Predictors of Nursing Performance for Patient Safety among Nurses in Regional Hospitals: A Cross-sectional Study

Predictors of Nursing Performance for Patient Safety among Nurses in Regional Hospitals

Authors

  • Siriporn Sangsrijan PhD (Candidate), Faculty of Nursing, Chiang Mai University, Thailand.
  • Thitinut Akkadechanunt Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand.
  • Bunpitcha Chitpakdee Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand.
  • Kulwadee Abhicharttibutra Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand.

DOI:

https://doi.org/10.60099/prijnr.2024.265725

Keywords:

Nursing hours per patient day, Nursing performance, Nurse practice environment, Nursing workload, Patient safety, Patient safety attitude, Patient safety knowledge, Patient-to-nurse ratio

Abstract

Nursing performance for patient safety is crucial for improving patient safety outcomes and quality of care. This cross-sectional study aimed to explore nursing performance for patient safety and identify the predictability of patient safety knowledge, patient safety attitude, nurse practice environment, patient-to-nurse ratio, and nursing hours per patient day on nursing performance for patient safety. The participants included 234 nurses randomly selected from six regional hospitals across Thailand. The research instruments included a demographic data form, the Practice Environment Scale of the Nursing Work Index, the Patient Safety Principles and Knowledge Questionnaire, the Safety Attitudes Questionnaire, and the Nursing Performance for Patient Safety Scale, which yielded scale-level content validity indices ranging from .85 to .88. The Cronbach’s alpha coefficients ranged from .81 to .98. Descriptive statistics and stepwise multiple regression were utilized for the data analysis.
The results revealed that the nurses perceived overall nursing performance for patient safety at a high level. Patient-to-nurse ratio was the strongest predictor of nursing performance for patient safety, followed by patient safety knowledge, patient safety attitude, nurse practice environment, and nursing hours per patient day. All predictors could predict nursing performance for patient safety, accounting for 56.00% of the variance. Nurse administrators and policymakers can use the results of this study to develop strategies for improving nursing performance for patient safety. We recommend longitudinal studies using different samples of Thailand nurses in diverse settings to confirm results across the country.

References

Phillips J, Malliaris AP, Bakerjian D. Nursing and patient safety [Internet]. 2021 [cited 2023 May 28]. Available from: https://psnet.ahrq.gov/primer/nursing-and-patient-safety

Greenslade JH, Jimmieson NL. Distinguishing between task and contextual performance for nurses: development of a job performance scale. J Adv Nurs. 2007;58(6):602-61. doi: 10.1111/j.1365-2648.2007.04256.x. DOI: https://doi.org/10.1111/j.1365-2648.2007.04256.x

Healthcare Accreditation Institute (Public Organization). Annual report 2022 [Internet]. 2022 [cited 2023 May 28]. Available from: https://www.ha.or.th/TH/Downloads/รายงานประจำปี (in Thai)

World Health Organization. Patient safety [internet]. 2019 [cited 2023 May 28]. Available from: https://www.who.int/news-room/fact-sheets/detail/patient-safety

Domer GM, Gallagher T, Shahabzada S, Sotherland JN, Paul E, Kumar KN, et al. Patient safety: preventing patient harm and building capacity for patient safety. In: Stawicki, SP, Firstenberg, MS, editors, Contemporary topics in patient safety. Vol. 1, London: IntechOpen; 2021, pp. 1-23. doi: 10.5772/intechopen.100559. DOI: https://doi.org/10.5772/intechopen.100559

Heier L, Riouchi D, Hammerschmidt J, Gambashidze N, Kocks A, Ernstmann N. Safety performance in acute medical care: a qualitative, explorative study on the perspectives of healthcare professionals. Healthcare (Basel). 2021; 9(11):1543. doi: 10.3390/healthcare9111543. DOI: https://doi.org/10.3390/healthcare9111543

Aziz Mamdouh E, Shehata Mohamed H, Abdallah Abdelatief D. Assessment of nurses’ performance regarding the implementation of patient safety measures in intensive care units. Egypt J Health Care. 2020; 11(1):82-100. doi: 10.21608/ejhc.2020.72596. DOI: https://doi.org/10.21608/ejhc.2020.72596

Panthulawan S, Kunaviktikul W, Nantsupawat R, Srisuphan W. Development and psychometric testing of the Nursing Performance for Patient Safety Scale. Pacific Rim Int J Nurs Res. 2016;20(1):45-59.

Bandura A. Social cognitive theory of self-regulation. Organ Behav Hum Decis Process. 1991;50:248-87. doi:10. 1016/0749-5978(91)90022-L. DOI: https://doi.org/10.1016/0749-5978(91)90022-L

Almeida IL, Ramos NM, Andrade IR, Carvalho RE, Silva LF, Oliveira SK, et al. Theories used by nurses to promote patient safety practices: a scoping review. J Nurs Educ Pract. 2022;12(7):1. doi:10.5430/jnep.v12n7p1. DOI: https://doi.org/10.5430/jnep.v12n7p1

Konicki T, Miller EU. Use of a simulation intervention to examine differences in nursing students’ hand hygiene knowledge, beliefs, and behaviors. Nurse Educ Today. 2016;45:96-101. doi:10.1016/j.nedt.2016.06.022. DOI: https://doi.org/10.1016/j.nedt.2016.06.022

Seo JK, Lee SE. Mediating roles of patient safety knowledge and motivation in the relationship between safety climate and nurses’ patient safety behaviors: a structural equation modeling analysis. BMC Nurs. 2022;21(1):335. DOI: https://doi.org/10.1186/s12912-022-01123-6

Wake AD, Tuji TS, Gonfa BK, Waldekidan ET, Beshaw ED, Mohamed MA, et al. Knowledge, attitude, practice and associated factors towards patient safety among nurses working at Asella Referral and Teaching Hospital, Ethiopia: a cross-sectional study. PLoS One. 2021;16(7):e0254122. doi: 10.1371/journal.pone.0254122. DOI: https://doi.org/10.1371/journal.pone.0254122

Lee MA, Kang S, Hyun HS. Relationship among nursing professionalism, nursing work environment, and patient safety nursing activities in general hospital nurses. J Korean Acad Nurs Adm. 2019;25(4):317-28. doi: 10.11111/jkana.2019.25.4.317. DOI: https://doi.org/10.11111/jkana.2019.25.4.317

Phillips J, Malliaris AP, Bakerjian D. Nursing and patient safety [Internet]. 2021 [cited 2023 May 28]. Available from: https://psnet.ahrq.gov/primer/nursing-and-patient-safety

Bridges J, Griffiths P, Oliver E, Pickering RM. Hospital nurse staffing and staff–patient interactions: an observational study. BMJ Qual Saf. 2019;28(9):706-13. doi: 10. 1136/bmjqs-2018-008948. DOI: https://doi.org/10.1136/bmjqs-2018-008948

Robson J, de Wet C, McKay J, Bowie P. Do we know what foundation year doctors think about patient safety incident reporting? Development of a web-based tool to assess attitude and knowledge. Postgrad Med J. 2011;87(1033): 750-6. doi: 10.1136/pgmj.2011.117366. DOI: https://doi.org/10.1136/pgmj.2011.117366

Li J, Wang S, Wu X, Liu M, Gan G, Dong X, et al. Factors to predict the knowledge, attitude and practice of nursing interruptions among nurses: a nationwide cross-sectional survey. Nurse Educ Pract. 2022;64:103428. doi: 10.1016/j.nepr.2022.103428. DOI: https://doi.org/10.1016/j.nepr.2022.103428

Sexton JB, Helmreich RL, Neilands TB, Rowan K, Vella K, Boyden J, et al. The Safety Attitudes Questionnaire: psychometric properties, benchmarking data, and emerging research. BMC Health Serv Res. 2006;6:44. doi: 10.1186/1472-6963-6-44. DOI: https://doi.org/10.1186/1472-6963-6-44

Biresaw H, Asfaw N, Zewdu F. Knowledge and attitude of nurses towards patient safety and its associated factors. Int J Afr Nurs Sci. 2020; 13:100229. doi: 10.1016/j.ijans.2020.100229. DOI: https://doi.org/10.1016/j.ijans.2020.100229

Lake ET. Development of the practice environment scale of the Nursing Work Index. Res Nurs Health. 2002; 25(3):176-88. doi: 10.1002/nur.10032. DOI: https://doi.org/10.1002/nur.10032

Mihdawi M, Al-Amer R, Darwish R, Randall S, Afaneh T. The influence of nursing work environment on patient safety. Workplace Health Saf. 2020;68(8):384-90. doi: 10.1177/2165079920901533. DOI: https://doi.org/10.1177/2165079920901533

Thailand Nursing and Midwifery Council. Nursing and Midwifery Council Announcement: nursing working hours for patient safety [Internet]. 2017 [cited 2023 June 19]. Available from: https://www.tnmc.or.th/images/userfiles/files/H002.pdf (in Thai)

Chang LY, Hsiu-Hui YU. The relationship between nursing workload, quality of care, and nursing payment in intensive care units. J Nurs Res. 2019;27(1):1-9. doi: https://doi.org/10.1097%2Fjnr.0000000000000265 DOI: https://doi.org/10.1097/jnr.0000000000000265

von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP; STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol. 2008;61(4):344-9. DOI: https://doi.org/10.1016/j.jclinepi.2007.11.008

Polit DF, Beck CT. Nursing research: generating and assessing evidence for nursing practice. 10th ed. Philadelphia: Wolters Kluwer Health; 2017.

Nantsupawat A, Srisuphan W, Kunaviktikul W, Wichaikhum OA, Aungsuroch Y, Aiken LH. Impact of nurse work environment and staffing on hospital nurse and quality of care in Thailand. J Nurs Scholarsh. 2011; 43(4):426-32. doi: 10.1111j.1547-5069.2011.01419.x. DOI: https://doi.org/10.1111/j.1547-5069.2011.01419.x

Brasaite I, Kaunonen M, Martinkenas A, Mockiene V, Suominen T. Health care professionals’ knowledge regarding patient safety. Clin Nurs Res. 2017;26(3):285-300. doi: 10.1177/1054773816628796. DOI: https://doi.org/10.1177/1054773816628796

Brislin RW. The wording and translation of research instruments. In: Lonner WL, Berry JW, editors. Field methods in cross-cultural research. Beverly Hills: Sage; 1986, pp. 137-64.

Tabachnick BG, Fidell LS. Using multivariate statistics. 7th ed. London: Pearson; 2019.

Hospital Accreditation Institution (Public Organization). Hospital and health care standards. 5th ed. Nonthaburi: Kor. Kanpim Tienkwang; 2022 (in Thai).

Thongpaknum C, Wannarit L, Khunthong T. Nursing knowledge and practice according to patient safety goals of registered nurses, Bhumibol Adulyadej Hospital. RHPC9 Journal. 2022;16(2):673-89 (in Thai).

Nnko EE, Nyang’au S, Odhiambo R. Influence of workload on performance of nurses in regional hospitals in Tanzania. Strateg J Bus Change Manag. 2019;6(3):804-15. DOI: https://doi.org/10.61426/sjbcm.v6i3.1333

Lee H, Lee K, Lee SH. Association of nursing hours with cognitive function, balance, and dependency level of stroke patients. Nurs. Open. 2023;10(3):1735-1743. doi: 10.1002/nop2.1430. DOI: https://doi.org/10.1002/nop2.1430

Department of Medical Services, Ministry of Public Health. Manpower of Ministry of Health employees [Internet]. 2013 [cited 2023 June 1]. Available from: http://110.164.68.234/news_raja/uploaded/001-2013.pdf

Hamed MM, Fakhry SF, Saad NF. Effect of on-the-job versus off-the-job training related to patient safety goals on staff nurses’ performance. HIV Nurs. 2022;22(2):1791-8.

Nurmaini N, Wahidi KR, Pamungkas RA. Work life quality role as a variable of knowledge mediation, spiritual intelligence, and attitudes towards nurse performance in applying patient safety (SKP). J Multidiscip Acad. 2021;5(1):26-35.

Aini Q. Model of patient safety behavior influenced by culture and attitudes of safety patients: case study of PKU Muhammadiyah Hospital in Bantul. Enferm Clin. 2020; 30(Suppl 6):272-5. DOI: https://doi.org/10.1016/j.enfcli.2020.06.062

Fu M, Wang T, Hu S, Zhang X, Wang F, Pan Y, et al. Patient safety value, safety attitude, and safety competency among emergency nurses in China: a structural equation model analysis. J Nurs Manag. 2022;30(8):4452-60. DOI: https://doi.org/10.1111/jonm.13876

Hwang SM. The impact of nurses’ nursing work environment and patient safety culture perceptions on patient safety management activities [master’s thesis]. [South Korea]: Youngsan University; 2020.

Downloads

Published

2024-03-21

How to Cite

1.
Sangsrijan S, Akkadechanunt T, Chitpakdee B, Abhicharttibutra K. Predictors of Nursing Performance for Patient Safety among Nurses in Regional Hospitals: A Cross-sectional Study: Predictors of Nursing Performance for Patient Safety among Nurses in Regional Hospitals. PRIJNR [Internet]. 2024 Mar. 21 [cited 2024 May 23];28(2):252-64. Available from: https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/265725