The impact of safety culture on nurse and patient outcomes in Middle East acute care hospitals
- UNCG Author/Contributor (non-UNCG co-authors, if there are any, appear on document)
- Monir Morisheed R. Almotairy (Creator)
- Institution
- The University of North Carolina at Greensboro (UNCG )
- Web Site: http://library.uncg.edu/
- Advisor
- Nancy Hoffart
Abstract: Background: Maintaining patient safety is an important pillar of health care delivery. Promoting a safe culture in a healthcare setting influences patient safety outcomes directly as well as indirectly through improved nurse outcomes. Previous studies of safety culture at hospitals in the Middle East have been descriptive in nature but few studies have examined its relationship with patient and nurse outcomes. Purpose: The purpose of this study was to examine the relationship between safety culture and nurse and patient outcomes in acute care Middle East hospitals using data from the National Database of Nursing Quality Indicators® (NDNQI®). Methods. Utilizing a cross-sectional correlational design, this study included 91 inpatient adult, pediatric, and perinatal units from seven Middle East hospitals that participated in the National Database of Nursing Quality Indicators® (NDNQI®) in 2018. Under a data use agreement with Press Ganey Associates LLC, unit safety culture was determined using data from the Practice Environment Scale of the Nursing Work Index [PES-NWI]. Data about four patient outcomes (CAUTI, CLABSI, falls, and pressure injuries) and three nurse outcomes (job enjoyment, psychological safety, and intent to stay at 1 and 3 years) were also extracted from the database and analyzed at the unit level. Results. Multiple regression models and mediation analyses showed that safety culture was significantly associated with nurses’ job enjoyment, psychological safety, and intention to stay at 1 and 3 years. Poisson count regression models showed that safety culture was significantly associated with two patient outcomes - CLABSI and pressure injuries. However, when examining the mediation effects of nurse outcomes on the relationships between safety culture and patient outcomes, no significant direct effect of safety culture on patient outcomes were found. Lastly, mediation analysis showed that (a) only the psychological safety-respect indicator significantly mediated the relationship between safety culture and CAUTI; and (b) only intent to stay at 1 year and psychological safety-respect indicator have significant direct effect on CAUTI. Conclusions and Recommendations. Safety culture was significantly associated with all nurse outcomes and some patient outcomes, and only psychological safety-respect mediated the relationship between safety culture and a patient outcome. The findings of this study are limited by the small number of hospitals that contributed data to NDNQI® for the variables of interest. Future research should examine these relationships in a larger sample. Hospital and nurse leaders should invest in optimizing safety culture to promote patient safety outcomes and nurse outcomes. [This abstract has been edited to remove characters that will not display in this system. Please see the PDF for the full abstract.]
The impact of safety culture on nurse and patient outcomes in Middle East acute care hospitals
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Created on 5/1/2020
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Additional Information
- Publication
- Dissertation
- Language: English
- Date: 2020
- Keywords
- Nurse Outcomes, Patient Outcomes, Safety Culture
- Subjects
- Patients $x Safety measures
- Nursing $x Practice
- Outcome assessment (Medical care)
- Hospitals $z Middle East