Patient Safety Silence and Safety Nursing Activities: Mediating Effects of Moral Sensitivity

Int J Environ Res Public Health. 2021 Nov 1;18(21):11499. doi: 10.3390/ijerph182111499.


Among the factors that threaten patient safety and quality of care due to the diversification and complication of hospital environments, nurses play a pivotal role regarding patient safety in the clinical setting. This study investigates the mediating effects of moral sensitivity on the relationship between nurses' patient safety silence and safety nursing activities and contributes to developing strategies. Nurses (n = 120) employed for at least one year in two university hospitals in Korea between 1 September and 30 October 2020 participated in the study. Data were analyzed using t-test, Pearson's correlation coefficients, and multiple regression using the SPSS/WIN 22.0 program. Additionally, the mediating effects were analyzed using Baron and Kenny's method and bootstrapping. Safety nursing activities were significantly negatively correlated with patient safety silence and significantly positively correlated with moral sensitivity. Patient safety silence was significantly negatively correlated with moral sensitivity. Moral sensitivity partially mediated the relationship between patient safety silence and safety nursing activities. There is a need to develop and implement individualized ethical programs that enhance moral sensitivity in nurses to promote patient safety nursing activities.

Keywords: hospitals; morals; nurses; patient safety; safety management.

MeSH terms

  • Humans
  • Morals*
  • Patient Safety*
  • Republic of Korea
  • Surveys and Questionnaires