The ability to evaluate research is an important skill when implementing evidence-based practice initiatives (Polit & Beck, 2014). Evidence-based research helps inform the decision-making process in nursing practice (Coughlan, Cronin, & Ryan, 2007). With this in mind, the purpose of this paper is to critique an article from a nursing journal. The purpose of the article is outlined along with a discussion of the importance of the research to nurse managers and leaders, along with the study’s implications for practice. A section is also devoted to personal impressions of the study.
Article
The article titled “How hospital leaders contribute to patient safety through the development of trust” authored by Auer, Schwendimann, Koch, De Geest, and Ausserhofer, and published in the Journal of Nursing Administration, in 2014 serves as the exemplar for this critique. This study used a quantitative method of inquiry with a cross-sectional research design. Data was obtained from self-report questionnaires from a sample of 1,633 registered nurses from 12 European countries.
Purpose
The purpose of this study was to examine the relationship between support for patient safety by hospital management, nurses’ trust in management and perceptions of patient safety. To carry out this purpose, the researchers obtained data from a cross-sectional nurse survey from registered nurses in 12 European countries. The aim of the survey data was to gain information on how factors related to the nurse work environment and staff deployment affects recruitment, retention, productivity and patient outcomes. The main variables examined from the questionnaire were related to safety and culture which included openness to feedback and communication regarding errors, organizational learning, support for patient safety, and perceptions of patient safety. Using path analysis, the results revealed that more than half of the nurses believed patient safety in their units were very good or excellent. Also, more than half of the nurses felt that when they did make a mistake, it was not held against them. However, less than half of nurses felt they could question their manager’s authority in terms of decisions or actions and only a quarter of the nurse felt confident that their managers would resolve problems personally reported in the context of patient care. Overall the results suggest a significant relationship between patient safety and management support and also a significant relationship between management support and trust in management.
Importance for Nurse Leader/Manager
This study is important for nurse leaders and managers because it confirms the fact that higher perceptions of patient safety and trust in management is related to higher levels of support from management. An environment which is open and in which nurses are not blamed for errors actually improves patient safety. Communication that is uninhibited and feedback on errors and organizational learning also contributed to improved patient safety. Nurse managers and leaders who actively engage nurses and other health care workers in participating in learning activities help to promote communication about safety which increases awareness of safety and allows for individuals and teams to take responsibility for the errors.
Personal Impressions
Personal impressions of the article are that the study yielded some important results for nurse leaders and managers in terms of how to communicate with staff especially regarding feedback on errors. Also, it provided important information on how to build an environment that fosters a culture of patient safety. The study was however not without its limitations. For example, the study data was obtained from self-report responses, which may have been at risk for potential social desirability bias. Also, because of the nature of the design, the study could not demonstrate causation between variables. However, the study did results in significant findings in regard to relationships between variables, which are relevant to manager and leader practices and in frontline nurses for building mutual trust and promoting an environment that enhances a culture of patient safety. For these reasons, this study illustrates the importance of the role of the nurse manager and leader in promoting a patient safety culture through trust and open communication.
Implications for Nursing Leader/Manager
The implications of this study for nursing leaders and managers is that trust is the link and basis for management and staff in productive collaboration. In order to gain trust, nurse leaders need to increase patient safety as a priority and foster an environment that promotes a culture of patient safety. To do this, nurse managers and leaders should demonstrate their commitment to their organization by their actions and words and should also include staff in this commitment. Managers and leaders’ who demonstrate their determination clearly in an effort to promote a culture of patient safety are creating and sustaining a delivery of care system that is focused on preventing adverse events. For example, many hospitals are implementing a Critical Incident Reporting system (CIRS) to improve organizational learning by way of analyzing risks and errors. Implementing CIRS demonstrates a commitment to creating a culture of patient safety, which simultaneously enhances the trust of RNs as well as other health care professionals.
Conclusion
This paper provided a critique of a study published in a nursing journal. The purpose of this study was to examine the relationship between support for patient safety by hospital management, nurses’ trust in management and perceptions of patient safety. This study is important for nurse leaders and managers because it confirms the fact that higher perceptions of patient safety and trust in management is related to higher levels of support from management. The implications of this study for nursing leaders and managers is that trust is the link and basis for management and staff in productive collaboration. In order to gain trust, nurse leaders need to increase patient safety as a priority and foster an environment that promotes a culture of patient safety.
- Auer, C., Schwendimann, R., Koch, R., De Geest, S., & Ausserhofer, D. (2014). How hospital leaders contribute to patient safety through the development of trust. Journal of Nursing Administration, 44(1), 23-29.
- Coughlan, M., Cronin, P., & Ryan, F. (2007). Step-by-step guide to critiquing research. Part 1: quantitative research. British journal of nursing, 16(11), 658-663.
- Polit, D. F., & Beck, C. T. (2014). Nursing research: Generating and assessing evidence for nursing practice (9th ed.). Philadelphia, PA: Lippincott Williams &Wilkins.
