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The impact of the work environment of nurses on patient safety outcomes:
safety is a priority for health services in all countries. The
importance of the nurse's role in patient safety has been established.
Effective nurse staffing levels, nurse education levels, and a positive
work environment for nurses are factors which are known to impact on
patient safety outcomes.
study sought to explore the relationship between the ward environment
in which nurses practice and specific patient safety outcomes, using
ward level variables as well as nurse level variables. The outcomes were
nurse-reported patient safety levels in the wards in which they work,
and numbers of formal adverse events reports submitted by nurses in the
cross-sectional quantitative study was carried out within a European FP7
project: Nurse Forecasting: Human Resources Planning in Nursing
108 general medical and surgical wards in 30 hospitals throughout Ireland.
nurses in direct patient care in the study wards were invited to
participate. Data from 1397 of these nurses were used in this analysis.
nurse survey was carried out using a questionnaire incorporating the
Practice Environment Scale of the Nursing Work Index (PES-NWI). Ethical
approval was obtained from the authors’ institution and all ethics
committees representing the 30 study hospitals. Multilevel modelling was
carried out to examine the impact of ward level factors on patient
safety. These included proportions of nurses on the ward educated to
degree level, and aggregated ward-level mean for PES-NWI scores.
study results support other research findings indicating that a
positive practice environment enhances patient safety outcomes.
Specifically at ward level, factors such as the ward practice
environment and the proportion of nurses with degrees were found to
significantly impact safety outcomes. The models developed for this
study predicted 76% and 51% of the between-ward variance of these
outcomes. The results can be used to enhance patient safety within
hospitals by demonstrating factors at ward-level which enable nurses to
effectively carry out this aspect of their role.
importance of ward-level nurse factors such as nurse education level
and the work environment should be recognised and manipulated as
important influences on patient safety.
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