重症监护护士的患者安全、护理质量、专业自我效能和护理缺失：结构方程模型分析。
Intensive and critical care nurses patient safety, care quality, professional self-efficacy, and missed nursing care: Structural equation model analysis.
机构信息
Department of Nursing, North Private College of Nursing, Arar City, Northern Borders Region, Arar, Saudi Arabia.
出版信息
Worldviews Evid Based Nurs. 2024 Oct;21(5):493-504. doi: 10.1111/wvn.12741. Epub 2024 Aug 20.
BACKGROUND
Globally, nurses' patient safety, care quality, and missed nursing care are well documented. However, there is a paucity of studies on the mediating roles of care quality and professional self-efficacy, particularly among intensive and critical care unit (ICCU) nurses in developing countries like the Philippines.
AIM
To test a model of the interrelationships of patient safety, care quality, professional self-efficacy, and missed nursing care among ICCU nurses.
METHODS
A cross-sectional, correlational design study was used. ICCU nurses (n = 335) were recruited via consecutive sampling from August to December 2023 and completed four validated self-report scales. Spearman Rho, structural equation modeling, mediation, and path analyses were utilized for data analysis.
RESULTS
The emerging model demonstrated acceptable fit parameters. Patient safety positively influenced care quality (β = .34, p = .002) and professional self-efficacy (β = .18, p = .011), while negatively affecting missed nursing care (β = -.34, p = .003). Care quality positively and negatively influenced professional self-efficacy (β = .40, p = .003) and missed nursing care (β = -.13, p = .003), respectively. Professional self-efficacy indirectly impacted missed nursing care (β = -.32, p = .003). Care quality (β = -.10, p = .003) and professional self-efficacy (β = .13, p = .003) showed mediating effects between patient safety and missed nursing care.
LINKING EVIDENCE TO ACTION
ICCU nurses' care quality and professional self-efficacy are essential mediating factors that can bolster patient safety practices, hence reducing missed nursing care. Therefore, healthcare organizations, nurse managers, and policymakers should cultivate care quality and self-efficacy by creating support programs and providing a positive practice environment. Nurses and nurse supervisors could directly observe missed nursing care in the ICCU to understand its underreported causes.
背景
在全球范围内，护士的患者安全、护理质量和护理遗漏得到了充分的记录。然而，在菲律宾等发展中国家，关于护理质量和专业自我效能的中介作用的研究很少，特别是在重症监护病房（ICU）护士中。
目的
测试 ICU 护士患者安全、护理质量、专业自我效能和护理遗漏之间相互关系的模型。
方法
采用横断面相关性设计研究。2023 年 8 月至 12 月，通过连续抽样招募 ICU 护士（n=335），并完成了四个经过验证的自我报告量表。使用 Spearman Rho、结构方程模型、中介和路径分析进行数据分析。
结果
新兴模型表现出可接受的拟合参数。患者安全正向影响护理质量（β=0.34，p=0.002）和专业自我效能（β=0.18，p=0.011），而负向影响护理遗漏（β=-0.34，p=0.003）。护理质量正向和负向影响专业自我效能（β=0.40，p=0.003）和护理遗漏（β=-0.13，p=0.003）。专业自我效能间接影响护理遗漏（β=-0.32，p=0.003）。护理质量（β=-0.10，p=0.003）和专业自我效能（β=0.13，p=0.003）在患者安全和护理遗漏之间显示出中介作用。
行动联系证据
ICU 护士的护理质量和专业自我效能是增强患者安全实践、从而减少护理遗漏的重要中介因素。因此，医疗机构、护士长和政策制定者应通过创建支持计划和提供积极的实践环境来培养护理质量和自我效能。护士和护士长可以直接观察 ICU 中的护理遗漏，以了解其未报告的原因。
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