Tlhako Naledi, Coetzee Siedine Knobloch, Ajanaku Olateju Jumoke, Fourie Erika
NuMIQ Research Focus Area, School of Nursing Science, North-West University, Private Bag, Potchefstroom, South Africa.
NuMIQ Research Focus Area, School of Nursing Science, North-West University, Private Bag, Potchefstroom, South AfricaAfrica.
PLoS One. 2025 May 21;20(5):e0323620. doi: 10.1371/journal.pone.0323620. eCollection 2025.
There is a well-established relationship between the quality of workplace interactions among nurses, physicians, their managers, and nurse colleagues, and the subsequent improvement in patient outcomes. However, despite the growing body of research on this topic in developed countries, there remains a notable paucity of literature exploring these dynamics in developing countries.
To investigate the impact of workplace relationships on nurse-reported quality of care and patient safety.
This study applied a cross-sectional survey design.
A multiphase sampling method was applied. Purposive sampling was used to select the province, health sector and hospitals (n = 3). All-inclusive sampling was applied to in-patient units of the selected hospitals and nursing staff in those units (n = 236). Data was collected in April 2021, using validated instruments.
Nurse manager ability, leadership, and support was not experienced as positively contributing to the practice environment and had the most impact on quality of care and patient safety. Collegial nurse-physician relationships were experienced as contributing positively to the practice environment, and had the most impact on adverse events, namely medication errors, patient falls after admission and healthcare-associated infections. Increased exposure to COVID-19 patients resulted in more positive perceptions of nurses regarding collegial nurse-physician relationships. The most common perpetrators of workplace violence were supervisors/managers, followed by nursing colleagues. On average participants experience more personal workplace violence than physical workplace violence. Personal workplace violence had more effect on quality of care, patient safety, and adverse events than physical workplace violence.
Positive workplace relationships or collegiality, especially nurse-manager relationships, appear to have the most impact on nurse-perceived quality of care and patient safety, followed by nurse-physician relationships, and then workplace violence.
The focus of education interventions should be on developing leadership, and recruiting and retaining relationship-focused leaders since leaders have the greatest impact on nurse-reported quality of care and patient safety.
护士、医生、他们的管理者以及护士同事之间的工作场所互动质量与随后患者预后的改善之间存在着既定的关系。然而，尽管发达国家关于这一主题的研究越来越多，但在发展中国家，探索这些动态关系的文献仍然明显匮乏。
调查工作场所关系对护士报告的护理质量和患者安全的影响。
本研究采用横断面调查设计。
采用多阶段抽样方法。目的抽样用于选择省份、卫生部门和医院（n = 3）。对所选医院的住院科室和这些科室的护理人员采用全包含抽样（n = 236）。2021年4月使用经过验证的工具收集数据。
护士管理者的能力、领导力和支持并未被视为对实践环境有积极贡献，且对护理质量和患者安全影响最大。护士与医生之间的同事关系被视为对实践环境有积极贡献，且对不良事件影响最大，即用药错误、入院后患者跌倒和医疗相关感染。接触新冠肺炎患者增加导致护士对护士与医生之间的同事关系有更积极的看法。工作场所暴力最常见的肇事者是主管/经理，其次是护士同事。平均而言，参与者经历的个人工作场所暴力多于身体工作场所暴力。个人工作场所暴力对护理质量、患者安全和不良事件的影响大于身体工作场所暴力。
积极的工作场所关系或同事关系，尤其是护士与管理者的关系，似乎对护士感知的护理质量和患者安全影响最大，其次是护士与医生的关系，然后是工作场所暴力。
教育干预的重点应是培养领导力，招聘和留住注重关系的领导者，因为领导者对护士报告的护理质量和患者安全影响最大。
