The mediating effect of error management climate on the relationship between nursing informatics competency and...

With the development of information technology, the issue of data leakage in hospitals has become increasingly prominent. As the primary personnel who handle sensitive data directly, the information security attitudes of nurses are a critical determinants of medical information safety. However, no studies have explored the relationships among nursing informatics competency, error management climate, and the information security attitudes of nurses. This study aimed to examine the influence of nursing informatics competency on the information security attitudes of nurses and to verify the mediating role of error management climate.

This study adopted a cross-sectional design and recruited 764 clinical nurses from 10 public secondary or higher-level hospitals across 5 cities in Ningxia Hui Autonomous Region between November 2024 and March 2025 using a convenience sampling method. Data were collected using a general information questionnaire, the Nursing Informatics Competency Scale, the Error Management Climate Scale, and the Information Security Attitude Scale. Data Analyses included descriptive statistics, Spearman correlation, and mediation modeling using the PROCESS Macro in SPSS 27.0.

The results of the correlation analysis showed that nursing informatics competency was positively correlated with information security attitude (r = 0.582, p < 0.001) and positively correlated with error management climate (r = 0.497, p < 0.001). Error management climate was significantly positively correlated with information security attitude (r = 0.635, p < 0.001). The results of the mediation analysis showed that the total effect of nursing informatics competency on clinical nurses' information security attitude was 0.495, of which the direct effect was 0.286, accounting for 57.78% of the total effect, and the effect of error management climate as a mediating variable was 0.209, accounting for 42.22% of the total effect.

Information security attitude among clinical nurses needs to be further improved, and nursing informatics competency is a positive predictor of information security attitude. In addition, error management climate plays a partial mediating role in the relationship between nursing informatics competency and information security attitude among nurses. These findings suggest that nursing managers should pay attention to and improve the nursing informatics competency of clinical nurses and create a positive error management climate to enhance information security attitude and behavior, thereby ensuring patient information security.