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theses

This study was undertaken to address a gap in knowledge by examining the interrelationships among organizational structures (hospital and nurse characteristics); patient safety practice dimensions of patient safety culture; and patient safety event reporting among Registered Nurses (RNs) who work in U.S. hospitals. Little is known of the extent to which hospital and nurse characteristics interact with patient safety practices to influence the patient safety event reporting practices of RNs working in U.S. hospitals. Method: Donabedian’s Healthcare Quality Model and the Patient Safety Culture Framework guided this research in exploring the interrelationships among hospital and nurse characteristics, patient safety practices, and patient safety event reporting practices of nurses working in U.S. hospitals. The study commenced following approval from the Institutional Review Board of Rutgers, The State University of New Jersey. Data used in this analysis were from the Agency for Healthcare Research and Quality (AHRQ) Hospital Survey on Patient Safety Culture Comparative Database. The database is funded by AHRQ and managed by Westat under contract # HHSA 290201300003C. Data from U.S. hospitals that voluntarily submitted their Hospital Survey on Patient Safety Culture (HSOPSC) data to the AHRQ collected during July 2011 through June 2013 was analyzed. Results: Hospital bed size, ownership status, and two geographic regions were independent predictors of the frequency of event/near miss reporting and the number of event reports completed. The number of hours worked/week was a significant independent predictor of the frequency of event/near miss reporting. Amount of experience in the profession was a significant independent predictor of the number of event reports completed. Manager safety practices had the biggest effect on predicting event/near miss reporting. Mediation testing revealed a full or partial mediating role of all patient safety practices in the relationship between hospital or nurse characteristics and patient safety event reporting outcomes. Conclusion: All hospital characteristics and patient safety practices were significantly related to one or both event reporting outcomes. All nurse characteristics were significantly related to one of the two event reporting outcomes. Patient safety practices serve as a mediator between hospital and nurse characteristics and the frequency of event/near miss reporting.

ETD_6483

Ph.D.

Includes bibliographical references

by Mary Ann Wafer

doi:10.7282/T3416ZZ3

ETD doctoral

The author owns the copyright to this work.