Safety culture on hospital nursing units: Human performance and organizational system factors that make a difference

作者:
 Moody, Roseanne F.
資料來源:
DAI-B 67/08, Feb 2007
文件類型:
Engineering Profession
主題術語:
Safety, Hospital nursing units, Organizational, Medication errors, Motivation
摘要:

Objective. To report evidence of relationships among selected human performance factors, perceptions of safety culture and productivity on medical-surgical nursing units, in relation to nurses' frequency of error reporting, and nurses' reported medication administration errors.

Background. Creating safety culture in healthcare institutions is critical to patient safety and high quality care. Most patient care in acute health care settings takes place on nursing units. Evidence of relationships among human performance and system factors that may influence the ability to develop safety culture on nursing units is needed, in order to understand and support the creation of safety culture in U.S. healthcare systems.

Method. Descriptive cross-sectional, correlational survey of medical-surgical staff nurses in two hospitals in a metropolitan healthcare system. Survey items measured nurses' motivation, cognitive decision-making style, and safety culture perceptions. Retrospective data collection also was implemented in relation to nurse productivity (nursing hours per patient care day-NHPPD) and nurses' reported medication administration errors across six contiguous months just prior to the cross-sectional component of the study.

Results. Variables that predict incidence of reported medication administration errors, accounting for nearly 30% of variance, are nurses' cognitive decision-making style and nursing unit management's actions and expectations in promoting safety. Variables that predict frequency of error reporting are overall perceptions of safety (patient safety grade) and open communication in relation to participants' comfort level in working the hierarchical authority gradient on nursing units. Variables associated with productivity (NHPPD) are motivational drive, reward responsiveness, unit teamwork, and perceptions of patient safety. Lower unit monthly NHPPD correlates with increased incidence of reported medication errors. Positive nursing unit leadership correlates with increased willingness to report error.

Conclusions. Behavioral motivation, cognitive decision making style, and open communication, in conjunction with perceptions of unit leadership and number of nursing care hours, clearly influence safety culture perceptions and behaviors.

作者所屬機構:
Indiana University
ISBN:
9780542847936
DOI:
10.2224/sbp.2011.39.2.287
入藏號碼:
1216746801
資料庫:
AtoZ