Journal List > J Korean Acad Nurs Adm > v.25(4) > 1134998

Lee, Kang, and Hyun: Relationship among Nursing Professionalism, Nursing Work Environment, and Patient Safety Nursing Activities in General Hospital Nurses

Abstract

Purpose:

This study was done to identify the relationships among nursing professionalism, nursing work environment, and patient safety activities, and to analyze the factors influencing nurses’ patient safety nursing activities.

Methods:

This descriptive study included 270 nurses from six general hospitals. Questionnaires were used to collect data between August 20 and September 21, 2018, using questionnaires. Analyses included descriptive statistics, t-test, analysis of variance, Pearson correlation coefficient, and stepwise multiple regression, conducted using IBM SPSS/WIN 21.0.

Results:

Mean scores on nursing professionalism, nursing work environment, and patient safety nursing activities were 3.51±0.41, 2.44±0.45, and 4.39±0.50, respectively. The patient safety nursing activities score was positively correlated with subscales of nursing professionalism variable: professional self-concept (r=.15, p=.019), social recognition (r=.10, p=.036), professional identity in nursing (r=.24, p<.001), role of nursing practice (r=.16, p=.012), nursing foundation for quality of care (r=.19, p=.003), and nurse manager’s ability (r=.14, p=.031). Patient safety nursing activities were influenced by professional identity in nursing (β=.22, p=.001) and nursing foundation for quality of care (β=.15, p=.001), which explained 8.0% of the variance.

Conclusion:

These results suggest that nurse managers should focus on creating an appropriate nursing environment and facilitating nursing professionalism to enhance hospital nurses’ patient safety nursing activities.

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Table 1.
General Characteristics of Participants (N=245
Characteristics Categories n (%) M±SD Min-Max
Gender Female 235 (95.9)
Male 10 (4.1)
Age (year) <25 38 (15.5) 31.72±7.96 23~55
25~29 95 (38.8)
30~34 32 (13.1)
≥35 80 (32.6)
Marital status Unmarried 147 (60.0)
Married 98 (40.0)
Education level College 89 (36.3)
Bachelor 151 (61.6)
≥Master 5 (2.1)
Religion Yes 89 (36.3)
No 156 (63.7)
Work department Medical unit 54 (22.0)
Surgical unit 74 (30.2)
Special unit 58 (23.7)
Others 59 (24.1)
Total practical experience <1 28 (11.4) 8.07±7.65 0.08~32
as a nurse (year) 1~<2 26 (10.6)
2~<5 67 (27.3)
5~<10 42 (17.2)
≥10 82 (33.5)
Hospital size (beds) <200 16 (6.5)
200~<400 156 (63.7)
400~<800 73 (29.8)
Numbers of patient in charg ge <10 40 (16.3) 23.45±15.97 1~90
10~<20 54 (22.1)
20~<30 52 (21.2)
30~<40 29 (11.8)
≥40 48 (19.6)
No response 22 (9.0)
Turnover experience No 137 (55.9) 1.59±1.04 1~7
Yes 108 (44.1)
Monthly income <200 35 (14.3)
(10,000 won) 200~<300 160 (65.3)
300~<400 ≥400 47 3 (19.2) (1.2)
Table 2.
Nursing Professionalism, Nursing Work Environment, Patient Safety Nursing Activities (N=245)
Variables M±SD Min-Max Range
Nursing professionalism 3.51±0.41 1.97~4.47 1~5
  Professional self-concept 3.61±0.51 1.83~5.00
  Social recognition 2.77±0.51 1.00~5.00
  Professional identity in nursing 3.51±0.51 1.00~5.00
  Role of nursing practice 3.49±0.51 1.00~5.00
  Originality of nursing 4.19±0.51 1.00~5.00
Nursing work environment 2.44±0.45 1.18~4.00 1~4
  Nurse participation in hospital affairs 2.50±0.49 1.22~4.00
  Nursing foundations for quality of care 2.73±0.45 1.00~4.00
  Nurse manager ability, leadership, and support for nurses 2.73±0.55 1.00~4.00
  Staffing and resource adequacy 2.39±0.60 1.00~4.00
  Collegial nurse-physician relations 1.87±0.66 1.00~4.00
Patient safety nursing activities 4.39±0.50 2.98~5.00 1~5
  Accuracy of patient identification 4.54±0.53 3.00~5.00
  Communication 4.23±0.66 2.50~5.00
  Operation/procedure prior patient safety 4.44±0.63 2.67~5.00
  Fall prevention 4.45±0.57 3.00~5.00
  Hand hygiene and infection prevention 4.53±0.52 2.60~5.00
  Fire safety and emergency management 4.21±0.73 2.00~5.00
  Medication 4.45±0.57 2.83~5.00
  Medical equipment and facilities management 4.29±0.68 2.50~5.00
Table 3.
Differences of Perceived Nursing Professionalism, Nursing Work Environment, Patient Safety Nursing Activitie according to Participants' General Characteristics (N=245
Characteristics Categories NP
NWE
PSNA
M±SD t or F (p) M±SD t or F (p) M±SD t or F (p)*
Gender Female 3.56±0.51 0.35 (.725) 2.66±0.53 1.56 (.120) 4.47±0.49 0.56 (.573)
Male 3.51±0.41 2.43±0.44 4.38±0.50
Age (year) <25a 25~29b 30~34c 3.59±0.35 347±0.41 3.46±0.51 1.23 (.300) 2.64±0.43 2.39±0.44 2.56±0.52 4.37 (.005) b, d<a, c* 4.22±0.56 4.38±0.46 4.50±0.49 2.31 (.077)
≥35d 3.56±0.40 2.37±0.41 4.44±0.49
Marital status Unmarried 3.5±0.42 0.03 (.976) 2.46±0.48 0.66 (.510) 4.35±0.50 -1.60 (.111)
Married 3.5±0.41 2.42±0.40 4.46±0.48
Education level College 3.48±0.46 1.10 (.334) 2.49±0.45 1.11 (.330) 4.46±0.46 1.53 (.218)
Bachelor 3.53±0.38 2.41±0.45 4.35±0.51
≥Master 3.73±0.40 2.59±0.11 4.44±0.61
Religion Yes 3.58±0.44 1.89 (.060) 2.44±0.45 -0.02 (.986) 4.41±0.45 0.64 (.523)
No 3.48±0.40 2.44±0.45 4.37±0.52
Work department Medical unita Surgical unitb Special unitc Othersd 3.55±0.35 3.45±0.44 3.53±0.45 3.55±0.40 1.00 (.393) 2.30±0.56 2.48±0.41 2.45±0.45 2.53±0.34 2.74 (.044) a<b, c, d* 4.36±0.53 4.39±0.48 4.38±0.51 4.42±0.47 0.16 (.921)
Total practical experience as a nurse (year) <1a 1~<2b 2~<5c 5~<10d 3.56±0.40 3.67±0.37 3.52±0.37 3.31±0.49 3.84 (.005) d<a, b, c, e* 2.65±0.53 2.55±0.41 2.37±0.45 2.46±0.42 2.59 (.038) c, d, e<a, b* 4.25±0.62 4.35±0.55 4.41±0.43 4.26±0.46 2.13 (.077)
≥10e 3.55±0.39 2.40±0.43 4.49±0.49
Hospital size <200 3.35±0.55 2.10 (.124) 2.26±0.64 1.72 (.181) 4.46±0.54 0.50 (.606)
(no. of bed) 200~<400 3.55±0.39 2.44±0.43 4.40±0.48
400~<800 3.48±0.43 2.49±0.44 4.35±0.52
Number of patients in charge <10a 10~<20b 20~<30c 30~<40d 3.42±0.47 3.55±0.39 3.59±0.40 3.55±0.31 1.32 (.263) 2.52±0.52 2.44±0.41 2.51±0.40 2.23±0.48 2.51 (.043) d, e<a, b, c* 4.38±0.53 4.40±0.50 4.40±0.50 4.31±0.50 0.28 (.888)
≥40e 3.53±0.43 2.36±0.45 4.44±0.49
Turnover No 3.54±0.42 1.28 (.200) 2.41±0.48 -1.32 (.187) 4.38±0.51 -0.32 (.748)
experience Yes 3.48±0.41 2.49±0.40 4.40±0.47
Monthly income <200 3.61±0.42 0.93 (.429) 2.53±0.47 1.35 (.260) 4.36±0.53 0.30 (.826)
(10,000 won) 200~<300 3.49±0.41 2.46±0.46 4.39±0.48
300~<400 3.55±0.40 2.34±0.40 4.39±0.54
≥400 3.50±0.74 2.32±0.32 4.64±0.47

*Duncan test (post-hoc); NP=Nursing professionalism; NWE=Nursing work environment; PSNA=Patient safety nursing activities.

Table 4.
Correlation among Perceived Nursing Professionalism, Nursing Work Environment, Patient Safety Nursing Activities (N=245)
Variables NP NWE PSNA
1 2 3 4 5 6 7 8 9 10
r (p) r (p) r (p) r (p) r (p) r (p) r (p) r (p) r (p) r (p) r (p)
NP 1. Professional self-concept 1
2. Social recognition .47 (<.001) 1
3. Professional identity in nursing .49 (<.001) .52 (<.001) 1
4. Role of nursing practice .53 (<.001) .52 (<.001) .65 (<.001) 1
5. Dependence of nursing .03 (.612) -.24 (<.001) .01 (.901) .02 (.788) 1
NWE 6. Nurse participation in hospital affairs .26 (<.001) .49 (<.001) .27 (<.001) .30 (<.001) -.10 (.118) 1
7. Nursing foundations for quality of care .16 (.011) .38 (<.001) .16 (.010) .21 (.001) -.08 (.241) .59 (<.001) 1
8. Nurse manager ability, leadership, and support of nurses .18 (.006) .47 (<.001) .28 (<.001) .29 (<.001) -.08 (.189) .62 (<.001) .64 (<.001) 1
9. Staffing and resource adequacy .23 (<.001) .44 (<.001) .24 (<.001) .26 (<.001) -.15 (.018) .66 (<.001) .63 (<.001) .70 (<.001) 1
1 10. Collegial nurse-physician relations .03 (.591) .36 (<.001) .10 (.126) .06 (.382) -.40 (<.001) .55 (<.001) .49 (<.001) .44 (<.001) .62 (<.001) 1
PSNA .15 (.019) .10 (.036) .24 (<.001) .16 (.012) .06 (.383) .11 (.102) .19 (.003) .14 (.031) .10 (.123) -.02 (.729) 1

NP=Nursing professionalism; NWE=Nursing work environment; PSNA=Patient safety nursing activities.

Table 5.
Factors influencing Patient Safety Nursing Activities (N=245)
Variables β t p R2 change Cumulative R2
(Constant) - 13.84 <.001 - -
Professional identity in nursing* .22 3.48 .001 .06 .06
Nursing foundations for quality of care .15 2.43 .016 .02 .08
R2=.08, Adjusted R2=.07, F=10.70, p<.001

*Subscale of nursing professionalism;

Subscale of patient safety nursing activities.

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