Safety Competencies Research Articles

Practising Safe Care in Critical Care: A Reflexive Thematic Analysis.

AbstractAimTo explore the meaning of ‘safety’ as it applies to critical care nurses during daily care practice in the intensive care setting.DesignA qualitative study design was employed.MethodsThe study enlisted 18 critical care nurses and nurse leaders from three hospitals in Sweden. Interview data were collected in 2017 and in 2024. The data were examined using reflexive thematic content analysis.ResultsThe meaning of safety within critical care settings was illustrated by the themes ‘Sustaining a safety mindset’, ‘Fostering commitment to patient safety’, ‘Showing individual accountability and continuous learning’ and ‘Managing complexity while prioritising safety standards’. Safe care practice in daily practice also involved adaptability and resilience in response to changing circumstances or unexpected events, ensuring thoroughness and allowing for a return to regular routines when conditions permitted, thereby preventing incomplete care. Core competencies in safety encompassed both technical and non‐technical skills, such as the ability to assess and use technology, remain vigilant and thorough, plan ahead, prioritise and identify, and follow through on nursing interventions, all while working in a team and allocating sufficient time for patients.ConclusionSustaining a safe mindset over time is both challenging and essential. Further research should focus on how to foster a sustained safety mindset. A more proactive approach to learning may be achieved by reflecting on and discussing things that have worked well even in challenging circumstances.Implications for the Profession and/or Patient CareThis study enriches our understanding of practising safe care in intensive care. It furnishes the nursing profession with a deeper theoretical grasp of proactive safety efforts, encompassing various factors that can mitigate risks in a technologically advanced environment.

Effects of Grit, Patient Safety Competence, and Patient Safety Culture on the Patient Safety Nursing Activities of Nurses in Comprehensive Nursing Service Wards

Purpose : In this study, we aimed to assess the impacts of grit, patient safety competence, and patient safety culture on the patient safety nursing activities of nurses in comprehensive nursing service wards. Methods : Here, a self-reported survey of 179 nurses from three tertiary hospitals was performed. Data from 171 valid responses were analyzed using descriptive statistics, independent <i>t</i>-test, one-way analysis of variance, Pearson’s correlation, and stepwise multiple regression analyses.Results : The key sub-factors influencing the patient safety nursing activities were attitude (<i>β</i>=.30, <i>p</i> ＜.001) and skill (<i>β</i>=.26, <i>p</i> ＜.001) in the patient safety competence factor and safety environment (<i>β</i>=.26, <i>p</i> ＜.001) in the patient safety culture factor. The regression model explained 42.7% of the variance in patient safety nursing activities (F=43.29, <i>p</i> ＜.001). Conclusion : Overall, these findings highlight the importance of improving the nurse attitude and skills related to patient safety as well as the safety environment in hospitals to enhance the patient safety nursing activities in comprehensive nursing service wards. Targeted educational and training programs should be provided along with organizational support to establish a safe and supportive nursing environment in comprehensive nursing service wards.

Research on the Impact of Managers’ Safety Perception on Construction Workers’ Safety Behaviors

The construction industry is replete with significant safety risks, underscoring the necessity to comprehend the factors that shape workers’ safety behaviors for efficacious accident prevention. This study aims to investigate the impact of managers’ safety perception (MSP) on construction workers’ safety behaviors (WSBs), while also exploring the mediating roles of workers’ safety awareness (WSA) and workers’ safety competency (WSC). Utilizing a structural equation model (SEM), data were collected from 248 construction workers through a validated questionnaire. The findings indicate that MSP has a direct influence on WSBs (mean effect size = 0.065, p < 0.01) and an indirect effect on WSBs through enhanced WSA (effect size = 0.386, p < 0.01) and WSC (effect size = 0.392, p < 0.01). This research makes a contribution to the existing literature in several ways. First, it introduces a new measurement scale for MSP. Second, it highlights the direct and indirect effects on WSBs. Third, it emphasizes the importance of fostering safety awareness and competency among workers. In addition, the study offers practical implications for construction managers seeking to improve safety outcomes on-site.

Patient Safety Competence Among Diploma III Nursing Student In Jakarta, Indonesia; A Cross-Sectional Survey

Nursing students frequently made errors or near-misses due to non-compliance with patient safety protocols, including authenticating medication administration rights, verifying patient identification, and reviewing allergy status. This study was conducted using cross-sectional design at nursing Academy in Jakarta. The inclusion criteria were nursing diploma student at grade 3, nursing students who had not passed any patient safety training courses, those who passed the credit of “Fundamentals of Nursing and Management Patient Safety”, and those who started learning in the clinical setting. The Health Professional Education in Patient Safety Survey (H-PEPSS) was designed by Agency for Healthcare Research and Quality to evaluate recently students' levels of clinical safety. A descriptive statistic was used to analyze data using mean, standard deviation. A simple linear regression was done to determine the relationship between gender, age, and religion with patient safety competence. About 55% student have moderate level of competence, 28% good, and 20% excellent. There was no significant difference on patient safety competence among nursing students in 8 nursing colleges in Jakarta (p>0.05). Gender was associated contributed significantly to the variance in patient safety competence with R square was 28.8%. The study suggests nursing institutions should develop new approaches to improve patient safety competence and culture among students, preparing them for advanced technology education in healthcare institutions.

Effectiveness of Educational Program for Nurses about Patient Safety Values, Attitudes and Competency

Effectiveness of Educational Program for Nurses about Patient Safety Values, Attitudes and Competency

Integration of Personal Safety in Students Training on the Specialty “Civil Safety” at Technical Institutions of Higher Education

Security is considered a legitimate goal of every society. In recent years of the pandemic and then the war in Ukraine, the issue of the security paradigm has become particularly relevant. It prompts a revision of conceptual approaches to the formation of human personal security competencies and especially the mechanisms and ways of ensuring it in society and the state in the present conditions. Therefore, in theory, national and international security concepts are being developed, and more recently, individual, social, and global security. This indicates, among other things, a significant expansion of new dimensions of security when political independence, territorial integrity, and viability of the country, as well as the survival and development of its inhabitants, are at stake. Security in itself should have the status of a fundamental human right. Many publicly discussed security issues are related to technical solutions. Debates are underway not only about society's attitude to security, but also about what research and for what purpose it is conducting or has conducted in this direction. This also applies to the educational environment. The article defines and substantiates the principles of the formation of personal safety of students, provides an essential characteristic of the pedagogical process of formation of personal safety of students, considers the technology of formation of personal safety of students based on the competence approach, reveals the content of the competences of the individual in the sphere of life safety. The purpose of this article is to study the process of forming the personal safety of students in the system of professional education in higher technical institutions of a technical profile. The methodology on which the research is grounded is based on the methodological principles of systematicity and an interdisciplinary approach and includes the use of a complex of general scientific methods, namely explanation, comparison, classification, generalization, and systematization. Based on them, a model of forming students' competencies in the life safety field was built. Within the framework of our research, the following results were achieved: the views of scientists on the issue of the formation of security competencies among students in the new context of the construction of Ukrainian society in conditions of war were summarized; the principles of forming students' personal safety based on the competence approach are substantiated; tasks for the development of students' competencies in the field of life safety are formulated; a structural model of students' competencies and the process of their formation in the field of life safety was built. The conclusions allow us to state that the problem of security is complex and multifaceted, since conflicts, wars or unstable state structures often have not only local significance, but also global consequences due to a closely interconnected and globalized world. The formation of personal safety competencies in students as future specialists is important as a basis for self-preservation, self-development and self-improvement. For this purpose, educational professional programs of technical universities should include fundamental educational disciplines that will ensure the development of worldview principles of life safety and determine generally accepted safety needs and generally recognized safety mechanisms.

Analysis of the current status and influencing factors of nurses' patient safety competence: a potential profile analysis.

The study aimed to understand the current situation of hospital nurses' patient safety competence, identify potential categories, and analyze the distribution characteristics of demographic variables in each subgroup. A total of 1,996 nursing staff were selected to be included in this research using a convenience sampling method. A questionnaire survey was conducted using the Chinese version of the Patient Safety Ability Scale, and three dimensions of the Patient Safety Ability Rating Scale were used as explicit variables for potential profile analysis. The influencing factors of different potential profiles of nurses' patient safety ability were analyzed using logistic regression analysis. The safety ability of the 1,996 nurses could be categorized into three potential groups as follows: "ability risk group" (14.3%), "medium ability group" (32.9%), and "ability advantage group" (52.7%), with monthly income, participation in department training, self-learning, and love of nursing as the influencing factors. The overall patient safety ability of nurses is at an upper-middle level. The classification of nurses can be predicted by factors, such as monthly income, participation in department training, self-directed learning, and love of nursing. Nursing managers can formulate targeted interventions according to the influencing factors of potential profiles to improve nurses' patient safety ability.

Effectiveness of Educational Interventions to Develop Patient Safety Competencies in Undergraduate Nursing Students: A Systematic Review.

Nursing professionals are key to providing safe care that improves patient outcomes. Hence, it is essential to focus on developing nurses' patient safety competencies and principles. This review examined the effectiveness of educational interventions in developing patient safety knowledge, skills, behaviors, and attitudes in undergraduate nursing students. The search strategy aimed to identify published and unpublished studies in databases and grey literature. Studies were assessed using the Joanna Briggs Institute critical appraisal tools. A total of 36 studies met the inclusion criteria. The teaching methods employed single or combined interventions and the educational interventions suggested either improvements in outcomes or no impact. The effectiveness of educational interventions to develop patient safety competencies in undergraduate nursing students, either as a single or combined strategy, was mixed. Further research is needed to provide more robust evidence on which teaching method for patient safety is most effective.

Evaluating the Incidence, Response, and Management Proficiency of Medical Emergencies in Dental Practices

Background: Dental professionals must be ready to respond quickly and effectively to medical emergencies that may arise in unexpected locations, such as dental offices. Given its sizable population and expanding dental sector, Pakistan is not exempt from such potential catastrophes. Objectives: The objective of this study was to determine the frequency of medical emergencies in dental outpatient departments (public and private). In addition, we aimed to pinpoint any inadequacies in procedures that impede efficient administration and offer ideas for enhancing the capacity to handle medical crises in dental offices. Methods: In a six-month cross-sectional study, dental professionals were given a reliable, closed-ended questionnaire to evaluate their attitudes, procedures, and level of expertise in handling medical emergencies. A total of 271 responses were evaluated. Results: Most instances recorded in medical crises were syncope (36%), followed by hypoglycemia (26%). The majority of reported medical situations (77.8%) were managed successfully within the hospital according to the findings of the study. Of the practitioners, approximately 55.9% adhered to all required guidelines for handling medical emergencies, while 34.8% only partially did so. Approximately 69.6% of practitioners did not follow the protocol when it came to using emergency equipment or drugs. Approximately 65% of practitioners stated that the most difficult aspects of handling medical emergencies were panic or disorientation and a lack of training. Dental professionals and personnel were trained in basic life support (39%), demonstration/lectures (21%), and addressing medical crises (figure 2). Conclusion: The fact that medical emergencies at dental offices are uncommon does not mean that a large percentage of dentists are well-equipped to manage these circumstances. By filling these gaps, the dental profession can improve patient safety and emergency practitioner competencies.

Psychological Safety Competency Training During the Clinical Internship From the Perspective of Health Care Trainee Mentors in 11 Pan-European Countries: Mixed Methods Observational Study.

In the field of research, psychological safety has been widely recognized as a contributing factor to improving the quality of care and patient safety. However, its consideration in the curricula and traineeship pathways of residents and health care students is scarce. This study aims to determine the extent to which health care trainees acquire psychological safety competencies during their internships in clinical settings and identify what measures can be taken to promote their learning. A mixed methods observational study based on a consensus conference and an open-ended survey among a sample of health care trainee mentors from health care institutions in a pan-European context was conducted. First, we administered an ad hoc questionnaire to assess the perceived degree of acquisition or implementation and significance of competencies (knowledge, attitudes, and skills) and institutional interventions in psychological safety. Second, we asked mentors to propose measures to foster among trainees those competencies that, in the first phase of the study, obtained an average acquisition score of <3.4 (scale of 1-5). A content analysis of the information collected was carried out, and the spontaneity of each category and theme was determined. In total, 173 mentors from 11 pan-European countries completed the first questionnaire (response rate: 173/256, 67.6%), of which 63 (36.4%) participated in the second consultation. The competencies with the lowest acquisition level were related to warning a professional that their behavior posed a risk to the patient, managing their possible bad reaction, and offering support to a colleague who becomes a second victim. The mentors' proposals for improvement of this competency gap referred to training in communication skills and patient safety, safety culture, work climate, individual attitudes, a reference person for trainees, formal incorporation into the curricula of health care degrees and specialization pathways, specific systems and mechanisms to give trainees a voice, institutional risk management, regulations, guidelines and standards, supervision, and resources to support trainees. In terms of teaching methodology, the mentors recommended innovative strategies, many of them based on technological tools or solutions, including videos, seminars, lectures, workshops, simulation learning or role-playing with or without professional actors, case studies, videos with practical demonstrations or model situations, panel discussions, clinical sessions for joint analysis of patient safety incidents, and debriefings to set and discuss lessons learned. This study sought to promote psychological safety competencies as a formal part of the training of future health care professionals, facilitating the translation of international guidelines into practice and clinical settings in the pan-European context.

Knowledge And Attitude Of Nurses About Radiation Safety And Radiation Protection: A Scoping Review

Background: Radiation is an electromagnetic wave which is coming across the daily activity of humans. There are naturally occurring and man-made radiations. X-rays, being the commonest radiation mostly known to the people are used in the medica field for diagnostic and therapeutic aspects. Despite of being at good in the preliminary evaluation of pathologies, it also possess a risk of biological effects of radiation on living tissues. This is crucial for the people who are associated with radiation as part of their occupation. The occupational staff must be well aware of the biological effects of radiation and the different means of radiation protection and safety. Nurses, being the largest community in the healthcare, and associated with most of the procedures carried out in a hospital, are expected to have a good knowledge and understanding about the radiation and radiation safety. The aim of this review was to assess the nurses’ awareness and knowledge of radiation safety and protection, which is essential for their health and performance as a healthcare team. Materials and Methods: A systematic search was conducted using PubMed and ProQuest databases with relevant keywords from 2013 to 2023. A total of 104 articles were found based on the search techniques, were screened for eligibility based on predefined criteria and only 7 articles were included in the final analysis. Results: The review found that nurses’ knowledge and attitudes towards radiation safety and protection were insufficient and varied across different settings and specialties. The main barriers to adequate knowledge and practice were lack of education, training, and resources. Conclusion: The review highlighted the need for improving nurses’ knowledge and competence in radiation safety and protection through regular and comprehensive training programs, guidelines, and policies. This would enhance the quality and safety of the services provided by the nurses and protect them from the harmful effects of radiation exposure.

Comparison of the effects of medication error encouragement training and problem-based scenario on the medication safety competence and knowledge of nursing students: A quasi-experimental study

BackgroundMedication errors among nursing students pose a threat to medication safety. Medication Error Encouragement Training and Problem Based Scenario are two innovative educational methods used in medication education. AimCompare the effects of Medication Error Encouragement Training and Problem Based Scenario on the knowledge and competency of medication safety among nursing students. DesignQuasi -experimental, double-blind, two-group pretest-posttest study. MethodThis study was conducted in 2023. Participants were randomly assigned to two groups: one group received the Medication Error Encouragement Training method, while the other group was taught using the Problem-Based Scenario method. Data collection was performed using the Medication Safety Critical Element Checklist and Medication Safety Knowledge Assessment before and four weeks after the intervention. Data analysis was conducted using SPSS version 16. ResultsThe Pair t-test demonstrated that the change in competency and knowledge scores of medication safety before and after the intervention was significant in both groups (P< 0.05). The results of the Mancova test indicated a significant increase in medication safety competency scores in the Medication Error Encouragement Training group compared with the Problem Based Scenario group after the intervention (P< 0.05), while there was no significant difference in medication safety knowledge scores between the two groups after the intervention (P> 0.05). ConclusionThe Medication Error Encouragement and Problem Based Scenario methods were effective in increasing the knowledge and competency of medication safety among students, but the effectiveness of the Medication Error Encouragement method was more pronounced in achieving safe medication administration.

Emergency department nurses' reflective thinking and patient safety competency: The mediating effect of patient safety culture

AimThis study aimed to identify the mediating effect of patient safety culture on the relationship between reflective thinking and patient safety competency in emergency department nurses. BackgroundGiven the complexity and the need for timely assessments and interventions in the emergency department, the patient safety competency of nurses is crucial for preventing safety incidents. MethodsThis study utilized a cross-sectional descriptive correlational design with a convenience sample of 200 emergency department nurses. Participants completed a web-based, self-administered questionnaire that assessed reflective thinking, patient safety culture, and patient safety competency. The percentile bootstrap method for mediation analysis was performed to ascertain the mediating role of patient safety culture in the relationship between reflective thinking and patient safety competency. ResultsBoth reflective thinking and patient safety culture were significant predictors of patient safety competency. Furthermore, patient safety culture was found to mediate the relationship between reflective thinking and patient safety competency among emergency department nurses. ConclusionsThe findings suggest that emergency department nurses could benefit from a competency enhancement program or quality improvement projects that focus on reflective thinking and patient safety culture, which are significant predictors of patient safety competency.

Influence of Medication Errors and Medication Safety Competency on Medication Safety Nursing Activities among General Hospital Nurses

Influence of Medication Errors and Medication Safety Competency on Medication Safety Nursing Activities among General Hospital Nurses

An analysis of the psychometric properties of the medication safety competence scale in Turkish

PurposeConsidering the key roles and responsibilities of nurses in ensuring medication safety, it is necessary to understand nurses’ competence in medication safety. Therefore, it was aimed to introduce a scale evaluating the medication safety competence of nurses into Turkish and to contribute to the literature by determining the medication safety competence levels of nurses.MethodsA methodological and descriptive research design was utilised. The population consisted of nurses in Turkey, and the sample comprised 523 nurses who volunteered to participate.ResultsThe content validity index of the scale was 0.98, and the scale showed a good fit (χ2/df = 3.00, RMSEA = 0.062). The Cronbach’s alpha coefficient of the scale was 0.97, indicating high reliability. The mean score was 4.12, which was considered high. Participants who were 40 years old or above, married, and graduates of health vocational schools or postgraduate programs, along with those who had received medication safety training, had higher medication safety competence scores.ConclusionThis study presents strong evidence that the Turkish version of the Medication Safety Competency Scale is valid and reliable when administered to nurses. The participants in this study had high levels of medication safety competence.

Determinants of clinical nurses’ patient safety competence: a systematic review protocol

IntroductionPatient safety has become a fundamental element of healthcare quality. However, despite the ongoing efforts of various organisations, patient safety issues remain a problem in the healthcare system. Given the...

A qualitative evaluation of rural and provincial surgery wānanga to enhance cultural safety among surgical registrars in Taranaki, New Zealand.

The Royal Australasian College of Surgeons (RACS) recently instituted cultural safety and cultural competency as its 10th competency with formalized cultural safety training yet to be instituted. Wānanga are Indigenous Māori teaching institutions that can be used contemporarily for cultural safety training. In 2022, surgical registrars based at Taranaki Base Hospital (TBH) held in-hospital wānanga ranging from 1 to 3 h focussed on cultural safety, professionalism and wellbeing. This study explores the perspectives of these registrars who attended wānanga using a Kaupapa Māori aligned methodological stance and interpretive phenomenological analysis. Twenty-six wānanga were held from March 22nd 2022 to January 30th 2023. Six registrars provided their perspectives with four major themes emerging from their stories including: cultural safety; unity; time, place and person; and a new era. Registrars valued the wānanga which was scheduled for Friday afternoons after daily clinical duties. Wānanga facilitated unity and understanding with registrars being able to reflect on the context within which they are practicing - describing it as a new era of surgical training. 'Time' was the biggest barrier to attend wānanga however, the number of wānanga held was testament to the commitment of the registrars. Regular wānanga set up by, and for, surgical registrars cultural safety development is feasible and well subscribed in a rural or provincial NZ setting. We present one coalface method of regular cultural safety training and development for surgical registrars and trainees in NZ.

The link between patient safety competence and adverse event among master of nursing students: a cross-sectional mixed-methods study

BackgroundPatient safety (PS) is a core competency for registered nurses. However, there is a gap between the PS competence of nursing students and their clinical experience in PS. This study explored the effect of PS competence levels on the occurrence of adverse events (AEs) among nursing master’s students in China.MethodsA sequential mixed methods design was used, with a purposive sample across seven colleges. A total of 327 graduate nursing students, aged 22 to 38, participated in the survey, and 15 participated in qualitative interviews. The Health Professional Education in Patient Safety Survey (H-PEPSS) assessed the students’ competence levels in PS. The respondents also reported any AEs that they had been involved in over the past year.ResultsA total of 78 AEs occurred in the past year, with 17.7% of the participants involved 1 to 3 AEs. The most common AEs were medication administration errors (30.77%) and improper use of medical equipment/supplies (28.20%). Students acquired more competencies from the clinical setting than from the classroom setting. Three competencies learned from classroom settings were associated with clinical AEs: low clinical safety skills [OR = 0.61], inappropriate identify, response to and disclosing AE and close calls [OR = 0.454], and low confidence in working in teams with other health professionals [OR = 2.168]. Qualitative data analysis revealed five themes: recognizing AEs, reducing harm by addressing immediate risks to patients and others involved, promoting safe medication and clinical practice, managing members’ authority and team dynamics, and dealing with inter-professional conflict.ConclusionsThe quantitative and qualitative data align, supporting the enhancement of students’ PS competence.

Safe provision of nursing care as predicted by nursing students: A cross-sectional study

Background &amp; Aim: Assessment of safety culture and nursing students’ competencies in patient safety is essential for readiness to provide quality and safe care. The objectives of the study are to examine how nursing students perceive patient safety culture and to evaluate factors that may influence their perceptions. Methods &amp; Materials: A descriptive cross-sectional study was conducted using the Slovak version of the Hospital Survey on Patient Safety Culture for Nursing Students and the Questionnaire for Measuring Demographic Variables and Information on the Education Process. The study involved 242 nursing students from two faculties in Slovakia. Data were analyzed using descriptive and inferential statistics. Results: None of the dimensions of patient safety culture was rated by the nursing students above the necessary level of 75 %. Statistically significant correlations and differences were found between the nursing students’ perceptions of patient safety culture and some selected sociodemographic variables. Multiple regression analysis revealed significant associations between the nursing students’ perceptions of patient safety culture and overall patient safety grade, the number of reported events in the workplace, and the number of reported events by nursing students. Conclusion: Recognising nursing students’ perceptions of patient safety culture enables identification of weaknesses, and early implementation of targeted interventions and educational initiatives to increase overall patient safety in care provision. Future research should focus on recognizing relationships between perceived patient safety culture, teamwork, education, and indicators of safe and quality care during clinical training from nursing students’ perspective.

Relationship between critical thinking ability and medication safety competence among clinical nurses: A multicenter cross-sectional study.

This study investigated the relationship between clinical nurses' critical thinking ability and medication safety competence, as well as the factors related to medication safety competence. Nurses can have an active role in promoting medication safety. However, the main factors associating with nurses' competence in medication safety are uncertain. This was a descriptive, multicenter cross-sectional survey study. A total of 1196 nurses from four different tertiary hospital in China were included in this study. A demographic information questionnaire, the Critical Thinking Diagnostic for nurses, and the Medication Safety Competence Scale for nurses were used to survey. Descriptive statistics, comparisons, correlation and regression analysis of the collected data were performed using SPSS 26.00 software. The study was reported using STROBE checklist. Included nurses obtained satisfactory scores on the critical thinking and medication safety scales and subscales. There was a strong statistically significant positive correlation between critical thinking ability and medication safety competence. Multiple linear regression analysis indicated that personal critical thinking scores and working years were positively associated with nurses' medication safety scores, accounting for 62.50% of the variance. Clinical nurses' critical thinking ability is positively associated with medication safety competence. As critical thinking ability positively predicts nurses' medication safety competence, hospitals and nursing administrators should consider continuing nursing education and training to improve critical thinking skills, thereby promoting medication safety competence among clinical nurses.