Effects of Nurses' Perceptions of Patient Safety Rules and Procedures on Their Patient Safety Performance: The Mediating Roles of Communication about Errors and Coworker Support.

Aim: This study aimed to (a) examine the relationship between staff nurses' perceptions of patient safety rules and procedures and their patient safety performance and (b) investigate potential mediators of this relationship. Background: Implementation of effective management interventions to improve patient safety requires knowledge of the extent to which nurses' perceptions of a hospital's rules and procedures regarding patient safety affect their patient safety performance. Methods: This correlational study involved a secondary analysis of cross-sectional survey data collected from 1,053 staff nurses in South Korea. Structural equation modeling was employed to test the proposed mediation model. Five standardized measures were used to assess key study variables: patient safety compliance, patient safety participation, nurses' perceptions of patient safety rules and procedures, communication about errors, and coworker support. Cronbach's alpha values for the scales ranged from 0.82 to 0.90. Results: Nurses' perceptions regarding the usefulness and effectiveness of rules and procedures about patient safety were positively related to their patient safety performance, measured in terms of safety compliance and participation behaviors. Communication about errors and coworker support showed significant mediating effects on these relationships. Conclusions: The findings indicate that the implementation of effective and useful rules and procedures for improving patient safety would facilitate error communication and coworker support, enhancing nurses' patient safety performance.