Association of Nursing Practice Environment on reported adverse events in private management hospitals: A cross-sectional study

Abstract

Aims and objectives: To examine the relationships between nurses' perceptions of their practice environment, other working conditions and reported adverse events in two private management hospitals.

Background: Patient safety is influenced by knowledge, available resources and the context in which nursing care is provided. In this sense, it has been found that certain work environments (e.g., workload, nurse turnover level, patient-to-nurse ratio, nurse staffing, nurse manager ability) influence patient outcomes. The association between nursing practice environment and reported adverse events has not been explored in private management hospitals.

Design: A cross-sectional study. The STROBE was selected as the checklist in this study.

Methods: A total of 219 nurses were included in the study. This study was conducted from June 2018-June 2019 in Spain. Data were collected through questionnaires focusing on work conditions, reported adverse events (falls, medication errors, catheter-related sepsis and pressure ulcer) and Practice Environment Scale of the Nursing Work Index. Binary logistic regression analysis was performed to determine the factors influencing the occurrence of errors.

Results: Nurses reported poor perception of the professional environment, and 62.1% reported having made at least one error in the previous year. Manager support and leadership and nurse-physician relations were the most favourable aspects of work environment. Medical-surgical units, rotating in the same shift and favourable work environment, were associated with more reporting of adverse events.

Conclusion: The factors of nursing practice (hospital area workload, staff rotating and perception of work environment) associated with reporting adverse events can be worked upon from the organisation and provided an opportunity for safety culture improvement and safer healthcare services.

Relevance to clinical practice: Improving the nurse work environment may reduce adverse patient events in private management hospitals.

Keywords: adverse event; cross-sectional study; hospitals; nursing; patient safety; private; work environment.