Abstract:

Objective To understand the status quo and influencing factors of safe behavior of new nurses,in order to provide a theoretical basis for managers to do a good job in the management and training of new nurses,improve their level of safe behavior,and ensure medical safety. Methods In September 2020,the convenience sampling method was used to select nurses enrolled in 4 tertiary A hospitals in Shandong Province from September 2018 to September 2019 as the research subjects. A general data questionnaire,Nurse Safety Behavior Questionnaire,Patient Safety Culture Assessment Scale,Perceived Organizational Support Questionnaire,Patient Safety Competency Self-rating Scale of Nurses were used to investigate. Results The safety behavior score of 454 new nurses was（56.56±5.19）;the safety behavior of new nurses was positively correlated with patients’ safety culture perception（except pressure dimension）,organizational support,total score of patients’ safety competence and all dimensions,and negatively correlated with the pressure dimension of patients’ safety culture perception;AMOS analysis showed that patients’ safety culture perception and patient safety competence had a direct positive impact on the safety behavior of new nurses（β=0.246,β=0.048,both P<0.001）. Bootstrap analysis showed that organizational support and patient safety competence had significant mediating effects on patients’ safety culture perception and nurses’ safety behavior（95%CI 0.031-0.091）. The total effect of new nurses’ patients safety culture perception on nurses’ safety behavior was 0.242（P<0.001,95%CI：0.207-0.277）,and the direct effect was 0.094（P<0.001,95%CI：0.049-0.140）. The indirect effect was 0.148（P<0.001,95%CI：0.085-0.215）,and the mediating effect accounted for 61.16% of the total effect value. Conclusion Organizational support and patient safety competency play a mediating role between patient safety culture perception and safety behavior of new nurses. The hospital should strengthen cultural awareness training for new nurses security,strengthen occupational stress management. The safety cognitive level and safety competency of the new nurses can be improved by the construction of a positive safety culture atmosphere,so as to raise the safety behavior level of new nurses.

Key words: Newly Recruited Nurses, Safety Behavior, Safety Culture Perception, Safety Competence, Organizational Support, Nursing Administration Research, Cross-Sectional Studies, Root Cause Analysis

摘要：

目的 了解新入职护士的安全行为现状、影响因素及其作用路径,以期为管理者做好新入职护士的管理与培训、提升其安全行为水平、保障医疗安全提供理论基础。 方法 于2020年9月采用方便抽样方法选取山东省4所三级甲等医院2018年9月—2019年9月新入职的护士为调查对象,采用一般资料调查表、护士安全行为量表、患者安全文化感知问卷、组织支持感问卷、患者安全胜任力护士评价量表进行调查。 结果 454名新入职护士的安全行为得分为（56.56±5.19）分;新入职护士安全行为量表总分与患者安全文化感知问卷（除压力维度外）、组织支持感问卷、患者安全胜任力护士评价量表总分及各维度得分呈正相关（均P<0.05）,与患者安全文化感知问卷中的压力维度得分呈负相关（P<0.05）;AMOS分析显示,患者安全文化感知、患者安全胜任力对新入职护士安全行为存在直接正向影响（β=0.246,β=0.048,均P<0.001）。Bootstrap分析显示,组织支持感、患者安全胜任力在患者安全文化感知和护士安全行为间的中介效应显著（95%CI：0.031~0.091）,新入职护士患者安全文化感知对护士安全行为的总效应为0.242（P<0.001,95%CI：0.207~0.277）,直接效应为0.094（P<0.001,95%CI：0.049~0.140）,间接效应为0.148（P<0.001,95%CI：0.085~0.215）,中介效应占总效应值的61.16%。 结论 组织支持感、患者安全胜任力在患者安全文化感知与新入职护士安全行为间起中介作用,应加强对新入职护士安全文化意识培训,加强职业压力管理,通过建设积极的安全文化氛围,提高新入职护士的安全认知水平及安全胜任力,进而提高新护士的安全行为水平。

关键词: 新入职护士, 安全行为, 安全文化认知, 安全胜任力, 组织支持感, 护理管理研究, 横断面研究, 影响因素分析