A qualitative study exploring nurses' communication about patient safety

Abstract

[ACCESS RESTRICTED TO THE UNIVERSITY OF MISSOURI AT AUTHOR'S REQUEST.] There is a growing body of evidence suggesting that an increased number of bachelor's prepared nurses at the bedside improves patient safety and outcomes. However, these studies do not stratify their sample into four-year BSNs and ADN to BSN graduates. There must be underlying reasons why the BSN degree as an entirety (BSN, accelerated BSN, and ADN to BSN completion) improves patient care and outcomes, but a gap in the literature remains. To begin to address this gap, a qualitative study was conducted to investigate potential differences in patient safety meaning among differently educated nurses, specifically BSNs and ADN to BSNs graduates and to better understand how/if the advanced BSN education for ADNs enhanced their understanding of patient safety. Guided by the theory of Language Convergence/Meaning Divergence, interview data from 8 BSN and 8 ADN to BSN graduates were analyzed. Findings indicate there are two meaning levels, including understanding the meaning of patient safety at the local level as well as at the systemic level. The local level was where the meaning of patient safety is focused at the patient's bedside is regulated by the nurse. The systemic level encompasses the local level, but also includes the notion that health system factors such as policies and staffing are paramount to keeping patients safe. More frequently, ADN to BSN graduates' meaning of patient safety was at the local level, while BSNs' meaning centered at the systemic level. In addition, ADN to BSN graduates were asked to discuss components of their degree programs that they perceived to influence their ability to keep patients safe. The graduates pursued their degrees for career advancement purposes, and did not correlate the advanced degree with their ability to keep patients safe. Additional research is needed to further explore patient safety meaning differences among differently educated nurses and the potential impact those differences might have on patient care and outcomes.