Investigation of the Relationship Between Stress, Workload, Medical Error Tendency and Perceived Quality of Care in Surgical Nurses

OZET Amac: Bu calismanin amaci, cerrahi hastalarinin ameliyat sonrasi hemsirelik bakim kalitesi algisini degerlendirmektir. Yontem: Tanimlayici turde olan bu calisma 2014-2015 yillari arasinda bir universite hastanesinin genel cerrahi kliniklerinde, 271 hasta ile yapildi. Verilerin toplanmasinda kisisel bilgi formu ve Bakim Davranislari Olcegi-24 kullanildi. Veriler SPSS 20.0 programinda tanimlayici analizler, Kolmogorov-Smirnov, Mann Whitney U, Kruskal-Wallis, Friedman testleri ile degerlendirildi. Bulgular: H astalarin % 55’inin kadin (n=149), % 70.8’inin (n=192) ilkogretim mezunu, % 90.4’unun (n=245) evli, yas ortalamalarinin 55.54±14.59 yil oldugu belirlendi. Hastalarin h emsirelik bakim kalitesi algilama puan ortalamasi 4.68±0.96; olcek alt boyut puan ortalamalari; guvence 4.78±1.04, bilgi-beceri 4.99±0.91, saygili olma 4.50±1.07, baglilik 4.41±1.13 olarak bulundu. Alt olceklerden bilgi-becerinin puan ortalamasi ve cerrahi hemsireleri tarafindan bilgilendirilen hastalarin hemsirelik bakim kalitesi algisi istatistiksel olarak anlamli duzeyde yuksek belirlendi (p<0.001). Sonuclar: Cerrahi hastalarinin ameliyat sonrasi hemsirelik bakim kalitesi algisi biraz yuksek belirlendi. Cerrahi hastalarinda bakim kalitesi algisinin arttirilmasi icin cerrahi hemsirelerinin bakim uygulamalarinda bilgili, becerili olmalarini ve hastalari bilgilendirmelerini onermekteyiz. Anahtar Kelimeler: Bakim kalitesi algisi; cerrahi hastasi; cerrahi hemsireligi; hemsirelik bakimi. ABSTRACT Surgical patients’ perception of the postoperative nursing care quality Aim: The aim of this study is to evaluate the surgical patients’ perception of postoperative nursing care quality. Method: This descriptive study was conducted with 271 patients in the general surgery clinics of a university hospital between 2014 and 2015. In data collection, a personal information form and the Caring Behaviors Inventory-24 were used. Statistical analysis were completed in the SPSS 20.0 program using descriptive analyses, the Kolmogorov-Smirnov, Mann Whitney U, Kruskal-Wallis, and Friedman tests. Results: I t was determined that 55% of the patients were female (n=149), 70.8% (n=192) had elementary education, and 90.4% (n=245) were married and the mean age was 55.54±14.59 years. The perception of nursing care quality mean score of the patients was 4.68±0.96, with sub scale mean score of assurance 4.78±1.04, knowledge and skill 4.99±0.91, respectfulness 4.50±1.07, and connectedness 4.41±1.13. Among sub scales, the mean score of skills and knowledge and the perception of nursing care quality of the patients who were informed by surgical nurses was found to be significantly higher (p<0.001). Conclusion: Surgical patients’ perception of postoperative nursing care quality was determined to be slightly higher. In order to increase perception of care quality in surgical patients, we suggest that nurses should have the sufficient skills and knowledge on care behaviors and inform patients. Key Words: Nursing care; perception of care quality; surgical nursing; surgical patients

Amaç: Hemşirelerin iş yükü algılarının ve tıbbi hataya olan eğilimlerinin belirlenmesi, hataların öngörülebilmesini ve gerekli yaklaşımların geliştirilmesini sağlayacaktır. Bu çalışma, cerrahi hemşirelerinin iş yükü algıları ile tıbbı hataya eğilimleri arasındaki ilişkinin belirlenmesi amacıyla yapılmıştır. Yöntem: Tanımlayıcı tipteki çalışmaya, Türkiye’nin iki farklı bölgesinde yer alan iki devlet hastanesindeki 139 cerrahi hemşiresi dahil edilmiştir. Verilerin toplanmasında Tanımlayıcı Form, Bireysel İş Yükü Algısı Ölçeği, Tıbbi Hataya Eğilim Ölçeği kullanılmıştır. Verilerin analizinde Statistical Package for Social Sciences (SPSS) 23 kullanılmıştır. Verilerin normal dağlımı Shapiro-Wilk testi ile değerlendirilmiştir. Sayı, yüzde, Mann-Whitney U, Kruskal Wallis ve Spearman Correlation analizi kullanılmıştır. Bulgular: Çalışmaya katılan hemşirelerin yaş ortalamaları 34.78±7.79 olup, %62.6’sı meslek hayatları boyunca tıbbi hata ile karşılaşmıştır. Çalışmamızda, hemşirelerin tıbbi hataya eğilimleri düşük (232.81±17.95), bireysel iş yükü algıları (100.30±12.79) olumlu olarak belirlenmiştir. Hemşirelerin bireysel iş yükü algılarının, tıbbi hataya eğilime yol açan tüm boyutlarla ilişkili olduğu saptanmış olup (p

To examine the association between components of safety climate and psychosocial hazards with safe work behaviours and test the moderating effects of psychosocial hazards on the safety climate-safety performance relationships. The effects of a strong safety climate on safety performance are well cited, however, the conditions that have an impact on this relationship warrant attention. While the psychosocial hazards commonly reported by nurses are predictors of well-being and job attitudes, evidence suggests that these may also place boundaries on the effects of safety climate on safe work practices. This study used a cross-sectional design to collect data from 146 nurses. Participants were recruited through convenience sampling and snowball sampling methods in 2017. Nurses completed an online questionnaire and received a $5 e-gift card as compensation. SPSS v.23 and PROCESS v3.0 were used to analyse the data. A strong safety climate was positively associated with nurses' safety performance. While psychosocial hazards did not predict safety performance, they did moderate the safety climate-performance relationship. High levels of perceived stressors weakened the association between promoting two-way safety communication, the use and implementation of procedures to promote safe work practices and management's endorsement of health and safety with safe work performance. The positive effects of safety climate on nurses' safety performance are contingent on the levels of psychosocial hazards nurses experience. When aiming to improve safety performance among nurses, it is important for efforts to also focus on the psychosocial conditions of the work environment.

It is stated that high ethical sensitivity positively affects the quality of nursing care. However, the relationship between nursing care quality and ethical sensitivity has not been clearly demonstrated in researches. This study was carried out to determine the relationship between surgical nurses' care behaviors and their ethical sensitivity. The sample of this cross-sectional, descriptive-correlational study consists of 308 nurses who worked at the surgical departments in four Turkish hospitals. The data were collected using the "Nurse Description Form" developed by the researcher, "Caring Behaviours Inventory-24" and "Ethical Sensitivity Questionnaire." Data were evaluated by the Mann Whitney U test, Kruskal Wallis one-way analysis of variance and Spearman correlation analysis. The study was approved by the ethics committee. Verbal and written consent was received from the nurses. It was found in the study that nurses' Caring Behaviours Inventory-24 total score median was 5.25 (4.83-5.58), nurses' perception level of caring quality was high, median of Ethical Sensitivity Questionnaire total score was 89.00 (75.00-101.00) and nurses' ethical sensitivity was moderate. A negative significant relation was found between nurses' Caring Behaviours Inventory-24 total score and Ethical Sensitivity Questionnaire total score (r = -0.162; p = 0.009). A negative relation was also detected between nurses' working period at the current clinic and providing benefit (r = -0.147; p = 0.012), holistic approach (r = -0.139; p = 0.018) and orientation (r = -0.175; p = 0.003) scores of Ethical Sensitivity Questionnaire sub-scales. Nurses' perception levels of caring quality were high and their ethical sensitivity levels were moderate. It was found out that nurses' ethical sensitivity increased together with their perception of caring quality, and as their working period at the current clinic increased, the ethical sensitivity also increased in terms of the sub-scales of providing benefit, holistic approach, and orientation. The factors that adversely affect the quality of nursing care and ethical sensitivity should be examined and attempts should be made to improve the working environment.

Objective: Psychological resilience is an important resource that protects surgical nurses against the adverse effects of job stress. This study sought to determine the correlation between work-related stress and psychological resilience in surgical nurses and the factors affecting these. Methods: This descriptive, cross-sectional study was conducted with 157 nurses working in surgical units between September 13, 2021, and January 21, 2022. A Nurse Information Form, the Nurse Stress Scale, and the Psychological Resilience Scale for Adults were used for data collection. Results: Very weak negative correlation was observed between work-related stress and the psychological resilience of surgical nurses (r = −0.159, P = .046), weak negative correlation between nurses&amp;#39; age and work stress (r = −0.332, P &lt; .001), weak negative correlation between working time and work stress (r = −0.336, P &lt; .001), and very weak positive correlation between age and resilience (r = 0.165, P = .039). Very weak positive correlation was determined between length of time in the profession and psychological resilience (r = 0.222, P = .005). Work-related stress was higher and psychological resilience was lower among nurses who were unmarried, who had a bachelor&amp;#39;s degree or higher level of education, who were not satisfied with the working environment, who had a poor quality of work life, and who did not take part in any hobby/activity outside work (P &lt; .05). Conclusion: There are individual, occupational, and environmental risk factors that affect work stress and psychological resilience levels in surgical nurses. Identifying variables that reduce job stress and contribute to resilience in surgical units can help implement strategies that encourage these behaviors and thus retain nurses in this specialty. Cite this article as: Mert S, Kersu Ö, Aydın Sayılan A. Examining the job stress experienced by surgical nurses and their psychological resilience status. Arch Health Sci Res. 2023;10(1):50-59.

Attitudes of surgical nurses towards pressure ulcer prevention

Surgical nurses work in demanding environments and play a vital role in maintaining and promoting patient safety due to the nature of their work. Hence it is important to know their attitudes toward patient safety. This research aimed to evaluate the patient safety attitudes of Turkish surgical nurses. This was a descriptive cross-sectional and questionnaire research. Data were collected from August 2015-January 2016 using the staff information form and the safety attitudes questionnaire (SAQ). The study population included 231 nurses who work in operating rooms, surgical intensive care, and surgical wards of four hospitals in western Turkey. Data were analyzed with frequency, percentage, mean, standard deviation, the Mann Whitney U test, and Kruskal Wallis tests using the SPSS 18. The teamwork and safety climate scores of operating room nurses were higher than the scores of surgical intensive care and ward nurses. The stress recognition scores of surgical ward nurses were the highest, followed by the scores of the operating room and surgical intensive care nurses. The perception of management scores of operating room nurses was higher than those of surgical ward nurses, and nurses ages 18-30 were higher than those of nurses ages 31-40. None of the six domains of safety culture, including job satisfaction, teamwork, safety climate, the perception of management, stress recognition, and working conditions achieved a positive mean score over 75. This research paper provides an evaluation of the safety attitudes of surgical nurses. Findings can provide information for healthcare leaders to improve the safety culture.

To investigate hospital nurses' involvement in the identification and reporting of medication errors in Turkey. Medication safety is an international priority, and medication error identification and reporting are essential for patient safety. A descriptive survey design consistent with the STROBE guidelines was used. The participants were 135 nurses employed in a university hospital in Turkey. The survey instrument included 18 sample cases and respondents identified whether errors had been made and how they should be reported. Descriptive statistics were analysed using the chi-square and Fisher's exact tests. The sample case of "Patient given 10mg morphine sulphate instead of 1.0mg of morphine sulphate" was defined as a medication error by 97% of respondents, whereas the sample case of "Omitting oral/IV antibiotics because of the need to take the patient out for X-rays for 3hr" was defined as a medication error by only 32.1%. It was found that eight sample cases (omitting antibiotics, diluting norodol drops with saline, giving aspirin preprandially, injecting clexane before colonoscopy, giving an analgesic at the nurse's discretion, dispensing undiluted morphine, preparing dobutamine instead of dopamine and administering enteral nutrition intravenously) were assessed as errors and reported, although there were significant statistical differences between the identification and reporting of these errors. Nurses are able to identify medication errors, but are reluctant to report them. Fear of the consequences was the main reason given for not reporting medication errors. When errors are reported, it is likely to be to physicians. The development of a commonly agreed definition of a medication error, along with clear and robust reporting mechanisms, would be a positive step towards increasing patient safety. Staff reporting medication errors should be supported, not punished, and the information provided used to improve the system.

The aim of this descriptive study is to determine the relationship between competencies and attitudes of nurses in medical errors. The level of competence of nurses directly affects the patient's safety, health status, morbidity and mortality rates, and satisfaction with nursing care. Nurses are expected to demonstrate a high level of competence in fulfilling their duties and responsibilities and thus to minimize the incidence of medical errors. This study was carried out with nurses (n=243) working in a university hospital in Turkey between May and July 2019. A personal information form, the Nurse Competence Scale and the Medical Errors Attitude Scale were used in the collection of data. A relationship was found between the competence of nurses and their attitudes in medical errors. It appeared that the work role subscale had the highest mean score (48.76±6.83) according to the Nurse Competence Scale subscales. The mean scores of the diagnostic functions and ensuring quality subscales of the scale were found to be low. While the mean scores of the Medical Errors Attitude Scale of the nurses were close to each other, the highest mean score was found in the subscale of approach to medical errors (3.94±0.35). The nurses had a modest level of competence and their attitudes towards medical errors were positive. It is necessary that the competence of nurses is increased. Increasing their competence will also increase their awareness on medical error attitudes.

Evaluation of surgical nurses' knowledge and attitudes towards pressure ulcer prevention.

This study aims to determine the effects of perceived organizational support on attitudes toward medical errors in surgical nurses. Nurses exhibit high performance in a work environment that supports, satisfies, and motivates them. Organizational support is one of the factors affecting the work environments of nurses. A strong nursing and hospital leadership supports the daily professional practices and well-being of nurses and is important in creating a positive work environment for nurses. The population of this cross-sectional study was composed of nurses (N = 414) in the surgical clinics of the Turgut Özal Medical Center. To reach the necessary sample size, the purposive sampling method, which is a nonprobability sampling method, was used. The data were collected using a personal information form, the Perceived Organizational Support Scale and the Scale of Attitudes toward Medical Errors. It was determined that 91.1% of the participants had positive attitudes toward the importance and reporting of medical errors and moderate perceived organizational support (3.04±0.67). The organizational support perceived by the participants did not have a statistically significant effect on their attitudes toward medical errors (β=0.015; p=0.865). The multiple linear regression model established in the study revealed that education level and previous medical error status were significant predictors of the attitudes of the participants toward medical errors. It was determined that surgical nurses had positive attitudes toward the importance and reporting of medical errors and moderate perceived organizational support levels, and perceived organizational support did not significantly affect attitudes toward medical errors in surgical nurses. In this study, it was determined that the perceived organizational support levels of surgical nurses did not have a significant effect on their attitudes toward medical errors. Assuming that adequate organizational support will reduce medical error rates, it is considered important to develop and implement policies to increase organizational support levels. Likewise, the use of safety reporting systems should be expanded to reduce medical error rates, reports should be used only to prevent and reduce risks, and systems and strategies should be developed instead of blaming individuals. In addition to the reporting of confirmed medical errors to ensure patient safety, the reporting of so-called "near misses" is also very important. For this reason, institutional support should be provided regarding the importance of "near miss" events in error reporting. Necessary practices should be provided to identify, report, correct, and prevent these events.

The effect of Emotional Freedom Techniques on nurses' stress, anxiety, and burnout levels during the COVID-19 pandemic: A randomized controlled trial

Aim: This study was realized with the aim to evaluate nurses’ attitudes toward medical errors. Method: Data were collected from 149 nurses in a university hospital in Turkey, using the Scale of Attitudes toward Medical Errors developed by Güleç and Seren Intepeler (2013) and a staff information form prepared in line with the literature data. Results: Nurses’ attitudes toward errors were generally positive, and intensive care unit (ICU) nurses were found to have more positive attitudes toward errors than ward nurses. The factors that caused medical errors included an increasing number of patients per shift, a workforce shortage, an intensifying workload, and lack of knowledge and experience. While the majority of the nurses believed that reporting errors decreased the number of errors, most of them refrained from reporting errors for which they were responsible. Conclusion: The results may be useful for nurse managers and leaders to reach a more comprehensive understanding of nurses’ attitudes toward medical errors and to encourage them to support their staff and improving their working environment.

Patient Safety: Grantmakers Join The Effort To Reduce Medical Errors

Relationship between job stress level and coping strategies used by Hong Kong nurses working in an acute surgical unit