Using problem-based learning to improve patient safety in the emergency department

Patient safety value, safety attitude and safety competency among emergency nurses in China: A structural equation model analysis

AIMS

We aim to determine the levels of patient safety value, safety attitude and safety competency and to explore the associations among these variables in emergency nurses in China.

BACKGROUND

Studies have focused on the individual characteristics of nurses as influencing factors of patient safety but not on the factors that may affect patient safety competency in the context of Chinese culture, such as safety value and safety attitude.

METHOD

A cross-sectional survey was conducted among emergency nurses in 22 hospitals.

RESULTS

The final model had acceptable fit indices (χ² /df = 3.512 < 5; CFI = 0.955 > 0.9; TLI = 0.942 > 0.9; IFI = 0.955 > 0.9; RMSEA = 0.068 < 0.08 [90% CI, 0.059 to 0.077]). A fully adjusted model was also tested, and the effects among variables were consistent with the hypothesized model. The SEM results showed that patient safety values had a significant direct effect on safety competency (b = .407, p < .001) and safety attitude (b = .656, p < .001). Patient safety attitude had a significant direct effect on safety competency (b = .493, p < .001). Patient safety values had an indirect effect on safety competency through safety attitude, and the total effect of safety values on safety competency was 0.730.

CONCLUSIONS

Chinese nurses are at a moderate level of patient safety attitude and competency. Emergency nurses' safety value and safety attitude can be direct predictors of patient safety competency, and safety value can indirectly predict their patient safety competency through safety attitude.

IMPLICATIONS FOR NURSING MANAGEMENT

Strengthening safety value is a critical step toward improving patient safety competency. Hospital administrators and educators should construct a patient safety culture that is guided and driven by appropriate values and ensure the development of necessary competencies in nurses.

Does problem-based learning education improve knowledge, attitude, and perception toward patient safety among nursing students? A randomized controlled trial

Background

Patient safety is a top priority for any health care system. Most universities are looking for teaching methods through which they would be able to enhance students’ clinical decision-making capabilities and their self-centered learning to ensure safe and quality nursing care. Therefore, this study aimed to determine the effect of patient safety education through problem-based learning (PBL) on nursing students’ knowledge, attitude, and perceptions toward patient safety.

Methods

This randomized, controlled trial was conducted from September 2019 to January 2020. A total of 78 fourth-year nursing students participated in this study. The participants were randomly assigned to either the intervention group or the control group. In the intervention group, the educational materials were presented to the students using the PBL method during eight sessions of 45–60 min. In each control group, nursing students received eight education sessions through lectures and discussing the same educational content. Data were gathered 1 month after the intervention using demographic information and knowledge, attitudes, and perception questionnaires. Data were analyzed in SPSS ver. 22.0 using descriptive (mean and standard deviation) and inferential (chi-square test, independent t-test, paired t-test, and analysis of covariance (ANCOVA)) statistics.

Results

The results indicated that the difference in the mean scores of knowledge, attitudes, and perceptions of the nursing students about patient safety was statistically significant between the two groups after the PBL education (p = 0.001). The mean scores of students’ knowledge, attitude, and perceptions of patient safety increased significantly in the intervention group.

Conclusions

Implementing patient safety education through PBL positively affects knowledge, attitudes, and perceptions of patient safety among nursing students. Thus, the research team recommended the PBL method to be used by nursing professors to improve nursing students’ clinical skills and cognitive abilities to ensure safe patient care.

Trial registration

IRCT20190925044881N1; October 17, 2019.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-021-00588-1.