Department of Management and Organization Studies, Owen Graduate School of Management, Vanderbilt University, Nashville, Tennessee 37203, USA.
J Nurs Adm. 2011 Jul-Aug;41(7-8 Suppl):S25-30. doi: 10.1097/NNA.0b013e318221c368.
Prior research has found that safety organizing behaviors of registered nurses (RNs) positively impact patient safety. However, little research exists on the joint benefits of safety organizing and other contextual factors that help foster safety.
Although we know that organizational practices often have more powerful effects when combined with other mutually reinforcing practices, little research exists on the joint benefits of safety organizing and other contextual factors believed to foster safety. Specifically, we examined the benefits of bundling safety organizing with leadership (trust in manager) and design (use of care pathways) factors on reported medication errors.
A total of 1033 RNs and 78 nurse managers in 78 emergency, internal medicine, intensive care, and surgery nursing units in 10 acute-care hospitals in Indiana, Iowa, Maryland, Michigan, and Ohio who completed questionnaires between December 2003 and June 2004.
Cross-sectional analysis of medication errors reported to the hospital incident reporting system for the 6 months after the administration of the survey linked to survey data on safety organizing, trust in manager, use of care pathways, and RN characteristics and staffing.
Multilevel Poisson regression analyses indicated that the benefits of safety organizing on reported medication errors were amplified when paired with high levels of trust in manager or the use of care pathways.
Safety organizing plays a key role in improving patient safety on hospital nursing units especially when bundled with other organizational components of a safety supportive system.
先前的研究发现，注册护士（RN）的安全组织行为对患者安全有积极影响。然而，关于安全组织行为以及其他有助于促进安全的背景因素的共同益处的研究甚少。
尽管我们知道组织实践通常与其他相互增强的实践相结合时会产生更强大的效果，但关于安全组织行为与其他被认为有助于安全的背景因素的共同益处的研究甚少。具体而言，我们研究了将安全组织与领导（对经理的信任）和设计（使用护理路径）因素相结合对报告的用药错误的益处。
印第安纳州、爱荷华州、马里兰州、密歇根州和俄亥俄州的 10 家急性护理医院的 78 个急诊、内科、重症监护和外科护理单元中的 1033 名注册护士和 78 名护士长，他们在 2003 年 12 月至 2004 年 6 月之间完成了问卷调查。
对医院事件报告系统中报告的用药错误进行横断面分析，该系统在调查后 6 个月内进行，调查数据与安全组织、对经理的信任、护理路径的使用以及 RN 特征和人员配备有关。
多水平泊松回归分析表明，当与高水平的经理信任或护理路径的使用相结合时，安全组织对报告的用药错误的益处会得到放大。
安全组织在改善医院护理单元的患者安全方面起着关键作用，尤其是当与安全支持系统的其他组织组成部分相结合时。
