Speaking up about patient safety concerns: view of nursing students.

Hoffmann, Magdalena; Schwarz, Christine Maria; Schwappach, David; Banfi, Chiara; Palli, Christoph; Sendlhofer, Gerald (2022). Speaking up about patient safety concerns: view of nursing students. BMC health services research, 22(1), p. 1547. BioMed Central 10.1186/s12913-022-08935-x

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BACKGROUND

"Speaking up" is considered an important patient safety behaviour. The main idea is to voice patient safety concerns; however, several studies revealed that the organisational culture can be obstructive. In previous studies, we already identified barriers for doctors, nurses and medical students. In the current study, we explore how nursing students use "speaking up" during their internship in an academic teaching hospital.

METHODS

Between 2019 and 2020, 212 nursing students were invited to take part in the survey. The validated Speaking Up about Patient Safety Questionnaire (SUPS-Q) was used to assess speaking up behaviours in nursing students. The SUPS-Q consisted of three behaviour related scales (11 items), three culture related scales (11 items), a question regarding barriers to speak up as well as a clinical vignette assessing a hypothetical speaking up situation.

RESULTS

In total, 118 nursing students took part in the survey (response rate: 56%). Most of them noticed specific safety concerns, observed errors or rule violations. The vignette was seen as very realistic and harmful to the patient. However, the majority responded that they did not speak up and remained silent. They reported a rather discouraging environment and high levels of resignation towards speaking up. However, more advanced students were less likely to speak up than less advanced students (p = 0.027). Most relevant barriers were fear of negative reaction (64%), reaction not predictable (62%) and ineffectiveness (42%).

CONCLUSIONS

Survey results of nursing students imply that speaking-up behaviours and remaining silent are common behaviours and coexist in the same individual. The clinical vignette and barriers to speaking up revealed that a hierarchical system does not support speaking-up behaviours. Organizational development is needed to foster professional teamwork, support attentive listening, encourage critical thinking, and problem-solving skills.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)

UniBE Contributor:

Schwappach, David

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

1472-6963

Publisher:

BioMed Central

Language:

English

Submitter:

Pubmed Import

Date Deposited:

20 Dec 2022 09:22

Last Modified:

06 Jan 2023 12:56

Publisher DOI:

10.1186/s12913-022-08935-x

PubMed ID:

36536431

Uncontrolled Keywords:

Communication Nursing students Patient safety Safety culture Speak-up

BORIS DOI:

10.48350/176154

URI:

https://boris.unibe.ch/id/eprint/176154

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