Testing the association between the enabling and enacting factors of patient safety culture and patient safety: structural equation modelling

BMC Nursing

Research

Jong Hyun Lee¹  Seung Eun Lee²  V. Susan Dahinten³ 

[1] Department of Psychology, College of Social Science, Gyeongsang National University, 501, Jinju-daero, 52828, Jinju-si, Gyeongsangnam-do, South Korea;Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, 03722, Seoul, South Korea;School of Nursing, University of British Columbia, T201–2211 Wesbrook Mall, V6T 2B5, Vancouver, BC, Canada;

关键词: Safety culture;    Safety climate;    Structural equation model;    Survey;    Nurses;    Korea;   

DOI  :  10.1186/s12912-023-01196-x

 received in 2022-07-04, accepted in 2023-01-31,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundDespite evidence linking a safety culture with patient safety, the processes by which aspect of safety culture influences patient safety are not yet well understood. Thus, this study aimed to test a theoretical model of the relationships between three enabling factors (supervisor/clinical leader support for patient safety, hospital management support for patient safety, and psychological safety), and four enacting factors of patient safety culture (handoffs and information exchange, teamwork, error reporting intention, and withholding voice) with nurse assessments of patient safety.MethodsA cross-sectional, descriptive correlational study design was used. Between May and June 2020, 526 nurses who provided direct care to patients in medical surgical units in three Korean hospitals completed an online survey that included four standardized scales or subscales. Structural equation modelling was used to test the hypothesized model.ResultsAmong the three enabling factors, psychological safety was associated with all four enacting factors, and all enacting factors were associated with overall patient safety. Hospital management support was associated with all enacting factors except teamwork, but supervisor/clinical leader support was associated with only handoffs and information exchange, and withholding voice. Thus, teamwork was influenced only by psychological safety. Findings demonstrate overall support for the theoretical model of safety culture wherein enabling factors influence enacting factors which, in turn, lead to patient safety outcomes, but emphasize the critical nature of psychological safety among nursing staff.ConclusionThis study provides further insight into the importance of support from hospital management and unit supervisors/clinical leaders for patient safety to motivate and enable hospital nurses to enact behaviours necessary for patient safety. However, such support must also take the form of enhancing psychological safety for nursing staff.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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