[Safety concerns and speak-up in patient care from the perspective of nursing assistant trainees in Tyrol - a...

'Speak up' refers to the act of raising safety concerns, which can greatly influence patient safety outcomes. In healthcare, hierarchical structures may inhibit nursing assistant trainees from voicing their concerns effectively. This study explored the speak-up behavior and perceptions of safety culture among nursing assistant trainees in Tyrol (Austria). It also investigated the reasons and barriers for speaking up, as well as potential differences in speak-up behavior based on macro-social characteristics.

Between May and July 2023, a multicentric, exploratory quantitative cross-sectional study was conducted involving 508 trainees in nursing assistance and advanced nursing assistance across seven training institutions in Tyrol. Data were collected using the "Speaking Up about Patient Safety Questionnaire" (SUPS-Q). Descriptive statistics along with the Mann-Whitney U test were employed for data analysis.

A total of 358 nursing assistant trainee participated in the study. Most trainees reported perceiving safety concerns, actively speaking up about them, and experiencing a generally positive safety culture during their internships. However, common barriers to speaking up included fear of negative repercussions for their training (45.6%) and uncertainty about how to articulate their concerns (31.8%). The primary motivations for addressing safety concerns were the desire to prevent harm (71.3%) and a strong sense of duty (62.5%).

Compared to existing studies with nursing students, trainees in the nursing assistant professions seem to express their safety concerns more often. The reasons for this could be primarily intradisciplinary communication and a higher average age.

Trainees in nursing assistance professions tend to be more willing to voice their safety concerns than nursing students. Further multicenter studies should be undertaken to improve the transferability of results.