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Impact of Patient Safety Culture on Missed Nursing Care and Adverse Patient Events
Amanda J Hessels1, Mani Paliwal, Susan H Weaver
1Columbia University, School of Nursing, New York, New York (Dr Hessels); Ann May Center for Nursing and Allied Health, Hackensack Meridian Health, Neptune, New Jersey (Drs Hessels, Weaver, and Wurmser); Institute of Evidence-Based Care, Hackensack Meridian Health, Neptune, New Jersey (Ms Paliwal); and Medical Services Division, United Nations, New York, New York (Dr Siddiqui).
Background:
A strong patient safety culture (PSC) may be associated with improved patient outcomes in hospitals. The mechanism that explains this relationship is underexplored; missed nursing care may be an important link.
Purpose:
The purpose of this study was to describe relationships among PSC, missed nursing care, and 4 types of adverse patient events.
Methods:
This cross-sectional study employed primary survey data from 311 nurses from 29 units in 5 hospitals and secondary adverse event data from those same units. Analyses include analysis of variance and regression models.
Results:
Missed nursing care was reported to occur at an occasional level (M = 3.44, SD = 0.24) across all 29 units. The PSC dimensions explained up to 30% of the variance in missed nursing care, 26% of quality of care concerns, and 15% of vascular access device events. Missed care was associated with falls (P < .05).
Conclusions:
Prioritized actions to enhance PSC should be taken to reduce missed nursing care and adverse patient outcomes.
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