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Reyes Ramos MJ, Costa Abós S. Patient Safety Culture: Nurses' Perspective in the Hospital Setting. Healthcare (Basel) 2024; 12:1010. [PMID: 38786420 PMCID: PMC11121312 DOI: 10.3390/healthcare12101010] [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: 03/26/2024] [Revised: 05/07/2024] [Accepted: 05/11/2024] [Indexed: 05/25/2024] Open
Abstract
(1) Background: Patient safety culture (PSC) encompasses the values, attitudes, norms, beliefs, practices, perceptions, competencies, policies, and behaviours of professionals that determine organisational commitment to quality and patient safety. Few studies use mixed methods to analyse patient safety culture, and none offer the richness of using a mixed methodology to develop their theoretical model. This study aims to identify the factors nurses believe contextualise and influence PSC in relation to existing theoretical frameworks. (2) Methods: This study employed a sequential explanatory mixed-methods design combined with the Pillar Integration Process for data integration. (3) Results: In the final data integration process, 26 factors affecting nurses' PSC were identified. Factors nurses related to PSC not being assessed with the tool used in phase 1 were notification system, flow of patients, patient involvement, resources and infrastructure, and service characteristics. (4) Conclusions: This mixed-methods study provides an opportunity to identify the weaknesses and strengths of currently developed theoretical frameworks related to PSC and offers content for its improvement. Even though multiple studies aim to assess PSC using existing quantitative method tools, the development of this study offers a glimpse of some aspects relevant to nurses' PSC not included in the theoretical framework of the said tools, such as patient involvement, the flow of patients, and service infrastructure.
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Affiliation(s)
- Maria José Reyes Ramos
- Facultat d’Infermeria, Universitat de Barcelona, 08907 Barcelona, Spain
- Fundació Sanitària Mollet, 08100 Mollet del Vallès, Spain
| | - Silvia Costa Abós
- Facultat d’Infermeria, Universitat de Barcelona, 08907 Barcelona, Spain
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Forbes J, Arrieta A. Comparing hospital leadership and front-line workers' perceptions of patient safety culture: an unbalanced panel study. BMJ LEADER 2024:leader-2023-000922. [PMID: 38569892 DOI: 10.1136/leader-2023-000922] [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: 10/06/2023] [Accepted: 03/21/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND/AIM This article examines the relationships between workers' hospital leadership status, hospital front-line status and patient safety culture in hospitals throughout the USA. By identifying possible disparities in perception, targeted interventions can aim at decreasing differences between the two groups to increase the quality of healthcare. METHOD Data from 1 739 083 individuals, spreading across 1810 hospitals between 2008 and 2017 were collected. 115 228 (6.63%) self-identified as leaders, and 772 505 (44.42%) self-identified as front-line workers. The participants also filled in information describing their demographics in reference to the hospital, such as how long they have worked at the facility, their working unit and their occupation. RESULTS Results showed that leaders responded more positively to items that are directly related to management, such as 'my supervisor/manager says a good word when he/she sees a job done according to established patient safety procedures' (0.33, p<0.01), where 0.33 signifies that leaders had an average response more positive by 0.33 compared with all other occupations on a Likert scale of 1-5. Based on multiple F-tests, all items have shown a statistical significance between leadership and front-line groups. CONCLUSION The findings highlight a compelling link between leadership roles and patient safety culture in hospitals, as well as between front-line worker status and patient safety culture. Moreover, a pronounced divergence in viewpoints regarding patient safety culture exists between hospital leaders and front-line staff. An in-depth investigation is necessary to comprehend the ramifications of these outcomes.
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Affiliation(s)
- Jayson Forbes
- Nova Southeastern University - Fort Lauderdale/Davie Campus, Fort Lauderdale, Florida, USA
| | - Alejandro Arrieta
- Department of Global Health, Florida International University, Miami, Florida, USA
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Soyer Er Ö, Gül İ. The Speaking Up Climate of Nurses for Patient Safety Concerns and Unprofessional Behaviors: The Effects of Teamwork and Safety Climate. J Perianesth Nurs 2024:S1089-9472(23)01070-5. [PMID: 38493404 DOI: 10.1016/j.jopan.2023.12.008] [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: 10/19/2023] [Revised: 12/01/2023] [Accepted: 12/04/2023] [Indexed: 03/18/2024]
Abstract
PURPOSE This study aims to investigate the influence of teamwork and safety climate on nurses' speaking up for patient safety concerns and unprofessional behaviors. DESIGN This study incorporates a cross-sectional research design. METHODS The study included 217 surgical nurses employed in a Turkish university hospital. The research data were collected between April and June 2023 using the Teamwork Climate, Safety Climate Survey, Speaking Up Climate for Patient Safety, and Speaking Up Climate for Professionalism instruments. The relationships between these scales were assessed using Pearson correlation analysis. The Turkish validity and reliability of the Speaking Up Climate for Patient Safety and Speaking Up Climate for Professionalism scales were verified. The research model was tested using path analysis. FINDINGS The mean age of the 217 surgical nurses was 25.88 ± 5.64 years. Teamwork climate showed a positive effect on safety climate and speaking up climate about patient safety concerns and unprofessional behaviors. Safety climate showed a positive association with nurses' speaking up climate about patient safety concerns and unprofessional behaviors. CONCLUSIONS Teamwork climate and safety climate both positively affect the speaking up climate about patient safety concerns and unprofessional behaviors. Nurse managers who wish to promote a culture of speaking up about patient safety and unprofessional behaviors should prioritize improvements in the teamwork climate and safety climate.
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Affiliation(s)
- Özlem Soyer Er
- Surgical Nursing Department, Afyonkarahisar Health Sciences University, Faculty of Health Sciences, Afyonkarahisar, Turkey
| | - İsa Gül
- Department of Healthcare Management, Faculty of Health Sciences, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey.
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Shatto B, Meyer G. The Challenge of Surveying New Graduate Nurses. J Contin Educ Nurs 2024; 55:145-148. [PMID: 38063796 DOI: 10.3928/00220124-20231130-01] [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: 03/02/2024]
Abstract
Random samples are the gold standard when surveying a nationwide population, such as new graduate nurses. The goal of this article is to detail the challenges experienced when sampling and surveying newly licensed RNs who entered the health care environment during the coronavirus disease (COVID-19) pandemic. To create a random sample of this population, all 51 U.S. state boards of nursing were contacted. State boards of nursing are the best resource for this information, but obtaining contact information, soliciting a response, and dealing with privacy laws as well as the cost of the lists reduced the survey frame. Of the 51 state boards, eight provided usable lists of participants. Obtaining a sampling frame was challenging. Once created, other issues arose. Finding ways to obtain random sampling lists of RNs and encouraging nurses to participate in research are key elements of addressing issues in health care today. [J Contin Educ Nurs. 2024;55(3):145-148.].
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Chen HM, Lu YCA, Pai HC. Impact of a Care Task Design Program on Novice Nursing Students' Self-Reflection and Insight, Teamwork Skills, and Holistic Nursing Competency. FLORENCE NIGHTINGALE JOURNAL OF NURSING 2023; 31:69-74. [PMID: 37404208 PMCID: PMC10440954 DOI: 10.5152/fnjn.2023.22265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 02/21/2023] [Indexed: 07/06/2023]
Abstract
AIM The aims of this study were to evaluate the effects of a self-appraisal of clinical simulation care tasks in novice nursing students and assess their self-reflection and insight, teamwork skills, and holistic nursing competence in four different periods. METHOD A single group pre- and post-test design was conducted. Data were collected between September 2019 and February 2020. Nursing students who participated in the fundamental nursing laboratory courses in the second year of the nursing department at a medical university were invited to participate in the study. Data were collected at four time points using the Self-Reflection and Insight Scale, Holistic Nursing Competence Scale, and the Teamwork Skills Scale. A generalized estimating equation was used for all statistical analyses. RESULTS Across the four measurements, the score of self-reflection and insight ranged from 76.68 to 78.00, teamwork skills from 68.83 to 71.21, and holistic nursing competence from 134.48 to 146.46. Student performance was above average on all research variables. The results confirm the hypotheses that the program improves self-reflection and insight, teamwork skills, and holistic nursing competencies in nursing students. CONCLUSION These findings suggest that the program can be used to improve students' self-reflection, and it may also help to enhance their teamwork skills and holistic nursing competence.
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Affiliation(s)
- Hsiao-Mei Chen
- Department of Nursing, Chung Shan Medical University, Taichung City, Taiwan
- Department of Nursing, Chung Shan Medical University Hospital, Taichung City, Taiwan
| | - Yen-Chiao Angel Lu
- Department of Nursing, Chung Shan Medical University, Taichung City, Taiwan
- Department of Nursing, Chung Shan Medical University Hospital, Taichung City, Taiwan
| | - Hsiang-Chu Pai
- Department of Nursing, Chung Shan Medical University, Taichung City, Taiwan
- Department of Nursing, Chung Shan Medical University Hospital, Taichung City, Taiwan
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Fox A, Dulhunty J, Ballard E, Fraser M, Macandrew M, Taranec S, Waters R, Yang M, Yates M, Yelland C, Beattie E. The impact of a cognitive impairment support program on patients in an acute care setting: a pre-test post-test intervention study. BMC Geriatr 2023; 23:260. [PMID: 37127621 PMCID: PMC10150670 DOI: 10.1186/s12877-023-03930-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 03/24/2023] [Indexed: 05/03/2023] Open
Abstract
BACKGROUND Patients with cognitive impairment are at greater risk of hospital acquired complications, longer hospital stays, and poor health outcomes compared to patients without cognitive impairment. The Cognitive Impairment Support Program is a multi-disciplinary approach to improve screening rates and awareness of patients with cognitive impairment and guide clinician response and communication during their hospitalisation to improve health outcomes. OBJECTIVE This study evaluated the impact of implementing the Cognitive Impairment Support Program on patient hospital acquired complications, patient reported quality of life and staff satisfaction in an outer metropolitan hospital. DESIGN A pre-test post-test design was used to collect data in two 6-month time periods between March 2020 and November 2021. PARTICIPANTS Patients aged ≥ 65 years, admitted to a participating ward for > 24 h. INTERVENTION The Cognitive Impairment Support Program consisted of four components: cognitive impairment screening, initiation of a Cognitive Impairment Care Plan, use of a Cognitive Impairment Identifier and associated staff education. MEASURES The primary outcome was hospital acquired complications experienced by patients with cognitive impairment identified using clinical coding data. Secondary outcomes were patient quality of life and a staff confidence and perceived organisational support to care for patients with cognitive impairment. RESULTS Hospital acquired complication rates did not vary significantly between the two data collection periods for patients experiencing cognitive impairment with a 0.2% (95% confidence interval: -5.7-6.1%) reduction in admissions with at least one hospital acquired complication. Patients in the post intervention period demonstrated statistically significant improvements in many items in two of the Dementia Quality of Life Measure domains: memory and everyday life. The staff survey indicated statistically significant improvement in clinical staff confidence to care for patients with cognitive impairment (p = 0.003), satisfaction with organisational support for patients (p = 0.004) and job satisfaction (p ≤ 0.001). CONCLUSION This study provides evidence that a multicomponent Cognitive Impairment Support Program had a positive impact on staff confidence and satisfaction and patient quality of life. Broader implementation with further evaluation of the multicomponent cognitive impairment intervention across a range of settings using varied patient outcomes is recommended.
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Affiliation(s)
- Amanda Fox
- Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, QLD, Australia.
- School of Nursing, Faculty of Health, Queensland University of Technology, N Block, Victoria Park Road, Kelvin Grove, Brisbane, QLD, Australia.
- Redcliffe Hospital, Anzac Avenue, Redcliffe, Australia.
| | - Joel Dulhunty
- Redcliffe Hospital, Anzac Avenue, Redcliffe, Australia
| | - Emma Ballard
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Maria Fraser
- Redcliffe Hospital, Anzac Avenue, Redcliffe, Australia
| | - Margaret Macandrew
- Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, QLD, Australia
- School of Nursing, Faculty of Health, Queensland University of Technology, N Block, Victoria Park Road, Kelvin Grove, Brisbane, QLD, Australia
| | - Sally Taranec
- Redcliffe Hospital, Anzac Avenue, Redcliffe, Australia
| | | | - Min Yang
- School of Nursing, Faculty of Health, Queensland University of Technology, N Block, Victoria Park Road, Kelvin Grove, Brisbane, QLD, Australia
| | - Mark Yates
- Ballarat Health Services, Ballarat, Australia
| | | | - Elizabeth Beattie
- Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, QLD, Australia
- School of Nursing, Faculty of Health, Queensland University of Technology, N Block, Victoria Park Road, Kelvin Grove, Brisbane, QLD, Australia
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Hanum AL, Hu Q, Wei W, Zhou H, Ma F. Professional identity, job satisfaction, and intention to stay among clinical nurses during the prolonged COVID-19 pandemic: A mediation analysis. Jpn J Nurs Sci 2023; 20:e12515. [PMID: 36203310 PMCID: PMC9874386 DOI: 10.1111/jjns.12515] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 08/02/2022] [Accepted: 08/29/2022] [Indexed: 01/27/2023]
Abstract
AIM This study aims to examine the relationship between professional identity and job satisfaction and their impact on intention to stay among clinical nurses in China during the prolonged COVID-19 pandemic. METHODS A cross-sectional survey was conducted from April 30 to May 25, 2021, in China. Data were collected using professional identity, job satisfaction, and intention to stay questionnaires from 1425 clinical nurses. A single mediation analysis was utilized to test the interrelationship among the variables, and the STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) checklist as a reporting guide. RESULTS Nurses indicated a medium level of professional identity, job satisfaction, and intention to stay, with mean scores of 3.85, 3.25, and 3.47, respectively. The professional identity displayed positive indirect effect on nurses' intention to stay through job satisfaction (indirect effect = 0.498, 95% CI [0.439, 0.558]). CONCLUSION Cultivating professional identity among nurses can increase their job satisfaction and ultimately enhance the intention to stay in the nursing profession. However, this study also suggests paying more attention to job satisfaction to keep nursing retention. These may be helpful to retain the nursing workforce.
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Affiliation(s)
- Ardani Latifah Hanum
- Department of NursingThe First Affiliated Hospital of Kunming Medical UniversityKunmingChina
| | - Qiulan Hu
- ICU in Geriatric DepartmentThe First Affiliated Hospital of Kunming Medical UniversityKunmingChina
| | - Wei Wei
- Gastroenterology DepartmentThe First Affiliated Hospital of Kunming Medical UniversityKunmingChina
| | - Huilin Zhou
- Department of NursingThe First Affiliated Hospital of Kunming Medical UniversityKunmingChina
| | - Fang Ma
- Department of NursingThe First Affiliated Hospital of Kunming Medical UniversityKunmingChina
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Flores IF, Dator WLT, Olivar JJ, Gaballah MK. Congruence of Effective Leadership Values between Nurse Leaders and Staff Nurses in a Multicultural Medical City in Saudi Arabia: A Sequential Mixed-Methods Study. Healthcare (Basel) 2023; 11:healthcare11030342. [PMID: 36766917 PMCID: PMC9914289 DOI: 10.3390/healthcare11030342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 01/14/2023] [Accepted: 01/20/2023] [Indexed: 01/26/2023] Open
Abstract
This study explores the perceived congruence of effective values of nursing leadership between the nurse leaders and the staff nurses in a multicultural tertiary hospital. METHODS This is a descriptive sequential mixed-methods study conducted in a multicultural medical city in Saudi Arabia. Purposive sampling was used in the qualitative phase, while stratified sampling was used for the quantitative part. There were 70 participants in the qualitative phase, including 33 nurse leaders and 37 staff nurses. The quantitative phase had 571 participants, including 105 nurse leaders and 466 staff nurses. RESULTS Congruent values were categorised into six emerging themes: (1) cascading deference; (2) paragon of probity; (3) professional competence; (4) compassionate presence; (5) team diversity and inclusion; (6) calibrated communication. The quantitative survey confirmed that the values identified from the interviews were considered to be vital by both nurse leaders and staff nurses, and there were no statistically significant differences between staff nurses' and nurse leaders' perceptions, regardless of their nationality, as demonstrated by one-way ANOVA, with p-values less than 0.05 deemed to be statistically significant. CONCLUSION Both nurse leaders and staff nurses in the multicultural institution have congruent leadership values that are perceived as essential to achieve institutional goals and, ultimately, safe and high-quality patient care.
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Affiliation(s)
- Ian Flor Flores
- College of Nursing and Allied Health Sciences, St. Paul University Manila, 680 Pedro Gil St. Malate, Metro Manila 1004, Philippines
| | - Wireen Leila T. Dator
- Department of Medical-Surgical Nursing, College of Nursing, Princess Nourah Bint Abdulrahman University, Riyadh 11671, Saudi Arabia
- Correspondence:
| | - Jennifer Joy Olivar
- College of Nursing and Allied Health Sciences, St. Paul University Manila, 680 Pedro Gil St. Malate, Metro Manila 1004, Philippines
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Holder H, Gannon BR. Reducing Tracheostomy Medical Device-Related Pressure Injury: A Quality Improvement Project. AACN Adv Crit Care 2022; 33:329-335. [PMID: 36477844 DOI: 10.4037/aacnacc2022874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To reduce the incidence of medical device-related pressure injuries associated with tracheostomies performed with the percutaneous dilation technique using a standardized multidisciplinary intervention. METHODS The intervention was developed using the Agency for Healthcare Research and Quality Preventing Pressure Injuries Toolkit. A fenestrated polyurethane foam dressing was sutured in place under the tracheostomy flange during insertion to reduce the risk of medical device-related pressure injuries. The sutures were removed in pairs over a period of 7 to 10 days. RESULTS Comparison of data from 2018 to 2021 demonstrated a decrease in the incidence of tracheostomy medical device-related pressure injuries from 13% to 0% in the first year, which was maintained for the following 3 years. This improvement was supported by electronic medical record audits, daily interdisciplinary rounds, weekly practice assessments, and primary nurse evaluations. CONCLUSION Implementation of a standardized process, supported by an interdisciplinary clinical team, can reduce medical device-related pressure injuries among patients undergoing percutaneous dilation tracheostomy.
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Affiliation(s)
- Hazel Holder
- Hazel Holder is Critical Care Clinical Nurse Specialist, New York Presbyterian Westchester, 55 Palmer Ave, Bronxville, NY 10708
| | - Brittany Ray Gannon
- Brittany "Ray" Gannon is Nurse Scientist, New York Presbyterian Hospital, New York, New York
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