Duke University School of Nursing, 307 Trent Drive, Durham, NC, 27710, USA.
Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, 50-1 Yonsei-ro, Seodaemoon-Gu, Seoul, 03722, South Korea.
BMC Geriatr. 2022 Jun 29;22(1):541. doi: 10.1186/s12877-022-03234-w.
In Korea, nurse aides (NAs) are legally permitted as substitutes for registered nurses (RNs) in long-term care (LTC) facilities, even though they have very different levels of education and qualification standards. Many studies in hospitals have shown better hospital nurse staffing, more educated nurses, and improved nurse work environments have been associated with lower hospital mortality and length of stay. There is research showing that a higher percentage of RNs with a bachelor's degree corresponded to lower incidence rates of pressure ulcers in Korean LTC facilities. This study aimed to explore the factors that influence patient safety activities of the RNs and NAs working in LTC facilities and to identify the relationship between patient safety culture (PSC) and patient safety activities.
This study is a descriptive cross-sectional survey. The study participants were conveniently collected from 88 RNs and 71 NAs who worked at 33 LTC facilities for more than three months. The patient safety activities tool was developed by the researchers for residents of LTC facilities based on the tools developed by Park et al. (2012) for hospital nurses and the patient safety goals of the Joint Commission. The questionnaires were collected by email or mobile application and kept confidential. Data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Pearson correlation coefficients, and multiple regression analysis.
The mean scores of PSC and patient safety activities were 4.03 ± 0.51 points and 4.29 ± 0.49 points out of 5, respectively. There was significant correlation between PSC and patient safety activities (r = .23, p = .004). Factors influencing patient safety activities among RNs and NAs in LTC facilities were RNs (β = .377, p < .001), organizational system of PSC (β = .314, p < .010), and work shift type (fixed night shift, on-call, 24-h shift) (β = -.264, p = .004), which explained about 36.0% of total variance (F = 5.69, p < .001).
The findings indicate that it is necessary to mandate RNs instead of NAs to enhance residents' safety in LTC facilities. Additionally, the importance of an organizational safety system and effective working shift types to prevent residents' safety accidents in LTC facilities is indicated.
在韩国，护士助理（NA）在法律上被允许代替注册护士（RN）在长期护理（LTC）机构工作，尽管他们的教育水平和资格标准有很大的不同。许多医院的研究表明，更好的医院护士配置、更有教育背景的护士以及改善的护士工作环境与降低医院死亡率和住院时间有关。有研究表明，在韩国的 LTC 机构中，拥有学士学位的 RN 比例越高，压疮的发生率越低。本研究旨在探讨影响 LTC 机构中 RN 和 NA 患者安全活动的因素，并确定患者安全文化（PSC）与患者安全活动之间的关系。
本研究是一项描述性的横断面调查。研究对象是从 33 家 LTC 机构工作三个月以上的 88 名 RN 和 71 名 NA 中方便选取的。患者安全活动工具是由研究人员根据 Park 等人（2012 年）为医院护士开发的工具和联合委员会的患者安全目标，为 LTC 机构的居民开发的。调查问卷通过电子邮件或移动应用程序收集，并保密。使用描述性统计、独立 t 检验、单因素方差分析、皮尔逊相关系数和多元回归分析进行数据分析。
PSC 和患者安全活动的平均得分分别为 5 分制中的 4.03±0.51 分和 4.29±0.49 分。PSC 和患者安全活动之间存在显著相关性（r=.23，p=.004）。影响 LTC 机构中 RN 和 NA 患者安全活动的因素有 RN（β=.377，p<.001）、PSC 的组织系统（β=.314，p<.010）和工作班次类型（固定夜班、随叫随到、24 小时班）（β=-.264，p=.004），这解释了总方差的 36.0%（F=5.69，p<.001）。
研究结果表明，有必要授权 RN 而不是 NA 来提高 LTC 机构居民的安全性。此外，还表明了 LTC 机构中组织安全系统和有效工作班次类型对预防居民安全事故的重要性。
