College of Management, Chang Jung Christian University, Tainan, Taiwan.
Department of Nursing, Taitung MacKay Memorial Hospital, Taitung, Taiwan.
J Nurs Manag. 2019 Mar;27(2):225-232. doi: 10.1111/jonm.12669. Epub 2018 Sep 10.
This study explores the impact of total quality management on patient-safety-culture attitudes among clinical nurses, focusing on the correlations between total quality management, work values, employee satisfaction, and patient-safety-culture attitudes.
Implementing total quality management can improve nurses' attitudes towards patient-safety culture.
This hospital-based, cross-sectional survey used a convenience sample of 30 inpatient units and 12 intensive care units at five Taiwanese regional teaching hospitals with over 500 beds. Seven hundred questionnaires were distributed (140 to each hospital) during 25 June-5 July 2015. Data were collected using an anonymous, self-administered, and structured questionnaire. The model was tested using structural equation modelling and serial mediation analysis.
Of 515 completed questionnaires (73.6% response rate), 23 were invalid and 492 were used (70.3% retrieved rate). The total effect of total quality management on patient-safety-culture attitudes was significant via work values, which had a direct influence on patient-safety-culture attitude. Total quality management affected employee satisfaction, which directly influenced patient-safety-culture attitudes.
Total quality management creates a beneficial working environment and improves patient-safety culture. Total quality management, work values, and employee satisfaction orientation are important predictors of nurses' attitudes toward patient-safety-culture attitudes.
Health care managers should cultivate nursing performance to achieve continuous quality improvement in nursing care.
本研究探讨全面质量管理对临床护士患者安全文化态度的影响，重点关注全面质量管理、工作价值观、员工满意度与患者安全文化态度之间的相关性。
实施全面质量管理可以改善护士对患者安全文化的态度。
本研究采用基于医院的横断面调查，使用台湾五所地区教学医院的 30 个住院病房和 12 个重症监护病房的便利样本，每个医院发放 140 份问卷，共发放 700 份问卷。2015 年 6 月 25 日至 7 月 5 日期间采用匿名、自填和结构化问卷收集数据。采用结构方程模型和串行中介分析检验模型。
在 515 份完成的问卷中（73.6%的应答率），有 23 份无效，共使用 492 份（70.3%的回收率）。全面质量管理对患者安全文化态度的总效应通过工作价值观显著，工作价值观对患者安全文化态度有直接影响。全面质量管理影响员工满意度，员工满意度对患者安全文化态度有直接影响。
全面质量管理营造有益的工作环境，改善患者安全文化。全面质量管理、工作价值观和员工满意度取向是护士对患者安全文化态度的重要预测因素。
医疗保健管理者应培养护理绩效，以实现护理质量的持续改进。
