Journal of Korean Academy of Nursing (대한간호학회지)

Korean Society of Nursing Science (한국간호과학회)
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Patient Safety Management Activities of Korean Nurses: A Meta-Analytic Path Analysis

국내 간호사의 환자안전관리활동에 대한 메타경로분석

  • Jeong, Seohee (Quality Improvement Team, Jeonbuk National University Hospital) ;
  • Jeong, Seok Hee (College of Nursing.Research Institute of Nursing Science, Jeonbuk National University)
  • 정서희 (전북대학교병원 의료질향상팀) ;
  • 정석희 (전북대학교 간호대학.간호과학연구소)
  • Received : 2022.02.25
  • Accepted : 2022.08.11
  • Published : 2022.08.31
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Abstract

Purpose: This study aimed to test a hypothetical model of Korean nurses' patient safety management activities using meta-analytic path analysis. Methods: A systematic review, meta-analysis, and meta-analytic path analysis were conducted following the PRISMA and MOOSE guidelines. Seventy-four studies for the meta-analysis and 92 for the meta-analytic path analysis were included. The R software program (Version 3.6.3) was used for data analysis. Results: Four variables out of 49 relevant variables were selected in the meta-analysis. These four variables showed large effect sizes (ESr = .54) or median effect sizes (ESr = .33~.40) with the highest k (number of studies) in the individual, job, and organizational categories. The hypothetical model for the meta-analytic path analysis was established using these variables and patient safety management activities. Twelve hypothetical paths were set and tested. Finally, the perception of the importance of patient safety management and patient safety competency directly affected patient safety management activities. In addition, self-efficacy, the perception of the importance of patient safety management, patient safety competency, and patient safety culture, indirectly affected patient safety management activities. Conclusion: Self-efficacy, the perception of the importance of patient safety management, patient safety competency, and the organization's patient safety culture should be enhanced to improve nurses' patient safety management activities.

Keywords

Acknowledgement

We would like to thank Yoonlee Kim, the professor of Hanil University and Presbyterian Theological Seminary, Sugyeong Cho, the librarians of Jeonbuk National University, for the assistance of literature searching, and Sunmi Kim, lecture visiting professor of Jeonbuk National University, for the quality assessment.

References

  1. World Health Organization (WHO). Quality of care: Patient safety. World Health Assembly Fifty-Fifth session Agenda item 13.9 (WHA 55.18) [Internet]. Geneva: WHO; c2002 [cited 2022 Jan 31]. Available from: https://apps.who.int/iris/handle/10665/78535.
  2. Korean Law Information Center. Patient Safety Act. [Enforcement Date 2016 Jul 29], (Act No. 13113, 2015 Jan 28 New Enactment) [Internet]. Sejong: Korea Ministry of Government Legislation; c2015 [cited 2021 Sep 17]. Available from: https://www.law.go.kr/법령/환자안전법/(13113,20150128).
  3. Ministry of Health and Welfare (MOHW); Korea Institute for Healthcare Accreditation (KOIHA). Korean patient safety incident report 2020 [Internet]. Seoul: KOIHA; c2021 [cited 2022 Jan 28]. Available from: https://www.kops.or.kr/portal/board/statAnlrpt/boardList.do.
  4. Brennan TA, Leape LL, Laird NM, Hebert L, Localio AR, Lawthers AG, et al. Incidence of adverse events and negligence in hospitalized patients: Results of the Harvard Medical Practice Study I. 1991. Quality & Safety in Health Care. 2004;13(2):145-151; discussion 151-152. https://doi.org/10.1136/qshc.2002.003822
  5. Joint Commission on Accreditation of Healthcare Organizations (JCAHO), Joint Commission International (JCI). Joint Commission International accreditation standards for hospitals. 3rd ed. Oakbrook Terrace (IL): Joint Commission Resources; 2007. p. 1-240.
  6. Cho HA, Shin H. A systematic review of published studies on patient safety in Korea. Journal of Korean Academy of Dental Administration. 2014;2(1):61-82. https://doi.org/10.22671/JKADA.2014.2.1.61
  7. Baek SM, Jeon SH. A review of patient safety activietes of nurses in Korea. Journal of Learner-Centered Curriculum and Instruction. 2021;21(6):657-667. https://doi.org/10.22251/jlcci.2021.21.6.657
  8. Jak S. Meta-analytic structural equation modelling. Cham: Springer; 2015. p. 1-88.
  9. Korea Health Industry Development Institute (KHIDI). Survey on the status of nurse activities [Internet]. Cheongju: KHIDI; c2014 [cited 2021 Oct 16]. Available from: https://bit.ly/35JtgED.
  10. Page MJ, Moher D, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. PRISMA 2020 explanation and elaboration: Updated guidance and exemplars for reporting systematic reviews. BMJ. 2021;372:n16. https://doi.org/10.1136/bmj.n160
  11. Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, et al. Meta-analysis of observational studies in epidemiology: A proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA. 2000;283(15):2008-2012. https://doi.org/10.1001/jama.283.15.2008
  12. Kim SY, Park JE, Seo HJ, Lee YJ, Jang BH, Son HJ, et al. NECA's guidance for undertaking systematic reviews and meta-analyses for intervention. Seoul: National Evidence-based Healthcare Collaborating Agency (NECA); 2011. p. 1-271.
  13. Cummings GG, Tate K, Lee S, Wong CA, Paananen T, Micaroni SPM, et al. Leadership styles and outcome patterns for the nursing workforce and work environment: A systematic review. International Journal of Nursing Studies. 2018;85:19-60. https://doi.org/10.1016/j.ijnurstu.2018.04.016
  14. Borenstein M, Hedges LV, Higgins JPT, Rothstein HR. Introduction to meta-analysis. Chichester: John Wiley & Sons Ltd; 2009. p. 1-421.
  15. Lee IH. EasyFlow statistics macro: EXCEL macro Ver 1.9 [Internet]. Iksan: StatEdu; c2020 [cited 2021 Sep 28]. Available from: https://doi.org/10.22934/StatEdu.2020.01.
  16. Cheung MW, Chan W. Meta-analytic structural equation modeling: A two-stage approach. Psychological Methods. 2005;10(1):40-64. https://doi.org/10.1037/1082-989X.10.1.40
  17. Bandura A. Social foundations of thought and action: A social cognitive theory. Englewood Cliffs (NJ): Prentice-Hall, Inc; 1986. p. 1-617.
  18. Neal A, Griffin MA, Hart PM. The impact of organizational climate on safety climate and individual behavior. Safety Science. 2000;34(1-3):99-109. https://doi.org/10.1016/S0925-7535(00)00008-4
  19. Bronfenbrenner U. The ecology of human development: Experiments by nature and design. Cambridge (MA): Harvard University Press; 1979. p. 1-352.
  20. Kim S, Jeong SH. A meta-analytic path analysis on the outcome variables of nursing unit managers' transformational leadership: Systemic review and meta-analysis. Journal of Korean Academy of Nursing. 2020;50(6):757-777. https://doi.org/10.4040/jkan.20205
  21. Kim H, Yu K. An ecological, meta-analytic path analysis of variables related to internet addiction in adolescents. The Korean Journal of Counseling and Psychotherapy. 2017;29(3):659-687. https://doi.org/10.23844/kjcp.2017.08.29.3.659
  22. Kim YE, Suh GH, Choi SH, Park SA. Effects of self-efficacy and safety culture perception on patient safety management activities among nurses in comprehensive nursing care units. Crisisonomy. 2020;16(4):33-44. https://doi.org/10.14251/crisisonomy.2020.16.4.33
  23. Kim HS, Han SJ. The survey on the influence of clinical nurse's critical thinking disposition, problem-solving skill and self-efficacy on patients safety competencies. Journal of the Korea Academia-Industrial Cooperation Society. 2016;17(6):598-608. https://doi.org/10.5762/KAIS.2016.17.6.598
  24. Kown KY, Oh PJ. Effects of nursing workplace spirituality and self-efficacy on the patient safety management activities of nurses. Journal of Korean Academy of Nursing Administration. 2019;25(2):106-114. https://doi.org/10.11111/jkana.2019.25.2.106
  25. Park HH, Kim S. A structural equation model of nurses' patient safety management activities. Journal of Korean Academy of Nursing Administration. 2019;25(2):63-72. https://doi.org/10.11111/jkana.2019.25.2.63
  26. Park MY, Kim EA. Perception of importance of patient safety management, patient safety culture and safety performance in hospital managerial performance of hospital nurses. Journal of Korean Academy of Nursing Administration. 2018;24(1):40-50. https://doi.org/10.11111/jkana.2018.24.1.40
  27. Park JH. Effects of nurses' patient safety management importance, patient safety culture and nursing service quality on patient safety management activities in tertiary hospitals. Journal of Korean Academy of Nursing Administration. 2020;26(3):181-191. https://doi.org/10.11111/jkana.2020.26.3.181
  28. Kim SJ. The structural equation model of the patient safety performance in clinical nurses [dissertation]. Seoul: Chung-Ang University; 2014. p. 1-111.
  29. Kim SI, Ha JY. The influence of patient safety culture and self- leadership on patient safety competence of nurses. Asia-pacific Journal of Multimedia Services Convergent with Art, Humanities, and Sociology. 2018;8(12):721-730. https://doi.org/10.35873/ajmahs.2018.8.12.069
  30. Kim JJ, Jung HM. Effect of patient safety culture and patient safety competence on safety nursing activity among nurses working in anesthetic and recovery rooms. Journal of Korean Clinical Nursing Research. 2020;26(2):164-174. https://doi.org/10.22650/JKCNR.2020.26.2.164
  31. Bae BR. Structural equation modeling with Amos 24. Seoul: Chungram; 2017. p. 193-194.
  32. Mark BA, Hughes LC, Belyea M, Bacon CT, Chang YK, Jones CA. Exploring organizational context and structure as predictors of medication errors and patient falls. Journal of Patient Safety. 2008;4(2):66-77. https://doi.org/10.1097/PTS.0b013e3181695671
  33. Huang DT, Clermont G, Kong L, Weissfeld LA, Sexton JB, Rowan KM, et al. Intensive care unit safety culture and outcomes: A US multicenter study. International Journal for Quality in Health Care. 2010;22(3):151-161. https://doi.org/10.1093/intqhc/mzq017
  34. Findler L, Wind LH, Mor Barak ME. The challenge of workforce management in a global society: Modeling the relationship between diversity, inclusion, organizational culture, and employee well-being, job satisfaction and organizational commitment. Administration in Social Work. 2007;31(3):63-94. https://doi.org/10.1300/J147v31n03_05
  35. Weaver SJ, Lubomksi LH, Wilson RF, Pfoh ER, Martinez KA, Dy SM. Promoting a culture of safety as a patient safety strategy: A systematic review. Annals of Internal Medicine. 2013;158(5 Pt 2):369-374. https://doi.org/10.7326/0003-4819-158-5-201303051-00002
  36. Jang KS, Lee MH, Lee TH, Kim JS, Kang KH, Kim MY, et al. Nursing management. 5th ed. Seoul: Hyunmoonsa; 2020. p. 26-36.
  37. Lee SE, Quinn BL. Safety culture and patient safety outcomes in East Asia: A literature review. Western Journal of Nursing Research. 2020;42(3):220-230. https://doi.org/10.1177/0193945919848755
  38. Mardon RE, Khanna K, Sorra J, Dyer N, Famolaro T. Exploring relationships between hospital patient safety culture and adverse events. Journal of Patient Safety. 2010;6(4):226-232. https://doi.org/10.1097/PTS.0b013e3181fd1a00
  39. Kim Y, Song Y. Organizational culture for infection control and practice of standard precaution in veterans hospital nurses: The mediating effect of self-efficacy. Journal of Health Informatics and Statistics. 2021;46(1):124-130. https://doi.org/10.21032/jhis.2021.46.1.124
  40. Jin M, Ha Y. Influencing factors on hospital fall prevention activities of tertiary hospital nurses and general hospital nurses. Journal of Health Informatics and Statistics. 2017;42(4):361-370. https://doi.org/10.21032/jhis.2017.42.4.361
  41. Judge TA, Bono JE. Relationship of core self-evaluations traits--self-esteem, generalized self-efficacy, locus of control, and emotional stability--with job satisfaction and job performance: A meta-analysis. Journal of Applied Psychology. 2001;86(1):80-92. https://doi.org/10.1037/0021-9010.86.1.80
  42. Lee TW, Ko YK. Effects of self-efficacy, affectivity and collective efficacy on nursing performance of hospital nurses. Journal of Advanced Nursing. 2010;66(4):839-848. https://doi.org/10.1111/j.1365-2648.2009.05244.x
  43. Lee CY, Byun EK, Jun SS. The effects of a self-growth program on the self-efficacy and depression in nurses. Journal of the Korean Data Analysis Society. 2011;13(2):721-730.