Undergraduate baccalaureate nursing students’ self-reported confidence in learning about patient safety in the classroom and clinical settings: An annual cross-sectional study (2010–2013)

Nursing students' patient safety competencies in the classroom and clinical settings: a cross-sectional study

INTRODUCTION

Patient safety is one of the critical indicators of providing qualified and high-quality health care services. Determining nursing students' patient safety competencies will significantly contribute to the literature. Therefore, this study aimed to investigate Iranian nursing students' patient safety competencies in classroom and clinical settings.

METHODS

In this cross-sectional study data were collected from 215 nursing of a university of medical sciences between February and May 2022, using a general questionnaire form and the Health Professional Education in Patient Safety Survey. Data analysis was done using descriptive and analytical statistics such as percentage, mean and paired-samples t-test.

RESULTS

The mean scores of nursing students' the Health Professional Education in Patient Safety Survey were 3.50 ± 0.55 in the classroom and 3.45 ± 0.57 in the clinical setting. The highest mean scores of nursing students were in subdimension of "clinical safety" in both the clinical (3.91 ± 1.13) and classroom settings (3.91 ± 0.78). In addition, a statistically significant difference was found in patient safety learning confidence in the classroom versus clinical setting in the "culture of safety" subdimension.

CONCLUSION

It appears that current educational programs provide opportunities to improve nursing students' patient safety, but they are not enough. Nurse educators should apply new teaching methods and evaluate clinical strategies to meet educational needs.

National Study of Quality, Safety, and Just Culture in Prelicensure Nursing Education

AIM

The study's aim was to evaluate the integration and application of quality and safety competencies and concepts of fair and just culture in prelicensure nursing education.

BACKGROUND

Health care organizations support a safety culture by encouraging error reporting without fear of punishment and by conducting investigations to determine causes to improve quality and learn from mistakes. In prelicensure nursing education, the response to errors is often punitive and threatens dismissal.

METHOD

Members of the National Student Nurses' Association were recruited to participate in an electronic assessment through the organization's mailing system.

RESULTS

Students representing all prelicensure program types (BSN, ADN, diploma, accelerated) and 46 states ( N = 268) completed the survey.

CONCLUSION

Nurse educators were found to have a positive impact on student quality and safety competency. Improvement is possible in developing and supporting just culture within nursing programs to bridge the gap between academia and practice.

Mediating effects of transition shock and professional identity on the perception of a caring climate in hospitals and patient safety attitudes of nursing interns: A cross-sectional study

AIM

To determine the association between the perception of a caring climate in hospitals and patient safety attitudes of nursing interns, and the multiple mediating effects of professional identity and transition shock on this relationship.

BACKGROUND

Limited research has been conducted on the involvement of nursing interns in patient safety management and the direct relationship between the perception of a caring climate in hospitals and patient safety attitudes of nursing interns. Furthermore, it remains unclear whether professional identity and transition shock play significant roles as mediating factors in this relationship.

DESIGN

A cross-sectional study.

METHODS

This study employed a convenience sampling to recruit 356 nursing interns from 30 nursing schools in a comprehensive hospital in Hunan Province, China, between December 2022 and April 2023. Data on general information, the perception of a caring climate in hospitals, professional identity, transition shock, and patient safety attitudes was collected from nursing interns using a general information questionnaire and reliable scales. This study utilized a structural equation model with AMOS 24.0 to examine the relationship between variables.

RESULTS

The perception of a caring climate in hospitals directly impacted patient safety attitudes of nursing interns (Effect = 0.253, 95% confidence interval: 0.218-0.542). Meanwhile, the perception of a caring climate in hospitals indirectly influenced patient safety attitudes of nursing interns through multiple mediating factors, including professional identity and transition shock (Effect = 0.037, 95% confidence interval: 0.017-0.073).

CONCLUSION

To ensure patient safety, it is crucial to enhance patient safety attitudes of nursing interns. Our findings suggest that nursing educators and managers can enhance patient safety attitudes of nursing interns by establishing a caring climate. Professional identity and transition shock are important mediators of the patient safety attitudes. Additionally, nursing educators can implement measures to foster a positive work environment, including providing care and support to nursing interns and reducing their workload, to increase professional identity, alleviate transition shock, and ultimately enhance patient safety attitudes of nursing interns.

TWEETABLE ABSTRACT

The relationship between the perception of caring climate in hospitals and patient safety attitudes of nursing interns. Professional identity and transition shock play multiple mediating roles in the relationship. #PatientSafetyAttitudes #NursingInterns #CaringClimate.

Senior nursing student's confidence in learnt competencies and perceptions of patient safety competency: a multisite cross-sectional study

OBJECTIVE

Nursing students' attainment of patient safety (PS) competency has always been a global concern among health and educational organisations. Therefore, this study was conducted to determine senior nursing students' confidence of their PS competencies, and associated predictive factors.

DESIGN

Cross-sectional study.

SETTING

Four faculties from the nursing faculties of East Azerbaijan province.

PARTICIPANTS

253 senior nursing students in Iran.

PRIMARY AND SECONDARY OUTCOME MEASURES

Using the modified version of the Health Professional Education Patient Safety Survey, data related to the level of confidence of nursing students in acquired competencies in seven sociocultural dimensions of PS in classroom learning and clinical settings were collected. In addition, the predictors of the patient's safety competencies were identified by linear regression statistics.

RESULTS

Mean scores of all dimensions of PS competencies both in the classroom and in clinical settings were higher than 3.11 (out of 5). The nursing students were most confident in their learning of 'understanding human and environmental factors' in the classroom and the clinical setting. Nursing students displayed the least confidence in learning 'work in teams with other health professionals' in both the classroom and the clinical settings. Type of university, prior experience with PS competencies education, and coverage of PS competency issues in the curriculum predicted the students' perceived competency scores in the classroom (R2=0.53, p<0.001). Also, perceived competence in the clinical settings was predicted by the variables of reporting errors to personnel and peers and the type of university (R2=0.65, p<0.001).

CONCLUSION

Study findings emphasise the role of learning environments and educational experiences of nursing students especially the clinical environment, clinical instructors and the hidden curriculum in improving safety competence. Nursing educators can use this information to revise and develop the undergraduate nursing curriculum, paying close attention to lesson plans and content in relation to teaching safety issues.

Development of an International Tool for Students to Record and Reflect on Patient Safety Learning Experiences

BACKGROUND

Underpinning all nursing education is the development of safe practitioners who provide quality care. Learning in practice settings is important, but student experiences vary.

PURPOSE

This study aimed to systematically develop a robust multilingual, multiprofessional data collection tool, which prompts students to describe and reflect on patient safety experiences.

APPROACH

Core to a 3-year, 5-country, European project was development of the SLIPPS (Sharing Learning from Practice for Patient Safety) Learning Event Recording Tool (SLERT). Tool construction drew on literature, theory, multinational and multidisciplinary experience, and involved pretesting and translation. Piloting included assessing usability and an initial exploration of impact via student interviews.

OUTCOMES

The final SLERT (provided for readers) is freely available in 5 languages and has face validity for nursing across 5 countries. Student reports (n = 368) were collected using the tool.

CONCLUSIONS

The tool functions well in assisting student learning and for collecting data. Interviews indicated the tool promoted individual learning and has potential for wider clinical teams.

The moderating role of resilience in the relationship between peer pressure and risky behaviors among nursing students

PURPOSE

To examine the moderating role of resilience in the relationship between peer pressure and risky behaviors among nursing students.

DESIGN AND METHODS

A cross-sectional correlational study carried out with 512 students.

FINDINGS

The mean age was 20.90 ± 1.66. Of the students, 82.4% were females 99.0% were single, 71.5% had moderate socioeconomic status. While peer pressure directly made an effect on whole subdimensions for risky behaviors (p < 0.001), resilience had an effect on antisocial behavior, dropout, eating habits, and suicidal tendency (p < 0.001). Moderation was supported as the relationship between peer pressure and substance use varied by resilience level (p < 0.001). PRACTICAL IMPLICATIONS: Students with high levels of resilience are less prone to exhibit some risky behaviors based on peer pressure. Resilience-building strategies should be incorporated into the curriculum.

The Role of Education in Developing a Culture of Safety Through the Perceptions of Undergraduate Nursing Students: An Integrative Literature Review

OBJECTIVE

This integrative literature review seeks to examine research-based knowledge about the role of education in developing a culture of safety through the perspectives of undergraduate nursing students.

METHODS

An integrative literature review of nursing and health databases was conducted and literature from 2009 to 2018 were reviewed. Studies focusing on patient safety education in undergraduate nursing students were analyzed to identify the current state of safety education in academia. The results and findings from the articles reviewed were included in the final synthesis of the literature.

RESULTS

A total of 336 articles were identified from the onset and 14 were selected for inclusion in the review. There were 3 qualitative studies, 8 quantitative studies, and 3 mixed-methods research studies included. Four themes emerged: students perceive patient safety education is important, safety education in the curriculum is important, students are afraid to speak up, and students perceive a lack of knowledge and support for speaking up.

CONCLUSIONS

The results of this integrative literature review demonstrate that nursing education plays an integral role in creating a culture of safety among nursing students. Nursing students lack a strong understanding of their role in patient safety. This translates into a need for dedicated patient safety curriculum to establish a culture of safety in nursing education.

The Turkish version of the Patient Safety Competency Self-Evaluation Tool: A validity and reliability study

AIM

To test the validity and reliability of the Patient Safety Competency Self-Evaluation Tool in Turkish, which was developed to evaluate the patient safety competencies of nursing students.

BACKGROUND

In nursing education, it is crucial to provide students with the necessary professional knowledge and skills as well as appropriate attitudes in certain subjects. It is essential to address frequently encountered problems, to train nurses who can be aware of patient safety and improve the quality of nursing education. A valid and reliable measurement tool is needed to evaluate nursing students' current patient safety knowledge, skills and attitudes and review the curriculum and learning objectives in this context.

DESIGN

This is a validation study with a cross-sectional design.

METHODS

The study sample consisted of 417 third and fourth-grade nursing students studying at two universities in Istanbul and volunteered to participate in the research. The study used the Turkish version of the Patient Safety Competency Self-Evaluation Tool was used for data collection. Content validity, construct validity, stability and reliability tests were performed. Data were analyzed using SPSS and AMOS programs. Ethics committee approval and permission from the institutions were obtained.

RESULTS

Nursing students' mean age was 21.98 (SD = 1.17). The Scope Validity Index of the scale was calculated as 0.97. As a result of the confirmatory factor analysis performed in the original structure consisting of three dimensions, 12 factors and 41 items, it was found that all items were in the sub-dimensions of the original scale and factor loads were between 0.168 and 0.918. Four models were tested in confirmatory factor analysis and Model 4 had the best-fit indices. They were calculated as: χ2/df = 2.38, RMSEA = 0.06 and CFI = 0.91 for Model 4. Cronbach's alpha value of the total scale was 0.941 and ranged between 0.642 and 0.932 in its sub-dimensions.

CONCLUSION

The Turkish version of the Patient Safety Competency Self-Evaluation Tool is valid and reliable to measure nursing students' patient safety competencies.

The Academic-Practice Partnership: Educating Future Nurses

Strong partnerships are essential to lead the innovative change needed to prepare future nurses who demonstrate quality and safety competence. Successful models involve senior leadership, a shared vision, mutual goals, mutual respect, and an access to shared knowledge. The academic-practice partnership between a private university-based school of nursing and its affiliated health care system facilitated the implementation of a new Accelerated Bachelor of Science in Nursing (ABSN) program track to provide a seamless education to practice pathway for graduate nurses educated with quality and safety competencies and to meet the workforce demands of the health care system. The academic-practice model is based on the Guiding Principles outlined by the American Association of Colleges of Nursing-American Organization of Nurse Leaders (AACN-AONL) Task Force on Academic Practice Partnerships. As a result of this partnership, 84% of the program's graduates accepted a position with the health care partner as an advanced medical-surgical nurse, and student outcomes in quality and safety competencies were encouraging.

The knowledge about patient safety among undergraduate nurse students in Cyprus and Greece: a comparative study

BACKGROUND

The Patient safety movement contributed to the reduction of preventable adverse events associated with health care. Although patient safety issues have received the attention of educators in the health care studies, there is evidence that in nursing education and the associated curricula it is not well-incorporated. This may not allow students to acquire scientific knowledge and develop strong competencies to assure patient safety throughout their professional life. The aım of the study was the exploration of the undergraduate nursing student perspectives regarding knowledge received during their training about patient safety-related issues.

METHODS

A descriptive comparative study was conducted with three and four-year undergraduate nursing students from the Cyprus Republic (n = 243) and Greece (n = 367). All students were surveyed using the Health Professional Education Patient Safety Survey (H-PEPSS) to describe students' knowledge in the classroom and clinical setting.

RESULTS

Students' Knowledge about patient safety was expressed significantly higher (p < 0.001) in the classroom (mean = 4.0) than the clinical setting (3.7) (1-5 scale). The knowledge in the dimension "clinical aspects" received the highest score and "working in teams" received the lowest. Also, differences were recorded between countries wıth Cypriot students reporting hıgher level of knowledge than the Greek students in most of the dimensions. CONCLUSıON: The findings revealed the gap between theory and practice and the need for collaboration between the two settings. Also, students reported relatively higher knowledge with regards to the technical aspects of patient safety. Still, they were less knowledgable about the sociocultural aspects of the patient, such as working in teams.

Validation of the attitudes to patient safety questionnaire for nursing students in the Spanish context

Background

There are different instruments to assess the attitudes of nursing students towards patient safety. However, no questionnaire validated in Spanish with this objective was identified. The objective of this study was to validate the Attitudes to Patient Safety (APS) questionnaire for nursing students in Spain and to study the attitudes towards patient safety of nursing students at the Universitat Jaume I (Spain).

Design

Cross-sectional psychometric study developed in a sample of 177 undergraduate nursing students. The study was carried out in the second semester of 2016.

Methods

First, a nominal group was created to perform cross-cultural adaptation and determine content validity of the Attitude to Patient Safety Questionnaire (APQS-III). Second, a cross-sectional study was conducted to determine the psychometric properties of the questionnaire and to study nursing student attitudes towards patient safety.

Results

Exploratory factorial analysis explained 53.82 % of the variance, with good internal consistency (α = 0.808), and confirmatory factor analysis indicate an adequate fit between the model and the data (χ2 = 366; p < 0.001; χ2/df = 1.886; RMSEA = 0.07; IC95 %=0.059–0.081; CFI = 0.885). Intra-observer reliability was good (ICC = 0.792, p < 0.001). The mean overall score of the questionnaire was 3.92 (95 % CI = 3.88–4.03). Significant differences were observed regarding whether the students had completed a clinical practicum (p = 0.012) and the academic year (p = 0.25).

Conclusions

The psychometric properties of the APS questionnaire adapted for Spanish nursing students are adequate. Students show an adequate attitude towards patient safety; however, it is necessary to develop a strategy to guarantee the acquisition of competency for patient safety as well as to design and evaluate specific educational interventions.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-021-00634-y.

Nursing Students' Knowledge of Patient Safety and Development of Competences Over their Academic Years: Findings from a Longitudinal Study

Introduction

Future nurses should possess the knowledge and competences necessary to ensure patient safety. However, little evidence is available on the way in which students learn patient safety-related principles over time. This study explored the progress of a cohort of Italian undergraduate nursing students as they acquired patient safety knowledge and competences from time of enrolment to graduation.

Methods

A longitudinal study carried out between 2015 and 2018 enrolled a cohort of 90 nursing students from two Italian Bachelor of Nursing Science Degree Courses at the Udine University, Italy. The students were followed-up on an annual basis and data collection was performed three times: at the end of the 1st, 2nd and 3rd years. The validated Italian version of the Professional Education in Patient Safety Survey tool was used to collect data.

Results

At the end of the 1st year, students reported an average 4.19 out of 5 patient safety knowledge acquired in classrooms (CI 95%, 4.11-4.28), which was stable at the end of the 2nd (4.16; CI 95%, 4.06-4.26) and 3rd years (4.26; CI 95%, 4.16-4.32) and no statistical differences emerged over the years. With regard to the competences acquired in clinical settings, at the end of the 1st year the students reported an average 4.28 out of 5 (CI 95%, 4.20-4.37), which decreased significantly at the end of the 2nd year (4.15; CI 95%, 4.07-4.23; p=0.02) and increased at the end of the 3rd year (4.37; CI 95%, 4.27-4.47; p<0.01).

Conclusions

Nursing students' competences in patient safety issues increases over time, while their knowledge remains stable. Students are more vulnerable at the end of the 1st year, when they seem to be overconfident about patient-safety issues.

Major educational factors associated with nursing adverse events by nursing students undergoing clinical practice: A descriptive study

BACKGROUND

As the main group of healthcare providers in hospitals, nurses have more frequent contacts than any other clinician and thus are in a better position to improve patient safety. With the purpose of cultivating competent nurses, nursing educators have the responsibility to promote patient safety. A better understanding of educational factors affecting nursing adverse events by nursing students undergoing clinical practice can help nursing educators find appropriate ways to fulfil their duty.

OBJECTIVE

To examine the status quo of nursing adverse events and to discuss the major educational factors concerned in different regions of China.

DESIGN

A descriptive study design was undertaken in 2018.

PARTICIPANTS AND SETTING

A convenience sample of 1173 nursing students undergoing clinical practice was recruited from 22 hospitals in different regions of China.

METHODS

The Chinese version of the Medical Student Safety Attitudes and Professionalism Survey (MSSAPS) was administered to and demographic and professional data were collected from clinical nursing students after obtaining informed consent.

RESULTS

The incidence of nursing adverse events in clinical student nurses was 17.8%. Approximately 87.01% of nursing adverse events were near miss. The positive response rate of safety attitudes and professionalism by clinical nursing students ranged from 57.5% to 96.9%. Logistic analysis indicated that gender, educational level, hospital regions, safety culture and professional behavior experience dimensions were the major factors influencing nursing adverse events.

CONCLUSION

Attention should be paid to the situation in which clinical nursing students are prone to nursing adverse events. Cooperation between nursing colleges and hospitals should be strengthened to promote patient safety in clinical nursing students. We suggest that nursing educators implement patient safety education in both theoretical and practical teaching and use multiple forms, especially simulation-based training, to strengthen safe nursing behavior to reduce the incidence of nursing adverse events.

Attitudes of Undergraduate Nursing Students towards Patient Safety: A Quasi-Experimental Study

Improving nursing students' attitudes towards patient safety is a current and relevant topic. This study aims to evaluate the effectiveness of an educational intervention based on critical incident and root cause analysis (RCA) techniques regarding attitudes towards patient safety in nursing students. A quasi-experimental before and after study was developed between January 2018 and December 2019 in a sample of 100 nursing students at Universitat Jaume I (Spain). The intervention was developed in two phases. Phase I was at university, where students applied the RCA technique in a real case. Phase II took place during clinical practice. Students used critical incidents to identify a risk situation for the patients and applied RCA to detect its root causes. The measurement of attitudes was performed with the Attitudes to Patient Safety Questionnaire (APSQ-III). The global score of the questionnaire in the baseline measurement was 3.911 (±0.335), in the intermediate measurement it was 4.031 (±0.337) and in the final measurement it was 4.052 (±0.335), with significant differences (p = 0.03). However, intra-group differences were observed in the final measurement (p = 0.021). The teamwork dimension had the highest mean score on all three measures and the notification dimension had the lowest mean scores. An educational intervention combining critical incident and RCA techniques can improves nursing students' attitudes toward patient safety.

Fourth-year dental hygiene students' educational preparedness: Self-confidence ratings of the Canadian Dental Hygienists Association baccalaureate competencies (2017-2019)

PROBLEM STATEMENT

The Canadian Competencies for Baccalaureate Dental Hygiene Programs (CCBDHP) were first published in 2015 by the Canadian Dental Hygienists Association. They reflect the first articulation of dental hygiene baccalaureate competencies in North America. However, there is little evidence to support baccalaureate graduates acquire these abilities.

OBJECTIVE

To examine the confidence levels of baccalaureate fourth-year students in their ability to demonstrate the CCBDHPs.

METHODS

This 3-year longitudinal study rated the self-confidence levels of fourth-year students as they neared graduation from the University of British Columbia from 2017 to 2019. It involved an online, anonymous survey using a 5-point scale ranging from not confident to confident. Respondents rated their self-confidence in the 110 sub-competencies articulated within the 13 competency domains of the CCBDHP.

RESULTS

Responses were received from 54 of the 70 graduating students for a cumulative 77% response rate. Respondents expressed the most confidence in the competency domains of Clinical Therapy (100%), Collaboration (100%), Disease Prevention (100%), Professionalism (100%), and Oral Health Education (90%) but expressed less confidence in Research Use (73%), Health Promotion (70%), Leadership (67%), Policy Use (20%), and Advocacy (11%).

CONCLUSION

These data suggest that curriculum revisions are needed in 5 domains but such changes may not be sufficient. Transition support may be warranted to assist graduates as they enter practice, while some competencies may be more appropriate for graduate studies. The study contributes to an international discussion about the educational preparedness of baccalaureate graduates, and the boundaries between diploma, baccalaureate and master's education.

The Effect of Patient Safety Education on Undergraduate Nursing Students' Patient Safety Competencies

Patient safety is influenced by a set of factors in various levels of the healthcare system. One of the factors affecting patient safety is safety competencies of the nursing students. The current study aimed to evaluate the effect of patient safety education on patient safety competencies of the nursing students. This quasi-experimental study was conducted with a pretest-posttest deign. The levels of patient safety competencies of 50 nursing students were investigated in a nursing school affiliated to large university of medical sciences in the south of Iran in 2019. Data were collected using Health Professional Education in Patient Safety Survey (H-PEPSS). The data were analyzed in SPSS 21 using descriptive statistics and repeated measures ANOVA. The three investigated intervals were significantly different in terms of the total H-PEPSS dimensions, while the lowest was attributed to the dimension "managing safety". Mean scores of "how broader patient safety issues are addressed in health professional education" and "comfort speaking up about patient safety" significantly increased during the follow-up periods. The educational intervention was partially effective in improving patient safety competencies of the nursing students over long term.

Embedding skin tone diversity into undergraduate nurse education: Through the lens of pressure injury

OBJECTIVE

To explore health disparity in on-campus undergraduate nurse education through the analysis of teaching and teaching material exploring pressure injuries.

BACKGROUND

As a discipline, nursing espouses ideologies of inclusion, equity and valuing diversity. However, little is known about how these ideologies translate into clinical care. Pressure injury prevention is a routine aspect of nursing care; yet, there is evidence of inequity in relation to clinical care and patient assessment, as people with darker skin tones have a higher prevalence of severe pressure injuries before detection of damage occurs. Despite limited literature being available surrounding the topic of pressure injuries and skin tone diversity, it remains the responsibility of nurse educators to address contemporary issues and health disparity within the nursing curriculum.

DESIGN

A multiple method collective case study. The STROBE checklist was followed in reporting this study.

METHODS

Documentary and observational data of lectures regarding pressure injuries were collected during 2017 and 2018 from five Higher Education Institutes in England delivering approved nursing undergraduate programmes.

RESULTS

Documentary analysis confirmed all Higher Education Institutes overwhelmingly directed teaching and learning activities about pressure injury towards people with Caucasian skin tones. Observation of teaching indicated all teaching sessions only contained brief, separate and superficial information on people with pressure injuries and darker skin tones. There was no discursive language or awareness of colour or colour blindness.

CONCLUSION

Radical critique of all teaching and learning activities needs to occur, to help explore, improve and meaningfully and authentically include diversity and inclusivity in nurse education, and in particular, how people across the skin tone spectrum are included and represented in teaching and learning activities.

RELEVANCE TO CLINICAL PRACTICE

Critical examination of current teaching practice is crucial to address disparity and ensure care for people with darker skin tones is optimised. Nurse educators have a responsibility to educate for the care needs of all, as the quality of nurse education has a direct impact on care delivery and health disparity. This paper highlights the importance of addressing skin tone diversity and offers the opportunity for reflective practice, not just in formal education, but in clinical settings by preceptors and senior staff.

Assessment of Patient Safety and Cultural Competencies among Senior Baccalaureate Nursing Students

This descriptive, correlational, cross-sectional study examined nursing students' educational experiences on self-reported perceptions of patient safety and cultural competence in terms of curriculum content and learning venues. We performed descriptive analyses and a one-way analysis of variance with a sample of senior-year nursing students (N = 249) attending three state universities in the United States. We used the Nurse of the Future Nursing Core Competency Model, the Patient Safety Competency Self-Evaluation Tool for Nursing Students, and The Cultural Competence Assessment Instrument. Overall, participants reported that patient safety and cultural competencies were addressed in their curricula primarily through classroom activities as opposed to laboratory/simulation or clinical settings. Among the required patient safety knowledge topics, elements of highly reliable organizations were covered the least. For patient safety competency, participants reported higher scores for attitude and lower scores for skill and knowledge. For cultural competency, participants scored much higher for cultural awareness and sensitivity than behavior. There was no statistically significant difference between scores for patient safety and cultural competencies by nursing school. The results support the need for curriculum development to include all important aspects of patient safety and cultural competencies in various teaching/learning venues.

Perceived Patient Safety Competence of Baccalaureate Nursing Students: A Descriptive Comparative Study

Introduction

Patient safety is an issue of utmost concern within health care. An interrelated approach between nursing education and practice is needed. For more than a decade, nursing education programs have responded to calls for curricular reform, integrating strategies to prepare graduates for safe nursing practice.

Objectives

The purpose of the descriptive study was to examine self-perceived safety competencies among baccalaureate (BSN) nursing students at end of program (n = 72) using the Health Professional Education in Patient Safety Survey. In addition to the objective of describing self-perceived safety competencies of BSN students, another objective was to investigate any significant differences in self-perceived competencies between traditional 4-year and accelerated 12-month program students.

Methods

A descriptive comparative design was used with a purposive sample of baccalaureate nursing students from both traditional and accelerated second-degree programs at a comprehensive university in the Northeast.

Results

Students rated self-confidence with patient safety learned in the clinical environment higher than within the classroom setting. Overall, students reported a high level of self-confidence within each of the seven patient safety dimensions with knowledge gained from the clinical setting higher than knowledge gained from the classroom setting. Paired t-test analyses revealed statistically significant differences (p < .05) between self-confidence gained in classroom and clinical environments with communicating effectively and managing safety risks. Independent t-test analyses revealed accelerated students reported lower self-confidence than traditional students, with statistically significant differences (p < .05) in dimensions of culture of safety, working in teams, managing safety risks, and disclosing adverse events/close calls.

Conclusion

In most patient safety dimensions, students felt confident with their competencies within each of the dimensions of patient safety. Results also revealed that accelerated second-degree students report lower confidence with their knowledge of patient safety gained from classroom and clinical settings. Nursing programs must continue to emphasize a culture of safety within the nursing curriculum.

A Comparison of Patient Safety Competencies between Clinical and Classroom Settings among Nursing Students

Background: As nurses play an important role in the implementation of patient safety in hospitals, competencies of patient safety should be developed and enhanced among nursing students. Self-assessment is a method that can be used to assess patient safety and its dimensions to help the students prepare themselves before entering the work life.Purpose: This study aimed to investigate differences in patient safety competencies between classroom and clinical settings among nursing students using a self-assessment method.Methods: A descriptive study using the Health Professional Education in Patient Safety Survey (H-PEPSS) questionnaire was conducted among 181 nursing students in a public university in Indonesia. Paired t-test, ANOVA, and independent t-test were performed to determine the comparison in the values of patient safety dimensions across classroom, clinical learning, and year of nursing course.Results: Nursing students showed a higher mean value in the classroom setting than the clinical setting. Out of the seven dimensions of patient safety competencies, “clinical safety” (M=4.36) and “communicate effectively” (M=4.29) obtained the highest score in classroom setting, while “adverse events” showed the lowest (M=4.03). In the clinical setting, “clinical safety” (M=4.19) and “communicate effectively” (M=4.12) obtained the highest score, while “working in teams” (M=3.82) was the lowest. The third-year students showed a better score than the fourth year in most dimensions.Conclusion: In this study, the patient safety competencies among nursing students were higher in the classroom setting than in the clinical setting. It is recommended to investigate the factors that can increase the achievement of patient safety competence among nursing student in the clinical setting.

Nursing Students' Perceptions of Just Culture in Nursing Programs: A Multisite Study

BACKGROUND

While just culture is embraced in the clinical setting, just culture has not been systematically incorporated into nursing education.

PURPOSE

The purpose of this study was to assess prelicensure nursing student perceptions of just culture in academia.

METHODS

Following a quantitative, descriptive design, the Just Culture Assessment Tool for Nursing Education (JCAT-NE) was used to measure just culture across multiple (N = 15) nursing programs.

RESULTS

The majority of JCAT-NE respondents (78%) reported their program has a safety reporting system, 15.4% had involvement in a safety-related event, and 12% submitted an error report. The JCAT-NE mean total score was 127.4 (SD, 23.6), with a statistically significant total score decline as students progressed from the beginning (133.6 [SD, 20.52]) to the middle (129.77 [SD, 23.6]) and end (122.2 [SD, 25.43]) of their programs (χ[2] = 25.09, P < .001).

CONCLUSIONS

The results from this study are a call to action for nursing education to emphasize the tenets of just culture, error reporting, and quality improvement.

Comparison of the effects of simulation training and problem-based scenarios on the improvement of graduating nursing students to speak up about medication errors: A quasi-experimental study

BACKGROUND

Medication administration errors are common among new nurses. Nursing students might be less willing to speak up about errors because of a lack of knowledge and experience.

OBJECTIVES

To examine the effects of simulation training and problem-based scenarios on speaking up about medication errors among graduating nursing students.

DESIGN

Prospective, controlled experimental study design.

SETTING

A university four-year nursing program in Taiwan.

PARTICIPANTS

In total, 93 graduating nursing students in their last semester were recruited. Sixty-six students who received both a problem-based scenario and medication administration simulation training comprised the experimental group, while 27 students who received problem-based scenarios alone comprised the control group.

METHODS

Experimental group students underwent 2 h of simulation training. This training class was designed based on Kolb's experiential learning theory for knowledge development and speaking up about errors. Students in both groups administered medications in problem-based scenarios with eight embedded errors. Students' performance in speaking up about medication errors was directly observed and graded using an objective structured checklist. The McNeamer Chi-squared test, paired t-test, Z test, t-test, and Hedges' g effect size were conducted.

RESULTS

The number of times participants spoke up about medication errors significantly improved in both the experimental group (pre-test: 2.05 ± 1.12 and post-test 6.14 ± 1.25, t = 22.85, p<0.001) and control group (pretest: 2.04 ± 1.16 and post-test: 4.26 ± 1.63, t = 6.33, p<0.001). However, after the intervention, the mean number of times participants spoke up about medication errors in the experimental group was significantly higher than that in the control group (t = 5.99, p<0.001) in the post-test.

CONCLUSIONS

Simulation training exhibited more-significant improvements than problem-based scenarios. Nursing schools and hospitals should incorporate simulation training or at least problem-based scenarios to improve medication safety.

Dental hygiene graduates' educational preparedness: Self-confidence ratings of the CDHA baccalaureate competencies

PURPOSE

In 2015, the Canadian Dental Hygienists Association (CDHA) published the first Canadian Competencies for Baccalaureate Dental Hygiene Programs (CCBDHP). To date, there is little evidence to support that baccalaureate graduates have gained these abilities. The purpose of the study was to investigate the confidence levels of baccalaureate graduates in their ability to demonstrate the CCBDHP.

METHODS

An online, anonymous study was conducted with the 2013-2016 graduates of the University of British Columbia to rate their confidence level in the 13 competency domains and associated 110 sub-competencies of the CCBDHP based on a 5-point scale ranging from not confident to confident.

RESULTS

Thirty of the 84 graduates responded to the survey for a 36% response rate. The mostly confident and confident scores were added to determine the number of sub-competencies within each domain in which 75% to 100% of respondents identified such confidence. The competency domains in which graduates expressed the highest confidence included Collaboration (100%), Communication (100%), Clinical Therapy (100%), Disease Prevention (100%), Oral Health Education (90%), Professionalism (90%), Research Use (90%) and Leadership (90%). They expressed the least confidence in the competency domains of Health Promotion (50%), Advocacy (22%) and Policy Use (0%).

CONCLUSION

These data provided the UBC faculty with important insights into the educational preparedness of baccalaureate graduates. The findings are also relevant for other Canadian programmes and contribute to a larger national dialogue about the CCBDHP and the transition of graduates into practice.

Self-reported confidence in patient safety competencies among Chinese nursing students: a multi-site cross-sectional survey

BACKGROUND

Nursing interns are an important backup force for nursing professionals, so efforts to strengthen their patient safety (PS) competencies are a major priority. To do so requires assessing the strengths and weaknesses of Chinese nursing students' PS competence and identifying the influencing factors.

METHODS

This was a multi-site, cross-sectional, web-based study that was carried out between September 2018 and January 2019. A national online survey was completed by 732 Chinese undergraduate nursing students. Our primary outcome factor was the Health Professional Education in Patient Safety Survey score. We also collected socio-demographic and clinical practice-related characteristics as independent variables. Multiple stepwise linear regression was performed to identify predictors of PS competence.

RESULTS

Chinese undergraduate nursing students were fairly confident in their clinical safety skills but less confident in what they learned about sociocultural or context-dependent aspects of PS and speaking up about PS, including effective communication and understanding human and environmental factors. Less than half of the students felt that they could approach someone engaging in unsafe practice and were reluctant to voice concern about adverse events. We observed significant differences in PS competence between students from different regions, across different PS learning styles (self-study and classroom theoretical study), with different self-assessed PS competence levels, and with experiences of adverse events (p < 0.05). These factors accounted for almost 15% of the total variance in PS competence scores (adjusted R² = 0.15, p = 0.00).

CONCLUSIONS

The results of this study provide a better understanding of PS competence among final-year nursing students in China. Our findings may help nursing educators or healthcare organizations to cultivate and improve PS competence by establishing documented policies or by improving the efficacy of intervention.

Development and Validation of the Just Culture Assessment Tool for Nursing Education

BACKGROUND

Patient safety efforts in practice have focused on creating a just culture where errors can be identified and reported, and system remedies created to prevent reoccurrence. The same is not true of nursing education where student experiences with error and the sequelae that follow focus on individual performance.

PURPOSE

The purpose of this study was to adapt the Just Culture Assessment Tool (JCAT) used in practice settings into a valid and reliable instrument to evaluate just culture in academic settings.

METHODS

A 27-item instrument was adapted for academia. Content validity was established. Reliability was determined in a pilot study with 133 prelicensure nursing students.

RESULTS

The scale content validity index (CVI) was calculated at 1. The reliability of the instrument is strong (α = .75).

CONCLUSIONS

The CVI and pilot study findings support the use of the JCAT for Nursing Education as a valid and reliable instrument to evaluate student perception of just culture in academia.

Psychometric testing of the Turkish version of the Health Professional Education in Patient Safety Survey: H-PEPSSTR

Nursing students are trained in patient safety issues in clinical settings during their undergraduate nursing education both theoretically and practically. This study aims to test the psychometric properties of the Turkish version of the "Health Professional Education in Patient Safety Survey" which was developed to measure healthcare professional candidates' patient safety knowledge and competence both in the classroom and clinical settings during their education. The data for this methodological study were collected from 305 nursing students in 2017. The tool consisted of 23 items, two main dimensions as classroom and clinical settings and six subscales. Content validity ratings of the scale items were over 0.80. Five modifications were made during the Confirmatory Factor Analyses. Three of the modifications were among classroom items and two of them were from clinical settings items. After modifications, fit indices were calculated as: χ2/df = 2.58, RMSEA = 0.072 and CFI = 0.95 for the classroom. They were χ2/df = 2.23, RMSEA = 0.063 and CFI = 0.96 for the clinical settings. Cronbach's alpha coefficient was 0.97 for both classroom and clinical settings. In conclusion, The Turkish version of the scale is valid and reliable in assessment of patient safety knowledge and competence of nursing students.

Nursing Students' Perceived Self-Efficacy and the Generation of Medication Errors with the Use of an Electronic Medication Administration Record (eMAR) in Clinical Simulation

Medication errors continue to be a significant issue, posing substantial threats to the safety and well-being of patients. Through Bandura's theory of self-efficacy, nursing students' self-efficacy (confidence) related to medication administration was examined to investigate its influence on the generation of medication errors with the use of an Electronic Medication Administration Record (eMAR) in clinical simulation. This study examined the generation of medication errors and the differences that may exist based on nursing students' perceived confidence. The findings of this study demonstrated that nursing students continue to generate medication errors within clinical simulation. No differences in the generation of medication errors were found between nursing students with perceived high levels of confidence and those with perceived low levels of confidence (one exception noted). Further examination of the variables and contextual factors related to safe medication administration practices is required to inform nursing education and practice.

Preregistration nursing students' perceived confidence in learning about patient safety in selected Kenyan universities

Background

Improvement of patient safety in Kenya depends on knowledgeable nurses who are equipped with the clinical safety and sociocultural competences of patient safety.

Objectives

This study assessed the theoretical and practical learning of these competences as perceived by nursing students.

Method

A cross-sectional descriptive study was conducted on 178 preregistration Bachelor of Nursing students from two Kenyan universities using the Health Professional Education in Patient Safety Survey. This tool assessed the students’ confidence in learning about clinical safety and the sociocultural aspects of patient safety in the classroom and clinical settings. Descriptive statistics summarised the sample and survey responses, while paired t-tests and ANOVA were used to compare responses across learning settings and year of study.

Results

The students reported higher confidence about learning on the clinical aspects than on the sociocultural issues of patient safety with the lowest mean scores recorded in ‘Understanding human and environmental factors’ and ‘Recognising, responding and disclosing adverse events’. They reported significantly higher confidence scores in the classroom setting than the clinical setting with no significant difference in reported confidence across the years of study. They were less confident in speaking up about patient safety issues in the clinical areas with 52.2% feeling that reporting a patient safety problem will result in negative repercussions.

Conclusion

Nursing programmes in Kenya need to reinforce the sociocultural aspects of patient safety in the curriculum. The patient safety culture in the clinical placements sites needs to be conducive to enable, and not hinder, the acquisition of these competences.

Attitudes towards patient safety culture among postgraduate nursing students in China: A cross-sectional study

Patient safety is crucial to healthcare quality. It is important to assess the nursing students' safety attitudes to identify the weaknesses for developing education program and fostering students' engagement in patient safety practices. This study aimed to assess attitudes towards patient safety culture among postgraduate nursing students in China, and explore the factors that affect their safety attitudes and the relationships of safety attitudes and safety-related behaviors. This study used a cross-sectional survey design. A convenience sample of 231 postgraduate nursing students from ten medical universities in China completed the Chinese version of Safety Attitude Questionnaire, including six domains: teamwork climate, safety climate, perceptions of management, job satisfaction, working conditions and stress recognition. The mean scores of the six domains ranged from 65.22 to 70.75 on a 100-point scale. Percentages of positive responses for the six domains were below 55%, with the two lowest percentages for working conditions (35.9%) and safety climate (30.7%). Significantly lower domain scores were found in students with younger age, no work experience, higher workload and received safety education. There were positive correlations between the six domains and safety-related behaviors except for stress recognition. Nursing educators should focus more on the improvement of patient safety education and establishment of supportive work environment to enhance postgraduate nursing students' attitudes towards safety culture.

The impact of an innovative curriculum to introduce patient safety and quality improvement content

BACKGROUND

The Fuld Fellows Program provides selected pre-licensure nursing students with a foundation in the science of patient safety, quality improvement and leadership through coursework and a mentored experience working on a quality improvement project. We evaluated this program's impact on Fellows' patient safety competence and systems thinking.

METHODS

Cohorts I-VI (n = 116) completed pre-post program evaluation that included measurement of patient safety competence through the Health Professional Education in Patient Safety Survey (H-PEPSS) and systems thinking using the Systems Thinking Scale. Pre- and post-program H-PEPSS and Systems Thinking Scale scores were compared using the Wilcoxon Signed-Rank Test. The Fellows were compared to non-Fellows on patient safety competence and systems thinking using t-tests.

RESULTS

Patient safety competence on all H-PEPSS scales improved from baseline to end of program: teamwork (2.6 to 3.1), communication (2.1 to 3.2), managing risk (2.2 to 3.3), human environment (2.8 to 3.7), recognize and respond to risk (2.7 to 3.6), and culture (2.9 to 3.8) (p < 0.05). The Fellows, in comparison to the non-Fellows, reported a significantly higher (p < 0.05) mean change score in five of the six H-PEPSS subscales. Fellows' mean systems thinking score increased from 66 ± 7 at baseline to 70 ± 6 at program completion (p < 0.05), this mean post completion score was significantly higher than the non-Fellows reported mean STS score of 62 ± 7.

CONCLUSION

The Fuld Fellows Program effectively facilitated patient safety and quality improvement and systems thinking learning among pre-licensure nursing students. This program can serve as a model for integrating quality and safety concepts into health professionals' curricula.

What influences nursing safety event reporting among nursing interns?: Focus group study

BACKGROUND

Nursing safety events involving undergraduate nursing interns often occur but are under-reported. Only a few nursing schools have instituted formal reporting systems. The factors that affect reporting by undergraduate nursing interns are largely unknown.

OBJECTIVE

The study aimed to explore the barriers and incentives to nursing safety event reporting by nursing interns.

DESIGN

Focus groups were adopted to generate data for qualitative, thematic analyses.

SETTINGS

Focus groups were held in intern dormitories during evenings or weekends.

PARTICIPANTS

Purposive sampling strategies were employed. The participants were undergraduate nursing interns from one medical university in Fuzhou, China.

METHODS

A total of six focus groups were conducted. Semi-structured questions guided the groups.

RESULTS

Thirty-eight undergraduate nursing interns attended the groups. Barriers to nursing safety event reporting had five major themes: "Lack of knowledge," "Inconvenience of the reporting system," "Feeling of uncertainty and dishonor," "No benefit from reporting," and "Social influence." Incentives had three major themes: "Nursing safety event education," "Optimization of the reporting system," and "Anonymous reporting." Specific and targeted suggestions were considered, such as education by QQ or WeChat and the use of mobile devices.

CONCLUSIONS

Nursing schools need to establish nursing safety event reporting systems for interns, and this needs to be accomplished in cooperation with teaching hospitals to clarify duties and management responsibilities. Practical and targeted management strategies need to be developed to foster reporting, improve nursing safety culture, and promote hospital quality.

How do nurses and midwives perceive their preparedness for quality improvement and patient safety in practice? A cross-sectional national study in Ireland

BACKGROUND

Although patient safety and quality are cornerstones of healthcare practice, evidence is limited of the knowledge, skills and competence of practicing nurses and midwives in Ireland.

OBJECTIVES

To investigate the perceptions of nurses and midwives regarding their continuing professional development-based preparedness for, and participation in quality and safety in the clinical setting.

DESIGN

A cross-sectional survey was undertaken across the Republic of Ireland in 2016 examining nurses and midwives' perceptions of their knowledge and skills in quality and safety methods and tools, their views of competence in this field using the domains from the Quality and Safety Education for Nurses (QSEN) framework (person-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics), and their participation in practice related to their access to quality and safety data.

SETTINGS

12 Health Service Executive (HSE) Centers of Nursing and Midwifery Education (CNMEs) in Ireland PARTICIPANTS: Practicing nurses and midwives (n = 654) working in acute hospitals and community healthcare organizations who were undertaking continuing professional development (CPD) education at the time of data collection (March-April 2016).

METHODS

Survey methodology. 1787 surveys were distributed. Data were analyzed by IBM Statistical Package for the Social Sciences.

RESULTS

A response rate of 37% (n = 654/1787) was achieved. While respondents were highly trained academically, many reported a lack of confidence in quality and safety methods and tools and QSEN competencies. Frontline staff nurses and midwives reported they were less prepared than their mid and senior level colleagues. Significant numbers indicated they were not engaged in quality and safety in practice.

CONCLUSIONS

This first nationwide study in Ireland has discovered that nurses and midwives perceive gaps in their preparedness to engage in quality improvement and patient safety in practice. To safeguard patient care, priority should be given to ensuring front-line staff are appropriately educated, have access to data, and time to competently participate in the continuous improvement of patient care.

Measuring Patient Safety Competence Among Nursing Students in the Classroom and Clinical Settings

BACKGROUND

Little is known of the extent to which patient safety (PS) education is addressed in nursing curricula in the classroom and clinical settings in Jordan.

METHOD

An Arabic version of the Health Professional Education in Patient Safety Survey was administered to a convenience sample of 297 nursing students from two governmental universities in Jordan.

RESULTS

Nursing students were moderately satisfied about their knowledge and competencies regarding most PS dimensions; they also had more confidence about the knowledge and competencies they learned in the classroom than during the clinical training. Students in their advanced year had lower confidence about their PS knowledge and competencies than students in the earlier years.

CONCLUSION

The study suggests the need to close the gap between theory and practice in the nursing curriculum. The adoption of a comprehensive framework that integrates PS knowledge and competencies is recommended.

[The Opinions and Practices of Nursing Students About Preoperative Patient Safety]

Amaç

Araştırma, ikinci sınıf hemşirelik öğrencilerinin ameliyat öncesi hasta güvenliğine ilişkin görüşleri ve uygulamalarının incelenmesi amacıyla yapıldı.

Yöntem

Tanımlayıcı tipte olan araştırma, Kasım 2016-Nisan 2017 tarihleri arasında iki üniversite hastanesinin cerrahi birimlerinde uygulamaya çıkan ve araştırmaya alınma kriterlerine uyan 219 hemşirelik 2. sınıf öğrencisi ile gerçekleştirildi. Verilerin toplanmasında araştırmacılar tarafından literatür doğrultusunda geliştirilen ve iki bölümden oluşan veri toplama formu kullanıldı. Araştırmaya başlamadan önce gerekli kurum ve etik kurul izinleri alındı. Verilerin analizinde tanımlayıcı istatistikler ile Ki-Kare testi kullanıldı.

Bulgular

Araştırmaya katılan öğrencilerin yaş ortalamasının 20.29±1.65 (yıl) olduğu ve %50.2’sinin iş olanağının fazla olması nedeniyle mesleği tercih ettiği saptandı. Öğrencilerin %33.8’inin hasta güvenliğine yönelik ders aldığı, %26.9’unun hasta güvenliğine yönelik seminer, kurs vb. eğitim etkinliklerine katıldığı belirlendi. Ameliyat öncesi hasta güvenliği uygulamalarını yapma durumları incelendiğinde ise araştırmaya katılan öğrencilerin ameliyat öncesi en çok yaptıkları ilk üç uygulamanın sırasıyla yaşam bulgularının ölçülmesi, kimlik bilgilerinin kontrolü ve ameliyat bölgesinin doğrulanması olduğu belirlendi.

Sonuç

Bu araştırmada öğrencilerin çoğunluğunun ameliyat öncesi hasta güvenliğine yönelik herhangi bir eğitim programına katılmadıkları; buna karşın, ameliyat öncesi hasta güvenliğine yönelik bazı uygulamaları gerçekleştirdikleri görüldü. Bu sonuçlar doğrultusunda, hasta güvenliğine yönelik eğitim faaliyetleri düzenlenerek ve öğrencilerin bu faaliyetlere katılımları sağlanarak, ameliyat öncesi hasta güvenliği uygulamalarına yönelik bilgilerinin arttırılması ve daha büyük örneklem grubu ile tüm sınıfların bilgi ve uygulama düzeylerinin karşılaştırılması önerilebilir.

Infection control and patient safety measures addressed in nursing pedagogical projects

OBJECTIVE

To characterize teaching about patient safety and standard precautionary measures for infection prevention and control in undergraduate nursing courses.

METHOD

A descriptive documentary analysis study carried out in undergraduate courses, with a concept equal to or greater than three in the National Student Performance Exam and in the Preliminary Course Concept, located in the state of Goiás, Brazil.

RESULTS

Six education institutions participated, with the majority being private with curricular structure by discipline. Six pedagogical projects and 273 subject plans were analyzed. The most discussed topics for patient safety development were human factors related to communication, interpersonal relationships, and principles and techniques. Thirty-nine (39) disciplines contemplated teaching infection prevention and control measures, and the most approached topics were personal protective equipment and hand hygiene.

CONCLUSION

Teaching about patient safety presented strong gaps in the six evaluated courses. There is fragility in teaching infection prevention and control measures. The data indicate the need to review the Course Pedagogical Projects in order to incorporate necessary educational demands for training professionals so that they develop safe and quality care.

Patient safety content and delivery in pre-registration nursing curricula: A national cross-sectional survey study

BACKGROUND

Patient safety is a core principle of health professional practice and as such requires significant attention within undergraduate curricula. However, patient safety practice is complex requiring a broad range of skills and behaviours including the application of sound clinical knowledge within a range of health care contexts and cultures. There is very little research that explores how this is taught within Australian nursing curricula.

OBJECTIVES

To examine how Australian nursing curricula address patient safety; identify where and how patient safety learning occurs; and describe who is responsible for facilitating this learning.

DESIGN

A cross-sectional study.

SETTING

Eighteen universities across seven Australian States and Territories.

PARTICIPANTS

The sample consisted of 18 nursing course coordinators or those responsible for the inclusion of patient safety content within a Bachelor of Nursing course at Australian universities.

METHODS

An online survey was conducted to evaluate the patient safety content included and teaching methods used in Australian pre-registration nursing curricula.

RESULTS

Approaches to teaching patient safety vary considerably between universities where patient safety tended to be integrated within undergraduate nursing course subjects rather than explicitly taught in separate, stand-alone subjects. Three-quarters of the surveyed staff believed patient safety was currently being adequately covered in their undergraduate nursing curricula.

CONCLUSION

Although there is consensus in relation to the importance of patient safety across universities, and similarity in views about what knowledge, skills and attitudes should be taught, there were differences in: the amount of time allocated, who was responsible for the teaching and learning, and in which setting the learning occurred and was assessed. There was little indication of the existence of a systematic approach to learning patient safety, with most participants reporting emphasis on learning applied to infection control and medication safety.

Patient safety in practical nurses' education: A cross-sectional survey of newly registered practical nurses in Canada

BACKGROUND

Practical nurses have experienced an increasing scope of practice, including an expectation to care for complex patients and function on interdisciplinary teams. Little is known about the degree to which patient safety principles are addressed in practical nursing education.

PURPOSE

To examine self-reported patient safety competencies of practical nurses.

DESIGN

A cross-sectional online survey (July 2014) and face-to-face interviews (June 2015).

SETTING

Ontario, Canada.

PARTICIPANTS

Survey participants were practical nurses newly registered with the College of Nurses of Ontario between January 2012 and December 2013. Interview participants were faculty and students in a practical nursing program in Ontario.

METHODS

Survey respondents completed the Health Professional Education in Patient Safety Survey online. Self-reported competencies in various patient safety domains were compared between classroom and clinical settings. Faculty members were interviewed about educational preparation of practical nurses and students were interviewed to provide insight into interpretation of survey questions.

RESULTS

The survey response rate was 28.4% (n=1104/3883). Mean domain scores indicated a high level of confidence in patient safety competence (<4.0/5.0). Confidence was highest in respondents registered with the College of Nurses of Ontario >2years and in those who obtained their education outside of Canada. Faculty believed their approach to teaching and learning instilled a deep understanding of the limits to practical nurse autonomous practice.

CONCLUSIONS

Practical nurses were confident in what they learned about patient safety in their educational programs. The high degree of patient safety competence may be a true reflection of practical nurses understanding of, and comfort with, the limits of their knowledge and, ultimately, the limits of their individual autonomous practice. Further exploration as to whether the questionnaire requires additional modification for use with practical nurse populations is warranted. However, this study provides the first examination of practical nurses' perspectives and perceptions about patient safety education.

Self-reported confidence in patient safety knowledge among Australian undergraduate nursing students: A multi-site cross-sectional survey study

BACKGROUND

Patient safety is critical to the provision of quality health care and thus is an essential component of nurse education.

OBJECTIVE

To describe first, second and third year Australian undergraduate nursing students' confidence in patient safety knowledge acquired in the classroom and clinical settings across the three years of the undergraduate nursing program.

DESIGN

A cross-sectional online survey conducted in 2015.

SETTING

Seven Australian universities with campuses across three states (Queensland, New South Wales, South Australia).

PARTICIPANTS

A total of 1319 Australian undergraduate nursing students.

METHODS

Participants were surveyed using the 31-item Health Professional Education in Patient Safety Survey (H-PEPSS). Descriptive statistics summarised the sample and survey responses. Paired t-tests, ANOVA and generalized-estimating-equations models were used to compare responses across learning settings (classroom and clinical), and year of nursing course.

RESULTS

Participants were most confident in their learning of clinical safety skills and least confident in learning about the sociocultural dimensions of working in teams with other health professionals, managing safety risks and understanding human and environmental factors. Only 59% of students felt confident they could approach someone engaging in unsafe practice, 75% of students agreed it was difficult to question the decisions or actions of those with more authority, and 78% were concerned they would face disciplinary action if they made a serious error. One patient safety subscale, Recognising and responding to remove immediate safety risks, was rated significantly higher by third year nursing students than by first and second year students. Two broader aspects of patient safety scales, Consistency in how patient safety issues are dealt with by different preceptors, and System aspects of patient safety are well covered in our program, were rated significantly higher by first year nursing students than by second and third year students. One scale, Understanding that reporting adverse events and close calls can lead to change and can reduce recurrence of events, was rated significantly higher by third year students than first and second year students.

CONCLUSIONS

In order are to achieve meaningful improvements in patient safety, and create harm free environments for patients, it is crucial that nursing students develop confidence communicating with others to improve patient safety, particularly in the areas of challenging poor practice, and recognising, responding to and disclosing adverse events, including errors and near misses.

Student Perceptions of Quality and Safety Competencies

Aim/Purpose: The purpose of the study was to evaluate senior students’ level of preparedness to perform and perceived importance of 22 QSEN-related skills over a three year project period.

Background: The national Quality and Safety Education in Nursing (QSEN) project promotes student learning in the provision of safe, quality health care. One Midwestern nursing program attempted to address health care challenges by purposefully utilizing the QSEN competencies for curricular changes.

Methods: This study collected data from students in their final semester of a baccalaureate program using the QSEN Student Evaluation Survey.

Results/Findings: Students reported they were somewhat prepared to perform skills related to all six QSEN competencies. Students perceived all QSEN related skills as being as least somewhat important.

Conclusions: As a result of this study, the nursing program identified areas to be developed for further growth and utilized findings to aid in curriculum revision.