Journal of Korean Critical Care Nursing (중환자간호학회지)

Korean Society of Critical Care Nursing (한국중환자간호학회)
권호 표지
DOI QR코드

DOI QR Code

Effects of Clinical Nurses Critical Reflection Competency, Professional Pride, and Person-Centered Care Practice on Patient Safety Management Activities

임상간호사의 비판적 성찰 역량, 전문직 자부심, 인간중심간호 수행이 환자안전간호활동에 미치는 영향

  • Lee, Subin (Graduate School of Education, Ewha Womans University.Asan Medical Center ) ;
  • Shin, Sujin (School of Nursing Science, Ewha Womans University)
  • 이수빈 (서울아산병원.이화여자대학교 교육대학원) ;
  • 신수진 (이화여자대학교 간호대학)
  • Received : 2023.08.22
  • Accepted : 2023.10.19
  • Published : 2023.10.31
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose : This descriptive survey investigated the effects of clinical nurses' critical reflection competency, professional pride, and person-centered care practices on patient safety management activities. Methods : The participants were 183 clinical nurses working at a tertiary hospital in South Korea. The questionnaires consisted of the Critical Reflection Competency Scale for Clinical Nurses Professional Pride the Person-Centered Nursing Assessment Tool and Patient Safety Management Activities. The collected data were analyzed using descriptive statistics, t-tests, ANOVA, Tukey's HSD, Pearson's correlation coefficient, and multiple regression using SPSS 29.0. Results : The mean score for patient safety management activities was 4.65±0.34 out of 5. There were significant differences in patient safety management activities according to age (F=3.90, p =.010), education level (t=-2.56, p =.013), total work experience (F=3.87, p =.010), and the number of healthcare accreditation system experiences (F=5.22, p =.006). Patient safety management activities were positively correlated with critical reflection competency (r=.337, p <.001), professional pride (r=.271, p <.001), and person-centered care practices (r=.399, p <.001). The results indicated that person-centered care practices affected patient safety management activities (𝛽=.358, p <.001) with the explanatory power of 22.5%. Conclusion : To improve clinical nurses' patient safety management activities, it is necessary to develop participatory educational programs that can integrate skills and attitudes based on conceptual knowledge of person-centered care. Intervention studies are needed to test the effect of person-centered care on patient safety when applied in clinical practice.

Keywords

References

  1. Korea Ministry of Government Legislation. Patient safety law [Internet]. Sejong: Korea Ministry of Government Legislation; 2020 [cited 2023 January 28]. Available from: https://www.law.go.kr/lsInfoP.do?lsiSeq=213551&efYd=20210130#0000
  2. Mun MY, Kim MY. Ethical climate and nursing professionalism on patient safety management activity by nurses. The Journal of Korean Nursing Administration Academic Society. 2019;25(5):458-466. https://doi.org/10.11111/jkana.2019.25.5.458
  3. Korea Institute for Healthcare Accreditation. Korean Patient Safety Incident Report 2021 [Internet]. Seoul: Korea Institute for Healthcare Accreditation; 2022 [cited 2023 February 10]. Available from: https://www.kops.or.kr/portal/common/file/fileDownload.do?serverType=S&atchFileId=AAGlNFNI1VJdeIKXWbPZvFv6&fileSn=2
  4. Korea Medical Dispute Mediation and Arbitration Agency. Medical dispute mediation and arbitration statistical yearbook 2021 [Internet]. Seoul: Korea Medical Dispute Mediation and Arbitration Agency; 2022 [cited 2023 February 10]. Available from: https://www.k-medi.or.kr/download.do?uuid=c54b2cd2-f401-40e9-8c7b-2354ca9a6474
  5. Ministry of Health and Welfare. The first patient safety master plan (2018~2022) [Internet]. Seoul: Ministry of Health and Welfare; 2018 [cited 2023 February 13]. Available from: https://www.mohw.go.kr/react/modules/download.jsp?BOARD_ID=1003&CONT_SEQ=344873&FILE_SEQ=233167
  6. World Health Organization. Patient Safety: Making Health Care Safer. Technical documents. Geneva: World Health Organization; 2017. Report No.: WHO/HIS/SDS/2017.11
  7. Kim YS, Park KY. Nurses' awareness on healthcare accreditation, work overload, and professional self-concept and their influencing activities of patient safety management among nurses. Journal of the Korean Data Analysis Society. 2014;16(6):3377-92.
  8. Manzo BF, Ribeiro HCTC, Brito MJM, Alves M. Nursing in the hospital accreditation process: practice and implications in the work quotidian. Revista Latino-Americana de Enfermagem. 2012;20(1):151-158. https://doi.org/10.1590/S0104-11692012000100020
  9. Paterson C, Chapman J. Enhancing skills of critical reflection to evidence learning in professional practice. Physical Therapy in Sport. 2013;14(3):133-8. https://doi.org/10.1016/j.ptsp.2013.03.004
  10. Shin S, Hong E, Do J, Lee MS, Jung Y, Lee I. Development of critical reflection competency scale for clinical nurses. International Journal of Environmental Research and Public Health. 2022;19(6):3483. https://doi.org/10.3390/ijerph19063483
  11. Scheel LS, Peters MD, Mobjerg ACM. Reflection in the training of nurses in clinical practice settings: a scoping review protocol. JBI Evidence Synthesis. 2017;15(12):2871-80. http://doi.org/10.11124/JBISRIR-2017-003482
  12. Pangh B, Jouybari L, Vakili MA, Sanagoo A, Torik A. The effect of reflection on nurse-patient communication skills in emergency medical centers. Journal of Caring Sciences. 2019;8(2):75. http://doi.org/10.15171/jcs.2019.011
  13. Do J, Shin S, Lee I, Jung Y, Hong E, Lee MS. Qualitative content analysis on critical reflection of clinical nurses. Journal of Qualitative Research. 2021;22(2):86-96. https://doi.org/10.22284/qr.2021.22.2.86
  14. Jeon JH, Lee EH, Kim EJ. Development of an instrument to assess the nursing professional pride. Journal of Korean Academy of Nursing. 2020;50(2):228-41. https://doi.org/10.4040/jkan.2020.50.2.228
  15. Lee MA, Kang S, Hyun HS. Relationship among nursing professionalism, nursing work environment, and patient safety nursing activities in general hospital nurses. Journal of Korean Academy of Nursing Administration. 2019;25(4):317-28. https://doi.org/10.11111/jkana.2019.25.4.317
  16. Bunkenborg G, Samuelson K, Akeson J, Poulsen I. Impact of professionalism in nursing on in-hospital bedside monitoring practice. Journal of Advanced Nursing. 2013;69(7):1466-77. https://doi.org/10.1111/jan.12003
  17. Kakemam E, Ghafari M, Rouzbahani M, Zahedi H, Roh YS. The association of professionalism and systems thinking on patient safety competency: a structural equation model. Journal of Nursing Management. 2022;30(3):817-26. https://doi.org/10.1111/jonm.13536
  18. Charmel PA, Frampton SB. Building the business case for patient-centered care. Health Finance Manage. 2008;62(3):80-5.
  19. Avanecean D, Calliste D, Contreras T, Lim Y, Fitzpatrick A. Effectiveness of patient-centered inter-ventions on falls in the acute care setting compared to usual care: a systematic review. JBI Evidence Synthesis. 2017;15(12):3006-48. https://doi.org/10.11124/JBISRIR-2016-003331
  20. Lee JJ. Development of person centered nursing assessment tool (PCNAT) [dissertation]. Daegu: Daegu Catholic University; 2018. p. 1-67.
  21. Choi HJ, Lee YM, Park HJ. Effects of awareness of patient safety culture, emotional labor and job stress on patient safety nursing activities by comprehensive nursing care medical service ward nurses. Korean Society of Critical Care Nursing. 2021;14(3):87-98. https://doi.org/10.34250/jkccn.2021.14.3.87
  22. Cheon G, Kim J. The relationships among awareness of patient safety culture, critical thinking disposition and patient safety nursing activities of nurses among comprehensive nursing care service ward. Journal of Korea Academia-Industrial cooperation Society. 2018;19(6):345-354. https://doi.org/10.5762/KAIS.2018.19.6.345
  23. Fujita S, Wu Y, Iida S, Nagai Y, Shimamori Y, Hasegawa T. Patient safety management systems, activities and work environments related to hospital-level patient safety culture: a cross-sectional study. Medicine (Baltimore). 2019;98(50):e18352. https://doi.org/10.1097/MD.0000000000018352
  24. Jung SY, Kim EY. Influence of the patient safety culture and nursing work environment on fall prevention activities of hospital nurses. Journal of Korean Academy of Nursing Administration. 2022;28(2):78-87. https://doi.org/10.11111/jkana.2022. 28.2.78
  25. Kim SG, Kang DHS. The effect of perception the importance of patient safety management, professional autonomy and safety climate on patient safety nursing activity on hospital nurses. The Society of Digital Policy and Management. 2022;20(4):715-24. https://doi.org/10.14400/JDC.2022.20.4.715
  26. Park YM, Nam KH, Kang KN, Nam JJ, Yun YO. Mediating effects of perceptions regarding the importance of patient safety management on the relationship between incident reporting attitudes and patient safety care activities for nurses in small- and medium-sized general hospitals. Journal of Korean Critical Care Nursing. 2019;12(2):85-96. https://doi.org/10.34250/jkccn.2019.12.2.85
  27. Lake ET, Sanders J, Duan R, Riman KA, Schoenauer KM, Chen Y. A meta-analysis of the associations between the nurse work environment in hospitals and 4 sets of outcomes. Medical Care. 2019;57(5):353-361. https://doi.org/10.1097/MLR.0000000000001109
  28. Lee SI. Current status and future challenges of patient safety improvement in Korea. Yakhak Hoeji. 2020;64(3):179-184. https://doi.org/10.17480/psk.2020.64.3.179
  29. Sherwood G, Barnsteiner J. Quality and safety in nursing: a competency approach to improving outcomes. Journal of Nursing Regulation. 2013;3(4):64. https://doi.org/10.1016/S2155-8256(15)30190-3
  30. Sherwood G, Zomorodi M. A new mindset for quality and safety: The QSEN competencies redefining nurses' roles in practice. The Journal of Nursing Administration. 2014;44(10):10-18. https://doi.org/10.1097/NNA.0000000000000124
  31. Cho MS, Cho YA, Kim KH, Kwon IG, Kim MS, Lee JL. Development of clinical ladder system model for nurses: for tertiary care hospitals. Journal of Korean Clinical Nursing Research. 2015;21(3):277-92. https://doi.org/10.22650/JKCNR.2015.21.3.277
  32. Kim HJ, Kim HJ. Influences of nursing workplace spirituality, organizational citizenship behavior, and perception of patient safety management on the patient safety nursing activities among a tertiary hospital nurses. Journal of Korean Academy of Nursing Administration. 2022;28(3):179-89. https://doi.org/10.11111/jkana.2022.28.3.179
  33. Kim JE, Song JE, Ahn JA, Boo S. Factors influencing patient safety nursing activities of intensive care unit nurses. Journal of Korean Critical Care Nursing. 2021;14(2):12-23. https://doi.org/10.34250/jkccn.2021.14.2.12
  34. Park JH. Effects of nurses' patient safety management importance, patient safety culture and nursing service quality on patient safety management activities in tertiary hospitals. The Journal of Korean Nursing Administration Academic Society. 2020;26(3):181-91. https://doi.org/10.11111/jkana.2020.26.3.181
  35. Yun J, Son H. Mediating effects of burnout between time pressure and safety care activities of nurses. Journal of Korean Academy of Nursing Administration. 2019;25(3):248-57. https://doi.org/10.11111/jkana.2019.25.3.248
  36. Kwon JH, Kang EH, Lee YM. Effect of nurses' organizational commitment in relationship between perception on safety culture and patient safety management activities in tertiary hospitals. Journal of the Korean Data Analysis Society. 2016;18(4):2231-44.
  37. Kim KS. Changes and strategies in the second cycle of the hospital accreditation program. Korean Journal of Hospital Management. 2015;20(1):65-70.
  38. Lee JH. Effects of clinical nurses evidence-based practice competency, critical thinking disposition, and nursing practice environment on patient safety management activities [master's thesis]. Seoul: Ewha Womans University; 2021. p. 1-34.
  39. Ministry of Health and Welfare. Fire safety manual in healthcare facility [Internet]. Seoul: Ministry of Health and Welfare; 2020 [cited 2023 February 13]. Available from: https://www.mohw.go.kr/react/modules/download.jsp?BOARD_ID=320&CONT_SEQ=352474&FILE_SEQ=283830
  40. Korea Institute for Healthcare Accreditation. Acute hospital healthcare accreditation standards (Ver 4.0) [Internet]. Seoul: Korea Institute for Healthcare Accreditation; 2021 [cited 2023 February 20]. Available from: https://www.koiha.or.kr/web/kr/library/establish_view.do
  41. Lee JY. Effective communication for patient safety. Journal of the Korean Medical Association. 2015; 58(2):100-104. https://doi.org/10.5124/jkma.2015.58.2.100
  42. Shin JY, Jang EH. Influence of person-centered perioperative nursing and patient safety competency on patient safety management activities among operating room nurses: a descriptive survey study. Korean Journal of Adult Nursing. 2023;35(2):97-106. https://doi.org/10.7475/kjan.2023.35.2.97
  43. Byeon SK. The effect of eldercare facility care workers' person-centered care and patient safety culture on fall prevention behavior of older adults with dementia [master's thesis]. Jeju: Jeju National University; 2023. p. 1-48.
  44. Alharbi TSJ, Carlstrom E, Ekman I, Jarneborn A, Olsson LE. Experiences of person-centred care - patients' perceptions: qualitative study. BMC Nursing. 2014;13(1):28. https://doi.org/10.1186/1472-6955-13-28
  45. Ekman I, Wolf A, Olsson LE, Taft C, Dudas K, Schaufelberger M, et al. Effects of person-centred care in patients with chronic heart failure: the PCC-HF study. European Heart Journal. 2012;33(9):1112-9. https://doi.org/10.1093/eurheartj/ehr306
  46. Kirch J, Marquardt G. Towards human-centred general hospitals: the potential of dementia-friendly design. Architectural Science Review. 2021;66(5):382-390. https://doi.org/10.1080/00038628.2021.1933889
  47. Shin S, Lee I, Kim J, Oh E, Hong E. Effectiveness of a critical reflection competency program for clinical nurse educators: a pilot study. BMC Nursing. 2023; 22(1):1-8. https://doi.org/10.1186/s12912-023-01236-6
  48. Kim YH, Min J, Kim SH, Shin S. Effects of a work-based critical reflection program for novice nurses. BMC Medical Education. 2018;18(1):30. https://doi.org/10.1186/s12909-018-1135-0
  49. Farrington N, Townsend K. Enhancing nurse-patient communication: a critical reflection. British Journal of Nursing. 2014;23(14):771-5. https://doi.org/10.12968/bjon.2014.23.14.771
  50. Liu Q, Wang L. t-Test and ANOVA for data with ceiling and/or floor effects. Behavior Research Methods. 2021;53(1):264-277. https://doi.org/10.3758/s13428-020-01407-2