ارتباط مراقبت پرستاري ايمن با كيفيت زندگي كاري پرستاران

The Correlation of Safe Nursing Care with the Quality of Work Life of Nurses

زمينه و هدف: پيشگيري از آسيب به بيمار، ابتدايي‌ترين هدف در ارائه‌ي خدمات بهداشتي- درماني است. مراقبت ايمن و كيفيت زندگي‌كاري، موضوعات مهمي هستند و مورد توجه بسيار قرار دارند و در بعضي از پژوهش‌ها به‌صورت جداگانه بررسي شده‌اند؛ ولي، راه بسياري براي شناخت كامل و بهبود آن وجود دارد. اين مطالعه، با هدف تعيين ارتباط مراقبت پرستاري ايمن و كيفيت زندگي‌كاري پرستاران بيمارستان‌هاي دولتي شهر رشت در سال 1399 انجام شد. روش بررسي: اين پژوهش، به‌صورت مقطعي، از نوع توصيفي– همبستگي انجام شد و ارتباط بين دو متغيّر مراقبت پرستاري ايمن و كيفيت زندگي‌كاري 250 نفر از پرستاران شاغل در بيمارستان‌هاي دولتي شهر رشت، سنجيده شد. روش نمونه‌گيري طبقه‌اي و تخصيص نسبتي و با استفاده از پرسشنامه‌هاي اطلاعات جمعيت شناختي، كيفيت زندگي‌كاري پرستاران (تكميل توسط پرستاران مورد پژوهش) و مراقبت پرستاري ايمن (تكميل توسط سرپرستاران)، تكميل گرديد. براي تحليل داده‌ها، از آمار توصيفي (فراواني مطلق و نسبي، ميانگين و انحراف معيار) و آمار استنباطي (t مستقل، آناليز واريانس و ضريب همبستگي پيرسون)، استفاده شد. داده‌ها، توسط نرم‌افزار كامپيوتري SPSS، نسخه 16 تحليل شد و سطح معني‌داري، كمتر از 05/0 در نظر گرفته شد. يافته‌ها: كيفيت زندگي‌كاري بيشتر (8/78%) پرستاران مورد پژوهش، در سطح متوسط بود و در بُعد زمينه‌ي كاري، بالاترين و در بُعد جهاني كار، پايين‌ترين ميانگين نمره را داشتند. مراقبت پرستاري ايمن بيشتر پرستاران مورد پژوهش (44/94%( ، در سطح خوب بود و در بُعد مشاركت پرستاران، بيشتر و در بُعد انجام مهارت‌هاي پرستاري كمتر از ساير ابعاد بود. مراقبت پرستاري ايمن، با كيفيت زندگي‌كاري و هيچ‌كدام از ابعاد آن‌ها، همبستگي معني‌دار آماري نداشتند. اما مراقبت پرستاري ايمن با جنسيت، تأهل، وضعيت استخدامي، سن و سابقه كار ارتباط معني‌دار آماري (001/0

Background & Aims: One of the primary goals of health service provision is to prevent patient harm and maintain patient safety. Patient safety is defined as minimizing the risk of unnecessary injuries compared to other treatments or lack of treatment. Safe nursing care has four dimensions of nursing skills, providing physical safety, providing mental safety, and nurses' cooperation with other members. The provision of safe care depends on the quality and efficiency of nursing services. The efficiency of nurses depends on the measures taken to preserve the body and mind of nurses and the improvement of the quality of their work life. Quality of work life emphasizes personal consequences and professional improvement to meet one's needs in the four dimensions of personal life, work framework, work context, and global dimension of work. Safe care and quality of work life are important issues, and their dimensions have been assessed and identified separately in some studies, while they could be fully recognized and promoted through more approaches. The present study aimed to assess the correlation of safe nursing care and the quality of work life of nurses in the public hospitals of Rasht, Iran in 2020. Materials & Methods: This cross-sectional, descriptive-correlational study was conducted to assess the correlation between safe nursing care and quality of work life in eight public hospitals in Rasht. The participants included 250 nurses who were selected via stratified sampling based on the ratio of the total number of the nurses in the public hospitals of Rasht and each hospital department accessibly. Data were collected using a demographic questionnaire, Brooks' quality of work life (QWL) for nurses (2005), and Rashvand safe nursing care questionnaire (2017). Brooks' QWL questionnaire has four dimensions regarding the quality of work life of nurses with 42 items, including personal life (seven items), work framework (10 items), work field (20 items), global work dimension (five items). Each items was assigned a score within the range of 1-6 (Strongly Disagree=1, Strongly Agree=6) within the score range of 42-252. The reliability coefficient of this questionnaire has been confirmed at the Cronbach's alpha of 0.91. Rashvand safe nursing care questionnaire had 33 items in the four dimensions of nursing skills (16 items), mental safety (four items), physical safety (seven items), team work (five items), and one general question. The demographic and QWL questionnaires were completed by the nurses, and the safe nursing care questionnaire was completed by the nursing supervisor. Sampling was performed during September 22-October 20, 2020, and each questionnaire was completed within 20-30 minutes. The inclusion criterion was employment in a public hospital in Rasht, and the exclusion criteria were incomplete questionnaires and not returning the questionnaires. After the sampling process, 250 questionnaires were collected. Data analysis was performed in SPSS version 16 using descriptive statistics (absolute and relative frequency, mean, and standard deviation) and inferential statistics (independent t-test, analysis of variance, and Pearson's correlation-coefficient), and the significance level was considered <0.05. Results: The quality of work life of the majority of the nurses (78.8%) was moderate. The highest and lowest mean scores were obtained in the work field dimension (58.37 ± 15.74) and the global work dimension (41.92 ± 18), respectively. In the majority of the studied nurses (94.4%), the level of safe nursing care was favorable and higher, while their cooperation level with the other healthcare team members was lower comparatively. Safe nursing care had no significant correlation with the quality of work life and none of its dimensions. In addition, none of the demographic variables were significantly correlated with the quality of work life of the studied nurses. However, safe nursing care had significant correlations with gender, marital status, employment status, age, and work experience (P>0.001). Conclusion: Despite the moderate quality of work life, safe nursing care was considered favorable. However, no significant correlations were observed between safe nursing care, the quality of working life, and its dimensions. This finding could be due to the prevailing professional rules and beliefs in the nursing profession, which maintains safe care despite the limitations in the factors associated with the quality of work life. Although safe nursing care was favorable, the constantly increasing need for promoting the quality of care and the competition of care service organizations to attract more clients, safe nursing care must be enhanced continuously. According to the findings, the dimension of clinical skills was rather poor in terms of safe nursing care, which requires skills retraining and further monitoring in this regard. Since the global quality of work life mainly concerns nurses, chief executives must pay special attention to the salaries and wages of these individuals, as well as their job security and presenting a correct image of nursing to the society.