Barriers and enablers to nurses' use of harm prevention strategies for older patients in hospital: A cross‐sectional survey.

Background: Preventable harms during hospitalization pose a major challenge for health systems globally. Nurse‐led strategies provide comprehensive harm prevention to keep the most vulnerable patients safe in hospital, but gaps in care are common. Nursing roles and activities to prevent harm to pati...

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Published in:Journal of Advanced Nursing (John Wiley & Sons, Inc.) Vol. 78; no. 11; pp. 3710 - 3721
Main Authors: Redley, Bernice, Taylor, Natalie, Hutchinson, Alison M.
Format: research tables/charts Journal Article
Published: John Wiley & Sons, Inc. Nov2022
Online Access:View this record in EBSCOhost
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      jtl: Journal of Advanced Nursing (John Wiley & Sons, Inc.)
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      dt: Nov2022
      vid: 78
      iid: 11
      pid: 52269
      pub: John Wiley & Sons, Inc.
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        159726048
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        10.1111/jan.15269
        159726048
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        atl: Barriers and enablers to nurses' use of harm prevention strategies for older patients in hospital: A cross‐sectional survey.
      aug:
        au:
          Redley, Bernice
          Taylor, Natalie
          Hutchinson, Alison M.
        affil: School of Nursing and Midwifery and Centre for Quality and Patient Safety, Institute for Health Transformation, Deakin University, Burwood Victoria,, Australia
      sug:
        subj:
          Harm Reduction Prevention and Control
          Nurse Attitudes
          Nursing Role
          Implementation Science
          Patient Safety
          Quality Improvement
          Human
          Cross Sectional Studies
          Aged
          Nurses
          Questionnaires
          Hospitals Victoria
          Convenience Sample
          Descriptive Statistics
          Coercion
          Patient Education
          Persuasive Communication
          Victoria
          Data Analysis Software
          Analysis of Variance
          Unpaired T-Tests
          Post Hoc Analysis
          Funding Source
          Male
          Female
          Aged: 65+ years
          Male
          Female
      ab: Background: Preventable harms during hospitalization pose a major challenge for health systems globally. Nurse‐led strategies provide comprehensive harm prevention to keep the most vulnerable patients safe in hospital, but gaps in care are common. Nursing roles and activities to prevent harm to patients during acute hospitalization are poorly understood. Aim: The aim of this study was to identify nurses' perceived enablers and barriers to the implementation of comprehensive harm prevention for older people admitted to an acute hospital setting. Design: Anonymous, online, cross‐sectional survey. Methods: The adapted Influences on Patient Safety Behaviours Questionnaire (IPSBQ) was used to collect data from nurses working on five general medicine wards across three hospitals of a single tertiary health service in Australia in 2019. Participants also rated their perceptions of overall quality of care, missed care and awareness of strategies for an eight‐factor framework for comprehensive harm prevention. The STROBE reporting checklist was used. Results: Ward response rates between 35% and 58% resulted in 132 complete questionnaires for analyses. High mean scores for behavioural regulation (3.28), beliefs about capabilities (2.96) and environmental context and resources (2.73) indicated these domains were perceived by nurses as enablers. Low mean scores for the domains of intentions (1.65), beliefs about consequences (1.69), optimism (1.72) and professional role and identity (1.85) indicated these were barriers to comprehensive harm prevention by nurses. High perceived quality of care (scored 9–10/10) (p =.024), and awareness of strategies for the eight‐factor framework (p =.019) were significant enablers of comprehensive harm prevention. Conclusion: Targeted evidence‐based strategies that include education, persuasion, incentivization, coercion and modelling would be most useful for promoting comprehensive harm prevention by nurses. However, to be most effective the harm prevention strategy may need to be tailored for each ward.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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