Relationship between work environment, RN involvement in patient care, patient safety culture, work experience and the patient safety grade outcome
| Unadjusted (bivariate) models | Adjusted (multivariate) models* | |||
|---|---|---|---|---|
| OR | 95% CI | OR | 95% CI | |
| Work environment (PES-NWI) | ||||
| Staffing and resource adequacy (four items) | 5.44 | 5.06 to 5.85 | 2.74 | 2.52 to 2.97 |
| Collegial nurse–physician relations (seven items) | 3.40 | 3.14 to 3.69 | 1.43 | 1.30 to 1.57 |
| Nurse manager ability, leadership and support of nurses (four items) | 4.50 | 4.18 to 4.84 | 1.49 | 1.36 to 1.63 |
| RNs’ level of involvement in direct patient care | ||||
| How would you describe your role in caring for most of the patients on your most recent shift? | ||||
| I provided most care myself vs I supervised the care by others and provided some myself | 1.16 | 1.06 to 1.27 | 1.15 | 1.04 to 1.27 |
| I provided most care myself vs I provided only limited care such as dressing changes or drug administration and most of the direct care was done by others | 1.28 | 1.13 to 1.44 | 1.19 | 1.04 to 1.35 |
| I supervised the care by others and provided some myself vs I provided only limited care such as dressing changes or drug administration and most of the direct care was done by others | 1.10 | 0.99 to 1.22 | 1.03 | 0.92 to 1.16 |
| Patient safety culture | ||||
| Staff feel like their mistakes are held against them | 0.53 | 0.51 to 0.55 | 0.85 | 0.82 to 0.89 |
| Important patient care information is often lost during shift changes. | 0.41 | 0.39 to 0.43 | 0.65 | 0.61 to 0.68 |
| Things ‘fall between the cracks’ when transferring patients from one unit to another | 0.47 | 0.45 to 0.49 | 0.80 | 0.76 to 0.84 |
| Staff feel free to question the decisions or actions of those in authority. | 1.67 | 1.61 to 1.73 | 1.01 | 0.97 to 1.06 |
| In this unit, we discuss ways to prevent errors from happening again. | 2.24 | 2.14 to 2.35 | 1.27 | 1.20 to 1.35 |
| We are given feedback about changes put into place based on event reports. | 1.75 | 1.69 to 1.82 | 1.04 | 0.99 to 1.09 |
| The actions of hospital management show that patient safety is a top priority | 2.33 | 2.24 to 2.43 | 1.51 | 1.44 to 1.58 |
| Work experience | ||||
| Work experience as a nurse (by increment of 5) | 1.07 | 1.05 to 1.09 | 1.01 | 0.98 to 1.04 |
*Adjustments were made for gender and education (not shown).
PES-NWI, Practice Environment Scale of the Nursing Work Index; RNs, registered nurse.