RESUMO
AIMS AND OBJECTIVES: To explore the cross-level effects of the four dimensions of patient safety climate on nursing innovation. BACKGROUND: Across the globe, nursing innovation is highly encouraged by nursing experts to improve nursing outcome. Nursing innovation, in turn, is affected by organisational climate, and a critical aspect of organisational climate is patient safety. DESIGN: This is a cross-sectional study. METHODS: We employed a questionnaire survey to collect data and selected nurses from Taiwan hospitals as samples. A total of 808 valid questionnaires in 172 teams of four hospitals were collected. Patient safety climate was aggregated by individual-level data; thus, we examined r(wg) , ICC 1 and ICC 2. Hierarchical linear modelling was used to analyse the data. RESULTS: Of these three dimensions of nursing innovation, the level of knowledge creation was perceived by the nurses as the highest. In terms of patient safety climate, managerial practices regarding patient safety scored the highest, followed by patient safety procedures, patient safety information flow and patient safety priority. Only patient safety information flow yielded a significant positive influence on knowledge creation, innovation behaviour or innovation diffusion. CONCLUSION: Hospital nurses do achieve better performance in knowledge creation. Patient safety information flow has positive and cross-level impact on nursing innovation; therefore, the method to increase safety information flow is the key focus of nursing innovation management. RELEVANCE TO CLINICAL PRACTICE: Through the improvements made in patient safety climate, hospital managers could promote the development of nursing innovation. Patient safety information flow is positively associated with nursing innovation. Patient safety information could be integrated in nursing training in all levels. Rules and procedures regarding patient safety should be drafted in simple and clear terms. A procedure to review and revise the rules and procedures will also be helpful in improving patient safety information flow.
