Identifying predictors of employee silence about patient safety based on environmental factors among nurses in Ardabil:A Cross-Sectional Study

Abstract

Background Nurses can detect situations that threaten patient safety by providing direct care to patients. But sometimes, instead of speaking about it, they remain silent, which can harm patients. Examining the causes of silence has become a challenge in the nursing profession. Factors related to the work environment influence silence about patient safety, but how it is not fully understood. This study was conducted to investigate the predictors of employees' silence regarding patient safety based on environmental factors among nurses in Ardabil city. Methodology This research was descriptive and analytical, conducted cross-sectionally among 630 nurses working in five medical training centers in Ardabil, northwest Iran. This study used employee silence about patient safety questionnaire, Practice Environment Scale of the Nursing Work Index (PES-NWI), psychological safety, leader-member exchanges (LMX), and Professional discrimination experienced by nurses. Descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient, and hierarchical regression analysis were used by SPSS 16.0 software. Results The average score of employee silence about patient safety was (2.62 ± 0.98). Nurse participation in hospital affairs (ß= 0.196, p = 0.002), nurse's role in the quality of care (ß= -0.352, p < 0.001), staff and facility adequacy (ß= 0.156, p = 0.001), communication with the physician (ß=-0.105, p = 0.015), LMX (ß=-0.284, p < 0.001) and job position (ß=-0.093, p = 0.018) were significant predictors of employees' silence about patient safety. Conclusion According to the findings, the participation of nurses as much as possible in decisions and matters related to the hospital, improving the relationship between physicians and nurses, providing sufficient resources and staff, proper communication between nursing leaders and staff, and also providing suitable conditions for providing quality and safe care, are necessary to reduce the amount of silence about patient safety.