Department of Nursing Teaching and Research, the Third Xiangya Hospital, Central South University, Changsha, China; Xiangya Nursing School, Central South University, Changsha, China.
Xiangya Nursing School, Central South University, Changsha, China.
Nurse Educ Today. 2024 Jan;132:105992. doi: 10.1016/j.nedt.2023.105992. Epub 2023 Oct 21.
Nursing interns are one of the most crucial providers of nursing services. Their safety behaviors are closely associated with adverse events. Therefore, it is vital to explore the factors influencing nursing intern safety behavior to improve patient safety.
To evaluate patient safety behavior among nursing interns and explore latent influencing mechanisms based on the capability opportunity motivation-behavior (COMB) model.
A cross-sectional study SETTINGS AND PARTICIPANTS: The participants were 422 nursing interns recruited through convenience sampling from a comprehensive teaching hospital.
Data on general information, nursing interns' patient safety behavior, metacognitive ability, clinical internship environment, and moral sensitivity were collected. Nursing interns' patient safety behavior was described with means and standard deviations. The independent sample t-test, ANOVA, Pearson's correlation, and SEM were used to determine contributing factors to nursing interns' patient safety behavior.
The mean total score for patient safety behavior was 53.08 ± 6.22. The results indicated that metacognitive ability not only directly affects the patient safety behavior of nursing interns (β = 0.554, P < 0.001, 95 % CI = [0.446, 0.637]) but indirectly affects interns' safety behavior through professional identity (β = 0.009, P = 0.031, 95 % CI = [0.001, 0.019]). The clinical internship environment also has both direct (β = 0.258, P = 0.001, 95 % CI = [0.166, 0.349]) and indirect (β = 0.007, P = 0.029, 95 % CI = [0.001, 0.015]) effects on the patient safety behavior of nursing interns.
There are some specific areas where nursing interns' safety behaviors need to be improved. This study reveals that strong metacognitive ability and a clinical internship environment with rich opportunities might be essential for the development of patient safety behaviors. To promote nursing interns' patient safety behaviors, clinical teachers could use reflective teaching methods and provide a supportive clinical environment to nurture nursing interns' professional identities and patient safety behaviors.
护理实习生是护理服务的最重要提供者之一。他们的安全行为与不良事件密切相关。因此，探索影响护理实习生安全行为的因素对于提高患者安全至关重要。
基于能力机会动机-行为（COMB）模型评估护理实习生的患者安全行为，并探讨潜在的影响机制。
横断面研究
参与者为通过便利抽样从一家综合性教学医院招募的 422 名护理实习生。
收集一般信息、护理实习生的患者安全行为、元认知能力、临床实习环境和道德敏感性的数据。使用平均值和标准差描述护理实习生的患者安全行为。采用独立样本 t 检验、方差分析、Pearson 相关和结构方程模型（SEM）来确定影响护理实习生患者安全行为的因素。
患者安全行为的总分平均值为 53.08 ± 6.22。结果表明，元认知能力不仅直接影响护理实习生的患者安全行为（β=0.554，P<0.001，95%CI=[0.446，0.637]），还通过专业认同间接影响实习生的安全行为（β=0.009，P=0.031，95%CI=[0.001，0.019]）。临床实习环境也对护理实习生的患者安全行为具有直接（β=0.258，P=0.001，95%CI=[0.166，0.349]）和间接（β=0.007，P=0.029，95%CI=[0.001，0.015]）的影响。
护理实习生的安全行为存在一些需要改进的具体方面。本研究表明，较强的元认知能力和丰富机会的临床实习环境可能是培养患者安全行为的关键。为了促进护理实习生的患者安全行为，临床教师可以使用反思性教学方法，并提供支持性的临床环境，培养护理实习生的专业认同和患者安全行为。
