Abstract
Objective to contribute to the validation study of the Scale of Adverse Events associated with Nursing Practices in the hospital context.Method cross-sectional study, in public hospital units, in the central and northern regions of Portugal. The exploratory factor analysis of the Scale of Adverse Events associated to Nursing Practices was conducted with a sample of 165 nurses and the confirmatory factorial analysis was made with a sample of 685 nurses. Reliability, internal consistency and construct validity were estimated. The invariance of the model was evaluated in two subsamples to confirm the stability of the factorial solution.Results the global sample consisted of 850 nurses aged between 22 and 59, mostly licensed professionals. The model had a good overall fit in the subscales (Nursing Practices: χ2/df = 2.88, CFI = 0.90, GFI = 0.86, RMSEA = 0.05, MECVI = 3.30; Adverse Events: χ2/df = 4.62, CFI = 0.93, GFI = 0.95, RMSEA = 0.07, MECVI = 0.39). There was a stable factor structure, indicating strong invariance in the subscale Nursing Practices and structural invariance in the subscale Adverse Events.Conclusion the refined model of the Scale of Adverse Events associated with Nursing Practices revealed good fit and stability of the factorial solution. The instrument was adjusted to evaluate the perception of nurses about adverse events associated with health care, precisely nursing care, in the hospital setting.
Highlights
Health care safety has become one of the priorities of national and international health organizations in recent decades
Health-related adverse events (AE) result from a succession of occurrences that favor unexpected/unwanted events arising from health care interventions due to failure or omission in its provision instead of factors associated with the patients’ underlying pathology
AE result from the combination of several factors in highly complex environments, including individual factors related to the patient, factors related to the health professionals such as professional skills, and economic-financial constraints and institutional weaknesses such as insufficient human resources, overcrowding of patients, inadequate structure and equipment, misfit accommodation care, poor hygiene conditions, among others
Summary
Health care safety has become one of the priorities of national and international health organizations in recent decades. Scientific evidence indicates high rates of adverse events (AE) arising from health care provision, with an impact on patients’ health and economic-financial systems, being an important indicator of the safety of care measures. Health-related AE result from a succession of occurrences that favor unexpected/unwanted events arising from health care interventions due to failure or omission in its provision instead of factors associated with the patients’ underlying pathology. These can cause adverse effects/harm to the patients, including permanent damages or even death, influencing the increase in morbidity and mortality, hospitalization time and consequent associated costs, with an impact on the health systems[4,5]. There are aspects related to the work environment, safety culture, leadership style and structure and development of the care process as determinants of health care safety[1,2,6,7,8]
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