Lan Yuansong, Qin Yan, Zhou Yuhua, Jiang Zhengyan, Liu Qian, Huang Debin, Tan Weiyu
School of Nursing, Guangxi Health Science College, Nanning, China.
Department of Intensive Care Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
Nurs Crit Care. 2025 Mar;30(2):e13294. doi: 10.1111/nicc.13294.
Missed nursing care (MNC) is a significant global issue in health care, especially in intensive care units (ICUs) where the complexity of patient care and high workloads increase the risk of errors and omissions. Nursing deficits impact patient safety, nurse efficiency and psychological well-being, yet the relationship between ICU nurses' perceptions of patient safety, their caring behaviour, professional self-efficacy and nursing deficits remains underexplored.
This study aimed to examine the relationships between ICU nurses' perceptions of patient safety, caring behaviour, professional self-efficacy and nursing deficits through a multiple mediation model.
A cross-sectional survey was conducted with 304 ICU nurses from general hospitals in Guangxi Province between January 2022 and January 2024. The study used validated instruments to measure patient safety perception, caring behaviour, professional self-efficacy and nursing deficits. Spearman correlation and multiple mediation analyses were applied to explore the relationships among these variables.
ICU nurses reported average scores of 63.35 ± 8.06 for patient safety perception, 70.28 ± 12.14 for caring behaviour, 26.19 ± 4.57 for professional self-efficacy and 75.92 ± 17.68 for nursing deficits. Significant negative correlations were found between patient safety perception, caring behaviour, professional self-efficacy and nursing deficits (r = -.483, -.516, -.326, p < .01). Caring behaviour and self-efficacy mediated the relationship between patient safety perception and nursing deficits, accounting for 74.65% of the total effect. This study follows the STrengthening the Reporting of OBservational studies in Epidemiology guidelines.
This study highlights that improving ICU nurses' perceptions of patient safety can reduce nursing deficits by enhancing caring behaviour and professional self-efficacy, offering a pathway to improve care quality in ICUs.
Hospital administrators should focus on strategies that enhance ICU nurses' safety perception, caring behaviour and self-efficacy to reduce nursing deficits and improve patient outcomes.
护理缺失（MNC）是全球医疗保健领域的一个重大问题，尤其是在重症监护病房（ICU），患者护理的复杂性和高工作量增加了差错和遗漏的风险。护理不足会影响患者安全、护士效率和心理健康，然而，ICU护士对患者安全的认知、他们的关怀行为、专业自我效能感与护理缺失之间的关系仍未得到充分研究。
本研究旨在通过多重中介模型检验ICU护士对患者安全的认知、关怀行为、专业自我效能感与护理缺失之间的关系。
2022年1月至2024年1月期间，对广西壮族自治区综合医院的304名ICU护士进行了横断面调查。该研究使用经过验证的工具来测量患者安全认知、关怀行为、专业自我效能感和护理缺失。采用Spearman相关性分析和多重中介分析来探讨这些变量之间的关系。
ICU护士报告的患者安全认知平均得分为63.35±8.06，关怀行为平均得分为70.28±12.14，专业自我效能感平均得分为26.19±4.57，护理缺失平均得分为75.92±17.68。患者安全认知、关怀行为、专业自我效能感与护理缺失之间存在显著负相关（r = -0.483、-0.516、-0.326，p < 0.01）。关怀行为和自我效能感在患者安全认知与护理缺失之间起中介作用，占总效应的74.65%。本研究遵循加强流行病学观察性研究报告规范。
本研究强调，提高ICU护士对患者安全的认知可以通过增强关怀行为和专业自我效能感来减少护理缺失，为提高ICU护理质量提供了一条途径。
医院管理人员应关注提高ICU护士安全认知、关怀行为和自我效能感的策略，以减少护理缺失并改善患者结局。
