write up on safety

Please provide an answer that is 100% original and do not copy the answer to this question from any other website since I am already well aware of this. I will be sure to check this.

Please be sure that the answer comes up with way less than 18% on Studypool’s internal plagiarism checker since anything above this is not acceptable according to Studypool’s standards. I will not accept answers that are above this standard.

No AI or Chatbot! I will be sure to check this.

Follow the guidelines attached when completing this assignment.

Please be sure to only read, use, and cite the selected required article which has been attached. Here is the citation for it:

Vaismoradi, M., Tella, S., A. Logan, P., Khakurel, J., & Vizcaya-Moreno, F. (2020). Nurses’ Adherence to Patient Safety Principles: A Systematic Review. International Journal of Environmental Research and Public Health, 17(6), 2028. https://doi.org/10.3390/ijerph17062028

Requirements: Minimum 1 Full Page Times New Roman Size 12 Font Double-Spaced APA Format Excluding the Title and Reference Pages | .doc file

Please provide an answer that is 100% original and do not copy the answer to this question from any other website since I am already well aware of this. I will be sure to check this.Please be sure that the answer comes up with way less than 18% on Studypool’s internal plagiarism checker since anything above this is not acceptable according to Studypool’s standards. I will not accept answers that are above this standard.No AI or Chatbot! I will be sure to check this.

Please be sure to carefully follow the instructions.

Please be sure to include an introduction paragraph with a clear thesis statement in the last sentence of the introduction paragraph and a conclusion paragraph.

No plagiarism & No Course Hero & No Chegg. The assignment will be checked for originality via the Turnitin plagiarism tool.

Please be sure to include at least one in-text citation in each body paragraph written.

NR103 Transition to the Nursing Profession
Transitions Paper Guidelines
Purpose
The purpose of this assignment is to explore a critical concept in nursing. The student will be able to demonstrate
application of information literacy and ability to utilize resources (library, writing center, Center for Academic Success
[CAS], APA resources, Turnitin, and others) through literature search and writing the paper.
Course outcomes: This assignment enables the student to meet the following course outcomes.
CO 2: Identify characteristics of professional behavior including emotional intelligence, communication, and conflict
resolution.
CO 3: Demonstrate information literacy and the ability to utilize resources.
Due date: Your faculty member will inform you when this assignment is due. The Late Assignment Policy applies to
this assignment.
Total points possible: 150 points
Preparing the assignment
Follow these guidelines when completing this assignment. Speak with your faculty member if you have questions.
1) Locating Evidence
a. Using the Chamberlain University library, search for a recent (published within the last five years) evidencebased article from a scholarly journal that addresses one of the topics listed.
• Safety
• Delegation
• Prioritization
• Caring
2) Include the following sections.
a. Introduction – 20 points/13%
• Clearly establishes the purpose of the paper
• Includes key points to be covered
• Captures the reader’s interest
b. Body of Paper – 60 points/40%
• Complete, well-developed discussion of key points
• Supports the purpose or main idea of the paper
• Logical development of ideas with clear and accurate information
• Ideas and statements are supported by three or more examples from personal and/or professional
experiences
• Provides own perspectives on the topic that is reflective, insightful, and original
c. Conclusion – 30 points/20%
• Clear and concise
• Summarizes key points discussed in the paper
• Leaves a strong impression, message, or idea on the reader
d. Writing Style – 15 point/10%
e. Correct use of standard English grammar, paragraph, and sentence structure
f. No spelling or typographical errors
g. Organized around required components
h. Information flows in a logical sequence that is easy for the reader to follow
i. APA Format, and References – 25 points/17%
• There is correct and appropriate use of margins, spacing, font, and headers
• Document setup includes title and reference pages in correct APA format
NR103_Transitions_Paper_Guidelines
© 2022 Chamberlain University. All Rights Reserved.
1
NR103 Transition to the Nursing Profession
Transitions Paper Guidelines
•
•
•
•
Citation of sources included in the body of the paper uses correct APA format for direct and indirect quotes
All elements of each reference are included in the correct order
All information taken from the source, even if summarized, is cited and listed on the Reference page
All sources used are nursing journals published within the last five years
For writing assistance visit The Writing Center located within the Virtual Center for Academic Success.
Please note that your instructor may provide you with additional assessments in any form to determine that you fully
understand the concepts learned.
NR103_Transitions_Paper_Guidelines
© 2022 Chamberlain University. All Rights Reserved.
2
NR103 Transition to the Nursing Profession
Transitions Paper Guidelines
Grading Rubric
Criteria are met when the student’s application of knowledge demonstrates achievement of the outcomes for this assignment.
Assignment Section and
Required Criteria
(Points possible/% of total points available)
Highest Level of
Performance
High Level of
Performance
Satisfactory Level
of Performance
Unsatisfactory
Level of
Performance
Section not
present in paper
20 points
19 points
15 points
7 points
0 points
Includes no fewer
than 3 requirements
for section.
Includes no fewer
than 2 requirements
for section.
Includes no less than
1 requirement for
section.
60 points
55 points
46 points
23 points
Includes 5
Required criteria
requirements for
1. Complete, well-developed discussion of key
section.
points
2. Supports the purpose or main idea of the paper
3. Logical development of ideas with clear and
accurate information
4. Ideas and statements are supported by three or
more examples from personal and/or
professional experiences
5. Provides own perspectives on the topic that is
reflective, insightful, and original
Includes 4
requirements for
section.
Includes 3
requirements for
section.
Includes 1-2
requirements for
section.
30 points
27 points
23 points
12 points
0 points
Includes 3
Required criteria
requirements for
1. Clear and concise
section.
2. Summarizes key points discussed in the paper
3. Leaves a strong impression, message, or idea on
the reader
Includes 2
requirements for
section.
Includes 1
requirement for
section.
Section present yet
includes no required
criteria.
No requirements for
this section
presented.
Introduction
(20 points/13%)
Required criteria
1. Clearly establishes the purpose of the paper
2. Includes key points to be covered
3. Captures the reader’s interest
Body of Paper – 60 points/40%
(60 points/40%)
Conclusion
(30 points/20%)
NR103_Transitions_Paper_Guidelines
© 2022 Chamberlain University. All Rights Reserved.
Present, yet includes No requirements for
no required criteria. this section
presented.
0 points
No requirements for
this section
presented.
3
NR103 Transition to the Nursing Profession
Transitions Paper Guidelines
Assignment Section and
Required Criteria
(Points possible/% of total points available)
Highest Level of
Performance
High Level of
Performance
Satisfactory Level
of Performance
Unsatisfactory
Level of
Performance
Section not
present in paper
15 points
14 points
11 points
6 points
0 points
Includes 4
requirements for
section.
Includes 3
requirements for
section.
Includes 2
requirements for
section.
Includes 1
requirement for
section.
25 points
23 points
19 points
9 Points
Includes 6
Required criteria
There is correct and appropriate use of margins, requirements for
section.
spacing, font, and headers.
Document setup includes title and reference
pages in correct APA format.
Citation of sources included in the body of the
paper uses correct APA format for direct and
indirect quotes.
Sources are cited correctly on the Reference
page. All elements of each reference are
included in the correct order.
All information taken from the source, even if
summarized, must be cited, and listed on the
Reference page.
All sources used are nursing journals published
within the last five years.
Includes 5
requirements for
section.
Includes 3-4
requirements for
section.
Includes 1-2
requirements for
section.
Writing Style
(15 points/10%)
Required criteria
1. Correct use of standard English grammar,
paragraph, and sentence structure
2. No spelling or typographical errors
3. Organized around required components
4. Information flows in a logical sequence that is
easy for the reader to follow
APA Style and Organization
(25 points/10%)
1.
2.
3.
4.
5.
6.
No requirements for
this section
presented.
0 points
No requirements for
this section
presented.
Total Points Possible = 150 points
NR103_Transitions_Paper_Guidelines
© 2022 Chamberlain University. All Rights Reserved.
4
International Journal of
Environmental Research
and Public Health
Review
Nurses’ Adherence to Patient Safety Principles:
A Systematic Review
Mojtaba Vaismoradi 1, * , Susanna Tella 2 , Patricia A. Logan 3 , Jayden Khakurel 4
Flores Vizcaya-Moreno 5
1
2
3
4
5
*
and
Faculty of Nursing and Health Sciences, Nord University, 8049 Bodø, Norway
Faculty of Health and Social Care, LAB University of Applied Sciences, 53850 Lappeenranta, Finland;
susanna.tella@saimia.fi
Faculty of Science, Charles Sturt University, 2795 Bathurst, Australia; plogan@csu.edu.au
Research Centre for Child Psychiatry, Department of Child Psychiatry, Faculty of Medicine, University of
Turku, 20014 Turku, Finland; jayden.khakurel@utu.fi
Nursing Department, Faculty of Health Sciences, University of Alicante, 03080 Alicante, Spain;
flores.vizcaya@ua.es
Correspondence: mojtaba.vaismoradi@nord.no; Tel.: +47-75517813
Received: 23 February 2020; Accepted: 16 March 2020; Published: 19 March 2020






Abstract: Background: Quality-of-care improvement and prevention of practice errors is dependent
on nurses’ adherence to the principles of patient safety. Aims: This paper aims to provide a systematic
review of the international literature, to synthesise knowledge and explore factors that influence
nurses’ adherence to patient-safety principles. Methods: Electronic databases in English, Norwegian,
and Finnish languages were searched, using appropriate keywords to retrieve empirical articles
published from 2010–2019. Using the theoretical domains of the Vincent’s framework for analysing
risk and safety in clinical practice, we synthesized our findings according to ‘patient’, ‘healthcare
provider’, ‘task’, ‘work environment’, and ‘organisation and management’. Findings: Six articles were
found that focused on adherence to patient-safety principles during clinical nursing interventions.
They focused on the management of peripheral venous catheters, surgical hand rubbing instructions,
double-checking policies of medicines management, nursing handover between wards, cardiac
monitoring and surveillance, and care-associated infection precautions. Patients’ participation,
healthcare providers’ knowledge and attitudes, collaboration by nurses, appropriate equipment and
electronic systems, education and regular feedback, and standardization of the care process influenced
nurses’ adherence to patient-safety principles. Conclusions: The revelation of individual and systemic
factors has implications for nursing care practice, as both influence adherence to patient-safety
principles. More studies using qualitative and quantitative methods are required to enhance our
knowledge of measures needed to improve nurse’ adherence to patient-safety principles and their
effects on patient-safety outcomes.
Keywords: adherence; quality of care; patient-safety principles; nursing intervention; practice errors;
safe care
1. Introduction
The World Health Organization defines patient safety as the absence of preventable harm to
patients and prevention of unnecessary harm by healthcare professionals [1]. It has been reported
that unsafe care is responsible for the loss of 64 million disability-adjusted life years each year
across the globe. Patient harm during the provision of healthcare is recognized as one of the top 10
causes of disability and death in the world [2]. Regarding the financial consequence of patient harm,
a retrospective analysis of inpatient harm based on data collected from 24 hospitals in the USA showed
Int. J. Environ. Res. Public Health 2020, 17, 2028; doi:10.3390/ijerph17062028
www.mdpi.com/journal/ijerph
Int. J. Environ. Res. Public Health 2020, 17, 2028
2 of 15
that harm-reduction strategies could reduce total healthcare costs by $108 million U.S. and generate a
saving of 60,000 inpatient care days [3]. Additionally, the loss of income and productivity due to other
associated costs of patient harm are estimated to be trillions of dollars annually [4]. The burden of
practice errors on patients, their family members, and the healthcare system can be reduced through
implementing patient-safety principles based on preventive and quality-improvement strategies [5].
Patient-safety principles are scientific methods for achieving a reliable healthcare system that minimizes
the incidence rate and impact of adverse events and maximizes recovery from such incidents [6].
These principles can be categorized as risk management, infection control, medicines management,
safe environment and equipment [7], patient education and participation in own care, prevention of
pressure ulcers, nutrition improvement [8], leadership, teamwork, knowledge development through
research [9], feeling of responsibility and accountability, and reporting practice errors [10].
The nurses’ role is to preserve patient safety and prevent harm during the provision of care in
both short-term and long-term care settings [11,12]. Nurses are expected to adhere to organizational
strategies for identifying harms and risks through assessing the patient, planning for care, monitoring
and surveillance activities, double-checking, offering assistance, and communicating with other
healthcare providers [13,14]. In addition to clear policies, leadership, research driven safety initiatives,
training of healthcare staff, and patient participation [1,15], nurses’ adherence to the principles of
patient safety [16,17] is required for the success of interventions aimed at the prevention of practice
errors and to achieve sustainable and safer healthcare systems.
Background
Adherence to and compliance with guidelines and recommendations are influenced by personal
willingness, culture, economic and social conditions, and levels of knowledge [18,19]. On the other
hand, lack of adherence and compliance contravenes professional beliefs, norms, and expectations of
the healthcare professional’s role [20].
Institutional systemic factors influencing nurses’ adherence to and compliance with patient-safety
principles are as follows: the organizational patient-safety climate [21], workload, time pressure,
encouragement by leaders and colleagues [22–24], level of ward performance [25], provision of
education for the improvement of knowledge and skills [11,18], institutional procedures or protocols,
and also communication between healthcare staff and patients [11]. In addition, personal motivation,
resistance to change, feelings of autonomy, attitude toward innovation, and empowerment are personal
factors that impact on the nurses’ adherence to patient-safety principles [26].
A theoretical framework for analysing risk and safety in healthcare practice has been devised by
Vincent et al. (1998) [27] based on the Reason’s model of organizational accidents [28]. It combines
‘person-centred’ approaches, where the focus is on individual responsibility for the preservation of
patients’ safety and prevention of their harm, and the ‘system-centred’ approach, which considers
organizational factors as precursors for endangering patient safety [29]. According to this theoretical
framework, initiatives aimed at the improvement of patient safety require systematic assessments
and integrative interventions to target different elements in the hierarchy of the healthcare system,
including patient, healthcare provider, task, work environment, and organization and management.
This framework, and similar models for risk and safety management, can help with the analysis of
patient harm, to identify probable pitfalls, as well as explore how to prevent future similar incidents [30].
Adherence to the principles of patient safety and the prevention and reduction of practice errors
have been facilitated by technological solutions in recent years [31,32]; however, suboptimal quality
and safety of care remain evident, indicating the need for improved understandings of the various
factors and conditions that increase adherence in daily nursing practice [33]. Consequently, this review
aimed to retrieve, explore, and synthesise factors evident in the international literature that influenced
nurses’ adherence to patient-safety principles. Vincent’s framework was used for the classification of
findings, in order to systematically present the findings and inform clinical practice.
Int. J. Environ. Res. Public Health 2020, 17, 2028
3 of 15
2. Materials and Methods
2.1. Design
A systematic review was conducted. It is an explicit and clear method of data collection, systematic
description, and synthesis of findings, to reach the study goal [34–36]. The review findings are presented
narratively since heterogeneities in the methods, objectives, and results of studies that met the inclusion
criteria did not lend themselves to meta-analysis. The Preferred Reporting Items Systematic Reviews
and Meta-analysis (PRISMA) Statement (2009) was applied to inform this systematic review [36].
2.2. Search Methods
Search keywords were determined after team discussions, performing a pilot search in general
and specialized databases, and consultation with a librarian. Key search terms relating to adherence to
patient-safety principles by nurses were used to conduct a Boolean search. For operationalising the
study concept, the definition of adherence as a behaviour carried out actively by people according to
orders or advice was used [37]. The word adherence is used interchangeably with, and sometimes
at the same time as, the word compliance, since both can indicate the outcome of care interactions
between the healthcare provider and the caregiver [38–42]. However, adherence indicates responsibility
and empowerment on the healthcare professional’s part to actively perform the expected behaviour
compared to compliance that shows responsibility on the patient’s part to follow up the therapeutic
regimen [43,44].
The search was limited to the time period of January 2010 to August 2019, in English scientific
journals available through the following online databases: PubMed (including Medline), CINAHL,
Scopus, Web of Science, PsycINFO, ProQuest, and EBSCO. In addition, the authors performed searches
in Nordic and Finnish databases to improve the search coverage. To find relevant studies for inclusion
in the data analysis and synthesis, inclusion criteria for selection were articles with a focus on adherence
to patient-safety principles in clinical nursing interventions published in online peer-reviewed scientific
journals. Articles on patients and other healthcare providers, or on non-clinical initiatives, or that had
no exact relevance to adherence to patient-safety principles were excluded.
2.3. Search Outcome and Data Extraction
The authors (M.V., S.T., J.K., and F.V.M.) independently performed each step of the systematic
review, holding frequent online discussions and making collective agreements on how to proceed
through the review steps. Gray literature, such as unpublished dissertations and policy documents
and cross-referencing from bibliographies, were assessed, to improve the search coverage. Guidance
and support with the search process were obtained from the librarian, when needed. All authors
independently screened the titles, abstracts, and full texts of the studies retrieved during the search
process. In the cases where disagreements about the inclusion of selected studies occurred, discussions
were held until a consensus was reached.
A data extraction table was used to collect data on the characteristics of studies. The table included
the lead author’s name, publication year, country, design, sample size and setting, and information
relating to adherence to patient-safety principles. Prior to the full data extraction, this table was
pilot-tested with a few selected studies, to ensure that data relevant to the review aim and analysis
would be appropriately gathered.
2.4. Quality Appraisal
The selected articles were appraised based on the appropriateness of the research structure using
the evaluation tools provided by the Enhancing the QUAlity and Transparency of health Research
(EQUATOR) website [45] and criteria outlined by Hawker et al. (2002) [46], addressing the study aim,
research structure, theoretical/conceptual research framework, conclusion, and references. The appraisal
tool appropriate to cross-sectional, observational and cohort studies such as the Strengthening the
Int. J. Environ. Res. Public Health 2020, 17, 2028
4 of 15
Reporting of Observational Studies in Epidemiology (STROBE) was used to evaluate the suitability of
selected studies for inclusion in the final data synthesis and analysis. The researchers believed that the
quality appraisal items for determining the inclusion of a study in the final dataset did not align to a
scoring system; therefore, they used a yes/no system to answer the appraisal-tool items during the
quality appraisal and held frequent discussions on the importance and quality of each article before
making the final decision on the selection of studies for data analysis and synthesis.
2.5. Data Abstraction and Synthesis
The Vincent’s framework for analysing risk and safety in clinical practice [27,47] was used
to organize and connect the review findings to the wider theoretical perspective of patient safety.
This framework was developed based on the Reason’s organisational accident model [28]. Accordingly,
issues in patient safety originate in various systemic features at different categories of patient, healthcare
provider, task, work environment, and organisation and management [27,47]. The use of this framework
helped with the description and categorisation of data retrieved and accommodated heterogeneities in
the studies retrieved, with respect to method, samples, settings, and findings, facilitating the integrative
presentation of the review findings. The authors (M.V., S.T., P.A.L., J.K., and F.V.M.) reviewed the
included studies, to allocate the studies’ findings to each category, and used frequent discussions to
reach a consensus.
3. Results
3.1. Search Results and Study Selections
The thorough literature search using the key terms led to the retrieval of 10,855 articles.
After deleting irrelevant and duplicate titles, 382 entered the abstract-reading phase. Each abstract
was assessed by using the inclusion criteria, resulting in 84 possibly relevant articles. The full texts
were obtained from Finnish and Norwegian libraries and were carefully read to select only those
articles that had a precise focus on adherence to patient-safety principles during clinical nursing
interventions by nurses. This resulted in the final six articles chosen for data analysis. Excluded studies
were on adherence by other healthcare providers, rather than nurses, or had no exact relevance to
patient-safety principles. The methodological quality of the selected articles was assessed during the
full-text appraisal, and no article was excluded. In general, they had acceptable qualities with respect
to study research structure, theoretical and conceptual research frameworks, and relevant findings to
the review aim. Grey literature and the manual search in the reference lists of the selected studies led
to no more articles being discovered for inclusion. Appendix A presents the search results, giving the
number of articles located in each database. The Preferred Reporting Items for Systematic Reviews
and Meta-Analyses (PRISMA) flowchart is shown in Figure 1.
3.2. General Characteristics of the Selected Studies
The general characteristics of the selected studies (n = 6) are presented in Table 1. The studies
were published from 2014 to 2019 and were conducted in Australia [48], Finland [49], Norway [50],
South Korea [51], Sweden [52], and the UK [53].
Three studies used a survey design [50–52]; one study used an observational method [53];
one applied an observational intervention design [49]; and another one was a three-stage pre-post
time-series study [48]. Except for one study [49] that was published in the Finnish language, all other
articles were written in English.
Diverse foci were evident in the studies: adherence to patient-safety principles on the management
of peripheral venous catheters [52], surgical hand rubbing instructions [49], double-checking policies
of medicines’ preparation and administration [53], handover from the intensive care unit (ICU) to the
cardiac ward [48], cardiac monitoring and surveillance standards [50], and care-associated infection
precautions [51].
ron. Res. Public Health 2020, 17, x
Int. J. Environ. Res. Public Health 2020, 17, 2028
5 of 15
Figure 1. The study flow diagram according to the Preferred Reporting Items for Systematic Reviews
and Meta-Analyses (PRISMA).
ure 1. The study flow diagram according to the Preferred Reporting Items for Systematic Revie
Meta-Analyses (PRISMA).
eral Characteristics of the Selected Studies
e general characteristics of the selected studies (n = 6) are presented in Table 1. The
ublished from 2014 to 2019 and were conducted in Australia [48], Finland [49], Norw
orea [51], Sweden [52], and the UK [53].
ree studies used a survey design [50–52]; one study used an observational method [5
an observational intervention design [49]; and another one was a three-stage pre-po
udy [48]. Except for one study [49] that was published in the Finnish language, a
were written in English.
verse foci were evident in the studies: adherence to patient-safety principles
Int. J. Environ. Res. Public Health 2020, 17, 2028
6 of 15
Table 1. Characteristics of selected studies for data analysis and synthesis.
Authors, Year, Country
Aim
Förberg et al., 2014, Sweden [52]
To investigate nurses’ adherence to
the clinical practice guidelines
regarding peripheral venous
catheters and investigate their
understandings of work context
influencing it.
Rintala et al., 2014, Finland [49]
To evaluate adherence to surgical
hand rubbing directives among
operating room personnel, in public
hospitals in Southwest Finland.
Alsulami et al., 2014, UK [53]
To explore the follow-up of
double-checking policies by nurses
and assess the identity of
medication-administration errors
despite double-checking.
Method
Sample and Setting
Main Finding
Conclusion
Survey
A children’s hospital with 245 beds,
373 nurses from 23 medical and
surgical inpatient, intensive care, the
operating, anaesthetic, advanced
homecare, and outpatient wards.
The importance of the
workplace condition in
terms of information
sharing and feedback.
The need for various
strategies for improving
adherence among nurses.
Observational before-after
intervention
11 surgical settings of four hospitals,
190 and 73 nurses in the first and
second observation rounds,
respectively.
The relative impact of the
feedback intervention on
adherence by nurses.
Necessity of effective
educational methods and
role models.
Prospective observational
Medical and surgical wards, the
PICU and NICU, observation of
preparation and administration of
2000 drug doses to 876 children.
Deviations from the
policies of medication
administration.
Encouragement of
double-checking steps
during medication
administration, and
prevention of
interruptions.
Graan et al., 2016, Australia [48]
To investigate the adoption of
standardised nursing handover
guidelines from the ICU to the
cardiac ward in regard to
understanding risks to patient
safety before and after the
implementation.
Three-stage, pre–post time
series, and focus group
interviews pre-and/or
post-implementation.
A metropolitan private hospital with
a 15-bed ICU and a 46-bed cardiac
surgical ward; 20 consecutive
episodes of ICU-to-ward handover
and a further 20 post-implementation
episodes; A purposive sample of 19
senior nurse managers and clinicians.
Unsafe practice of
handover interventions
and information gap.
The need for the adoption
of standardised handover
tools for reducing
handover variabilities.
Fålun et al., 2019, Norway [50]
To study cardiovascular nurses’
knowledge of, and adherence to,
practice standards for cardiac
surveillance and their knowledge
improvements over time, in years
2011 and 2017.
Survey
363 nurses from 44 hospitals in 2011
and 38 hospitals in 2017.
Failure to fully adhere to
cardiac telemetry
monitoring standards.
Developing educational
programmes regarding
the safe practice of cardiac
monitoring.
Lim et al., 2019, South Korea [51]
To investigate nurses’ adherence to
standard precautions and its
association with their perceptions
of safe care.
Cross-sectional
329 nurses working in a teaching
hospital.
Intermediate adherence to
standard precautions.
Devising integrative
curricula to improve
nurses’ transition to
professional practice.
PICU: paediatric intensive care unit; NICU: neonatal intensive care unit; ICU: intensive care unit.
Int. J. Environ. Res. Public Health 2020, 17, 2028
Int. J. Environ. Res. Public Health 2020, 17, x FOR PEER REVIEW
7 of 15
7 of 15
3.3. Findings of Studies with Connection to the Vincent’s Framework
3.3. Findings of Studies with Connection to the Vincent’s Framework
The findings were classified based on the theoretical framework for analysing risk and safety in
The
findings
were classified
based
on the
theoretical
framework
forfactors
analysing
riskto
and
in
clinical
practice
developed
by Vincent
(1998,
2010)
[27,47] and
grouped by
related
thesafety
patient,
clinical practice
developed
by Vincent
(1998,and
2010)
[27,47] andand
grouped
by factors
related in
to the
the
healthcare
provider,
task, work
environment,
organisation
management.
Variations
patient,
healthcare
provider,
task,
work
environment,
and
organisation
and
management.
Variations
findings within the selected studies related to the type of patient-safety principles or different clinical
in the findings
within
selected and
studies
relatedoftofindings
the typeunder
of patient-safety
principles or
different
settings
facilitated
the the
description
synthesis
the above-mentioned
categories
clinical
settings
facilitated
the
description
and
synthesis
of
findings
under
the
above-mentioned
(Figure 2).
categories (Figure 2).
Figure 2.
model
of nurses’
adherence
to patient-safety
principles
based onbased
the Vincent’s
Figure
2. Schematic
Schematic
model
of nurses’
adherence
to patient-safety
principles
on the
framework.
Vincent’s
framework.
3.3.1.
3.3.1. Patient
Patient
This
This category
category was
was about
about the
the role
role of
of patients
patients and
and how
how they
they could
could impact
impact nurses’
nurses’ adherence
adherence to
to
patient-safety
For For
instance,
errors made
administration,
patient-safetyprinciples.
principles.
instance,
errorsduring
mademedicines’
during preparation
medicines’ and
preparation
and
and
a deviation from
bysafety
nursesprinciples
were reported.
The deviation
with a high
administration,
and medication
a deviationsafety
from principles
medication
by nurses
were reported.
The
possibility
of
endangering
patient
safety
happened
where
the
parents
of
patients
or
their
companions
deviation with a high possibility of endangering patient safety happened where the parents of
were
left unobserved
and unsupervised
nurses to administer
medicinesby
to patients.
patients
or their companions
were leftbyunobserved
and unsupervised
nurses toUnobserved
administer
or
unsupervised
administration
contravenes
the
medicines
management
principle,
which
a
medicines to patients. Unobserved or unsupervised administration contravenes the requires
medicines
nurse’s
direct
supervision;
a
crucial
consideration
for
the
prevention
of
abuse
and
patient
avoidance
of
management principle, which requires a nurse’s direct supervision; a crucial consideration for the
taking
medicines
as and
prescribed
Moreover,
in spite
of the emphasis
on patient
participation
in
prevention
of abuse
patient[53].
avoidance
of taking
medicines
as prescribed
[53]. Moreover,
in spite
patient-safety
activities,
nursing
handovers
were
delivered
mainly
outside
the
patient’s
room
[48],
or
no
of the emphasis on patient participation in patient-safety activities, nursing handovers were
information
was provided
patients
regarding
the purpose
and process of
cardiac
monitoring
[50].
delivered mainly
outside to
the
patient’s
room [48],
or no information
was
provided
to patients
These
deviations
could
hinder
patients’
active
involvement
in
their
own
safe
care.
Additionally,
the
only
regarding the purpose and process of cardiac monitoring [50]. These deviations could hinder
communication
between patients
and nurses
wasAdditionally,
the call bell, and
nurses
rarely questioned
patients’ active line
involvement
in their own
safe care.
the only
communication
line
patients
their
pain
or comfort.
identified
issues
represent
missed
opportunities
forpain
the
betweenabout
patients
and
nurses
was the These
call bell,
and nurses
rarely
questioned
patients
about their
nurses’
continuous
observation
role
for
early
detection
and
prevention
of
harm
during
handovers
from
or comfort. These identified issues represent missed opportunities for the nurses’ continuous
the
ICU to the
cardiac
warddetection
[48].
observation
role
for early
and prevention of harm during handovers from the ICU to the
cardiac ward [48].
3.3.2. Healthcare Provider
3.3.2.This
Healthcare
categoryProvider
described how nurses’ knowledge and attitudes were associated with their adherence
to patient-safety principles. Variations in nurses’ adherence to patient-safety principles could be
This category described how nurses’ knowledge and attitudes were associated with their
attributed to their varied levels of knowledge and attitudes. Examples included nurses’ incomplete
adherence to patient-safety principles. Variations in nurses’ adherence to patient-safety principles
adherence to infection-control principles, which encompassed the daily inspection of peripheral venous
could be attributed to their varied levels of knowledge and attitudes. Examples included nurses’
catheter sites, surgical hand rubbing, disinfection of hands, and the use of disposable gloves and
incomplete adherence to infection-control principles, which encompassed the daily inspection of
aprons when exposed to patient excretions [49,51,52]. Other examples were related to the principles of
peripheral venous catheter sites, surgical hand rubbing, disinfection of hands, and the use of
medicines’ management: inappropriate speed of intravenous bolus, incorrect medicines’ preparation,
disposable gloves and aprons when exposed to patient excretions [49,51,52]. Other examples were
administration at incorrect times, problematic labelling of flush syringes and administration of
related to the principles of medicines’ management: inappropriate speed of intravenous bolus,
intravenous antibiotics without flushing, not receiving the medicines’ complete dose by patients,
incorrect medicines’ preparation, administration at incorrect times, problematic labelling of flush
and incorrect mixing of medicines with diluent [53]. Lack of sufficient knowledge and skills regarding
syringes and administration of intravenous antibiotics without flushing, not receiving the medicines’
cardiac monitoring and surveillance standards were also evident, with incorrect placement of cardiac
complete dose by patients, and incorrect mixing of medicines with diluent [53]. Lack of sufficient
knowledge and skills regarding cardiac monitoring and surveillance standards were also evident,
Int. J. Environ. Res. Public Health 2020, 17, x; doi:
www.mdpi.com/journal/ijerph
Int. J. Environ. Res. Public Health 2020, 17, 2028
8 of 15
electrodes and/or skin preparation before the procedure leading to inconsistent monitoring, which could
endanger patient safety [50]. Interestingly, being a newly graduated nurse with less time having passed
since obtaining the nursing certificate was associated with better adherence to the peripheral venous
catheter-care principles, possibly due to having more informatics skills and updated knowledge of
nursing care and following up of rules set by senior nurses [52]. Additionally, negative attitudes
and perceptions toward the significance of care standards, individual aesthetic manicure preferences,
and the presence of eczema and skin wounds hindered adherence to the surgical hand rubbing protocol,
thus having negative implications for patient safety [49].
3.3.3. Task
In this category, the association between the identity and type of nursing task and adherence
to patient-safety principles by nurses was considered. The lowest adherence rates were evident in
‘independent’ medicine management tasks such as dose calculation, rate of administering intravenous
bolus drugs, and labelling of flush syringes. On the other hand, a higher rate of adherence was reported
for ‘cooperative’ tasks with higher levels of complexity, such as the double-checking of drugs for the
actual administration of medicine to the patient [53]. Similarly, a higher number of nurses working and
collaborating together in the ward was associated with a higher rate of adherence to infection-control
precautions, including putting sharp articles into appropriate boxes, covering both the mouth and
nose, and disinfection of hands after glove removal [51].
3.3.4. Work Environment
The effect of equipment and the workplace condition on adherence to patient-safety principles
was reported in this category. The availability of equipment and electronic resources and digitalization
increased the likelihood of adherence to patient safety principles related to medicine management [53],
peripheral venous catheter care [52], and cardiac monitoring and surveillance [50]. Accordingly,
a telemetry cover on cardiac telemetry and monitoring units helped with the prevention of nosocomial
infection by preventing contamination of shared equipment [50]. Electronic resources and digitalization
helped with reminding the daily inspection and information-sharing between nurses regarding
peripheral venous catheter insertion sites [52]. The existence of an environmental space for preparation
of medicines without interruptions helped nurses adhere more closely to double-checking instructions
of preparation and administration on weekends, as compared with weekdays [53].
3.3.5. Organisation and Management
This category focused on collaboration between nurses and the leadership role in motivating
nurses’ adherence to patient-safety principles. As an example, adherence to the surgical hand rubbing
principles, including properly drying hands after alcohol hand rubbing and washing with water and
soap, and alcohol hand rubbing up to elbows, was improved after the provision of feedback by nurse
leaders [49]. Regular practical feedback processes, interaction opportunities and observation of peers
and senior colleagues, and leadership motivated nurses’ adherence to daily inspection of the peripheral
venous catheter site and the use of disposable gloves when handling peripheral venous catheters
insertion sites [52]. Adherence to patient-safety principles by cardiac nurses was improved through
feedback provision and informing nurses in the ICU of the type of nursing interventions conducted in
cases of serious dysrhythmias and their outcomes [50].
The provision of a standard process for handover, such as the introduction of a validated handover
tool, improved nurses’ readiness to receive patients from the ICU. It informed the preparation of the
required equipment for care, enabled performance of handovers at the patient bedside, and involved
patients in their care, while also assisting with attending patients’ needs, checking patients’ identity,
and collecting data of their medical history and allergies. Further, the standardising of the handover
process helped with the continuity of care plan by formalising discussions between nurses and assisting
with removal of any ambiguities, so increasing awareness of risks to patient safety [48]. The higher
Int. J. Environ. Res. Public Health 2020, 17, 2028
9 of 15
adherence rate to standard precautions for infection control were found when there was a higher
nurse-to-patient ratio indicating the association between workload and patient-safety management [51].
Similarly, the development of a local practice standard for cardiac monitoring and surveillance, as well
as for assessing the eligibility of patients for admission to critical and non-critical telemetry sections,
would improve adherence to patient-safety principles for the cardiac patient [50].
4. Discussion
This systematic review integrated current international knowledge through the categorization
of factors affecting adherence to patient-safety principles by nurses to the elements of the Vincent’s
framework (1998 and 2010) for analysing risk and safety in clinical practice [27,47].
In this review, leaving patients’ companions unsupervised during medicines’ administration,
performing handovers outside patients’ rooms, and lack of the provision of information and appropriate
communication with patients hindered patient participation in their understandings of their own care.
Lack of engagement of patients in safe-care initiatives contravenes nurses’ adherence to patient-safety
principles. Benefiting from patients’ participation requires understanding of how to improve the
patient’s willingness to act as an active member of the healthcare team, development of practical
guidelines for such an engagement with the consideration of patients and their relatives’ knowledge
and skills of the care process, as well as definition of the role and provision of supervision and guidance
by nurses. The assigned participation task should be communicated appropriately to the patient,
have congruity with patients’ knowledge of nursing routines and their own implementation capacity,
as well as be incorporated into routine care with the consideration of infrastructures and healthcare
missions [14,54,55]. It has been suggested that planning and performing nursing care at the patient’s
bedside can improve patient participation, reduce work interruptions [56], and consequently improve
nurses’ adherence to safe care guidelines [11].
The findings of this review highlighted that nurses’ knowledge, perceptions, and attitudes
influenced their adherence to patient-safety principles. Nurses have multiple roles and central
responsibility to keep patients safe in the complex healthcare environment [57,58]. The effect of
personal and professional values and attitudes on the consistency of adherence to patient safety by
nurses has been shown to be more important than the effect of their workloads [22]. It is believed that
individual factors such as nurses’ attitudes, perceptions, knowledge, and information seeking can
facilitate or hinder the use of clinical practice guidelines by nurses and consequently endanger patient
safety [11,26] through inconsistent adherence to patient-safety principles [59].
It was evident that collaborative tasks fostered nurses’ adherence to patient-safety principles.
Improving nurses’ knowledge of tasks improves nurses’ adherence [60]. Moreover, the coordinated
management approach and collaboration with team members enhance the effectiveness of patient-safety
interventions due to the creation of a shared understanding of changes that should be made by all
healthcare staff to improve the quality of care [61,62].
With regard to the work environment, the findings of this review highlighted how equipment and
electronic systems could assist with sharing information between healthcare providers and enhance
adherence to patient-safety principles. One part of the healthcare system’s commitment to patient
safety is the preparation of appropriate work equipment [63,64]. Technology can support data security
and facilitate nursing care through the provision of real-time and ubiquitous documentation, which is
needed for professional interactions and collaboration [65]. Digital systems can reduce the time needed
to perform nursing care and limit errors in drug administration, as well as improve nurses’ and patients’
satisfaction with care [66,67].
An appropriate work environment was characterised as one where nurses were less interrupted,
and lower workloads improved adherence to patient-safety principles. An appropriate work
environment is associated with better patient safety and less burnout. Workload and burnout act
as negative mediators of safe care [68,69]. A work environment characterised by a heavy workload
and mental pressure [23,24,70] and frequent disruptions [71] has been implicated in reducing nurses’
Int. J. Environ. Res. Public Health 2020, 17, 2028
10 of 15
adherence to safety-related principles. There is an association between patient safety and the nurses’
work environment [39,72,73] and implementation of patient-safety principles to prevent errors and
adverse events [26,74].
The findings of this review emphasized the role of regular education and provision of feedback
to nurses. Taking responsibility for actions and behaviours through education and feedback is a
crucial aspect of professional practice [75]. The empowerment of nurses to intervene based on care
standards is an expectation of healthcare leaders which can be achieved through the development
of the culture of patient safety [33,76–78], the implementation of educational programs, and timely
feedback and reminders [79–81]. Further, the use of standard processes, supported by validated tools,
guided nurses and facilitated their adherence to patient-safety principles. Usability, format, easy access
of the contents of guidelines, and consideration of time, staffing, chain of communication, accuracy of
practice, supplies of equipment, and logistics are the main advantages of guidelines that facilitate the
implementation of safe care [26,82].
Limitations and Suggestions for Future Studies
In spite of the emphasis on adherence to patient-safety principles and patient-care outcomes,
this study has directly focused on nurses’ adherence to patient-safety principles, which can impact
our understandings of the variation of factors influencing this important concept. However, the wide
nature of the search in the electronic databases and in various languages convinced the researchers
that the study topic has been addressed appropriately and an answer based on the current knowledge
can be provided. However, the limited number of studies that met the inclusion criteria for this review
hinders the full exploration of the relationship between individual and systemic factors that impact on
nurses’ adherence to patient-safety principles in inpatient and outpatient settings.
5. Conclusions
This review has shown that adherence to patient-safety principles was affected by numerous
intersecting and complex factors. Variations in the studies’ aims, methods, and results hinder the
formation of a determinant conclusion on how adherence to patient-safety principles can be improved.
However, based on the review results, general indications are that improvement of nurses’ knowledge
about patient safety, collaboration in performing tasks, reduction of workloads, provision of appropriate
equipment and electronic systems for communication and sharing information, regular feedback in the
workplace, and standardization of the care processes can help with enhancing nurses’ adherence to
patient-safety principles. Future qualitative and quantitative studies are needed to better understand
how to promote and mitigate adherence to safe-care principles by clinical nurses.
Author Contributions: The authors contributed to the design and implementation of the research, to the analysis of
the results and to the writing of the manuscript as follows; M.V., S.T., J.K., F.V.-M.: Conceptualization, Data curation,
Formal analysis, Investigation, Methodology, Project administration, Resources, Software; M.V., S.T., J.K., F.V.-M.,
P.A.L.: Writing—original draft, Writing—review and editing. All authors have read and agreed to the published
version of the manuscript.
Funding: This research received no external funding.
Acknowledgments: Nord University, Bodø, Norway has supported the publication of this manuscript through
coverage of publication charges.
Conflicts of Interest: The authors have no conflicts of interest to declare.
Int. J. Environ. Res. Public Health 2020, 17, 2028
11 of 15
Appendix A
Table A1. Search strategy and results based on each database.
Database
ProQuest
CINAHL
EBSCO
PubMed [including
Medline]
PsycINFO
Scopus
Web of Science
Norwegian databases
Oria
Idunn
Norart
Helsebiblioteket.no
Cristin
Finnish database—Medic
Manual search/backtracking
references
Total of databases
Total in Each
Database
Selection Based
on Title Reading
Selection Based
on Abstract
Reading
Selection Based
on Full-Text
Reading/Appraisal
3169
4271
673
0
40
7
0
8
5
0
1
0
33
27
20
1
442
1387
856
42
203
62
6
33
11
0
2
1
4
0
0
1
4
15
0
0
0
0
0
1
0
0
0
0
0
0
0
0
1
1
0
0
0
0
10855
382
84
6
References
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
World Heath Organization (WHO). Patient Safety. 2019. Available online: https://www.who.int/patientsafety/
en/ (accessed on 24 December 2019).
Harvard Global Health Institute. Patient Safety: A Major Public Health Challenge. Available online:
https://globalhealth.harvard.edu/qualitypowerpoint (accessed on 8 March 2020).
Adler, L.; Yi, D.; Li, M.; McBroom, B.; Hauck, L.; Sammer, C.; Jones, C.; Shaw, T.; Classen, D. Impact
of Inpatient Harms on Hospital Finances and Patient Clinical Outcomes. J. Patient Saf. 2018, 14, 67–73.
[CrossRef] [PubMed]
Slawomirski, L.; Auraaen, A.; Klazinga, N.S. The Economics of Patient Safety. Available online: https://www.
oecd-ilibrary.org/social-issues-migration-health/the-economics-of-patient-safety_5a9858cd-en (accessed on
19 March 2020).
Rodziewicz, T.L.; Hipskind, J.E. Medical Error Prevention. In StatPearls; StatPearls Publishing: Treasure
Island, FL, USA, 2020.
Emanuel, L.; Berwick, D.; Conway, J.; Combes, J.; Hatlie, M.; Leape, L.; Reason, P.; Schyve, P.; Vincent, C.;
Walton, M. What Exactly is Patient Safety. In Advances in Patient Safety: New Directions and Alternative
Approaches; Agency for Healthcare Research and Quality: Rockville, MD, USA, 2008.
Sibal, A.; Uberoi, R.S.; Malani, A. An approach to improve patient safety and quality beyond accreditation.
World Hosp. Health Serv. 2016, 52, 10–12. [PubMed]
Mitchell, P. Defining Patient Safety and Quality Care. In Patient Safety and Quality: An Evidence-Based Handbook
for Nurses; Agency for Healthcare Research and Quality: Rockville, MD, USA, 2008.
Kanerva, A.; Kivinen, T.; Lammintakanen, J. Collaborating with nurse leaders to develop patient safety
practices. Leadersh Health Serv. 2017, 30, 249–262. [CrossRef] [PubMed]
Dixon-Woods, M. Why is Patient Safety so Hard? A Selective Review of Ethnographic Studies. J. Health Serv.
Res. Policy 2010, 15, 11–16. [CrossRef] [PubMed]
Lin, F.; Gillespie, B.M.; Chaboyer, W.; Li, Y.; Whitelock, K.; Morley, N.; Morrissey, S.; O’Callaghan, F.;
Marshall, A.P. Preventing surgical site infections: Facilitators and barriers to nurses’ adherence to clinical
practice guidelines—A qualitative study. J. Clin. Nurs. 2019, 28, 1643–1652. [CrossRef] [PubMed]
Sermeus, W. Understanding the role of nurses in patient safety: From evidence to policy with RN4CAST.
BMC Nurs. 2016, 15, 1.
Int. J. Environ. Res. Public Health 2020, 17, 2028
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
12 of 15
Henneman, E.A. Recognizing the Ordinary as Extraordinary: Insight into the “Way We Work” to Improve
Patient Safety Outcomes. Am. J. Crit. Care 2017, 26, 272–277. [CrossRef]
Vaismoradi, M.; Jordan, S.; Kangasniemi, M. Patient participation in patient safety and nursing input—a
systematic review. J. Clin. Nurs. 2015, 24, 627–639. [CrossRef]
International Council of Nurses (ICN). Patient Safety-ICN Position. 2019. Available online: https://www.icn.
ch/sites/default/files/inline-files/D05_Patient_Safety_0.pdf (accessed on 24 December 2019).
Rashvand, F.; Ebadi, A.; Vaismoradi, M.; Salsali, M.; Yekaninejad, M.S.; Griffiths, P.; Sieloff, C. The assessment
of safe nursing care: Development and psychometric evaluation. J. Nurs. Manag. 2017, 25, 22–36. [CrossRef]
Vaismoradi, M.; Salsali, M.; Turunen, H.; Bondas, T. A qualitative study on Iranian nurses’ experiences and
perspectives on how to provide safe care in clinical practice. J. Res. Nurs. 2013, 18, 351–365. [CrossRef]
Efstathiou, G.; Papastavrou, E.; Raftopoulos, V.; Merkouris, A. Factors influencing nurses’ compliance with
Standard Precautions in order to avoid occupational exposure to microorganisms: A focus group study.
BMC Nurs. 2011, 10, 1. [CrossRef] [PubMed]
Haynes, R.B.; Sackett, D.L.; Taylor, D.W. Compliance in Health Care; John Hopkins University Press: Baltimore,
MD, USA, 1979.
Playle, J.F.; Keeley, P. Non-compliance and professional power. J. Adv. Nurs. 1998, 27, 304–311. [CrossRef]
[PubMed]
Hessels, A.J.; Larson, E.L. Relationship between patient safety climate and standard precaution adherence:
A systematic review of the literature. J. Hosp. Infect. 2016, 92, 349–362. [CrossRef] [PubMed]
Jam, R.; Mesquida, J.; Hernández, Ó.; Sandalinas, I.; Turégano, C.; Carrillo, E.; Pedragosa, R.; Valls, J.;
Parera, A.; Ateca, B.; et al. Nursing workload and compliance with non-pharmacological measures to
prevent ventilator-associated pneumonia: A multicentre study. Nurs. Crit. Care 2018, 23, 291–298. [CrossRef]
[PubMed]
Jimmieson, N.L.; Tucker, M.K.; White, K.M.; Liao, J.; Campbell, M.; Brain, D.; Page, K.; Barnett, A.G.;
Graves, N. The role of time pressure and different psychological safety climate referents in the prediction of
nurses’ hand hygiene compliance. Saf. Sci. 2016, 82, 29–43. [CrossRef]
Zhang, S.; Kong, X.; Lamb, K.V.; Wu, Y. High nursing workload is a main associated factor of poor hand
hygiene adherence in Beijing, China: An observational study. Int. J. Nurs. Pract. 2019, 25, e12720. [CrossRef]
Schutijser, B.; Klopotowska, J.E.; Jongerden, I.; Spreeuwenberg, P.; Wagner, C.; de Bruijne, M. Nurse
compliance with a protocol for safe injectable medication administration: Comparison of two multicentre
observational studies. BMJ Open 2018, 8, e019648. [CrossRef]
Jun, J.; Kovner, C.T.; Stimpfel, A.W. Barriers and facilitators of nurses’ use of clinical practice guidelines:
An integrative review. Int. J. Nurs. Stud. 2016, 60, 54–68. [CrossRef]
Vincent, C.; Taylor-Adams, S.; Stanhope, N. Framework for analysing risk and safety in clinical medicine.
BMJ 1998, 316, 1154–1157. [CrossRef]
Reason, J. Human error: Models and management. BMJ 2000, 320, 768–770. [CrossRef]
van Beuzekom, M.; Boer, F.; Akerboom, S.; Hudson, P. Patient safety: Latent risk factors. BJA Br. J. Anaesth.
2010, 105, 52–59. [CrossRef]
Vincent, C.; Burnett, S.; Carthey, J. Safety measurement and monitoring in healthcare: A framework to
guide clinical teams and healthcare organisations in maintaining safety. BMJ Qual. Saf. 2014, 23, 670–677.
[CrossRef]
Kutney-Lee, A.; Kelly, D. The effect of hospital electronic health record adoption on nurse-assessed quality of
care and patient safety. J. Nurs. Adm. 2011, 41, 466–472. [CrossRef]
Strudwick, G.; Reisdorfer, E.; Warnock, C.; Kalia, K.; Sulkers, H.; Clark, C.; Booth, R. Factors Associated With
Barcode Medication Administration Technology That Contribute to Patient Safety: An Integrative Review.
J. Nurs. Care Qual. 2018, 33, 79–85. [CrossRef]
Hessels, A.J.; Wurmser, T. Relationship among safety culture, nursing care, and Standard Precautions
adherence. Am. J. Infect. Control 2019. [CrossRef]
Evans, D. Systematic reviews of nursing research. Intensive Crit. Care Nurs. 2001, 17, 51–57. [CrossRef]
Higgins, J.P.T.; Green, S.E. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1 [updated
March 2011]. 2011. Available online: http://handbook-5-1.cochrane.org/ (accessed on 19 March 2020).
Int. J. Environ. Res. Public Health 2020, 17, 2028
36.
37.
38.
39.
40.
41.
42.
43.
44.
45.
46.
47.
48.
49.
50.
51.
52.
53.
54.
55.
56.
57.
58.
59.
60.
13 of 15
Liberati, A.; Altman, D.G.; Tetzlaff, J.; Mulrow, C.; Gøtzsche, P.C.; Ioannidis, J.P.A.; Clarke, M.; Devereaux, P.J.;
Kleijnen, J.; Moher, D. The PRISMA statement for reporting systematic reviews and meta-analyses of studies
that evaluate healthcare interventions: Explanation and elaboration. BMJ 2009, 339, b2700. [CrossRef]
Gardner, C.L. Adherence: A concept analysis. Int. J. Nurs. Knowl. 2015, 26, 96–101. [CrossRef]
Brown, M.T.; Bussell, J.; Dutta, S.; Davis, K.; Strong, S.; Mathew, S. Medication Adherence: Truth and
Consequences. Am. J. Med. Sci. 2016, 351, 387–399. [CrossRef]
Kim, J.M.; Suarez-Cuervo, C.; Berger, Z.; Lee, J.; Gayleard, J.; Rosenberg, C.; Nagy, N.; Weeks, K.; Dy, S.
Evaluation of Patient and Family Engagement Strategies to Improve Medication Safety. Patient 2018, 11,
193–206. [CrossRef]
Lam, W.Y.; Fresco, P. Medication Adherence Measures: An Overview. Biomed. Res. Int. 2015, 2015, 217047.
[CrossRef]
Roter, D.L.; Wolff, J.; Wu, A.; Hannawa, A.F. Patient and family empowerment as agents of ambulatory care
safety and quality. BMJ Qual. Saf. 2017, 26, 508–512. [CrossRef]
Sharma, A.E.; Rivadeneira, N.A.; Barr-Walker, J.; Stern, R.J.; Johnson, A.K.; Sarkar, U. Patient Engagement in
Health Care Safety: An Overview Of Mixed-Quality Evidence. Health Aff. 2018, 37, 1813–1820. [CrossRef]
Bissonnette, J.M. Adherence: A concept analysis. J. Adv. Nurs. 2008, 63, 634–643. [CrossRef]
Kyngäs, H.; Duffy, M.E.; Kroll, T. Conceptual analysis of compliance. J. Clin. Nurs. 2000, 9, 5–12. [CrossRef]
EQUATOR Network. Enhancing the QUAlity and Transparency of health Research. 2019. Available online:
http://www.equator-network.org/ (accessed on 4 November 2019).
Hawker, S.; Payne, S.; Kerr, C.; Hardey, M.; Powell, J. Appraising the evidence: Reviewing disparate data
systematically. Qual. Health Res. 2002, 12, 1284–1299. [CrossRef]
Vincent, C. Patient Safety, 2nd ed.; Wiley-Blackwell: Oxford, UK, 2010.
Graan, S.M.; Botti, M.; Wood, B.; Redley, B. Nursing handover from ICU to cardiac ward: Standardised tools
to reduce safety risks. Aust. Crit. Care 2016, 29, 165–171. [CrossRef]
Rintala, E.; Laurikainen, E.; Kaarto, A.-M.; Routamaa, M. Adherence to surgical hand rubbing directives in a
hospital district of Southwest Finland. Suomen Lääkärilehti 2014. [CrossRef]
Fålun, N.; Oterhals, K.; Pettersen, T.; Brørs, G.; Olsen, S.S.; Norekvål, T.M.; TELMON-NOR Investigators.
Cardiovascular nurses’ adherence to practice standards in in-hospital telemetry monitoring. Nurs. Crit. Care
2020, 25, 37–44. [CrossRef]
Lim, J.-H.; Ahn, J.-W.; Son, Y.-J. Association between Hospital Nurses’ Perception of Patient Safety
Management and Standard Precaution Adherence: A Cross-Sectional Study. Int. J. Environ. Res. Public
Health 2019, 16, 4744. [CrossRef]
Förberg, U.; Wallin, L.; Johansson, E.; Ygge, B.-M.; Backheden, M.; Ehrenberg, A. Relationship between work
context and adherence to a clinical practice guideline for peripheral venous catheters among registered
nurses in pediatric care. Worldviews Evid. Based Nurs. 2014, 11, 227–239. [CrossRef]
Alsulami, Z.; Choonara, I.; Conroy, S. Paediatric nurses’ adherence to the double-checking process during
medication administration in a children’s hospital: An observational study. J. Adv. Nurs. 2014, 70, 1404–1413.
[CrossRef]
Ijkema, R.; Langelaan, M.; van de Steeg, L.; Wagner, C. Do patient characteristics influence nursing adherence
to a guideline for preventing delirium? J. Nurs. Scholarsh. 2014, 46, 147–156. [CrossRef]
Tobiano, G.; Bucknall, T.; Marshall, A.; Guinane, J.; Chaboyer, W. Nurses’ views of patient participation in
nursing care. J. Adv. Nurs. 2015, 71, 2741–2752. [CrossRef]
Malfait, S.; Eeckloo, K.; Van Biesen, W.; Van Hecke, A. The effectiveness of bedside handovers: A multilevel,
longitudinal study of effects on nurses and patients. J. Adv. Nurs. 2019, 75, 1690–1701. [CrossRef]
Cathro, H. Navigating Through Chaos: Charge Nurses and Patient Safety. J. Nurs. Adm. 2016, 46, 208–214.
[CrossRef]
Gaffney, T.A.; Hatcher, B.J.; Milligan, R. Nurses’ role in medical error recovery: An integrative review. J. Clin.
Nurs. 2016, 25, 906–917. [CrossRef]
Ribeiro, L.; Fernandes, G.C.; Souza, E.G.d.; Souto, L.C.; Santos, A.S.P.D.; Bastos, R.R. Safe surgery checklist:
Filling adherence, inconsistencies, and challenges. Rev. Col. Bras. Cir. 2019, 46, e20192311. [CrossRef]
Simons, P.A.M.; Houben, R.; Benders, J.; Pijls-Johannesma, M.; Vandijck, D.; Marneffe, W.; Backes, H.;
Groothuis, S. Does compliance to patient safety tasks improve and sustain when radiotherapy treatment
processes are standardized? Eur. J. Oncol. Nurs. 2014, 18, 459–465. [CrossRef]
Int. J. Environ. Res. Public Health 2020, 17, 2028
61.
62.
63.
64.
65.
66.
67.
68.
69.
70.
71.
72.
73.
74.
75.
76.
77.
78.
79.
80.
14 of 15
Manser, T. Teamwork and patient safety in dynamic domains of healthcare: A review of the literature.
Acta Anaesthesiol. Scand. 2009, 53, 143–151. [CrossRef]
O’Brien, B.; Graham, M.M.; Kelly, S.M. Exploring nurses’ use of the WHO safety checklist in the perioperative
setting. J. Nurs. Manag. 2017, 25, 468–476. [CrossRef]
Massey, D.; Chaboyer, W.; Anderson, V. What factors influence ward nurses’ recognition of and response to
patient deterioration? An integrative review of the literature. Nurs. Open 2016, 4, 6–23. [CrossRef]
Ross, C.; Rogers, C.; King, C. Safety culture and an invisible nursing workload. Collegian 2019, 26, 1–7.
[CrossRef]
Tunlind, A.; Granström, J.; Engström, Å. Nursing care in a high-technological environment: Experiences of
critical care nurses. Intensive Crit. Care Nurs. 2015, 31, 116–123. [CrossRef]
Lee, T.-Y.; Sun, G.-T.; Kou, L.-T.; Yeh, M.-L. The use of information technology to enhance patient safety and
nursing efficiency. Technol. Health Care 2017, 25, 917–928. [CrossRef]
Pirinen, H.; Kauhanen, L.; Danielsson-Ojala, R.; Lilius, J.; Tuominen, I.; Díaz Rodríguez, N.; Salanterä, S.
Registered Nurses’ Experiences with the Medication Administration Process. Adv. Nurs. 2015, 941589.
[CrossRef]
Liu, X.; Zheng, J.; Liu, K.; Baggs, J.G.; Liu, J.; Wu, Y.; You, L. Hospital nursing organizational factors, nursing
care left undone, and nurse burnout as predictors of patient safety: A structural equation modeling analysis.
Int. J. Nurs. Stud. 2018, 86, 82–89. [CrossRef]
Usher, K.; Woods, C.; Parmenter, G.; Hutchinson, M.; Mannix, J.; Power, T.; Chaboyer, W.; Latimer, S.; Mills, J.;
Siegloff, L.; et al. Self-reported confidence in patient safety knowledge among Australian undergraduate
nursing students: A multi-site cross-sectional survey study. Int. J. Nurs. Stud. 2017, 71, 89–96. [CrossRef]
Hall, L.H.; Johnson, J.; Watt, I.; Tsipa, A.; O’Connor, D.B. Healthcare Staff Wellbeing, Burnout, and Patient
Safety: A Systematic Review. PLoS ONE 2016, 11, e0159015. [CrossRef]
Schutijser, B.C.F.M.; Klopotowska, J.E.; Jongerden, I.P.; Spreeuwenberg, P.M.M.; De Bruijne, M.C.; Wagner, C.
Interruptions during intravenous medication administration: A multicentre observational study. J. Adv.
Nurs. 2019, 75, 555–562. [CrossRef]
Havaei, F.; MacPhee, M.; Lee, S.E. The effect of violence prevention strategies on perceptions of workplace
safety: A study of medical-surgical and mental health nurses. J. Adv. Nurs. 2019, 75, 1657–1666. [CrossRef]
Manapragada, A.; Bruk-Lee, V.; Thompson, A.H.; Heron, L.M. When safety climate is not enough: Examining
the moderating effects of psychosocial hazards on nurse safety performance. J. Adv. Nurs. 2019, 75, 1207–1218.
[CrossRef]
Kim, J.; Bates, D.W. Medication administration errors by nurses: Adherence to guidelines. J. Clin. Nurs. 2013,
22, 590–598. [CrossRef]
Aveling, E.-L.; Parker, M.; Dixon-Woods, M. What is the role of individual accountability in patient safety?
A multi-site ethnographic study. Sociol. Health Illn. 2016, 38, 216–232. [CrossRef]
DiCuccio, M.H. The Relationship Between Patient Safety Culture and Patient Outcomes: A Systematic
Review. J. Patient Saf. 2015, 11, 135–142. [CrossRef]
Gurková, E.; Zeleníková, R.; Friganovic, A.; Uchmanowicz, I.; Jarošová, D.; Papastavrou, E.; Žiaková, K.
Hospital safety climate from nurses’ perspective in four European countries. Int. Nurs. Rev. 2019. [CrossRef]
Hessels, A.J.; Genovese-Schek, V.; Agarwal, M.; Wurmser, T.; Larson, E.L. Relationship between patient
safety climate and adherence to standard precautions. Am. J. Infect. Control 2016, 44, 1128–1132. [CrossRef]
Doronina, O.; Jones, D.; Martello, M.; Biron, A.; Lavoie-Tremblay, M. A Systematic Review on the Effectiveness
of Interventions to Improve Hand Hygiene Compliance of Nurses in the Hospital Setting. J. Nurs. Scholarsh.
2017, 49, 143–152. [CrossRef]
Martos-Cabrera, M.B.; Mota-Romero, E.; Martos-García, R.; Gómez-Urquiza, J.L.; Suleiman-Martos, N.;
Albendín-García, L.; Cañadas-De la Fuente, G.A. Hand Hygiene Teaching Strategies among Nursing Staff:
A Systematic Review. Int. J. Environ. Res. Public Health 2019, 16, 3039. [CrossRef]
Int. J. Environ. Res. Public Health 2020, 17, 2028
81.
82.
15 of 15
Shimoni, Z.; Kama, N.; Mamet, Y.; Glick, J.; Dusseldorp, N.; Froom, P. Empowering surgical nurses improves
compliance rates for antibiotic prophylaxis after caesarean birth. J. Adv. Nurs. 2009, 65, 2345–2349. [CrossRef]
Leotsakos, A.; Zheng, H.; Croteau, R.; Loeb, J.M.; Sherman, H.; Hoffman, C.; Morganstein, L.; O’Leary, D.;
Bruneau, C.; Lee, P.; et al. Standardization in patient safety: The WHO High 5s project. Int. J. Qual.
Health Care 2014, 26, 109–116. [CrossRef]
© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access
article distributed under the terms and conditions of the Creative Commons Attribution
(CC BY) license (http://creativecommons.org/licenses/by/4.0/).