A systematic integrative review of specialized nurses' role to establish a culture of patient safety: A modelling perspective

Abstract

Aims: To understand specialized nurses' role in the culture of patient safety and their ability to promote and enforce it within healthcare. Design: A systematic integrative review using the approach of Whittemore and Knafl. Methods: Systematic literature search for qualitative, quantitative and mixed-methods studies, followed by data evaluation, quality assessment, analysis and research synthesis with a narrative perspective. Findings were contextualized within a ‘framework for understanding the development of patient safety culture’. Data Sources: Searches were conducted in PubMed [including MEDLINE], Scopus, CINAHL, Web of Science and EMBASE from Jan 2013 until Sep 2023. Results: Sixteen studies published in English from six different countries were selected and used for research synthesis. Diverse enabling factors and enacting behaviours influencing specialized nurses' roles to promote patient safety culture were identified, mainly focusing on nurses' workload, professional experiences and organizational commitment. Patient safety outcomes focused on medication management, infection prevention, surveillance process in critical care, oversight on quality and safety of nurses' practice, patient care management, continuity of care, adherence to the treatment plan and implementation of a specialized therapeutic procedure. Conclusion: Specialized nurses can make a significant contribution to promote patient safety culture and support organizational initiatives to prevent adverse events. Implications for the Profession and/or Patient Care: Stronger participation and leadership of specialized nurses in initiatives to improve patient safety culture requires appropriate investments and support by policy makers and managers in terms of resources and training. Impact: There is a gap in existing literature on the contribution that specialized nurses can make in promoting patient safety culture. Review results highlight the importance of interprofessional collaboration and teamwork by involving specialized nurses. They inform healthcare policy makers about recognizing their roles and competencies in patient safety culture. Preferred reporting items for systematic reviews and meta-analysis. No patient or public contribution.