Exploring Organizational Context and Structure as Predictors of Medication Errors and Patient Falls

Mark, Barbara A.; Hughes, Linda; Belyea, Michael; Bacon, Cynthia Thornton; Chang, Yeon S.; Jones, Cheryl

doi:10.1097/pts.0b013e3181695671

Cited by 46 publications

(44 citation statements)

References 65 publications

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“…Therefore, the organizational context includes aspects that affect nursing unit operations, including unit technology and nursing unit characteristics such as skill mix, nursing experts, unit size, and type of unit (Mark et al, 2008;Mark, Salyer, & Wan, 2003). Many managerial studies have categorized organizational structures into two types: mechanistic and organic (Daft, 2009;Liaw, Fan, & Sheu, 2001).…”

Section: Conceptual Frameworkmentioning

confidence: 99%

The Effects of Contextual and Structural Factors on Patient Safety in Nursing Units

Hung¹,

Hsu

Lee

et al. 2013

Journal of Nursing Research

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Section: Conceptual Frameworkmentioning

confidence: 99%

The Effects of Contextual and Structural Factors on Patient Safety in Nursing Units

Hung¹,

Hsu

Lee

et al. 2013

Journal of Nursing Research

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“…21 Measuring the relationship between competence of individual registered nurses and safety of patients is methodologically difficult because nursing is practiced and characterized as a group; consequently, individual competency of registered nurses must be aggregated to the patient care unit level for purposes of study. [22][23][24] The nursing work group comprises individual registered nurses and other personnel who have different professional competencies. The proportion of certified staff registered nurses in a unit, represented in this study as registered nurse work group competence, theoretically incorporates individual nurses' competence at the bedside within a group practice model.…”

Section: Introductionmentioning

confidence: 99%

Competence and Certification of Registered Nurses and Safety of Patients in Intensive Care Units

Kendall-Gallagher¹,

Blegen²

2010

JONA: The Journal of Nursing Administration

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Background-Adverse events that place patients at risk for harm are common in intensive care units. Clinicians' level of knowledge and judgment appear to play a role in the prevention, mitigation, and creation of adverse advents. Research suggests a possible association between nurses' specialty certification and clinical expertise. The relationship between specialty certification and clinical competence of registered nurses and safety of patients is a relatively new area of inquiry in nursing.

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“…[29,32,33] As described above, patient turnover and safety climate are our main context factors, along with length of stay, patient age and nursing care time per patient, as a proxy for patient complexity. As structural factors, we used nurse staffing and nurse characteristics variables.…”

Section: Conceptual Frameworkmentioning

confidence: 99%

“…A strong safety climate supports the adherence to safe work practices and mitigates the effect of factors that hinder safe work behaviors. [29] Several studies indicate that a unit's safety climate is a predictor of patient outcomes, but results vary. For example, whereas Vogus & Sutcliff [30] and Taylor, et al [31] negatively correlated safety climate with in-patient falls, Ausserhofer et al…”

Section: Introductionmentioning

confidence: 99%

Nurse staffing, patient turnover and safety climate and their association with in-patient falls and injurious falls on medical acute care units: a cross-sectional study

Hirsbrunner

Denhaerynck

Fierz

et al. 2015

JHA

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Objective: Falls and related injuries remain a considerable health risk for in-patients. Numerous studies link falls with nurse staffing levels, but the results are inconsistent. The purpose of this study was to explore the associations between fall prevalence and injurious falls on medical wards and three unit-level system factors: daily nurse staffing, patient turnover, and safety climate. Methods: Using a cross-sectional design, we conducted a secondary data analysis of data from the Patient Safety and Falls Project. Five medical units in a Swiss university hospital were included, resulting in a data set of 949 days, with daily measures of nurse staffing, patient turnover and falls. The safety climate was measured using a subscale of the Safety Attitudes Questionnaire and analyzed at the unit level including data from 154 nurses. Robust multivariate logistic regression was used to explore nurse staffing, patient turnover, and safety climate's associations with in-patient falls and fall injuries. Results: After controlling for patient age, length of stay and nursing fulltime equivalents, registered nurse experience showed a significant negative relationship with falls (OR = .83, p < .0001). Patient turnover and safety climate were not significantly associated to falls or fall injuries. Conclusions: By linking nurse staffing variables to in-patient falls and fall injuries, the current study's findings partly confirm those of previous research. Further investigation will be necessary to isolate key factors influencing the association at the unit level between safety climate and in-patient falls.

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Exploring Organizational Context and Structure as Predictors of Medication Errors and Patient Falls

Cited by 46 publications

References 65 publications

The Effects of Contextual and Structural Factors on Patient Safety in Nursing Units

The Effects of Contextual and Structural Factors on Patient Safety in Nursing Units

Competence and Certification of Registered Nurses and Safety of Patients in Intensive Care Units

Nurse staffing, patient turnover and safety climate and their association with in-patient falls and injurious falls on medical acute care units: a cross-sectional study

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