Relationship among Nursing Professionalism, Nursing Work Environment, and Patient Safety Nursing Activities in General Hospital Nurses

Mi-Aie Lee; Sunjoo Kang; Hye Sun Hyun

doi:10.11111/jkana.2019.25.4.317

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

Original Article

J Korean Acad Nurs Adm 2019;25(4):317-328.

Published online: 17 January 2019

DOI: https://doi.org/10.11111/jkana.2019.25.4.317

Relationship among Nursing Professionalism, Nursing Work Environment, and Patient Safety Nursing Activities in General Hospital Nurses

Mi-Aie Lee¹, Sunjoo Kang^2,, Hye Sun Hyun³

¹Department of Nursing, Dongguk University

²Graduate School of Public Health, Yonsei University

³Department of Nursing, Sangmyung University

Corresponding author: Kang, Sunjoo, Graduate School of Public Health, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea. Tel: +82-2-2228-0994, Fax: +82-2-2227-6572, E-mail: ksj5139@hanmail.net

Received 17 March 2019 Revised 2 May 2019 Accepted 17 June 2019

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Nurse, Nursing activities, Patient safety, Professionalism, Work environment

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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
Characteristics	Categories	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)	＜25^a 25~29^b 30~34^c	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)
	≥35^d	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 unit^a Surgical unit^b Special unit^c Others^d	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)	＜1^a 1~＜2^b 2~＜5^c 5~＜10^d	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)
	≥10^e	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	＜10^a 10~＜20^b 20~＜30^c 30~＜40^d	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)
	≥40^e	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	PSNA
	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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