The Impact Of Safety Climate, Work Environment And Demographics On Nurses' Perceptions Of Barriers To Medication Error Report

Objective:To describe the nurses'perceptions of work environment, safety climate, barriers to medication error(ME) report, and to explore the relationships among the barriers, work environment, safety climate, and demographic variables so as to provide a theoretical basis for patient safety management.Methods:1. A cross-sectional survey was undertaken from November 2010 to March 2011, using the Chinese version of the Safety Climate Scale (SCS), and the Work Envrionment Questionnaire (WEQ), Barriers to MAE Reporting Questionnaire(BMAERQ). The multi-stage cluster random sample of 569 nurses worked at 4 GradeⅢhospitals in Suzhou was obtained.2. All data were input into SPSS13.0, Amos 9.0 software for statistical analysis. F test, Canonical correlation analysis and multiple linear regression analysis were employed to exam the relationships aomong the barriers, work environment, safety climate, and demographic variables.Results:1. The average SCS, WEQ and BMAERQ scores of 569 nurses were 114.92±11.08, 67.46±6.65, 86.83±14.71 respectively. Ward, job position, shift type were found to influence nurses'perceptions of safety climate(P<0.05), and the latter two variables also influenced the nurses'perception of work environment (P<0.05). There was significant difference between nurses'percetptions of barriers to medication error report who have different personal income per year (P<0.05).2. The canonical correlation analysis indicated that blame, safety emphysis, worker safety were negatively correlated with administrators'reaction and fear (︱r︱=0.51,P<0.05). Team workers'positive attitude was negatively correated with face(︱r︱=0.27,P<0.05). Qualtiy management, adequacy of physical supply were negatively correlated with disagreement over errors and administrators'reaction (︱r︱=0.36,P<0.05). 3. The results of multiple linear regression analysis showed nurses'perceptions of barriers to medication error report were mainly explained by personal income, blame, adequacy of physical supply, reporting system, nonpunitive system (R2=0.263,F=28.225,P<0.05).Conclusion:1. Nurses'perceptions of safety climate are influenced by ward, job position, shift type while the latter two variables also affect nurses'perceptions of work environment.2. Professional title, age, marital status, educational background, job position were the main reasons for nurses'perceptions of power distance, which indicates that authorized management and effective communication would be appropriate way to promote administrative execution and to reduce the excessive controls of the subordinates.3. Personal income, blame, adequacy of physical supply, reporting system, non-punitive system provide considerable reasons for not reporting medication errors among nurses in Suzhou.4. Efforts to improve medication error reporting frequency should focus on organizational level which includes nurses'working environment and safety climate. Non-punitive system, safety emphasis, positive team attitude towards medication errors should be introduced to promote nurses'perceptions of safety climate. Sufficient physical supply, strengthened quality management are critical to improve nurses'working environment.