, China
| | - Lingyun Tian
- Department of Nursing, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Yanfang Long
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China
| | - Li Li
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China.
| | - Ning Yang
- Emergency Department, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Siyuan Tang
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
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Manzo BF, Correa ADR, Chaves TV, Damaceno MAF, Antunes K, Macieira TGR, Diniz CG, Parker LA. Influence of Sociodemographic and Occupational Factors on Safety Culture in Neonatal Intensive Care in Brazil. J Nurs Care Qual 2023; 38:E1-E8. [PMID: 36112966 DOI: 10.1097/ncq.0000000000000649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Patient safety culture is influenced by factors such as professional category, experience, and age. Understanding these factors can inform initiatives to improve safety. PURPOSE To evaluate the relationship between sociodemographic and occupational characteristics on health professionals' perception of patient safety culture. METHODS A cross-sectional study involving 514 health care professionals from Brazilian neonatal intensive care units was conducted using the Hospital Survey on Patient Safety Culture. RESULTS Several sociodemographic and occupational characteristics were associated with higher perceptions of safety culture, including older age and having a higher level of education. CONCLUSION Sociodemographic and occupational factors may influence the safety culture in neonatal intensive care units and should be considered when developing and implementing strategies to improve safety.
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Affiliation(s)
- Bruna Figueiredo Manzo
- Departments of Maternal Child and Public Health (Dr Manzo and Ms Chaves) and Basic Nursing (Dr Correa), School of Nursing (Mss Damaceno, Antunes, and Diniz), Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; and Department of Biobehavioral Nursing Science (Drs Parker and Manzo), University of Florida College of Nursing (Dr Macieira), Gainesville
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Liao X, Zhang P, Xu X, Zheng D, Wang J, Li Y, Xie L. Analysis of Factors Influencing Safety Attitudes of Operating Room Nurses and Their Cognition and Attitudes toward Adverse Event Reporting. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:8315511. [PMID: 35178235 PMCID: PMC8844141 DOI: 10.1155/2022/8315511] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 01/19/2022] [Accepted: 01/21/2022] [Indexed: 11/17/2022]
Abstract
Operating room nurses play a critical role in patient safety. The evaluation of safety attitudes of operating room nurses reflects their awareness and belief of patient safety. Currently, however, the research on the safety attitudes of operating room nurses is hard to track in the existing literature in China. Therefore, this paper was conducted to explore the factors influencing the safety attitudes of operating room nurses and their cognition and attitudes toward adverse event reporting. A total of 711 operating room nurses from 16 tertiary hospitals in Sichuan Province from March 1, 2018, to 2019 were selected. The general information of operating room nurses, such as age, gender, and years of service in the operating room, was obtained through the basic information questionnaire. The Chinese version of the Safety Attitudes Questionnaire (C-SAQ) was used to evaluate the safety attitude of operating room nurses, and the cognition and attitude of the subjects to adverse event reports were assessed through the questionnaire of cognition and attitude toward adverse event reporting. The average score of safety attitudes of operating room nurses was 4.20 ± 0.49. The two dimensions with a lower positive reaction rate of the safety attitudes of operating room nurses were stress recognition and working conditions. The main factors affecting the safety attitude of operating room nurses were night shifts, as well as cognition and attitudes toward adverse event reporting. There was a positive correlation between the total score of C-SAQ and the total score of cognition and attitudes toward adverse event reporting (P < 0.01, r = 0.445). The safety attitude of operating room nurses is at the upper-middle level, but the stress recognition and working conditions need to be improved. Through the allocation of nursing human resources, the strengthening of hospital logistics support, and the establishment of nonpunitive nursing adverse event reporting system, the operating room safety can be significantly enhanced.
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Affiliation(s)
- Xin Liao
- Department of Operating Room, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu 610041, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu 610041, China
| | - Peijia Zhang
- Department of Operating Room, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu 610041, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu 610041, China
| | - Xiaofeng Xu
- Department of Operating Room, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu 610041, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu 610041, China
| | - Dan Zheng
- Department of Operating Room, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu 610041, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu 610041, China
| | - Jing Wang
- Department of Operating Room, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu 610041, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu 610041, China
| | - Yunfei Li
- Department of Operating Room, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu 610041, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu 610041, China
| | - Li Xie
- Department of Operating Room, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu 610041, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu 610041, China
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Wang H, Buljac-Samardzic M, Wang W, van Wijngaarden J, Yuan S, van de Klundert J. What Do We Know About Teamwork in Chinese Hospitals? A Systematic Review. Front Public Health 2021; 9:735754. [PMID: 34976910 PMCID: PMC8719585 DOI: 10.3389/fpubh.2021.735754] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 11/15/2021] [Indexed: 11/23/2022] Open
Abstract
Background and Objective: Improving quality of care is one of the primary goals in current Chinese hospital reforms. Teamwork can play an essential role. Characteristics of teamwork and interventions for improving teamwork in hospitals have been widely studied. However, most of these studies are from a Western context; evidence from China is scarce. Because of the contextual differences between China and Western countries, empirical evidence on teamwork from Western hospitals may have limited validity in China. This systematic review aims to advance the evidence base and understanding of teamwork in Chinese hospitals. Methods: Both English (i.e., Embase, Medline, and Web of Science) and Chinese databases (i.e., CNKI, CQVIP, and Wanfang) were searched for relevant articles until February 6, 2020. We included the studies that empirically researched teamwork in Chinese hospitals. Studies were excluded if they (1) were not conducted in hospitals in Mainland China, (2) did not research teamwork on team interventions, (3) were not empirical, (4) were not written in English or Chinese, (5) were not published in peer-reviewed journals, and (6) were not conducted in teams that provide direct patient care. Both deductive and inductive approaches were used to analyze data. The Mixed Methods Appraisal Tool (MMAT) was used to assess their methodological quality. Results: A total of 70 articles (i.e., 39 English articles and 31 Chinese articles) were included. The results are presented in two main categories: Teamwork components and Team interventions. The evidence regarding the relationships among inputs, processes, and outcomes is scarce and mostly inconclusive. The only conclusive evidence shows that females perceive better team processes than males. Similar types of training and tools were introduced as can be found in Western literature, all showing positive effects. In line with the Chinese health reforms, many of the intervention studies regard the introduction of multidisciplinary teams (MDTs). The evidence on the implementation of MDTs reveals that they have led to lower complication rates, shorter hospital stays, higher diagnosis accuracy, efficiency improvement, and a variety of better disease-specific clinical outcomes. Evidence on the effect on patient survival is inconclusive. Conclusion: The Chinese studies on teamwork components mainly focus on the input-process relationship. The evidence provided on this relationship is, however, mostly inconclusive. The intervention studies in Chinese hospitals predominantly focus on patient outcomes rather than organizational and employee outcomes. The introduction of training, tools, and MDTs generally shows promising results. The evidence from primary hospitals and rural areas, which are prioritized in the health reforms, is especially scarce. Advancing the evidence base on teamwork, especially in primary hospitals and rural areas, is needed and can inform policy and management to promote the health reform implementation. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020175069, identifier CRD42020175069.
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Affiliation(s)
- Hujie Wang
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Martina Buljac-Samardzic
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Wenxing Wang
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Jeroen van Wijngaarden
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Shasha Yuan
- Institute of Medical Information and Library, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Joris van de Klundert
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, Netherlands
- Prince Mohammad Bin Salman College of Business and Entrepreneurship, King Abdullah Economic City, Saudi Arabia
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Edgar D, Middleton R, Kalchbauer S, Wilson V, Hinder C. Safety attitudes build safety culture: Nurse/midwife leaders improving health care using quantitative data. J Nurs Manag 2021; 29:2433-2443. [PMID: 34350644 DOI: 10.1111/jonm.13444] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 08/02/2021] [Indexed: 11/28/2022]
Abstract
AIM We aim to determine safety attitudes of nurses and midwives across a Local Health District in Australia and compare results 1 year later following facilitated feedback of results. BACKGROUND Positive safety cultures are imperative for positive patient and staff outcomes. Staff member's attitude contribute to an organisations safety culture but can differ between health professional groups and across different subcultures. METHOD The Safety Attitudes Questionnaire (SAQ-Short version) was administered to all nurses and midwives within a Local Health District in NSW, Australia in 2019 and 2020. Results were facilitated back to nursing/midwifery leadership teams with an expectation of developing and enacting an action plan, based on results. RESULTS Of the six domains in the SAQ-Short version, five domains scores increased significantly (p < .001) over the time period. CONCLUSIONS Measures over time are important to establish differences in perceptions and feedback on impact of actions. Facilitated feedback of results shows meaning when nursing/midwifery leadership staff have data explained and an opportunity to discuss and plan. IMPLICATIONS FOR NURSING MANAGEMENT This study shows that facilitated feedback of quantitative survey results brings improved results when a survey is replicated. Nurse managers should enact a contextualized action plan with teams based on survey results to influence improvement in safety attitudes of staff.
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Affiliation(s)
- Denise Edgar
- Nursing and Midwifery Research Unit, Illawarra Shoalhaven Local Health District, Wollongong, Australia
| | - Rebekkah Middleton
- Nursing and Midwifery Research Unit, Illawarra Shoalhaven Local Health District, Wollongong, Australia.,School of Nursing, University of Wollongong, Wollongong, New South Wales, Australia.,IHMRI, University of Wollongong, Wollongong, New South Wales, Australia
| | - Sarah Kalchbauer
- Nursing and Midwifery Research Unit, Illawarra Shoalhaven Local Health District, Wollongong, Australia
| | - Val Wilson
- Nursing and Midwifery Research Unit, Illawarra Shoalhaven Local Health District, Wollongong, Australia.,School of Nursing, University of Wollongong, Wollongong, New South Wales, Australia
| | - Christopher Hinder
- Nursing and Midwifery Research Unit, Illawarra Shoalhaven Local Health District, Wollongong, Australia
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Altmiller G, Bleich MR, Jun D. QSEN Transcends Cultures: Teaching Quality and Safety Education in China. J Contin Educ Nurs 2020; 51:106-108. [PMID: 32119104 DOI: 10.3928/00220124-20200216-04] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
There has been increasing focus on improving the quality and safety of health care globally. Understanding that the health of one nation impacts others worldwide drives initiatives for collaboration to improve the health of all. In this, the Year of the Nurse and Midwife as designated by the World Health Organization, The Quality and Safety Education for Nurses (QSEN) Competencies provide structure that transcends culture for framing the nursing role to contribute to improving patient safety and the quality of care delivery internationally. This article describes initiatives to share resources and strategies to support quality and safety education and practice with nurses across countries. [J Contin Educ Nurs. 2020;51(3):106-108.].
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