Patient safety competency and it associated with teamwork and psychological safety among emergency nurses in Iran

Patient safety competence, teamwork, and psychological safety are fundamental components in emergency patient care, as these elements can affect the quality of nursing care and patient safety. Therefore, the present study aimed to assess the level of patient safety competence and explore its correlations with teamwork and psychological safety among emergency department nurses in Iran. This cross-sectional descriptive-analytical study was conducted using stratified sampling proportional to the research community, involving 472 nurses from public hospitals affiliated with Mashhad University of Medical Sciences, Iran, in 2023. Data were collected using questionnaires on patient safety, teamwork, and psychological safety and analyzed with independent the Mann-Whitney U test, Pearson correlation, and linear regression analysis in SPSS-26 at a significance level of 0.05. Patient safety competence and teamwork among nurses were at a high level, while their psychological safety was at a moderate level. There was a significant inverse relationship between nurses' age and patient safety competence (p = 0.04). Patient safety competence varied significantly among nurses from different hospitals (p < 0.001). A direct and significant relationship existed between teamwork and psychological safety with patient safety competence, as well as between teamwork and psychological safety among nurses (p < 0.001). A multiple linear regression with teamwork, psychological safety, work experience and hospital type as independent variables explained 43.1% of the variance in patient safety competency (R² = 0.431). Regression analysis revealed that teamwork (B = 0.169, 95% CI 0.139, 0.199, p < 0.001) and psychological safety (B = 0.252, 95% CI 0.205, 0.299, p < 0.001) were significant positive predictors for patient safety competency. Patient safety competency in teaching hospitals was more than not-teaching hospitals (B = 0.773, 95% CI 0.052, 1.494, p = 0.036). Work experience did not have a significant association with patient safety competency (p = 0.294). The model explained 43.1% of the variance in patient safety competency (R² = 0.431). While nurses demonstrated high levels of patient safety and teamwork competence, their psychological safety was moderate, indicating the need to create a supportive work environment. So, increased teamwork and psychological safety can influence patient safety competence.