Search

Purpose: In healthcare settings, a climate that encourages speaking up among staff is believed to enhance patient safety and quality of care. However, the specific mechanisms of this relationship remain underexplored. Particularly, there is a need to understand how components of teamwork, such as situation monitoring, can be linked to the impact of a speaking-up climate on relevant outcomes. This study aimed to investigate the direct and indirect effects of a speaking-up climate on patient safety and quality of care using situation monitoring as a potential mediator. Patients and Methods: This cross-sectional study used survey data from 380 staff nurses who provided direct patient care at three Korean hospitals. Structural equation modeling was utilized to test a hypothesized mediation model using Mplus 7.0. Results: Our data analysis confirmed the partial mediation model. As hypothesized, a speaking-up climate directly improved patient safety (β = 0.384, p < 0.001) and quality of care (β = 0.393, p < 0.001). Also, we found that indirect effects of a speaking-up climate on patient safety (β = 0.224, p < 0.001) and quality of care (β = 0.186, p = 0.005) through situation monitoring were significant. These results indicate that situation monitoring was found to significantly mediate the relationship between a speaking-up climate, patient safety, and quality of care. Conclusion: Our study demonstrates that the positive impact of a speaking-up climate extends beyond improving nurses' speaking up. Further, fostering a speaking-up climate can significantly improve patient safety and quality of care, and situation monitoring has a critical role in this relationship. These findings contribute to understanding how encouraging a speaking-up climate could benefit patient safety and care quality in healthcare organizations. [ABSTRACT FROM AUTHOR]

Aim. This study aimed to (a) examine the relationship between staff nurses' perceptions of patient safety rules and procedures and their patient safety performance and (b) investigate potential mediators of this relationship. Background. Implementation of effective management interventions to improve patient safety requires knowledge of the extent to which nurses' perceptions of a hospital's rules and procedures regarding patient safety affect their patient safety performance. Methods. This correlational study involved a secondary analysis of cross-sectional survey data collected from 1,053 staff nurses in South Korea. Structural equation modeling was employed to test the proposed mediation model. Five standardized measures were used to assess key study variables: patient safety compliance, patient safety participation, nurses' perceptions of patient safety rules and procedures, communication about errors, and coworker support. Cronbach's alpha values for the scales ranged from 0.82 to 0.90. Results. Nurses' perceptions regarding the usefulness and effectiveness of rules and procedures about patient safety were positively related to their patient safety performance, measured in terms of safety compliance and participation behaviors. Communication about errors and coworker support showed significant mediating effects on these relationships. Conclusions. The findings indicate that the implementation of effective and useful rules and procedures for improving patient safety would facilitate error communication and coworker support, enhancing nurses' patient safety performance. Implications for Nursing Management. Hospital administrators and nurse managers should consider how they can foster conditions in which nurses perceive rules and procedures regarding patient safety as useful and effective. [ABSTRACT FROM AUTHOR]