Job autonomy, perceptions of organizational policy, and the safety performance of nurses

Aims This study aimed to identify the relationship between nurses' job autonomy, perceptions of organizational policy, and safety performance by identifying the safety performance predictors of nurses working in acute health care settings in South Korea. Methods Using data from a structured questionnaire, this cross‐sectional descriptive study assessed the relationship between nurses' job autonomy, perceptions of organizational policy, and safety performance. In 2016, of the 290 nurses from nine acute care hospitals in South Korea invited to participate in the survey, 254 successfully did. Using cross‐sectional data, characteristics of hospitals and nurses were analysed with t tests, one‐way analyses of variance, Pearson correlations, and regression models. Results On a scale of one to five, the mean job autonomy was 3.37, mean perceptions of organizational policy was 3.09, and mean safety performance was 3.75. Statistically significant positive correlations were found among job autonomy, perceptions of organizational policy, and safety performance. Multiple regression results found 44% of the variation in safety performance explained by job autonomy, length of employment, and perceptions of organizational policy. Conclusion Job autonomy and perceptions of organizational policy were positively related to safety performance. Hospital executives and nurse managers should work to enhance job autonomy and positive perceptions of organizational policy, to contribute to improving patient safety. SUMMARY STATEMENT What is already known about this topic? Nurses' role in patient safety is important, and factors that influence patient outcomes include organizational factors, team culture, and nurses' characteristics. Restricted job autonomy of nurses can lead to emotional exhaustion and aversion to patients. When nurses' participation in clinical decision making is limited, this can reduce the effectiveness of care and harm patient outcomes. What this paper adds? Study results indicate a need to improve nurses' job autonomy. It highlights the importance of nurses' positive perceptions of organizational policies regarding safety performance. Job autonomy is a concept acquired in a particular work environment, regardless of the size of the hospital. The implications of this paper: Hospital executives and nurse managers should be actively involved in improving nurses' job autonomy, nurses' participation in decision making, and shared governance. These efforts might bro