Ching-I Teng

Interactive effects of nurse-experienced time pressure and burnout on patient safety: A cross-sectional survey

BACKGROUND Global nursing shortages have exacerbated time pressure and burnout among nurses. Despite the well-established correlation between burnout and patient safety, no studies have addressed how time pressure among nurses and patient safety are related and whether burnout moderates such a relation. OBJECTIVES This study investigated how time pressure and the interaction of time pressure and nursing burnout affect patient safety. DESIGN-SETTING PARTICIPANTS: This cross-sectional study surveyed 458 nurses in 90 units of two medical centres in northern Taiwan. METHODS Nursing burnout was measured by the Maslach Burnout Inventory-Human Service Scale. Patient safety was inversely measured by six items on frequency of adverse events. Time pressure was measured by five items. Regressions were used for the analysis. RESULTS While the results of regression analyses suggest that time pressure did not significantly affect patient safety (beta=-.01, p>.05), time pressure and burnout had an interactive effect on patient safety (beta=-.08, p<.05). Specifically, for nurses with high burnout (n=223), time pressure was negatively related to patient safety (beta=-.10, p<.05). CONCLUSION Time pressure adversely affected patient safety for nurses with a high level of burnout, but not for nurses with a low level of burnout.

Emotional stability of nurses: impact on patient safety

AIM This paper is a report of a study conducted to examine the influence of the emotional stability of nurses on patient safety. BACKGROUND Individuals with greater emotional stability are less likely to exhibit strong emotional reactions to stressful situations, and tend to be more proactive and successful in problem-solving. Effectively managing patient safety is a priority concern in countries where nurses face high pressure. A heavy work load leads to burnout (a syndrome associated with negative emotions), reduced job satisfaction and increased turnover. While emotional stability influences job performance in various contexts, its influence on patient safety has not been addressed. METHOD A cross-sectional design was adopted. The sample comprised 263 nurses working in two Taiwanese medical centres. The data were collected in 2007-2008, with a response rate of 926%. All participants were nursing college graduates aged below 50 years. Participants provided information on both their emotional stability and patient safety. Staffing adequacy, hospital, and years of nursing experience served as control variables. FINDINGS Hierarchical regression analysis indicated that emotional stability predicted patient safety (beta = 0.18, P < 001). The addition of emotional stability as a predictor of patient safety increased the associated explained variance (deltaR2 = 0.03, P < 0.01). CONCLUSION It is important for to managers create an organisational climate that promotes the emotional stability of nurses. This could help to improve global patient safety by reducing the frequency of adverse events.

Professional Commitment, Patient Safety, and Patient‐Perceived Care Quality

PURPOSE To examine how professional commitment influences patient safety and patient-perceived care quality. DESIGN Investigators for this study used a cross-sectional design with questionnaires. A total of 348 pairs of nurses and inpatients were contacted at two medical centers in Taiwan during the period from August 2007 to January 2008, yielding 284 pairs of completed questionnaires. METHODS Frequencies of six adverse patient events were used to measure patient safety; and the Service Quality Scale was used to measure patient-perceived care quality. Four items of the Professional Commitment Questionnaire were used to measure professional commitment. Regressions were used for the analyses. FINDINGS Professional commitment positively influenced overall patient safety (ss=.19, p=.00) and overall patient-perceived care quality (ss=.13, p=.03). Furthermore, professional commitment positively influenced all patient safety indicators (ss>or=.12, p<or=.04), except frequency of nosocomial infections, the coefficient of which reached borderline significance (ss=.11, p=.07). Professional commitment also positively influenced care quality in terms of responsiveness (ss=.16, p=.01) and empathy (ss=.14, p=.03). CONCLUSIONS Professional commitment may enhance patient safety and patient-perceived care quality. CLINICAL RELEVANCE This study indicates that nurse professional commitment can enhance patient safety and patient-perceived care quality.

Influence of personality on care quality of hospital nurses.

This study investigates the relationship between hospital nurse personality and care quality in Taiwan. Hierarchical regression analysis was applied to data for 192 pairs of nurses and patients. Analytical results are as follows: (1) nurse openness was positively correlated with patient perceptions of responsiveness and (2) nurse neuroticism was negatively correlated with patient perceptions of responsiveness, assurance, and empathy.

Development of Service Quality Scale for Surgical Hospitalization

BACKGROUND/PURPOSE Findings from literature showed inconsistent results for applying service quality scale in hospitals. Moreover, hospitalization services are provided by diversified departments and a scale designed to measure the overall hospitalization quality is difficult and capturing special characteristics of different departments is also not an easy task. This study attempted to develop a service quality scale for surgical hospitalization (SQSH). METHODS Forty-two items were designed via literature review, interviews with patients, health professionals and experienced care givers. A cross-sectional survey was conducted in one hospital. A total of 271 patients in surgical wards were chosen using stratified random sampling; 57.7% of the sampled patients were aged below 55, and 52.2% were male. RESULTS The response rate was 93.4%. Twenty-nine items were retained through the scale development process and six factors were formed: needs management, assurance, sanitation, customization, convenience and quiet, and attention. Six factors explained 57.3% of total variance. Five experts assessed the content validity; content validity index was 0.964. Furthermore, all Cronbachs alpha exceeded 0.642 and all factor loadings exceeded 0.5. The concurrent validity correlation was 0.583, which had a p value below 0.01. CONCLUSION The SQSH has sufficient usefulness, reliability and validity. Future research on service quality can apply the SQSH scale to link with utilization intention and patient loyalty and attempt to develop a hospitalization quality scale for other departments.

Nursing accreditation system and patient safety.

AIMS This study investigated whether nursing accreditation level affects patient safety. BACKGROUND The nursing accreditation system evaluates the capabilities of nursing professionals in Taiwan. While this system has been in place for years, few studies have investigated whether nursing accreditation level is associated with patient safety indicators. This study can help in understanding how nursing capabilities affect patient safety and can subsequently contribute to improvements in patient safety. METHODS This study adopted a cross-sectional research design using questionnaires to collect responses from nurses working in two major medical centres in northern Taiwan. Regression analyses were conducted to test the study hypothesis. RESULTS The analytical results show that nursing accreditation level is positively related to patient safety indicators. CONCLUSION Health services managers should encourage nurses to advance their knowledge, skills, and professional capabilities because these may be positively related to patient safety. IMPLICATIONS FOR NURSING MANAGEMENT Nursing managers who seek to improve patient safety should consider encouraging nurses to advance their accreditation level.

How Can Supervisors Improve Employees’ Intention to Help Colleagues? Perspectives From Social Exchange and Appraisal-Coping Theories

Previous studies have not sufficiently investigated how supervisors can improve employees’ intention to help their colleagues. Therefore, research regarding this issue is required. Social exchange theory and the appraisal-coping model were adopted herein to hypothesize that supervisor-employee guanxi—informal interpersonal connections that involve the exchange of favors—and a supervisor’s negative mood are associated with employees’ intention to help their colleagues. The findings indicate that employees’ intention to help their colleagues is negatively related to their supervisor’s negative mood but positively related to employee agreeableness. Furthermore, for employees who have weak guanxi with their supervisors, the negative mood of the supervisors is negatively related to the employees’ intention to help colleagues, but this relationship does not apply to employees who have strong guanxi with their supervisors. The findings suggest that supervisors should manage their negative moods and strengthen their guanxi with employees to improve their employees’ intention to help colleagues.

Professional Practice Environment Scale-Chinese Version: Development and Psychometric Testing.

Background: The Professional Practice Environment (PPE) scale is widely used to assess the quality of the healthcare environment around the world. No validated Chinese-language scale that is designed to address this issue currently exists. Purpose: The present study evaluates the construct validity of the Chinese-version PPE on a sample of 290 healthcare workers in Taiwan. Methods: Forward and backward translations of the PPE scale of Halcomb et al. were used to ensure semantic equivalence. Further, multiple psychometric properties were examined. Results: The developed scale showed sufficient equivalence. The results of a survey of 290 healthcare providers demonstrated that the developed Chinese-version PPE scale had high reliability (Cronbach’s alpha = .88) and validity. Conclusions/Implications for Practice: The findings of the present study support the effectiveness and efficiency of the Chinese-version 30-item Halcomb’s PPE in assessing the professional practice environment in Taiwan.