Seung Eun Lee1, Catherine Vincent2, V Susan Dahinten3, Linda D Scott4, Chang Gi Park5, Karen Dunn Lopez6. 1. Assistant Professor, School of Nursing, University of Massachusetts, Lowell, MA, USA. 2. Associate Professor, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA. 3. Associate Professor, School of Nursing, University of British Columbia, Vancouver, BC, Canada. 4. Professor, School of Nursing, University of Wisconsin, Madison, WI, USA. 5. Research Assistant Professor, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA. 6. Assistant Professor, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA.
Abstract
PURPOSE: This study aimed to investigate effects of individual nurse and hospital characteristics on patient adverse events and quality of care using a multilevel approach. DESIGN: This is a secondary analysis of a combination of nurse survey data (N = 1,053 nurses) and facility data (N = 63 hospitals) in Canada. METHODS: Multilevel ordinal logistic regression was employed to examine effects of individual nurse and hospital characteristics on patient adverse events. Multilevel linear regressions were used to investigate effects of individual nurse and hospital characteristics on quality of care. FINDINGS: Organizational safety culture was associated with patient adverse events and quality of care. Controlling for effects of nurse and hospital characteristics, nurses in hospitals with a stronger safety culture were 64% less likely to report administration of wrong medication, time, or dose; 58% less likely to report patient falls with injury; and 60% less likely to report urinary tract infections; and were more likely to report higher levels of quality of care. Additionally, the effects of individual-level baccalaureate education and years of experience on quality of care differed across hospitals, and hospital-level nurse education interacted with individual-level baccalaureate education. CONCLUSIONS: This study makes significant contributions to existing knowledge regarding the positive effect of organizational safety culture on patient adverse events and quality of care. CLINICAL RELEVANCE: Healthcare organizations should strive to improve their safety culture by creating environments where healthcare providers trust each other, work collaboratively, and share accountability for patient safety and care quality.
PURPOSE: This study aimed to investigate effects of individual nurse and hospital characteristics on patient adverse events and quality of care using a multilevel approach. DESIGN: This is a secondary analysis of a combination of nurse survey data (N = 1,053 nurses) and facility data (N = 63 hospitals) in Canada. METHODS: Multilevel ordinal logistic regression was employed to examine effects of individual nurse and hospital characteristics on patient adverse events. Multilevel linear regressions were used to investigate effects of individual nurse and hospital characteristics on quality of care. FINDINGS: Organizational safety culture was associated with patient adverse events and quality of care. Controlling for effects of nurse and hospital characteristics, nurses in hospitals with a stronger safety culture were 64% less likely to report administration of wrong medication, time, or dose; 58% less likely to report patient falls with injury; and 60% less likely to report urinary tract infections; and were more likely to report higher levels of quality of care. Additionally, the effects of individual-level baccalaureate education and years of experience on quality of care differed across hospitals, and hospital-level nurse education interacted with individual-level baccalaureate education. CONCLUSIONS: This study makes significant contributions to existing knowledge regarding the positive effect of organizational safety culture on patient adverse events and quality of care. CLINICAL RELEVANCE: Healthcare organizations should strive to improve their safety culture by creating environments where healthcare providers trust each other, work collaboratively, and share accountability for patient safety and care quality.
Authors: Amanda Garcia; Ragnhildur Raga I Bjarnadottir; Gail M Keenan; Tamara G R Macieira Journal: J Nurs Care Qual Date: 2021-11-12 Impact factor: 1.728
Authors: Seung Eun Lee; Meen Hye Lee; Anya Bostian Peters; Seok Hyun Gwon Journal: Int J Environ Res Public Health Date: 2020-06-13 Impact factor: 3.390