Patient Safety Culture Associated with Patient Safety Competencies among Registered Nurses

By Cho, Seon Mi; Choi, JiSun | Journal of Nursing Scholarship, September 2018 | Go to article overview

Patient Safety Culture Associated with Patient Safety Competencies among Registered Nurses


Cho, Seon Mi, Choi, JiSun, Journal of Nursing Scholarship


Patient safety has been a high priority in healthcare systems around the world over the past two decades. Numerous initiatives and programs, including surveys on patient safety culture, team strategies, and tools to enhance patient safety performance, and international accreditation and certification programs, have been developed and implemented to promote patient safety at the hospital and national levels (Agency for Healthcare Research and Quality [AHRQ], 2017; Joint Commission International, n.d.). More importantly, the role of nurses, the largest group of healthcare professionals, has been recognized as vital in providing safe and quality care to patients (Institute of Medicine [IOM]; 2004). Likewise, in South Korea, patient safety has become a major focus in recent years, resulting in the initiation of a hospital accreditation program surveyed by the Korea Institute for Healthcare Accreditation (KOIHA) in 2010 to ensure patient safety and quality of care in Korean healthcare settings (KOIHA, n.d.). Many Korean hospitals have spent substantial funds and resources to prepare for the KOIHA survey, which appears to be effective in facilitating the improvement of patient safety (Kim, Jung, Kim, & Lee, 2015; Park, Jung, Park, Hwang, & Suk, 2017). Moreover, the KOIHA accreditation brought into focus the need for the education and training of nurses to enhance their patient safety competencies in their work (Hwang, 2015).

The patient safety competency of registered nurses (RNs) can be defined as the ability to integrate attitudes, skills, and knowledge into nursing practices (Campbell & Mackay, 2001; Lee, An, Song, Jang, & Park, 2014) that are relevant for minimizing the risk for harm to patients in their nursing units. Therefore, RNs with patient safety competency understand basic safety principles and system design, optimize human and environmental factors, demonstrate effective communication abilities, and use appropriate strategies, safety resources, and error reporting systems (Canadian Patient Safety Institute, 2009; Cronenwett et al., 2007). To develop these competencies for RNs, transforming nursing education and practice has been emphasized as a major contributor (IOM, 2010). There have been increasing efforts to provide a fundamental framework for nursing safety education, such as the Quality and Safety Education for Nurses project, which may lead to changes in the roles and practices of nurses (Cronenwett et al., 2007; Sherwood & Zomorodi, 2014). In response to the need to evaluate the effects of such efforts, most previous studies of patient safety competency have focused on the development of measurement tools to accurately capture patient safety attitudes, skills, and knowledge of healthcare professionals (Ginsburg, Castel, Tregunno, & Norton, 2012; Lee et al., 2014; Okuyama, Martowirono, & Bijnen, 2011; Schnall et al., 2008). Self-report tools, which were established to be valid and reliable, are frequently used to measure patient safety competency. Considering that a reliable and valid tool to objectively measure overall patient safety competency is not yet available, self-report tools are efficient and effective in assessing healthcare professionals' patient safety competency and enhancing their own patient safety awareness (Ginsburg et al., 2012; Lee et al., 2014).

Although the importance of the RNs' competency in relation to patient care quality and safety is well recognized (Cronenwett et al., 2007; IOM, 2010; Sherwood & Zomorodi, 2014), few studies have examined the patient safety competency of RNs working in acute care hospitals (Dycus & McKeon, 2009; Hwang, 2015). In a recent study of 459 RNs working in acute care hospitals, a significant link between patient safety competency among RNs and patient safety culture was found (Hwang, 2015). Developing a patient safety culture is an effective strategy to promote patient safety in acute care settings (Morello et al. …

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Patient Safety Culture Associated with Patient Safety Competencies among Registered Nurses
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