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医疗环境中患者安全文化与护理缺失之间的关联:一项系统综述和荟萃分析

Association Between Patient Safety Culture and Missed Nursing Care in Healthcare Settings: A Systematic Review and Meta-Analysis.

作者信息

Labrague Leodoro J, Cayaban Arcalyd Rose

机构信息

School of Nursing and Healthcare Leadership, University of Washington-Tacoma, Tacoma, Washington, USA.

College of Nursing, Sultan Qaboos University, Seeb, Oman.

出版信息

J Adv Nurs. 2025 Jan 23. doi: 10.1111/jan.16758.

Abstract

AIM

To appraise and synthesise existing research on the relationship between patient safety culture and missed nursing care.

DESIGN

Systematic review and meta-analysis.

METHODS

Peer-reviewed articles published from 2010 onwards were searched from five databases (CINAHL, ProQuest, PubMed, ScienceDirect and Web of Science). A total of nine studies were identified. Among these, seven studies with a combined sample size of 1661 participants were included in the meta-analysis.

RESULTS

The meta-analysis revealed a significant negative correlation between overall patient safety culture and missed nursing care, with a pooled correlation coefficient of -0.205 (95% CI: -0.251 to -0.158) (p < 0.001). Heterogeneity was low to moderate (I = 13.18%, 95% CI: 0.00 to 78.60), and publication bias tests indicated no significant bias (Egger's test p = 0.0603; Begg's test p = 0.3476).

CONCLUSION

The findings underscore a significant inverse relationship between patient safety culture and missed nursing care, highlighting the specific predictive roles of management support, organisational learning and unit-level safety culture. Enhancing patient safety culture within healthcare organisations can be a strategic approach to mitigate missed nursing care.

IMPACT

Nursing leaders and administrators should prioritise fostering a safety-oriented culture through targeted interventions, continuous education and supportive policies to improve patient care outcomes.

REPORTING METHOD

Preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

摘要

目的

评估并综合现有的关于患者安全文化与护理缺失之间关系的研究。

设计

系统评价和荟萃分析。

方法

从五个数据库(CINAHL、ProQuest、PubMed、ScienceDirect和Web of Science)中检索2010年起发表的同行评审文章。共识别出9项研究。其中,7项研究合并样本量为1661名参与者,被纳入荟萃分析。

结果

荟萃分析显示,整体患者安全文化与护理缺失之间存在显著负相关,合并相关系数为-0.205(95%置信区间:-0.251至-0.158)(p<0.001)。异质性为低到中度(I=13.18%,95%置信区间:0.00至78.60),发表偏倚检验表明无显著偏倚(Egger检验p=0.0603;Begg检验p=0.3476)。

结论

研究结果强调了患者安全文化与护理缺失之间存在显著的反向关系,突出了管理支持、组织学习和科室层面安全文化的具体预测作用。加强医疗机构内的患者安全文化可能是减少护理缺失的一种战略方法。

影响

护理领导者和管理人员应优先通过有针对性的干预、持续教育和支持性政策来培养以安全为导向的文化,以改善患者护理结果。

报告方法

系统评价和荟萃分析的首选报告项目(PRISMA)指南。

患者或公众贡献

无患者或公众参与。

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