Nurses' Perception of Relationship-Based Care Environment and its Relationship with Compliance with Standard Precautions among Clinical Nurses affiliated to Educational and Medical Centers of Tabriz University of Medical Sciences: A Descriptive Correlational Study

Abstract

AbstractIntroduction: Relationship is a complex multidimensional concept. It is a critical component of professional practice and core to the interaction between nurse and patient. Relationship-based care occurs in environments where all members of the organization respect and affirm the knowledge and contribution of other disciplines and work collaboratively together. nurses’ perceptions of the relationships within their practice environment can affect their performance. Nurses’ perception of relationship-based care environment in relation to various professional practice including compliance with standard precautions has not been explored exclusively in clinical settings. Standard Precautions represent the minimum infection prevention measures that apply to all patient care, regardless of suspected or confirmed infection status of the patient, in any setting where healthcare is delivered. This study was carried out aiming at examine nurses' perception of relationship-based care environment, describe nurses’ compliance with standard precautions, and explore the relationships between nurses’ perception of relationship-based care environment and their compliance with standard precautions.Methods: This descriptive correlational study was conducted in Tabriz, northwest Iran. The data was collected over six months from January 2022 until June 2022. Simple random sampling technique were used to get the sample from the population. Participants were asked to complete an online self-reported questionnaire through Google form. The questionnaire was composed of three parts including the nurse’s demographic and professional variables, and professional variables, nurse’s perception of the relationship based care environment scale, and the compliance with standard precautions scale. Data were analyzed using SPSS V.24 through descriptive and exploratory statistics and a regression model. Results: Totally, 517 clinical nurses from 26 wards from 10 hospitals participated in this study. In the present study, the average score of the nurses' compliance with Stan Precautions Was 11.87 out of 20 (SD= 4.69, 95% CI=11.47-12.28). The overall compliance with standard Precautions rate was 59.36% (SD=23.47, 95% CI=57.33-61.39) which is a suboptimal level. The average score of the nurses' perception of the relationship-based care environment was 233.95 out of the possible range of scores 56 to 336 (SD= 35.52, 95% CI=230.88-237.02). The nurses' perception of relationship-based care environment standardized mean score in this study was 63.55 (SD=12.69, 95% CI=62.46-64.65) out of 100 that is at a moderate level. Nurses' perception of relationship-based care environment in the ‘Nurse to patient: Respect for the patient’ component received the highest scores, and in the ‘Nurse to organization’ component, received the lowest scores. There was a direct, positive, and moderate correlation between nurses' perception of relationship-based care environment and compliance with standard precautions (r=0.65, p>0.001). In addition, the male gender, less educated, unfamiliarity with standard precautions was associated with less compliance.Conclusion: This study found that the overall compliance with standard precautions rate among hospital nurses was suboptimal. This study offers preliminary support for the relationship between nurses’ perception of relationship-based care environment and compliance with standard precautions among hospital nurses in clinical settings. Nurses' perception of relationship-based care environment in the ‘Nurse to organization’ component, received the least scores. The findings will be basic knowledge for further study in nurses’ perception of relationship-based care environment in this study settings and reference for other studies in Iran and other countries. Future studies are needed to investigate the causal relationships between nurses’ perception of relationship-based care environment and compliance with compliance with standard precautions in clinical settings. It is suggested to carry out studies in the field of improving nurses' perception of the relationship-based care environment, with focusing on the nurse's relationship with the organization, reasons for low compliance with standard precautions, and the factors affecting it.