Study On The Establishment Of Patient Safety Competency Norms For Nurses In Tertiary Class A General Hospitals In Shanxi Province

Objective:Establish the weights of all levels of the Patient Safety Competency Nurse Evaluation Scale and test its reliability and validity.On this basis,the Shanxi Province norm of the scale was developed to provide a comparable standard for the evaluation of patient safety competence of nurses.It is helpful to understand the status of patient safety competencies of nurses in tertiary class A general hospitals in Shanxi Province,and is of positive significance for hospital care managers to identify areas with weak patient safety competencies,promote nurse safety education and build an effective training system.Methods:1.In this study the patient safety competency evaluation scale compiled by Wang Qing was selected to evaluate the patient safety competence of nurses.In order to objectively evaluate the patient safety competence of nurses,it is necessary to first determine the weights of all levels of the scale.Through an expert meeting,22 experts with a high academic level and rich clinical practice experience in the field of patient safety research were invited to participate in this meeting.Using the analytic hierarchy process,the experts assign values to the first-level indicators of the indicator system.Evaluation of the importance of secondary indicators.2.The convenience sampling method was adopted to select 306 nurses from two Class-A general hospitals in Taiyuan to complete the survey,so as to conduct preliminary reliability and validity test of the scale:Convergent validity testing using the core competence scale for Registered Nurses:test its construction validity through the correlation analysis of the various dimensions of the scale;two weeks after the survey,30subjects with better cooperation were selected for re-testing,and the correlation coefficients within the group obtained from the two measurements are analyzed to describe the overall evaluation table and the retest reliability of each dimension.3.The proportional stratified cluster sampling method was used to select 11 tertiary general hospitals in the northern Shanxi,central Shanxi,southern Shanxi and Southeastern Shanxi.Each hospital selects nurses from 7 different departments（wards）for investigation,and the final effective sample size is 2417 cases.The reliability and validity of the total evaluation scale were tested again.By analyzing the characteristics of the total score and each dimension of patient safety competency of 2417 nurses,the mean norm was constructed with“Mean±SD”and the percentile norm was established with 5%percentile interval.On this basis,the demarcation norm was constructed.At the same time,analyzed the status quo of patient safety competence of the nurses in Shanxi Province and each group.Results:.1.Results of indicator weights at each level.The six first-level indicators of this evaluation scale from high to low in turn were safety risk management（W₆=0.289）,clinical practice（W₂=0.212）,patient-centered（W₁=0.173）,continuous quality improvement（W₃=0.142）,patient safety culture（W₅=0.102）,evidence-based nursing practice（W₄=0.083）.In the same way,the weight of secondary indexes is calculated and the combined weight of secondary indexes is obtained by product method.The consistency test of each judgment matrix is good,which means that the weight results are logical.2.The result of the preliminary test of the reliability and validity for the scale..The convergent validity of the Patient Safety Competency Nurse Evaluation Scale is 0.722,which is highly correlated with the Registered Nurses Core Competency Scale（P<0.001）;The Cronbach’sαcoefficient within each dimension is greater than the correlation coefficient with other dimensions,which means that the construct validity of the scale is good;the retest reliability of the total evaluation scale with each dimension ranges from 0.778 to 0.874,indicating that its stability across time is relatively high.In general,the reliability and validity of the Patient Safety Competency Nurse Evaluation Scale is good,and the norm can be established.3.The construction and status analysis of the norms of patient safety competency of nurses in in tertiary class A general hospitals in Shanxi Province.The sampling range determined by the stratified cluster sampling method according to proportion is wide.the effective sample size of 2417 cases basically meets the demand of the norm sample size,and the distribution of the characteristics of the sample data is reasonable and has good representativeness.The internal consistency test and validation factor analysis of the overall sample yielded good reliability and validity of this evaluation scale.Developed the mean norms of the total evaluation scale and each dimension,and constructed the mean norms of 6 classification groups of different ages,nursing age,department,position,regions and training times received;developed the percentile norms.The demarcation norm was established with P10,P35,P70,and P90 as the boundary points,so that patient safety competence of nurses was divided into 5 levels:≥96.31 for excellent,88.80～96.31for good,75.75～88.80 for general,69.43～75.75 for sub-standard and<69.43 for poor.The total patient safety competency score of nurses in the top three general hospitals in Shanxi Province was（82.28±13.05）points,the conversion scores of each dimension from high to low in turn were patient safety culture（85.83±13.52）,clinical practice（85.28±13.40）,Security risk management（82.64±14.08）,continuous quality im-provement（82.45±14.46）,evidence-based nursing practice（78.35±16.25）and patient-centered（77.62±15.97）.Conclusion:1.Established the index weights and verified that the evaluation scale has good reliability and validity,which can be used as a tool to evaluate the level of patient safety competence of nurses;2.The norms developed for nurses’patient safety competency in Tertiary Class A General Hospitals in Shanxi Province are representative.By establishing standard reference scoring method,it provides a comparable standard for objective evaluation of nurses’patient safety competency;3.The patient safety competence of nurses in Shanxi Province is at an intermediate level,the abilities of each dimension are different.The scores of nurses with different ages,nursing ages,departments,positions,regions and training times were different,which provide a reference for related research.