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Learning Objective 1: The learner will be able to know the effects of structural factors on patient safety
Learning Objective 2: The learner will be able to get directions in developing a nursing practice structure
Methods: The study framework derived from the concept of structural contingency theory. A cross-sectional design was used and data were collected through self-administered questionnaires using Dillman’s Tailored Design Method. A total of 1,364 participants who worked in 64 surgical and medical units were invited. Data aggregation included Eta-squared coefficient, inter-item consistency, and F ration were used to aggregate data from the individual to the unit level. Multiple regression was used for data analysis.
Results: A total of 1,039 participants (76.7%) completed and returned the questionnaire. Eta-squared coefficient (h2), inter-item consistency (rwg), and F ratio showed that data at the individual level were appropriate to aggregate to the unit level. Results shown that the medication error rate was higher on units with a high degree of professional autonomy (b =.59; p < .05) and participation in decision making (b =.25; p < .05). Similarly, the nursing units with a high degree of participation in decision making would have high rates of patient fall (b =.25; p < .05).
Conclusion: This study provides support for the use of structural approaches to examine patient safety issues, and also provide some directions for head nurses in developing a nursing practice structure.