Impacts of job-related stress and patient safety culture on patient safety outcomes among nurses in Taiwan

Abstract

ABSTRACT Background: Patient safety is critical in healthcare. Studies have documented high level of stress among nurses that may adversely affect quality of patient care and patient safety. Methods: This study measured job-related stress, patient safety culture and patient safety outcomes among nurses in Taiwan. A total of 1562 respondents completed the survey. Partial Least Square-Structural Equation Modelling (PLS-SEM) was applied to explore the relationship between job-related stress, patient safety culture, and patient safety outcomes. Result: Job-related stress was found to have varying influence on the perception of patient safety culture. Specifically, stress related to interpersonal relationship and work environment is negatively related to patient safety culture, whereas nurse–patient relationship stress is positively related to patient safety culture. Meanwhile, patient safety culture was found to have positive influence on patient safety outcomes and fully mediates the relationship between job-related stress and patient safety outcomes. Conclusion: This study points to job-related stress as a challenge and hindrance to improve patient safety culture, necessitating implementation of appropriate strategies for managing stress among nurses. Patient safety culture is vital for healthcare organizations to promote patient safety and to enhance quality of care.