Tai Chunling, Chen Dong, Zhang Yuhuan, Teng Yan, Li Xinyu, Ma Chongyi
Nursing Department, The Second Affiliated Hospital Zhejiang University School of Medicine, No.88 Jiefang Road, Hangzhou, 310009, Zhejiang Province, China.
Nursing Department, Heilongjiang Nursing College, Harbin, 150086, Heilongjiang Province, China.
BMC Nurs. 2024 Mar 4;23(1):154. doi: 10.1186/s12912-024-01817-z.
Clinical nurses play an important role in ensuring patient safety. Nurses' work experience, organizational environment, psychological cognition, and behavior can all lead to patient safety issues. Improving nurses' attention to patient safety issues and enhancing their competence in dealing with complex medical safety issues can help avoid preventable nursing adverse events. Therefore, it is necessary to actively identify the latent profiles of patient safety competency of clinical nurses and to explore the influencing factors.
A cross-sectional design was conducted. A total of 782 Chinese registered nurses were included in the study. Demographic characteristics questionnaire, Error Management Climate scale, Security Questionnaire, Proactive Behavior Performance scale and Patient Safety Competency Self-Rating Scale of Nurses were used. Latent profile analysis (LPA) was performed to categorize nurses into latent subgroups with patient safety competency differences. Multinomial logistic regression was conducted to explore the influencing factors of nurses' patient safety competency (PSC) in different latent profiles.
A total of 782 questionnaires were valid. Nurses' PSC was positively related to error management climate, and psychological safety and proactive behavior. The PSC score was 121.31 (SD = 19.51), showing that the PSC of clinical nurses was at the level of the medium on the high side. The error management climate score was 70.28 (SD = 11.93), which was at a relatively high level. The psychological safety score was 61.21 (SD = 13.44), indicating a moderate to low level. The proactive behavior score was 37.60 (SD = 7.33), which was at a high level. The latent profile analysis result showed that three groups of profile models were fitted acceding to the evaluation of PSC. They were defined as Low-competency Group (74 (9.5%)), Medium-competency Group (378 (48.3%)) and High-competency Group (330 (42.2%). Working years, professional titles, departments, error management climate, psychological security and proactive behavior were the influencing factors of PSC in three latent profiles.
The PSC of clinical nurses had obvious classification characteristics, and the main influencing factors were working years, professional titles, working departments, error management climate, psychological security and proactive behavior. This study suggests that managers should pay attention to the continuous cultivation of patient safety competence among clinical nurses, provide targeted intervention measures for nurses at different work stages, professional titles, and departments, and use efficient management strategies to create a positive error management atmosphere. In patient safety management, providing nurses with more psychological security is conducive to stimulating more proactive behaviors and continuously improving the level of patient safety competence.
临床护士在确保患者安全方面发挥着重要作用。护士的工作经验、组织环境、心理认知和行为都可能导致患者安全问题。提高护士对患者安全问题的关注度，增强其处理复杂医疗安全问题的能力，有助于避免可预防的护理不良事件。因此，有必要积极识别临床护士患者安全胜任力的潜在类型，并探索其影响因素。
采用横断面设计。本研究共纳入782名中国注册护士。使用了人口学特征问卷、差错管理氛围量表、安全问卷、主动行为表现量表和护士患者安全胜任力自评量表。进行潜在类别分析（LPA），将护士分为具有患者安全胜任力差异的潜在亚组。进行多项逻辑回归分析，以探索不同潜在类型中护士患者安全胜任力（PSC）的影响因素。
共782份问卷有效。护士的PSC与差错管理氛围、心理安全和主动行为呈正相关。PSC得分为121.31（标准差=19.51），表明临床护士的PSC处于偏高的中等水平。差错管理氛围得分为70.28（标准差=11.93），处于较高水平。心理安全得分为61.21（标准差=13.44），表明处于中低水平。主动行为得分为37.60（标准差=7.33），处于较高水平。潜在类别分析结果显示，根据PSC评估拟合出三组类别模型。它们被定义为低胜任力组（74人（9.5%））、中等胜任力组（378人（48.3%））和高胜任力组（330人（42.2%））。工作年限、职称、科室、差错管理氛围、心理安全和主动行为是三种潜在类型中PSC的影响因素。
临床护士的PSC具有明显的分类特征，主要影响因素为工作年限、职称、工作科室、差错管理氛围、心理安全和主动行为。本研究表明，管理者应关注临床护士患者安全胜任力的持续培养，针对不同工作阶段、职称和科室的护士提供有针对性的干预措施，并采用有效的管理策略营造积极的差错管理氛围。在患者安全管理中，为护士提供更多的心理安全有利于激发更多的主动行为，不断提高患者安全胜任力水平。
Zotero 插件