Nurses' safety climate, quality of care, and standard precautions adherence and compliance: A cross-sectional study

Linking patient safety, caring behaviours and professional self-efficacy with missed nursing care among Filipino emergency room nurses: A structural equation model study

AIMS

To investigate the interrelationships of patient safety, caring behaviours, professional self-efficacy and missed nursing care among emergency room nurses.

DESIGN

Cross-sectional, correlational study.

METHODS

Filipino emergency room nurses (n = 345) participated via convenience sampling from September 2023 to January 2024. Four validated self-report scales were used to collect data and were analysed using Spearman rho, covariance-based structural equation modelling, mediation and path analyses.

RESULTS

The emerging model of study variables displayed satisfactory fit indices. Patient safety directly influenced caring behaviours and professional self-efficacy, while negatively influencing missed nursing care. Caring behaviours directly and indirectly affected professional self-efficacy and missed nursing care, respectively. Professional self-efficacy negatively influences missed nursing care. Finally, caring behaviours and professional self-efficacy were significant mediators between the association of patient safety and missed nursing care.

CONCLUSION

Caring behaviours and professional self-efficacy of emergency room nurses demonstrated mediating effects that can potentially improve patient safety practices thereby minimizing unfinished or missed nursing care.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

Nurses and healthcare organizations should commit to consistently maintain a workplace culture that fosters patient safety, caring behaviours and professional self-efficacy to minimize avoidable injuries and omitting nursing care tasks.

REPORTING METHOD

STrengthening the Reporting of OBservational studies in Epidemiology (STROBE).

PATIENT OR PUBLIC CONTRIBUTION

No Patient or Public Contribution.

Psychiatric Nurses' Compassion Fatigue, Moral Commitment, Workplace Civility, and Missed Nursing Care: The Mediating Role of Practice Environment

To the best of our knowledge, this study was the first to explore the moral commitment and workplace civility of psychiatric nurses working in a Middle Eastern country, as well as the mediating role of the practice environment in the associations between compassion fatigue, moral commitment, workplace civility, and missed nursing care. This cross-sectional and correlational study consecutively recruited psychiatric nurses (n = 207) from three government-owned mental health centers in Saudi Arabia. Five standardised scales were used to collect data from June to November 2024. Covariance-based structural equation modelling was used for data analyses. Psychiatric nurses' moral commitment had a direct, negative, and moderate influence on compassion fatigue (β = -0.24, p = 0.013), practice environment (β = -0.21, p = 0.007), and missed nursing care (β = -0.20, p = 0.008). Compassion fatigue had a direct, positive effect on the practice environment (β = 0.14, p = 0.033) but a negative, direct influence on missed nursing care (β = -0.28, p = 0.003). The practice environment directly and positively influenced missed nursing care (β = 0.16, p = 0.015). Path analyses indicated that moral commitment (β = -0.04, p = 0.027) and compassion fatigue (β = 0.02, p = 0.015) had statistically significant indirect effects on missed nursing care through the mediation of practice environment. Nurse leaders and healthcare institutions are responsible for creating an efficient practice environment for psychiatric nurses, strengthening their moral commitment while effectively managing their compassion fatigue and minimising missed nursing care.

Resilience, compassion fatigue, moral distress and moral injury of nurses

Background: Compassion fatigue, moral distress, and moral injury are interconnected phenomena that have a detrimental impact on the delivery of nursing care. Nurses possess the inherent resilience necessary to effectively handle these three adverse occurrences. Aim: To determine the mediating impact of resilience on compassion fatigue, moral distress, and moral injury among nurses in Saudi Arabia. Design: The final product was a structural equation model (SEM) generated using a quantitative correlation cross-sectional design, and we followed the STROBE guidelines for this study. Methods: The study involved a sample of 511 staff nurses, who were selected using consecutive sampling. The study was conducted in three government hospitals in Saudi Arabia. Ethical considerations: This study received approval from Ethics Committee under approval number H-2021-151 on March 5, 2021. The survey's description and consent statements were clearly presented on Google survey forms in both English and Arabic. Results: Results showed that resilience negatively influenced moral distress, while compassion fatigue and moral injury had a positive influence. Likewise, compassion fatigue had a direct, positive effect on moral distress and moral injury, and moral distress had a direct, positive effect on moral injury. Analyses also showed that resilience had positive, indirect effects on moral injury through the mediation of both compassion fatigue and moral distress. Similarly, compassion fatigue had a positive, indirect effect on moral injury through the mediation of moral distress. Conclusion: Because resilience enables nurses to adapt, it helps them overcome obstacles in their career and professional lives. Resilience is frequently cited by nurses as a protective quality. Moral injury, compassion fatigue, and moral distress can negatively impact the health of nurses. Implications for the profession and/or patient care: Nurse leaders should develop programmes and initiate efforts to improve nurses' resilience as an important protective trait against compassion fatigue, moral distress, and moral injury. Patient or Public Contribution: There was no public or patient participation in this study.

Exploring nurses' leadership and resilience in a complex daily work environment: a qualitative study

BACKGROUND

The contemporary healthcare system is inherently complex, necessitating organizational and ward-level changes to address challenges. Continuous adaptations in daily practices are essential to meet unexpected patient needs. These dynamic changes require resilience from healthcare staff, including nurses. This paper explores how nurses show leadership in response to changes within a complex work environment that demands resilience in their daily practices.

METHODS

An empirical qualitative study was employed. Non-participatory observations were conducted in February and March 2022 (n = 60 h), providing thick descriptions of nurses working across various shifts. Subsequently, two semi-structured group interviews were held: the first with nurses only and the second with multidisciplinary healthcare professionals. The interview transcripts and thick descriptions were analyzed using thematic analysis. Descriptive statistics were used to summarize participant characteristics.

RESULTS

Responding to a changing work environment requires resilience from nurses who exhibit leadership showing four distinct behaviors: proactive, patient-centered care; investigative problem-solving; reflective learning; and profession-based approaches.

CONCLUSION

Collaboration is a key factor in resilient nurse leadership, both among nurses, and in interaction with patients, other healthcare professionals, and management. This research highlights how nurses' considerations, beliefs, and interactions, make their leadership behavior visible in a context that demands situated, structural, and social resilience.

Intensive and critical care nurses patient safety, care quality, professional self-efficacy, and missed nursing care: Structural equation model analysis

BACKGROUND

Globally, nurses' patient safety, care quality, and missed nursing care are well documented. However, there is a paucity of studies on the mediating roles of care quality and professional self-efficacy, particularly among intensive and critical care unit (ICCU) nurses in developing countries like the Philippines.

AIM

To test a model of the interrelationships of patient safety, care quality, professional self-efficacy, and missed nursing care among ICCU nurses.

METHODS

A cross-sectional, correlational design study was used. ICCU nurses (n = 335) were recruited via consecutive sampling from August to December 2023 and completed four validated self-report scales. Spearman Rho, structural equation modeling, mediation, and path analyses were utilized for data analysis.

RESULTS

The emerging model demonstrated acceptable fit parameters. Patient safety positively influenced care quality (β = .34, p = .002) and professional self-efficacy (β = .18, p = .011), while negatively affecting missed nursing care (β = -.34, p = .003). Care quality positively and negatively influenced professional self-efficacy (β = .40, p = .003) and missed nursing care (β = -.13, p = .003), respectively. Professional self-efficacy indirectly impacted missed nursing care (β = -.32, p = .003). Care quality (β = -.10, p = .003) and professional self-efficacy (β = .13, p = .003) showed mediating effects between patient safety and missed nursing care.

LINKING EVIDENCE TO ACTION

ICCU nurses' care quality and professional self-efficacy are essential mediating factors that can bolster patient safety practices, hence reducing missed nursing care. Therefore, healthcare organizations, nurse managers, and policymakers should cultivate care quality and self-efficacy by creating support programs and providing a positive practice environment. Nurses and nurse supervisors could directly observe missed nursing care in the ICCU to understand its underreported causes.

The Safety Climate and Patient Safety Activities in Mental Health Nurses: The Mediating Effect of Safety Control

This study aimed to investigate the mediating effect of safety control on the relationship between safety climate and patient safety management activities for mental health nurses. A survey was conducted on 177 nurses working at mental hospitals in G-do from 28 July 2023 to 15 August 2023. Data were analyzed using the SPSS/WIN 27.0 and Sobel test. Significant relationships were found between safety climate and safety control (r = 0.40, p < 0.001), safety climate and patient safety management activities(r = 0.40, p < 0.001), and safety control and patient safety management activities (r = 0.43, p < 0.001). Additionally, safety control partially mediated the safety climate and the patient safety management activities (Z = 3.63, p < 0.001). Therefore, programs that increase safety control and create a safety climate need to be developed to promote patient safety activities of mental health nurses.