Research On Nurses' Attitudes Towards Patient Safety And The Influencing Factors

Objective:This study aimed to determine nurses'attitudes towards patient safety and the main influencing factors in China,in order to provide evidences for health administrations to measure safety culture and develop and implement interventions,thereby improving the quality of medical care and patient safety.Methods:Stratified cluster random sampling method was used to select 3000 nurses from municipal,county,and village level medical institutions in 12 Chinese provinces.The questionnaire consists of three parts:the self-designed sociodemographic and working characteristic questionnaire was used to collect the demographic data,health status,medical disputes and adverse event reports of the nurses;the Chinese version of the Safety Attitude Questionnaire was used to investigate the attitudes of the nurses towards patient safety culture;the Nursing Work Environment Scale was used to investigate the nurses'perceptions of work environment.The data were statistically analyzed by SPSS18.0 software and AMOS21.0 software using descriptive analysis,independent samples t test,one-way analysis of variance,Pearson's correlation analysis and multiple linear regression models.P<0.05 was considered statistically significant.Results:1.The total mean score of nurses'safety attitudes was 77.33±14.53.The scores of each subscale were in descending order:job satisfaction(81.35±19.19),perceptions of management(81.06±18.80),working conditions(79.69±16.05),stress recognition(78.50±22.49),safety climate(72.48±14.08),and teamwork climate(70.89±13.89).The positive response rate of each dimension was less than 80%,then there was no strong positive dimension;the positive response rates of the teamwork climate and safety climate were both less than 60%,which were considered to need improvement.2.The results of univariate analysis showed that the nurses'safety attitudes were associated with gender,household registration,marital status,child-bearing,monthly income,employee category,hospital grade,total years of nursing experience,years of nursing experience in the current unit,professional title,position,direct contact with patients,medical disputes,and number of adverse events reported in last 12 months(P<0.05).The safety attitudes mean score and its subscales were found to have positive correlation with practice environment score and its subscales(P<0.05).3.As a result of the multiple linear regression analysis,practice environment,number of adverse events reported,employee category,professional title,position,and total years of nursing experience were the influencing factors of nurses'safety attitudes(R~2=0.441,F=217.418,P<0.001).Conclusion:1.Nurses'attitudes towards patient safety were generally at the upper-middle level,but the teamwork climate and safety climate need to be further improved.2.Nurse work environment and number of adverse event reported are related factors of nurses'safety attitudes.Hospital administrators should improve the work environment and adverse event reporting system.3.Employee category,professional title,position,and total years of nursing experience are related with nurses'safety attitudes.Nurses with high-professional title or in off-staff category or having low nursing experience years should be more focused on,to continuously improve and promote patient safety culture.