Influence of Critical Thinking Disposition, Clinical Reasoning Competence, and Nursing Practice Environment on Medication Safety Competence of Hospital Nurses

批判性思维倾向、临床推理能力和护理实践环境对医院护士用药安全能力的影响

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Abstract

OBJECTIVES: This study examined the impact of nurses' critical thinking disposition, clinical reasoning competency, and nursing practice environment on their medication safety competency. METHODS: A cross-sectional design was employed, involving a convenience sample of 210 nurses from four tertiary general hospitals and two general hospitals. Data were collected in September 2023 utilizing structured online self-report questionnaires and analyzed utilizing descriptive statistics, independent t-tests, one-way analysis of variance, Pearson's correlation coefficients, and stepwise multiple regression with SPSS/WIN 28.0 software. RESULTS: Significant positive relationships (p < 0.001) were found between nurses' medication safety competence and critical thinking disposition (r = 0.47), clinical reasoning competence (r = 0.67), and nursing practice environment (r = 0.40). Factors influencing medication safety competence were identified as clinical reasoning competence (β = 0.55, p < 0.001), nursing practice environment (β = 0.30, p < 0.001), and critical thinking disposition (β = 0.19, p < 0.001). The regression model accounted for 57% of the variance in medication safety competence and was statistically significant (F = 91.70, p < 0.001). CONCLUSIONS: These findings highlight key factors influencing medication safety competence of nurses and underscore the need for targeted strategies to enhance patient safety by optimizing critical thinking, clinical reasoning, and the nursing practice environment in healthcare settings.

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