Alanazi Faisal Khalaf, Lapkin Samuel, Molloy Luke, Sim Jenny
School of Nursing, University of Wollongong, Wollongong, NSW, 2500 Australia.
Discipline of Nursing, Faculty of Health, Southern Cross University, Gold Coast, QLD 4225, Australia.
Int J Nurs Stud Adv. 2023 Mar 29;5:100125. doi: 10.1016/j.ijnsa.2023.100125. eCollection 2023 Dec.
Safety culture is known to influence patient outcomes, but the relationship between nursing units' safety cultures and the development of pressure injuries in acute care hospitals is unclear. Pressure injuries are a nursing-sensitive patient outcome and are widely considered preventable.
To examine the impact of unit safety culture, nursing unit characteristics, and missed care on pressure injury rates in Saudi Arabian hospitals.
A multi-center cross-sectional study was conducted between August and November 2021 and compared to secondary data on the incidence of pressure injuries.
SETTINGS/PARTICIPANTS: A total of 653 nurses from 35 units in five Ministry of Health hospitals in Saudi Arabia participated in this study.
The survey included validated scales of safety culture, nurse staffing, and nurses' perceptions of quality of care, missed care, and the frequency of pressure injury. Secondary data on pressure injuries were collected from the Ministry of Health administrative database between 2018 and 2021. Descriptive analysis and Generalized Linear Models were performed.
Higher safety culture scores were associated with fewer pressure injuries (β = -2.000, 95% Confidence Interval [CI] -3.107, -0.893) and lower nurses' perceptions of the frequency of pressure injuries in their unit (β = -1.224, 95% CI -2.255, -0.192). High scores on the sub-scales of hospital management (β = -2.105, 95% CI -2.835, -1.375) and safety climate (β = -1.402, 95% CI -2.383, -0.421) were the most statistically significant predictor for pressure injury prevention. Higher frequency of missed nursing care was positively associated with higher rates of pressure injuries (β = 1.606, 95% CI 0.187, 3.024) and higher nurses' perceptions of the frequency of pressure injuries (β = 1.243, 95% CI 0.211, 2.363). There was a positive relationship between higher nurses' perceptions of the frequency of pressure injury and higher incidence rate of pressure injury as reported in the incident management system (β = 1.183, 95% CI 0.065, 2.301).
Nursing units with stronger safety climate and safety behavior scores, higher ratings of hospital and unit quality of care, and lower levels of missed nursing care were associated with lower incidence of pressure injury and nurses' perceptions of the frequency of pressure injury in their units. Nurses' perceptions of the frequency of pressure injuries are concordant with the incidence of pressure injuries and can be a valid measure to capture patient outcomes within a specific time.
High safety culture and lower missed care are linked to fewer pressure injuries in Saudi Arabian hospitals. Nurses' perceptions of pressure injury frequency aligned with reported incidence rates, indicating a valid measure of patient outcomes.
安全文化已知会影响患者预后，但急性护理医院中护理单元的安全文化与压力性损伤的发生之间的关系尚不清楚。压力性损伤是一种护理敏感型患者预后，并且被广泛认为是可预防的。
研究沙特阿拉伯医院中单元安全文化、护理单元特征及护理缺失对压力性损伤发生率的影响。
2021年8月至11月进行了一项多中心横断面研究，并与压力性损伤发生率的二级数据进行比较。
设置/参与者：沙特阿拉伯五家卫生部医院35个单元的653名护士参与了本研究。
该调查包括经过验证的安全文化量表、护士配备情况，以及护士对护理质量、护理缺失和压力性损伤发生频率的看法。2018年至2021年期间从卫生部行政数据库收集压力性损伤的二级数据。进行了描述性分析和广义线性模型分析。
较高的安全文化得分与较少的压力性损伤相关（β = -2.000，95%置信区间[CI] -3.107，-0.893），且护士对其所在单元压力性损伤发生频率的认知较低（β = -1.224，95% CI -2.255，-0.192）。医院管理（β = -2.105，95% CI -2.835，-1.375）和安全氛围（β = -1.402，95% CI -2.383，-0.421）子量表的高分是预防压力性损伤最具统计学意义的预测因素。较高的护理缺失频率与较高的压力性损伤发生率呈正相关（β = 1.606，95% CI 0.187，3.024），且护士对压力性损伤发生频率的认知较高（β = 1.243，95% CI 0.211，2.363）。护士对压力性损伤发生频率的较高认知与事件管理系统中报告的较高压力性损伤发生率之间存在正相关关系（β = 1.183，95% CI 0.065，2.301）。
具有更强安全氛围和安全行为得分、更高医院及单元护理质量评级以及更低护理缺失水平的护理单元，其压力性损伤发生率及护士对所在单元压力性损伤发生频率的认知较低。护士对压力性损伤发生频率的认知与压力性损伤发生率一致，并且可以作为在特定时间内衡量患者预后的有效指标。
在沙特阿拉伯医院中，高安全文化和较低的护理缺失与较少的压力性损伤相关。护士对压力性损伤发生频率的认知与报告的发生率一致，表明是衡量患者预后的有效指标。
