Cracking the Code for Quality: The Interrelationships of Culture, Nurse Demographics, Advocacy, and Patient Outcomes

The aim of this study was to describe the complex relationships among patient safety culture, nurse demographics, advocacy, and patient outcomes.

Why has healthcare lagged behind other industries in improving quality? Little nursing research exists that explores the multifactorial relationships that impact quality.

A convenience sample of 1045 nurses from 40 medical/surgical units was analyzed using a correlational cross-sectional design with secondary data analysis. Data sources included survey results for patient safety culture, nurse perceptions of patient advocacy, and patient experience and fall and pressure ulcer rates.

Significant findings included a positive correlation between patient safety culture and advocacy and a negative correlation between safety culture, advocacy, and years of experience as a nurse. No significant correlations were found between safety culture and patient outcomes or advocacy and patient outcomes.

Newer nurses were more positive about safety culture and advocacy, whereas experienced nurses were overall less positive.