| ObjectiveTo understand the current status of the level of safe behavior of newly recruited nurses and explore its influencing factors,and to study the role path between perceived organizational support,safety competence,safety culture perception and safe behavior,so as to provide a theoretical basis for nursing managers to do a good job in the management and training of new recruited nurses and improve their level of safe behavior.MethodsA convenient sampling method was used to investigate the nurses who entered the service from September 2018 to September 2019 in four tertiary hospitals in Shandong Province.The survey tools included:General Information Questionnaire,Nurse safety behaviors questionnaire(NSBQ),Patient Safety Culture Assessment Scale(PSCAS),Perceived Organizational Support Questionnaire(POSQ),Work Environment Questionnaire(WEQ),and Patient Safety Competency Self-rating Scale of Nurses(PSCSSN).SPSS23.0 and AMOS21.0 software packages were used for data consolidation and analysis,and the test level was a=0.05.Results1.A total of 454 newly recruited nurses participated in the survey in this study,ranging in age from 19 to 33 years old,with an average age of(23.69±1.85)years old.There were 91 male nurses(20.04%)and 363 female nurses(79.96%).207(45.59%)received junior college degree,247(54.51%)received bachelor degree or above;281(61.89%)who have worked for 1-2 years;Unmarried 408 persons(89.87%);443 persons(97.58%)received hospital training on knowledge of patient safety culture.2.The total score of safe behavior of newly recruited nurses was(56.5615.19).3.The results of independent sample t-test or one-way analysis of variance showed that there were statistically significant differences in the score of safe behavior of nurses with working years and whether they had received training on patient safety culture(P<0.05),while there were no statistically significant differences in the score of safe behavior of nurses with age,gender and education background(P>0.05).4.The total score of safety culture perception of patients was(100.90±11.84)points,The lowest score of "cognition of pressure" in each dimension was(1.98±1.03)points.5.The total score of organizational support was(57.63±10.42),and the score of instrumental support was(4.52±0.76)higher than that of affective support(4.01 ± 0.83).6.The score of work environment perception was(81.85±11.46),among which the score of "colleague relationship" was the highest(4.33±0.68),and the score of"human resources" was the lowest(4.04±0.79).7.The patient’s safety competence score was(160.24±22.55),and the score of"patient safety culture" was the highest(4.62±0.65).8.The total score of nurses’ safe behavior was positively correlated with the total score of patients’ safety culture perception(r=0.556,P<0.01),team atmosphere(r=0.522,P<0.01),job satisfaction(r=0.562,P<0.01),safety atmosphere(r=0.553,P<0.01),management feeling(r=0.547,P<0.01),and negatively correlated with the perception of pressure dimension(r=-0.107,P<0.05).It was positively correlated with the total score of organizational support(r=0.535,P<0.01),affective support(r=0.529,P<0.01)and instrumental support(r=0.331,P<0.01).It was positively correlated with the total score of work environment perception(r=0.562,P<0.01),human resources(r=0.562,P<0.01),medical configuration(r=0.489,P<0.01),quality management(r=0.514,P<0.01),and colleague relationship(r=0.681,P<0.01).It was positively correlated with the total score of patient safety competence(r=0.665,P<0.01),patient-centered(r=0.575,P<0.01),clinical safety(r=0.645,P<0.01),continuous quality improvement(r=0.640,P<0.01),evidence-based use of information(r=0.627,P<0.01),patient safety culture(r=0.633,P<0.01),and safety risk management(r=0.642,P<0.01).9.Multiple stepwise linear regression analysis results showed that the patient safety culture awareness(team atmosphere,job satisfaction,the cognition to the pressure,safety atmosphere,)of the feelings of the management,patient safety competence(patients as the center,clinical practice,continuous quality improvement,evidence-based nursing practice,patient safety culture,safety risk management),working environment perception of "relationships" score entered the regression equation,explain new nurses behavior of safety and 55.8%of total variation.10.Path analysis showed that patients’ safety culture perception had a direct positive impact on safety behavior(β=0.246,P<0.001).Patients’ safety competence had a direct positive impact on safety behavior(β=0.048,P<0.001).The total effect of the safety culture perception of the newly recruited nurses on the safe behavior of nurses was 0.242(P<0.001,95%CI:0.207-0.277),the direct effect was 0.094(P<0.001,95%CI:0.049-0.140),and the indirect effect was 0.148(P<0.001,95%CI:0.085-0.215).The mediating effect accounted for 61.16%(0.148/0.242)of the total effect value.There was no significant mediating effect of perceived organizational support in the path of perceived safety culture→perceived organizational support→ safe behavior.In the path of safety culture perception→organizational support→ patient safety competence→ safety behavior,there is a significant mediating effect,the indirect effect is 0.053,and the mediating effect accounts for 0.053/0.242=21.90%of the total effect.Patients’ safety competence has a significant mediating effect in the path of safety culture perception→patient safety competence safety behavior.The size of the indirect effect is 0.061,and the mediating effect accounts for 0.061/0.242=25.21%of the total effect.Conclusions1.The safety behavior of newly recruited nurses is above the average level,which suggests that medical institutions should pay more attention to the safety training of new employees and cultivate their safety culture awareness.2.Nursing managers should pay more attention to the group of new nurses and pay more attention to the adverse effects of occupational pressure on new nurses.3.Nursing management personnel can take targeted measures to improve the safety behavior level of new nurses from various aspects,such as training in theory and skills,providing a good working and learning environment,and creating a positive safety culture atmosphere. |
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