Search

Background: Because of limited research on patient safety from a macrolevel perspective, our understanding of how to reduce the risk of system failures that impact patient safety outcomes in Taiwanese healthcare organizations is limited.Purpose: We conducted this study to explore the relationships between macrolevel factors and patient safety outcomes.Methods: Structural contingency theory was used as the framework for the study. A cross-sectional design was used, and data were collected from self-administered questionnaires. Head nurses and registered nurses working in 64 in-patient nursing units at three hospitals participated in the study. A tailored design method was used for data collation, and the data collection lasted 3 weeks during the winter of 2010. Data were aggregated from the individual to the unit level, and path analysis was used to examine the hypothesized model.Results: Sixty-two head nurses (96.8%) and 977 staff nurses (72%) completed and returned the questionnaire. Eta-squared coefficient (ŋ^2), interitem consistency (rwg), and F ratio results showed that data at the individual level are appropriate for aggregating to the unit level. These findings show that nursing units with high degrees of professional autonomy, comparatively higher proportions of nursing experts, and relatively large unit sizes tend to have higher rates of medication errors. In addition, we found high degrees of unit technology associated with higher rates of medication errors and patient falls.Conclusions/Implications for Practice: These findings suggest a link between macrolevel factors and patient safety outcomes. This study shows that redesigning continuing education programs encourages nurses to participate in patient safety training and understand the nursing unit characteristics that enhance patient safety outcomes to improve the patient safety of nursing units.

The Leadership Orientation Program is designed to provide new nurse managers with the experience and support that assures them of a smooth transition from their current roles to being managers. The main objective of this study was to gain an understanding of the relationship that exists between a nursing preceptorship and a new nurse manager's competencies; it also attempted to establish a predictive model of leader competencies to improve the program. A descriptive cross-sectional research design and rigorous questionnaires were used in this study. Fifteen new nurse managers, 101 staff nurses, and 20 nurse administrators were recruited from those engaged in ongoing preceptorship. Over the course of the study statistically significant improvements in preceptorship were noted in both new manager educational background and support from staff nurses. Eighty-five percent of new nurse managers had good or excellent performance ratings (Mean=84.25%). The significant predictive factors of nurse leader competencies were the educational background of new managers and the teaching resources available with regard to preceptorship (R(2)=88.5%, F=6.86, p