Occupational stress and cognitive failure of nurses and associations with self‐reported adverse events: A national cross‐sectional survey

Aim To determine correlations for nurse self‐reported occupational stress, prevalence of cognitive failure (CF), and adverse events. Design Cross‐sectional nationwide survey. Methods Tertiary‐level public hospitals (N = 115) from 13 provinces in Iran were recruited and 2,895 nurses surveyed (August 2016–December 2017). Participants’ self‐reported demographic information, occupational stress, CF, and frequency of adverse events were analysed using chi‐square, t tests, and binary logistic regression. Results This study showed that 29.1% of nurses had experienced adverse events in the past six months. Significant predictors for reported adverse events from logistic regression were ‘Role stressors’, ‘Interpersonal relations stressors’, and ‘Action’, while ‘Working environment stressors’ was protective for reported adverse events. Demographic predictors of adverse events were longer work hours and male gender, while those working in critical care units, general wards, and other wards had higher reported adverse events than for emergency wards. Conclusions Occupational stress and CF are associated with the reporting of adverse events. Further research is needed to assess interventions to address occupational stress and CF to reduce adverse events. Impact Adverse events compromise patient safety, lead to increased healthcare costs, and impact nursing staff. Higher self‐reported adverse events were associated with higher reported stressors and CF. Understanding the factors that influence occupational stress, CF, and adverse events will support quality patient care and safety. 目的 为确认护士自我报告的职业压力、认知障碍患病率以及不良事件之间的关系。 设计 全国性的横断面调查 方法 我们招募了来自伊朗13个省的三级公立医院(N = 115),并对2895名护士进行了调查(2016年8月至2017年12月)。我们使用了卡方检验、t检验以及二元逻辑回归对参与者自我报告人口统计信息、职业压力、认知障碍以及不良事件发生频率进行分析。 结果 本研究表明,在过去六个月中,有29.1%的护士经历过不良事件。根据逻辑回归分析,已报告不良事件的显著预测变量为“角色压力源”、“人际关系压力源”以及“行动”,而“工作环境压力源”对报告不良事件起到了保护作用。不良事件的人口统计学预测变量为更长时间的工作和男性,而在重症监护病房、普通病房和其他病房中工作的护士所报告的不良事件要多于急诊病房。 结论 职业压力以及认知障碍与不良事件的报告有关。需要进一步的研究以评估应对职业压力和认知障碍以减少不良事件的干预措施。 影响 不良事件危及患者安全,导致医疗费用增加,并对医护人员产生影响。更高级别的自我报告不良事件与较高的报告压力源和认知障碍有关。了解职业压力、认知障碍和不良事件的影响因素有助于提高对患者的护理质量和安全。