The Effects of Contextual and Structural Factors on Patient Safety in Nursing Units

Abstract

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.

Job autonomy, perceptions of organizational policy, and the safety performance of nurses

“…These results are also suggested by the current study in the multiple regression results that found 44% of the variation in safety performance explained by job autonomy, length of employment, and perceptions of organizational policy. These results are consistent with findings from previous studies conducted in acute care settings (Alves et al, 2017;Asiri et al, 2016;Hung et al, 2013;Manal et al, 2014).…”

“…For example, high job autonomy and a relatively large unit size were related to lower rates of medication errors. The researchers concluded that job autonomy was the only structural factor that influenced patient safety (Hung et al, 2013).…”

“…Restricted job autonomy is a factor that could lead to emotional exhaustion and aversion to patients (WHO, 2009). Job autonomy is usually defined as the extent of authority in decision making regarding a particular practice (Hung, Hsu, & Lee, 2013). Although research on patient safety is relatively limited regarding nurses' job autonomy, some studies have found that when nurses have job autonomy, they experience support, trust, and respect from their supervisors, which improves their reliability, communication, and coordination.…”

“…The organizational factors involved in improving patient safety are, for example, nurses' participation in decision making and organizational policy. These major factors are used to measure the extent of organizational centralization (Hung et al, 2013). These macro-level organizational factors (Mick & Mark, 2005) might influence nurses' individual perceptions (the micro level), which might, in turn, influence patient safety (Hung et al, 2013).…”

“…These major factors are used to measure the extent of organizational centralization (Hung et al, 2013). These macro-level organizational factors (Mick & Mark, 2005) might influence nurses' individual perceptions (the micro level), which might, in turn, influence patient safety (Hung et al, 2013). Manal, Manal, and Hala (2014) reported that patient safety was directly related to the extent to which nurses' were empowered to influence care plans and contribute to organizational decisions.…”