Aims:The aim of this study is to identify how professionalism and systems thinking contribute to patient safety competency among Iranian nurses.Background: Professionalism, systems thinking and patient safety competency play important roles in the quality of care. Strategies to enhance the patient safety competency of nurses must be devised by identifying the relationships between these variables.Methods: A cross-sectional, descriptive survey study was conducted in 10 teaching hospitals in Tabriz, Iran. A total of 358 nursing staff with at least 12 months of experience in nursing were enrolled. Data were collected using the Professionalism scale, Systems Thinking Scale and Patient Safety Competency Self-Evaluation tool. Structural equation modelling analysis was performed to test the relationship between variables. Results:The final model illustrated a good fit (χ 2 /df = 2.329, goodness-of-fit index = 0.990, Tucker-Lewis index = 0.906 and root mean square error of approximation = 0.068). Professionalism directly influenced patient safety competency (β = 0.59, p < 0.001) and indirectly influenced systems thinking (β = 0.29, p < 0.001).Systems thinking directly influenced patient safety competency (β = 0.46, p < 0.001).Results indicated that 91% of the variance in patient safety competency was explained by professionalism while 40.1% of the variance in the systems thinking was explained by professionalism. Conclusions:The professionalism and systems thinking of hospital nurses play a pivotal role as predictors in patient safety competency. Training opportunities, mentorship and nursing managers' leadership are needed to assist hospital nurses in their perceptions of professionalism and systems thinking.Implications for Nursing Management: Nursing educators and managers should implement patient safety training strategies and improve the professionalism and systems thinking of hospital nurses to promote patient safety and quality care.

Background The use of validated questionnaires to assess the perception of teamwork can be an early step in improving team training activities. Team-STEPPS® Teamwork Perception Questionnaire (T-TPQ) has been adapted and validated for hospital setting use in several countries. Due to linguistic and cultural differences, there is need to test the psychometrics of the adapted versions. However, no research have not yet assessed the psychometric properties of the Persian T-TPQ. Therefore, this study aims to assess the internal consistency reliability and construct validity of an Iranian version of the Team-STEPPS® Teamwork Perception Questionnaire (IR-T-TPQ). Methods To conduct this study, we undertook a cross-sectional survey approach between May 2020 and January 2021. In total, 404 nurses were recruited by convenience sampling technique from 10 teaching hospitals in Tabriz, Iran. Internal consistency reliability was analyzed using Cronbach’s alpha coefficient. Confirmatory factor analysis was performed to test the construct validity of the instrument. Results Cronbach’s alpha coefficients for each subscale were acceptable, ranging from 0.84 to 0.92, as well as for the total IR-T-TPQ (α = 0.96). The confirmatory factor analysis demonstrated a five-factor model, all of whose fit indices were acceptable, except for the goodness-of-fit index and normed fit index (χ2 (df) 1332 (550), p < 0.001, Normed chi-square (χ2/df) = 2.423, RMSEA = 0.059, TLI = 0.897, CFI = 0.904, AGFI = 0.814). Conclusions The psychometric properties of the IR-T-TPQ resulted in acceptable levels of internal consistency reliability and construct validity, respectively, in Iranian hospital nurses. Further study is needed to compare the teamwork level of nurses in various settings or to evaluate the effectiveness of the teamwork intervention using this validated and reliable tool.

Aim This study aimed to determine the correlations between workplace deviant behaviors (WDBs) and the levels of the perceived organizational justice among Iranian nurses. Design This was a cross‐sectional quantitative research. Methods The present research was conducted on 424 nurses selected by a convenience sampling method in 2019 (May–August) in Tabriz, Iran. A self‐administered questionnaire, including demographic information, organizational justice, and WDBs, was used for data collection. The data were analyzed using descriptive analysis, the Pearson correlation coefficient, and multiple linear regression analysis. Results Based on the findings, nurses had a moderate level of perception of organizational justice while having a low level of perception regarding the occurrence of WDBs. A significantly reverse correlation was found between perceived organizational justice and WDBs (r = −.295, p <.001). Eventually, the findings of multiple linear regression analysis indicated that the level of perceived organizational justice could significantly predict WDBs (the coefficient of determination, R2 = 0.111). Conclusion The study findings confirmed the hypothesis that an improvement in the levels of organizational justice was related to a decrease in the occurrence of WDBs. Therefore, hospitals and nursing managers are suggested to build and maintain a supportive and healthy work environment to enhance the levels of perceived organizational justice and to minimize the incidence of WDBs. They should also address reward systems, organizational policies and procedures, interpersonal justice, and shared decision‐making in this respect.