Background The nursing profession requires ethical and legal regulations to guide nurses’ performance. Ethical climate plays a part in shaping nurses’ ethical practice. Therefore, ethico-legal aspects and ethical climate contribute to improving nurses’ ethical practice and competencies with reducing medical errors in hospital settings. Objective This study examined the effect of ethico-legal aspects and ethical climate on managing safe patient care and medical errors among nurses. Materials and methods A cross-sectional correlational study was carried out on 548 nurses. Data were collected through self-administered questionnaires about nurses’ knowledge in both ethical and legal aspects, ethical practice, competencies, ethical climate and experience with medical error. Results The main sources of nurses’ knowledge of ethical and legal aspects were undergraduate lectures, job experience and colleagues. Nurses’ knowledge in both ethical and legal aspects, nurses’ ethical practice and competencies were insufficient. Nurses fairly perceived their ethical climate. Also, nurses experienced medical errors about 22.6% in their units. Nurses’ knowledge of ethical and legal aspects, as well as the ethical climate were positive predictors of inadequate nurses’ ethical practice and competencies. Additionally, nurses’ knowledge in both ethical and legal aspects, ethical climate and practice had a negative influence on the occurrence of medical errors. Conclusion Enhancing nurses’ knowledge in both ethical and legal aspects as well as ethical climate could significantly influence improving nurses’ ethical practice, competencies and reducing medical errors in the study units. Therefore, planning for enhancing the nurses’ ethico-legal learning and ethical climate seems to be mandatory.

Nurses’ satisfaction with performance appraisal is a critical and important aspect for increasing intrinsic motivation and achieving better work outcomes among nurses. The present study attempted to understand how satisfaction with the performance appraisal process among nurses affects their motivation and their work outcomes as well as to identify the influence of nurses’ motivation on nurses’ work outcomes. Additionally, it tried to describe obstacles that hinder nurses’ satisfaction with performance appraisal process. The study applied cross-sectional descriptive correlation study amongst 323 nurses in Critical Care and Toxicology Units. This study revealed that nurses were dissatisfied with the performance appraisal process and less motivated in their work. Also, their performance and productivity were at fair levels. The present study found that nurses’ satisfaction with performance appraisal had a highly significant positive impact on nurses’ intrinsic motivation and nurses’ work outcomes. This study also indicated that nurses’ intrinsic motivation had a highly significant positive relationship with nurses’ work outcomes. Additionally, nurses perceived that managerial and organizational forces may hinder their satisfaction with the performance appraisal process.

Background: Blood administration failures and errors have been a crucial issue in health care settings. Failure mode and effects analysis is an effective tool for the analysis of failures and errors in such lifesaving procedures. These failures or errors would lead to adverse outcomes for patients during blood administration. Objectives: The study aimed to: use health care failure mode and effect analysis (HFMEA) for assessing potential failure modes associated with blood administration processes among nurses; develop a categorization of blood administration errors; and identify underlying reasons, proactive measures for identified failure modes, and corrective actions for identified high-risk failures. Methods: A cross-sectional descriptive study was conducted in surgical care units by using observation, HFMEA, and brainstorming techniques. Prioritization of detected potential failures was performed by Pareto analysis. Results: Eleven practical steps and 38 potential failure modes associated with 11 categories of errors were detected in this process. These categories of errors were newly developed in this study. In total, 17 of 38 potential failures were detected as high-risk failures that occurred during the sample-drawing, checking, preparing, administering, and monitoring steps. For cause analysis of failures and errors, proactive suggested actions were undertaken for 38 potential failure modes, and corrective actions for 17 high-risk failures. Conclusion: HFMEA is an efficient and well-organized tool for identification of and reduction in high-risk failures and errors in the blood administration process among nurses without building punitive culture. This tool also helps pay attention to redesigning and standardizing the blood administration process as well as providing training and educational programs for providing knowledge.

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Background and PurposeMeasuring and monitoring the quality of nursing care are essential for improving quality of nursing care and safety. This study aimed to develop an Egyptian validation tool for measuring the quality of nursing care from the perspectives of patients based on consumer quality index and describe the aspects of quality of nursing care that need improvement.MethodsA cross-sectional descriptive survey using Consumer quality index questionnaire of nursing care aspects was carried on 400 patients.Results44 attributes of care were extracted into nine dimensions accounting for 70.4% of the total variance. The majority of nursing care aspects needed moderate levels of quality improvement.ConclusionsA valid and reliable Egyptian tool was developed for measuring the quality of nursing care built upon consumer quality index.