Emergency department nurses' reflective thinking and patient safety competency: The mediating effect of patient safety culture

Aim: This study aimed to identify the mediating effect of patient safety culture on the relationship between reflective thinking and patient safety competency in emergency department nurses. Background: Given the complexity and the need for timely assessments and interventions in the emergency department, the patient safety competency of nurses is crucial for preventing safety incidents. Methods: This study utilized a cross-sectional descriptive correlational design with a convenience sample of 200 emergency department nurses. Participants completed a web-based, self-administered questionnaire that assessed reflective thinking, patient safety culture, and patient safety competency. The percentile bootstrap method for mediation analysis was performed to ascertain the mediating role of patient safety culture in the relationship between reflective thinking and patient safety competency. Results: Both reflective thinking and patient safety culture were significant predictors of patient safety competency. Furthermore, patient safety culture was found to mediate the relationship between reflective thinking and patient safety competency among emergency department nurses. Conclusions: The findings suggest that emergency department nurses could benefit from a competency enhancement program or quality improvement projects that focus on reflective thinking and patient safety culture, which are significant predictors of patient safety competency.