Educational background of nurses and their perceptions of the quality and safety of patient care

Nursing categories' perceptions of the practice environment and quality of care in North West Province: a cross-sectional survey design

BACKGROUND

There is a substantial amount of literature on the perception of the practice environment and quality of care as perceived by registered nurses and community services nurses in South Africa and worldwide, but there is little to no research that could be found regarding other categories of nurses, and how these perceptions differ between the different categories. Therefore, the aim of this study is to describe the different nursing categories' perceptions of the practice environment and quality of care and the association between the variables.

METHODS

This study applied a cross-sectional survey design. Data were collected in April 2021 in the public sector of the North West Province. Multiphase sampling was applied to all categories of nurses who worked in an in-patient unit in the selected hospital for at least 3 months (n = 236).

RESULTS

All nursing categories perceived the practice environment as negative, regarding nurse participation in hospital affairs; nurse manager ability, leadership, and support of nurses and staffing and resource adequacy. Perceived quality of care and patient safety items were perceived as neutral and good. However, in all instances, the perceptions of community service nurses and registered nurses were most negative, and enrolled nurse assistants most positive. Adverse events towards patients and nurses were perceived to only occur a few times a year. Overall, nurse perceptions of quality of care and patient safety were most correlated with the subscale of nurse foundations of quality of care and nurse manager ability, leadership, and support of nurses. Adverse events towards patients were most correlated with the collegial nurse-physician relationship subscale, while adverse events towards nurses were correlated with the foundations of quality of care subscale.

CONCLUSION

Improving the practice environment, especially regarding the subscale nurse foundations of quality of care and nurse manager ability, leadership, and support of nurses, is associated with improved quality of care. Nurses with higher qualifications, registered nurses and community service nurses rated quality of care lower than other categories of nurses, contributing to literature that higher qualified staff are more competent to assess the practice environment and quality of care.

Preoperative Patient Education: Perceptions and Actual Practice among Nurses Working in Surgical Units

Introduction

Preoperative education is an essential nursing task that can be affected by the nurses' perception. Patients may be receiving insufficient vital information before surgery. However, the essential information that should be provided to patients undergoing surgery is not fully addressed.

Objective

To assess the essential elements of preoperative information as perceived by the surgical nurses.

Methods

This was a cross-sectional study. A convenience sample of 224 registered nurses who were working at surgical units was recruited from two hospitals. A preoperative teaching questionnaire was used.

Results

Details about the operation (4.39 ± 0.61) and preoperative preparation (4.36 ± 0.61) were the most important domains of preoperative education as perceived by nurses. The results show significant differences between the perceived and actual preoperative educational practice across all domains except the preoperative preparation.

Conclusions

The delivery of preoperative education could be affected by nurses' perceptions. Efforts to facilitate the implementation of effective education as perceived by nurses should be conducted by minimizing potential barriers.

The status and the factors that influence patient safety in health care institutions in Africa: A systematic review

Poor patient safety practices may result in disability, injury, poor prognosis, or even death and are primarily associated with a common concern in Africa. This study synthesized the factors influencing the maintenance of patient safety in Africa's healthcare institutions. There was an in-depth search in PubMed Central, CINAHL, Cochrane library, web of science, and Embase using the PICO framework. The search results were filtered for Africa and from 2011 to September 2021 to yield 9,656 titles after duplicates were removed using endnote software, and 211 titles were selected for full-text reading as 16 were selected based on predetermined criteria. The quality appraisal was done using the Mixed Methods Appraisal Tool. A matrix was developed, discussed, accepted, and used as a guide for the data extraction. A convergent synthesis design was adopted for data analysis as the data was transformed into qualitative descriptive statements. Patient safety ratings ranged from 12.4% to 44.8% as being good. Patient safety was identified as an essential structure to improve patient outcomes. The factors associated with patient safety were level of education, professional category, hours worked per week, participation in a patient safety program, reporting of adverse events, openness in communication, organizational learning, teamwork, physical space environment, exchange of feedback about error, and support by hospital management. Poor patient safety environment could lead to the staff being prosecuted or imprisoned, lack of respect and confidence by colleagues, embarrassment, loss of confidence and trust in the health team by patients, documentation errors, drug errors, blood transfusion-related incidences, development of bedsores, and disability. These strategies by health institutions to promote patient safety must focus on reducing punitive culture, creating a culture of open communication, and encouraging incidence reporting and investigations to ensure continuous learning among all health care professionals.

Psychological capital and organisational citizenship behaviour in selected public hospitals in the Eastern Cape Province of South Africa

Orientation: The relationship between psychological capital (PsyCap) and organisational citizenship behaviour (OCB) is important to establish especially in the South African public hospitals where the quality of healthcare services have been reported to have deteriorated.Research purpose: The purpose of this study was to examine the relationship between psychological capital and organisational citizenship behaviour among nurses in the public hospitals.Motivation for the study: There is crisis in the public nursing sector as nurses are reported to be working under pressure as a result of increased workload and responsibilities beyond their scope of practice (in terms of doing the work that they are not trained for and more work than they can handle), in addition to rapidly changing work environments.Research approach, design and method: The present study follows a quantitative cross-sectional design using a questionnaire on a sample of 228 nurses from public hospitals in the Eastern Cape Province, South Africa.Main findings: The findings of the study confirm that psychological capital has a significant positive relationship with organisational citizenship behaviour.Practical/managerial implications: The study recommends management to recognise the area of OCB in the public hospitals and work in nurturing and retaining those nurses capable of displaying such behaviours.Contribution/value add: The study validates aspect of reciprocity of the Social exchange theory. Nurses with high levels of hope, self-efficacy, resilience and optimism showed reciprocity through the display of OCBs. The study also validates the aspect of job resources in eroding job demands from the Job demands resources model.

Nurses' experiences of patient safety incidents in Korea: a cross-sectional study

OBJECTIVES

The aim of this study was to investigate the scope and severity of the second victim problem among nurses by examining the experiences and effects of patient safety incidents (PSIs) on them.

PARTICIPANTS/SETTING

492 nurses who had experienced PSIs and provide direct care in South Korean medical institutions.

DESIGN

A cross-sectional study with anonymous online self-report questionnaires was conducted to nurses in order to examine the experiences and effects of PSIs. Scales measuring post-traumatic stress disorder (PTSD) and post-traumatic embitterment disorder (PTED) were used for a more quantitative examination of the effects of PSIs. A χ2 test was administered to find any difference in responses to difficulties due to PSIs between the direct and indirect experience of PSIs. Furthermore, linear regression analysis was conducted to investigate the factors related to scores on the PTSD and PTED scales.

RESULTS

A statistically significant difference was observed for participants who reported having experienced sleeping disorders, with those with direct experience showing 42.4% sleeping disorders and indirect experience at 21.0%. Also, there was a statistically significant difference between the 34.3% with direct experience and the 22.1% with indirect experience regarding having considered duty or job changes (resignation). Regression analysis showed total PTSD scores for indirect experience at 11.97 points (95% CI: -17.31 to -6.63), lower than direct experience. Moreover, those who thought the medical error was not involved in PSI had a total PTED score 4.39 points (95% CI: -7.23 to -1.55) lower than those who thought it was involved.

CONCLUSIONS

A considerable number of nurses experienced psychological difficulties due to PSIs at levels that could interfere with their work. The effect of PSIs on nurses with direct experience of PSIs was greater compared with those with indirect experience. There need to be psychological support programmes for nurses to alleviate the negative effects of PSIs.

Barriers to reporting of patient safety incidents in tertiary hospitals: A qualitative study of nurses and resident physicians in South Korea

We explored the barriers to reporting patient safety incidents experienced by nurses and resident physicians while working in tertiary hospitals in South Korea. Sixteen in-depth interviews with 10 nurses and 6 resident physicians, all of whom had experienced patient safety incidents, were conducted. The interviews were analyzed using directed content analysis in accordance with a coding scheme developed in this study, which contains 4 categories (incidents and reporters, reporting procedures and systems, feedbacks, and reporting culture) and 9 subcategories. The barriers to reporting near-misses included the following: characteristics of the incident (eg, nonhazardous and high frequency), reporters' lack of knowledge, uncertainty, fear of blame, lack of role model, and inappropriate responses. Reporting adverse/sentinel events was also prevented by feelings of pressure or guilt, the fact that reporting was nonmandatory, and a belief that reporting was not part of the job. Some other barriers included lack of education, review process after reporting, lack of confidentiality when reporting, absence of feedback for reporting, unfair reporting based on work experience, perception of potential blame, and stigmatization resulting from it. In South Korea, a national system for reporting and learning of patient safety accidents has been operating since July 2016. To fully implement this system, it is necessary to encourage reporting at the institutional level. Our results might help reduce the barriers to patient safety incident reporting among nurses and resident physicians in tertiary hospitals in Korea through informing the development of improvement plans.