How do nurses and midwives perceive their preparedness for quality improvement and patient safety in practice? A cross-sectional national study in Ireland

Background: Although patient safety and quality are cornerstones of healthcare practice, evidence is limited of the knowledge, skills and competence of practicing nurses and midwives in Ireland. Objectives: To investigate the perceptions of nurses and midwives regarding their continuing professional development-based preparedness for, and participation in quality and safety in the clinical setting. Design: A cross-sectional survey was undertaken across the Republic of Ireland in 2016 examining nurses and midwives' perceptions of their knowledge and skills in quality and safety methods and tools, their views of competence in this field using the domains from the Quality and Safety Education for Nurses (QSEN) framework (person-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics), and their participation in practice related to their access to quality and safety data. Settings: 12 Health Service Executive (HSE) Centers of Nursing and Midwifery Education (CNMEs) in Ireland Participants: Practicing nurses and midwives (n = 654) working in acute hospitals and community healthcare organizations who were undertaking continuing professional development (CPD) education at the time of data collection (March April 2016). Methods: Survey methodology. 1787 surveys were distributed. Data were analyzed by IBM Statistical Package for the Social Sciences. Results: A response rate of 37% (n = 654/1787) was achieved. While respondents were highly trained academically, many reported a lack of confidence in quality and safety methods and tools and QSEN competencies. Frontline staff nurses and midwives reported they were less prepared than their mid and senior level colleagues. Significant numbers indicated they were not engaged in quality and safety in practice. Conclusions: This first nationwide study in Ireland has discovered that nurses and midwives perceive gaps in their preparedness to engage in quality improvement and patient safety in practice. To safeguard patient care, priority should be given to ensuring front-line staff are appropriately educated, have access to data, and time to competently participate in the continuous improvement of patient care.