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影响本科护生患者安全文化发展的因素——一项综合综述

Factors Influencing the Development of Patient Safety Culture in the Undergraduate Nursing Student Population-An Integrative Review.

作者信息

Gore Judy, Schrems Berta

机构信息

University of Vienna, Vienna, Austria.

University of Applied Sciences FH JOANNEUM Graz, Graz, Austria.

出版信息

J Adv Nurs. 2025 Mar 26. doi: 10.1111/jan.16880.

Abstract

AIMS

To identify factors that influence the development of patient safety culture among nursing students.

DESIGN

Integrative review.

METHODS

A comprehensive literature search for publications from 2004 to 2024 was conducted using PubMed, LIVIVO, CINAHL, SCOPUS, and ERIC. A summarising content analysis was performed on 47 articles.

RESULTS

Students value patient safety but need guidance, supervision, structured education, supportive environments, interdisciplinary curricula, simulation training, and error-reporting training. Teamwork fosters learning, but hierarchical cultures, poor mentorship, unclear roles, stress, negative experiences, and bullying hinder communication and students' willingness to speak up. Emotions, identity, socialisation, and resilience shape students' safety practices, confidence, and advocacy.

CONCLUSION

Enhancing nursing education, clinical environments, and policies is vital to patient safety practices among student nurses. Integrating comprehensive patient safety education, reflective learning, and structured transition programmes can bridge gaps between theory and practice, fostering critical thinking and confidence. Cultivating non-punitive cultures and collaboration across institutions and professions ensures learning, mutual support, and safer care delivery, with future research needed to assess long-term patient safety culture development.

IMPACT

No comprehensive review has yet examined all factors influencing the development of patient safety culture in undergraduate nursing students. This review addresses this gap. Understanding these factors can foster a sustainable safety culture, reduce student stress, and guide improvements in education and clinical practice. Inadequate safety integration into curricula, hierarchical dynamics, and mentorship gaps risk undermining patient safety. By synthesising evidence from multiple studies, it yields comprehensive insights for both educational and clinical settings. The findings have important implications for educators, policymakers, and healthcare organisations, guiding improvements in curricula, teaching methods, and clinical learning environments to foster a robust patient safety culture from the beginning of training.

REPORTING METHOD

This study followed EQUATOR and PRISMA reporting guidelines for systematic reviews.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public involvement.

摘要

目的

确定影响护生患者安全文化发展的因素。

设计

综合综述。

方法

使用PubMed、LIVIVO、CINAHL、SCOPUS和ERIC对2004年至2024年的出版物进行全面文献检索。对47篇文章进行了总结性内容分析。

结果

学生重视患者安全,但需要指导、监督、结构化教育、支持性环境、跨学科课程、模拟培训和错误报告培训。团队合作促进学习,但等级文化、指导不力、角色不明确、压力、负面经历和欺凌会阻碍沟通以及学生表达意见的意愿。情感、身份认同、社会化和适应力塑造了学生的安全实践、信心和维权行为。

结论

加强护理教育、临床环境和政策对于护生的患者安全实践至关重要。整合全面的患者安全教育、反思性学习和结构化过渡计划可以弥合理论与实践之间的差距,培养批判性思维和信心。营造非惩罚性文化以及跨机构和专业的合作可确保学习、相互支持和更安全的护理服务,未来需要开展研究以评估患者安全文化的长期发展情况。

影响

尚无全面综述考察影响本科护生患者安全文化发展的所有因素。本综述填补了这一空白。了解这些因素有助于培养可持续的安全文化,减轻学生压力,并指导教育和临床实践的改进。课程中安全整合不足、等级动态和指导差距可能会损害患者安全。通过综合多项研究的证据,本综述为教育和临床环境提供了全面的见解。研究结果对教育工作者、政策制定者和医疗保健组织具有重要意义,可指导课程、教学方法和临床学习环境的改进,以便从培训开始就培养强大的患者安全文化。

报告方法

本研究遵循EQUATOR和PRISMA系统评价报告指南。

患者或公众参与

无患者或公众参与。

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