Factors Associated With Medication Safety Competence Among Clinical Nurses in China: A Latent Profile Analysis.

Ping Zhang, Genzhen Yu, Rong Xu, Shuai Cao, Lin Mo, Yang Liu, Yujie Wu
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Abstract

Background: Nurses can promote medication safety. However, the main factors affecting their ability to do so are uncertain.

Purpose: In this study, a person-centered approach was employed to analyze the latent profiles of medication safety competence in clinical nurses in China and to identify the significant influencing factors.

Methods: A multicenter cross-sectional online survey was conducted. From January 17 to February 18, 2024, 1,228 nurses (mean age=33.52, SD =7.55; 97.20% female) were recruited from several hospitals in the Chinese provinces of Hubei, Chongqing, and Guangzhou and enrolled as participants. The Critical Thinking Diagnostic Scale and Medication Safety Competence Scale were used in collecting study data. Mplus 8.3 software was adopted for the latent profile analysis to clarify the medication safety competence subgroups. SPSS 24.0 software was employed to perform the analysis of variance (ANOVA), Pearson's Chi-square analysis, and logistic regression analysis to examine the factors associated with medication safety competence.

Results: Four profiles were derived from the latent profile analysis: Profile 1 (low medication safety competence; 9%), Profile 2 (medium low medication safety competence; 8%), Profile 3 (medium high medication safety competence; 40%), and Profile 4 (high medication safety competence; 44%). The total critical thinking score was identified as a positive predictor of profile affiliation. The results of the regression analysis found that, compared with Profile 4, being a junior nurse ( OR =2.341, 95% CI [1.005, 5.450]), having no self-perceived nursing achievement ( OR =6.205, 95% CI [2.084, 18.473]), and occasionally having self-perceived nursing achievement ( OR =7.495, 95% CI [3.419, 16.430]) increased the likelihood of being in Profile 1; that having no history of medication error ( OR =0.408, 95% CI [.177, .938]) decreased the likelihood of being in Profile 1; that having 11-15 years of work experience ( OR =2.239, 95% CI [1.166, 4.299]) and occasionally having self-perceived nursing achievement ( OR =3.102, 95% CI [1.074, 8.953]) increased the likelihood of being in Profile 3; and that being a supervisor nurse ( OR =0.404, 95% CI [.242, .728]) decreased the likelihood of being in Profile 3.

Conclusions: Based on the results, the medication safety competence of nurses in China may be divided into four subgroups. Having a higher critical thinking score, a professional title (supervisor nurse or above), self-perceived nursing achievement (often/always), and no history of medication error all increase the likelihood of being in Profile 4. The findings provide a reference for nursing managers when formulating continuing education to promote medication safety competence. The factors associated with the various profiles identified in this study may facilitate the development of better-tailored intervention strategies.

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中国临床护士用药安全能力相关因素:一项潜在特征分析。
背景:护士可以促进用药安全。然而,影响他们这样做的能力的主要因素是不确定的。目的:本研究采用以人为本的方法,分析中国临床护士用药安全能力的潜在特征,并找出其显著影响因素。方法:采用多中心横断面在线调查方法。于2024年1月17日至2月18日,从中国湖北、重庆和广州三省的多家医院招募1228名护士(平均年龄33.52岁,SD=7.55,女性占97.20%)作为研究对象。采用批判性思维诊断量表和用药安全能力量表收集研究资料。采用Mplus 8.3软件进行潜在特征分析,明确用药安全能力亚群。采用SPSS 24.0统计软件进行方差分析(ANOVA)、皮尔逊卡方分析(Pearson’s Chi-square)和logistic回归分析,对影响用药安全能力的因素进行检验。结果:从潜在特征分析中得出4个特征:特征1(低用药安全能力;9%)、特征2(中低用药安全能力;8%)、特征3(中高用药安全能力;40%)和特征4(高用药安全能力;44%)。总批判性思维得分被确定为档案隶属关系的积极预测因子。回归分析结果发现,与档案4相比,初级护士(OR=2.341, 95% CI[1.005, 5.450])、无自我感知护理成就(OR=6.205, 95% CI[2.084, 18.473])和偶尔有自我感知护理成就(OR=7.495, 95% CI[3.419, 16.430])增加了进入档案1的可能性;无用药错误史(OR=0.408, 95% CI)。177年,。[38])降低了出现在档案1中的可能性;拥有11-15年的工作经验(OR=2.239, 95% CI[1.166, 4.299])和偶尔有自我感知的护理成就(OR=3.102, 95% CI[1.074, 8.953])增加了进入档案3的可能性;作为主管护士(OR=0.404, 95% CI[。242年,。[728])降低了出现在档案3中的可能性。结论:根据研究结果,中国护士用药安全能力可分为4个亚组。具有较高的批判性思维得分、专业职称(主管护士或以上)、自我感知的护理成就(经常/总是)和无用药错误史都增加了出现特征4的可能性。研究结果可为护理管理者制定继续教育以提升患者用药安全能力提供参考。与本研究中确定的各种概况相关的因素可能有助于制定更有针对性的干预策略。
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