Unsafe by design: Infusion task reallocation and safety perceptions in U.S. hospitals

Area of Science:

• Nursing Practice
• Organizational Psychology
• Patient Safety

Background:

• Changes in nurse roles, specifically infusion task reallocation from specialist to generalist nurses, may negatively impact perceived organizational safety.
• Job demands-resources theory posits that task reallocation can either enrich or enlarge jobs, affecting resources, demands, and performance outcomes like safety.
• Limited research exists on the direct effects and mechanisms of infusion task reallocation on nurse roles and safety perceptions.

Purpose of the Study:

• To investigate the association between infusion task reallocation and nurses' perceptions of organizational safety.
• To explore the mediating roles of infusion-related resources and psychological safety in this relationship.

Main Methods:

• A survey was administered to 623 nurses across 580 U.S. hospitals.
• Structural equation modeling was employed to analyze the relationships between infusion task reallocation, psychological safety, infusion-related resources, and perceived organizational safety.

Main Results:

• Infusion task reallocation showed a negative correlation with perceived organizational safety.
• Nurses in organizations without dedicated infusion teams reported lower safety perceptions.
• Psychological safety mediated the negative relationship, while infusion-related resources did not.

Conclusions:

• Infusion task reallocation, while potentially cost-saving, appears to enlarge nurses' jobs by increasing demands and reducing resources, leading to diminished perceived organizational safety.
• The decline in perceived safety is primarily linked to reduced psychological safety among nurses, rather than technical limitations.