Improving Safety Attitudes in New Graduate Registered Nurses

This presentation explains an evidence translation project designed to improve the attitudes of new graduate registered nurses (NGRN) toward patient safety practices and their accountability for it. Evidence supports that safety is driven by organizational culture, which is determined by individuals, especially nurses, who support it through knowledge, skills, and attitudes (KSA) that create safety focused professional identities, prevent practice breakdowns, and instill clinical competencies that transform safety theory into safety practice. This project incorporates this evidence by inculcating attitudinal values during the NGRNs’ initial residency period at an acute care hospital using tools from the Quality and Safety Education in Nursing Institute, video simulation, and live simulation experiences in a four-week new nurse fellowship program (NNFP). The project hypothesis is framed by the PICOT question: For the hospital reporting NGRNs’ weakness in attitudes, beliefs, and values about patient safety related to performance skills, does the implementation of a four-week, QSEN-based, safety-focused, NNFP improve the NGRN’s attitudes about patient safety as measured by the Healthcare Professionals Patient Safety Assessment Curriculum Survey (HPPSACS) (Chenot & Daniel, 2010), compared with no QSEN safety-focused program? The presentation describes representative examples of instructional design elements, simulations, and the project measurement tool. The HPPSACS (Chenot & Daniel, 2010) is a validated and reliable tool that measures four constructs of attitude in the safety-related themes of (a) comfort in revealing errors, (b) error reporting, (c) denial tendencies, and (d) culture of safety improvement. Paired t-tests will compare means between pre- and post- intervention scores. For data not normally distributed, the nonparametric Mann-Whitney U will be used instead to compare pre- and post-intervention data. Responses to binomial yes/no questions will be analyzed using the nonparametric chi-square. Since this is not a research design and the number of the subjects will be fixed, performing a power analysis for sampling is not practical for this evidence translation project. The Statistical Package for the Social Sciences (SPSS) version 22 will be used for statistical calculations. The ties to the project interventions will be established. The project incorporated a non-interventional, control group’s post-NNFP sample that was compared to a pre and post NNFP interventional group. Institutional review board approval was received before project recruitment, interventions, or measurements were implemented. Applications for patient safety initiatives, professional development, and patient safety culture change are highlighted.