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To appraise and synthesise existing research on the relationship between patient safety culture and missed nursing care.
Systematic review and meta-analysis.
Peer-reviewed articles published from 2010 onwards were searched from five databases (CINAHL, ProQuest, PubMed, ScienceDirect and Web of Science). A total of nine studies were identified. Among these, seven studies with a combined sample size of 1661 participants were included in the meta-analysis.
The meta-analysis revealed a significant negative correlation between overall patient safety culture and missed nursing care, with a pooled correlation coefficient of −0.205 (95% CI: −0.251 to −0.158) (p < 0.001). Heterogeneity was low to moderate (I 2 = 13.18%, 95% CI: 0.00 to 78.60), and publication bias tests indicated no significant bias (Egger's test p = 0.0603; Begg's test p = 0.3476).
The findings underscore a significant inverse relationship between patient safety culture and missed nursing care, highlighting the specific predictive roles of management support, organisational learning and unit-level safety culture. Enhancing patient safety culture within healthcare organisations can be a strategic approach to mitigate missed nursing care.
Nursing leaders and administrators should prioritise fostering a safety-oriented culture through targeted interventions, continuous education and supportive policies to improve patient care outcomes.
Preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines.
No patient or public contribution.
Workplace safety culture is pivotal in healthcare settings, known to enhance nurses' effectiveness and productivity. Yet, the specific pathways through which safety culture influences these outcomes, especially in relation to compassion fatigue, are not fully understood.
This study investigated the mediating role of compassion fatigue in the relationship between workplace safety culture, career satisfaction, and turnover intention among nurses.
A cross-sectional survey was conducted with 269 nurses from various acute healthcare facilities in Eastern Visayas, Philippines. Three standardized scales were used to collect the data. Mediation testing was performed using Hayes' PROCESS macro in SPSS (Model 4).
Workplace safety culture was negatively associated with compassion fatigue (β = −0.2604, p = 0.0012) and turnover intention (β = −0.2778, p = 0.0048) and positively associated with career satisfaction (β = 0.3986, p = 0.0001). Compassion fatigue partially mediated the relationship between workplace safety culture and career satisfaction (β = 0.0645, 95% CI [0.0213, 0.1215]) and the relationship between workplace safety culture and intention to stay (β = −0.0756, 95% CI [−0.1398, −0.0263]).
A positive workplace safety culture was associated with a lower compassion fatigue, which in turn enhanced career satisfaction and lower turnover intention among nurses. Healthcare organizations and policymakers should prioritize strategies that enhance safety culture and provide support for nurses to manage compassion fatigue effectively, ultimately leading to better patient care and a more stable nursing workforce.
Compassion competence among nurses is crucial for patient safety and the quality of nursing care, yet the mechanisms linking these factors remain unclear, indicating a significant gap in current understanding.
This study aimed to explore the mediating role of adherence to safety standards in the relationship between nurse compassion competence and patient safety incidents.
A cross-sectional study was conducted among 455 nurses across 3 hospitals in Visayas, Philippines. Participants completed self-report measures assessing compassion competence, adherence to safety standards, and perceived patient safety incidents. Data were analyzed using SPSS Hayes Macro Model 4 to examine direct and indirect effects.
Higher levels of compassion competence in nurses were positively associated with increased adherence to safety standards (β = 0.3438, p = 0.0019) and fewer patient safety incidents (β = −0.2586, p = 0.0001). Adherence to safety standards was found to partially mediate the relationship between compassion competence and patient safety incidents (β = 0.0451, 95% CI [0.0106, 0.0862]).
Fostering compassion competence in nurses can enhance adherence to safety standards, ultimately leading to a reduction in patient safety incidents in healthcare environments. The findings underscore the critical role of compassion competence not just as a desirable nursing trait but as a strategic lever for improving patient safety. Healthcare organizations should implement structured professional development programs that cultivate empathy, emotional intelligence, and effective communication—core elements of compassion competence. Nursing leadership must also embed compassion-driven practices into patient safety protocols, promote a culture of accountability and empathy, and support interdisciplinary collaboration to ensure consistent adherence to safety standards and minimize preventable harm.
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