Linking Patient Safety Climate With Missed Nursing Care in Labor and Delivery Units: Findings From the LaborRNs Survey

doi:10.1097/PTS.0000000000001106

. 2023 Apr 1;19(3):166-172.

doi: 10.1097/PTS.0000000000001106. Epub 2023 Jan 14.

Linking Patient Safety Climate With Missed Nursing Care in Labor and Delivery Units: Findings From the LaborRNs Survey

Jie Zhong¹, Kathleen Rice Simpson², Joanne Spetz³, Caryl L Gay⁴, Jason Fletcher¹, Gay L Landstrom⁵, Audrey Lyndon

Affiliations

¹ From the Rory Meyers College of Nursing, New York University, New York City, New York.
² Mercy Hospital Saint Lewis, St. Louis, Missouri.
³ Phillip R. Lee Institute for Health Policy Studies, University of California San Francisco.
⁴ Department of Family Health Care Nursing, University of California San Francisco School of Nursing, San Francisco, California.
⁵ Trinity Health, Livonia, Michigan.

PMID: 36728161
PMCID: PMC10050088
DOI: 10.1097/PTS.0000000000001106

Linking Patient Safety Climate With Missed Nursing Care in Labor and Delivery Units: Findings From the LaborRNs Survey

Jie Zhong et al. J Patient Saf. 2023.

. 2023 Apr 1;19(3):166-172.

doi: 10.1097/PTS.0000000000001106. Epub 2023 Jan 14.

Authors

Jie Zhong¹, Kathleen Rice Simpson², Joanne Spetz³, Caryl L Gay⁴, Jason Fletcher¹, Gay L Landstrom⁵, Audrey Lyndon

Affiliations

¹ From the Rory Meyers College of Nursing, New York University, New York City, New York.
² Mercy Hospital Saint Lewis, St. Louis, Missouri.
³ Phillip R. Lee Institute for Health Policy Studies, University of California San Francisco.
⁴ Department of Family Health Care Nursing, University of California San Francisco School of Nursing, San Francisco, California.
⁵ Trinity Health, Livonia, Michigan.

PMID: 36728161
PMCID: PMC10050088
DOI: 10.1097/PTS.0000000000001106

Abstract

Objective: This study aimed to explore the association of nurses' perceptions of patient safety climate with missed nursing care in labor and delivery (L&D) units.

Methods: We recruited nurse respondents via email distribution of an electronic survey between February 2018 and July 2019. Hospitals with L&D units were recruited from states with projected availability of 2018 state inpatient data in the United States. Measures included the Safety Attitudes Questionnaire Safety Climate Subscale and the Perinatal Missed Care Survey. We estimated the relationship between safety climate and missed care using Kruskal-Wallis tests and mixed-effects linear regression.

Results: The analytic sample included 3429 L&D registered nurses from 253 hospitals (response rate, 35%). A majority of respondents (65.7%) reported a perception of good safety climate in their units, with a mean score of 4.12 (±0.73) out of 5. The mean number of aspects of care occasionally, frequently, or always missed on respondents' units was 11.04 (±6.99) out of 25. χ2 Tests showed that six mostly commonly missed aspects of care (e.g., timely documentation) and three reasons for missed care (communications, material resources, and labor resources) were associated with safety climate groups ( P < 0.001). The adjusted mixed-effects model identified a significant association between better nurse-perceived safety climate and less missed care ( β = -2.65; 95% confidence interval, -2.97 to -2.34; P < 0.001) after controlling for years of experience and highest nursing education.

Conclusions: Our findings suggest that improving safety climate-for example, through better teamwork and communication-may improve nursing care quality during labor and birth through decreasing missed nursing care. Conversely, it is also possible that strategies to reduce missed care-such as staffing improvements-may improve safety climate.

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Conflict of interest statement

The authors disclose no conflict of interest.

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References

1. Chassin MR, Loeb JM. High-Reliability Health Care: Getting There from Here. Milbank Q. 2013;91(3):459–490. doi:10.1111/1468-0009.12023 - DOI - PMC - PubMed
1. Advisory Committee on the Safety of Nuclear Installations (ACSNI)Advisory Committee on the Safety of Nuclear Installations (ACSNI). Organizing for Safety: Third Report of the ACSNI. HM Stationery Office; 1993.
1. Sexton JB, Helmreich RL, Neilands TB, et al. The Safety Attitudes Questionnaire: psychometric properties, benchmarking data, and emerging research. BMC Health Serv Res. 2006;6(1):44. doi:10.1186/1472-6963-6-44 - DOI - PMC - PubMed
1. Kho M, Carbone J, Lucas J, Cook D. Safety Climate Survey: reliability of results from a multicenter ICU survey. Qual Saf Health Care. 2005;14(4):273–278. doi:10.1136/qshc.2005.014316 - DOI - PMC - PubMed
1. Modak I, Sexton JB, Lux TR, Helmreich RL, Thomas EJ. Measuring Safety Culture in the Ambulatory Setting: The Safety Attitudes Questionnaire—Ambulatory Version. J Gen Intern Med. 2007;22(1):1–5. doi:10.1007/s11606-007-0114-7 - DOI - PMC - PubMed

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[1] Chassin MR, Loeb JM. High-Reliability Health Care: Getting There from Here. Milbank Q. 2013;91(3):459–490. doi:10.1111/1468-0009.12023 - DOI - PMC - PubMed

[2] Chassin MR, Loeb JM. High-Reliability Health Care: Getting There from Here. Milbank Q. 2013;91(3):459–490. doi:10.1111/1468-0009.12023 - DOI - PMC - PubMed

[3] Advisory Committee on the Safety of Nuclear Installations (ACSNI)Advisory Committee on the Safety of Nuclear Installations (ACSNI). Organizing for Safety: Third Report of the ACSNI. HM Stationery Office; 1993.

[4] Advisory Committee on the Safety of Nuclear Installations (ACSNI)Advisory Committee on the Safety of Nuclear Installations (ACSNI). Organizing for Safety: Third Report of the ACSNI. HM Stationery Office; 1993.

[5] Sexton JB, Helmreich RL, Neilands TB, et al. The Safety Attitudes Questionnaire: psychometric properties, benchmarking data, and emerging research. BMC Health Serv Res. 2006;6(1):44. doi:10.1186/1472-6963-6-44 - DOI - PMC - PubMed

[6] Sexton JB, Helmreich RL, Neilands TB, et al. The Safety Attitudes Questionnaire: psychometric properties, benchmarking data, and emerging research. BMC Health Serv Res. 2006;6(1):44. doi:10.1186/1472-6963-6-44 - DOI - PMC - PubMed

[7] Kho M, Carbone J, Lucas J, Cook D. Safety Climate Survey: reliability of results from a multicenter ICU survey. Qual Saf Health Care. 2005;14(4):273–278. doi:10.1136/qshc.2005.014316 - DOI - PMC - PubMed

[8] Kho M, Carbone J, Lucas J, Cook D. Safety Climate Survey: reliability of results from a multicenter ICU survey. Qual Saf Health Care. 2005;14(4):273–278. doi:10.1136/qshc.2005.014316 - DOI - PMC - PubMed

[9] Modak I, Sexton JB, Lux TR, Helmreich RL, Thomas EJ. Measuring Safety Culture in the Ambulatory Setting: The Safety Attitudes Questionnaire—Ambulatory Version. J Gen Intern Med. 2007;22(1):1–5. doi:10.1007/s11606-007-0114-7 - DOI - PMC - PubMed

[10] Modak I, Sexton JB, Lux TR, Helmreich RL, Thomas EJ. Measuring Safety Culture in the Ambulatory Setting: The Safety Attitudes Questionnaire—Ambulatory Version. J Gen Intern Med. 2007;22(1):1–5. doi:10.1007/s11606-007-0114-7 - DOI - PMC - PubMed

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Linking Patient Safety Climate With Missed Nursing Care in Labor and Delivery Units: Findings From the LaborRNs Survey

Affiliations

Linking Patient Safety Climate With Missed Nursing Care in Labor and Delivery Units: Findings From the LaborRNs Survey

Authors

Affiliations

Abstract

Conflict of interest statement

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Cited by

References

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Grants and funding

LinkOut - more resources

Full Text Sources