Psychosocial Determinants of Patient Safety Competencies Among Paediatric Nurses in Pakistan: A Qualitative Study

Abstract

Background: The role of a paediatric nurse is complex clinically and also has many emotional and relational demands. Childcare nurses often face long hours, family problems, critical illnesses and emotional upsets in the clinical setting. The psychosocial experiences can affect attentiveness, decision making, teamwork, etc., as skills that are necessary for safe patient care. But few studies have qualitatively examined the perceived relationship between paediatric nurses' psychosocial well-being and patient safety competencies in Pakistan.

Objective: The aim of this study was to examine the psychosocial experiences of paediatric nurses and how they believed they affected paediatric nurses' competencies for patient safety and the quality of paediatric care.

Method: A qualitative study was carried out with eight female public and private healthcare institution paediatric nurses from Gujranwala, Pakistan. Purposive criterion sampling method was used for the selection of the participants. The interviews were in-depth, of about 60-90 minutes, were audio-recorded with the consent of the participants and transcribed verbatim. The thematic analysis of data was done using the six phases suggested by Braun and Clarke.

Results: Eight broad themes were found: Physical Exhaustion and its effects, Emotional burden and psychological strain, Compassion fatigue and patient safety risk, Nurse leadership and charge nurse support, Professional boundary management, Team dynamics and patient safety, Strategies to cope and foster resilience, and Nurse emotional disposition and paediatric wellbeing. The results showed that physical and emotional fatigue was felt to impact on concentration, clinical judgement, communication and sustained engagement with children and families. The perceived protective resources were supportive leadership, collaborative teams, professional boundaries, and adaptive coping strategies.

Conclusion: It would seem that the competence of paediatric nurses in relation to psychosocial well-being and safety of their patients seems to be closely intertwined. Healthcare organizations should tackle both structural and emotional needs, such as developing the supportive leadership, staffing policies, peer support, coping resources, and psychologically supportive work environments.