Intensive care unit nurses' perceptions of safety after a highly specific safety intervention

Area of Science:

• Healthcare Management
• Patient Safety
• Nursing Practice

Background:

• The generalization of specific safety practice improvements to broader patient safety concepts among intensive care unit (ICU) staff nurses remains unclear.
• Understanding how focused safety interventions impact overall nursing perceptions of patient safety is crucial for healthcare quality improvement.

Purpose of the Study:

• To investigate ICU nurses' perceptions of patient safety after their involvement in a project aimed at reducing hospital-acquired infections.
• To explore whether participation in a targeted safety initiative influences nurses' broader understanding and engagement with patient safety.

Main Methods:

• Focus groups were conducted with ICU nurses post-implementation of practices that reduced catheter-related bloodstream infections.
• Data from focus groups were thematically analyzed and triangulated with safety climate survey responses and leadership safety checklists.
• Qualitative data from 33 nurses in focus groups were supplemented by survey data from 92 nurses and managers and review of leadership checklists.

Main Results:

• Nurses primarily associated patient safety with environmental hazards and medication administration, aligning with leadership checklist focus areas.
• Self-initiated "double checking" was identified as the primary safety task by nurses.
• Nurses reported a perceived inconsistency between management's stated commitment to safety and their daily support.

Conclusions:

• ICU nurses did not extend their learning from a specific infection reduction project to other patient safety aspects or management's role.
• Findings suggest that self-directed learning and immediate problem-solving are more potent educational influences for nurses than management-driven activities with delayed feedback.
• Adult learning principles highlight the importance of experiential and self-initiated learning in shaping healthcare professionals' safety perspectives.