۱- INTRODUCTION

۲- METHOD

۳- RESULTS

۴- DISCUSSION

۵- STRENGTHS AND LIMITATIONS

۶- CONCLUSION AND RECOMMENDATIONS

۷- IMPLIC ATIONS FOR NURSING MANAGEMENT

REFERENCES

Abstract

Aim: This study explores the impact of total quality management on patient‐safety‐ culture attitudes among clinical nurses, focusing on the correlations between total quality management, work values, employee satisfaction, and patient‐safety‐culture attitudes.
Background: Implementing total quality management can improve nurses’ attitudes towards patient‐safety culture.
Method: This hospital‐based, cross‐sectional survey used a convenience sample of 30 inpatient units and 12 intensive care units at five Taiwanese regional teaching hospitals with over 500 beds. Seven hundred questionnaires were distributed (140 to each hospital) during 25 June–۵ July 2015. Data were collected using an anonymous, self‐administered, and structured questionnaire. The model was tested using struc‐ tural equation modelling and serial mediation analysis.
Results: Of 515 completed questionnaires (73.6% response rate), 23 were invalid and 492 were used (70.3% retrieved rate). The total effect of total quality management on patient‐safety‐culture attitudes was significant via work values, which had a direct influence on patient‐safety‐culture attitude. Total quality management affected em‐ ployee satisfaction, which directly influenced patient‐safety‐culture attitudes.
Conclusion: Total quality management creates a beneficial working environment and improves patient‐safety culture. Total quality management, work values, and em‐ ployee satisfaction orientation are important predictors of nurses’ attitudes toward patient‐safety‐culture attitudes.
Implications for nursing management: Health care managers should cultivate nurs‐ ing performance to achieve continuous quality improvement in nursing care.

INTRODUCTION

The issues of primary medical negligence, medication safety, and personnel education and training are critical for health care insti‐ tutions in Taiwan and worldwide (Chen, Chang, & Pan, 2009). Total quality management (TQM) is a concept used by organisations to maintain a competitive advantage and to ensure overall effective performance (Chang, Chiu, & Chen, 2010; Nasser, Yusoff, & Islam, 2013). Several studies have reported that total quality management has a positive effect on hospital performance, showing that accred‐ ited hospitals are more likely than unaccredited hospitals to engage in total quality management practices (Alaraki, 2014). Total quality management is characterized by the design and implementation of organisation‐wide quality improvement programmes centred on core principles of customer focus, employee participation, reduced variability, and the continuous improvement of systems and pro‐ cesses (Rennie et al., 2007). Total quality management can simply be defined as an element of overall management, required of every organisational employee engaged in the daily management of an organisation. Total quality management can help an organisation to achieve its quality goals and satisfy customer demand by enhancing company performance (Lam, Lee, Ooi, & Lin, 2011). Adjusting a hos‐ pital’s existing training system and workflow can enhance the men‐ tal health and job satisfaction of nurses (Gountas, Gountas, Soutar, & Mavondo, 2014). Although some organisations within the health care industry do not have total quality management programmes, the TQM concept is an important tool for assessing health care pro‐ viders in health care settings.