EXPLORATION OF THE INFLUENCE OF REGISTERED NURSE AND NURSING ASSISTANT RELATIONAL QUALITY ON PATIENT SAFETY CULTURE
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Date
2020-06-22
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Authors
Campbell, Amy Richmond
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Publisher
East Carolina University
Abstract
This study used a framework derived from the Systems Engineering Initiative for Patient Safety to provide insight into how Registered Nurses (RNs) and Nursing Assistants (NAs) perceive relational quality in acute care systems. The study also explored the supervisor/manager's influence on this relationship and how all of these factors correlate with the professional outcomes of teamwork and communication as well as the organizational outcomes of overall perceptions of patient safety and patient safety grade of the unit. The primary delivery of nursing care within acute care systems uses teams of RNs and NAs. Evidence posits that good relational quality, the effective interpersonal exchange between the RN and NA, is one avenue for improving patient safety culture and patient safety outcomes. Role clarity, differences in mental models, and the inability of the RN to successfully lead the NA create barriers to teamwork and communication; thus, compromising the quality of the interpersonal relationship and potentially placing patient safety outcomes at risk. In addition, few studies have been done to evaluate the quality of the RN and NA relationship and how perceptions of RN and NA relational quality (RQ) are correlated with supervisor/manager influence on safety and overall patient safety culture. A cross sectional secondary analysis was used to examine relational quality among fulltime RNs and NAs engaging in clinical practice in an acute system. To meet the objectives of this study, data analysis was conducted using data collected from the completed Agency for Healthcare and Quality (AHRQ) Hospital Survey of Patient Safety Culture (HSOPSC) and seven questions the investigator posed to measure relational quality. In the past, research has focused on the RN and Physician and hierarchical barriers. There has been little attention given to the manager's influence on the RN-NA relational quality. This study provided insight into the relational quality of RN and NA exchanges and how the quality was associated with professional and organizational levels of patient safety. This study was the first to look at the nature of the RN and NA person-to person interaction and how this interaction can be used to achieve a positive patient safety-culture.