الفهرس 
Purpose of the studyOnly 14 pages are availabe for public view
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Abstract
Nowadays, the world of health care is complex and growing more complex every day. Managers must contend with technological innovation along with an ever-growing global economy in which events on one end of the globe will affect your organization. Making effective decisions is much more difficult in this brave new world, and systems thinking provides a model of decision-making that helps organizations effectively deal with change and adapt (Notarnicola et al., 2019).
Systems thinking can be regarded as a way of viewing, communicating, and understanding relationships that determine the functioning of systems. It is a process that connects the etiology of system-based problems to adverse consequences with improvement processes and outcomes (Notarnicola et al., 2019). Safe nursing care in healthcare has received substantial attention worldwide since the late recent years, the issues of safe nursing care have become important topics in health policy and health care practice in several countries. Rapid change in health care has mandated greater attention to safety of care, which is essential to efficient and competent delivery of quality care. World health care organization safety is a condition or state of resulting from the modification of human behavior and /or designing of the physical environment to reduce hazard thereby reducing the chance of accident (WHO, 2020).
The current study was conducted to determine the relation between systems thinking and safe nursing care among studied nurses at Menoufia University Hospital through answering the following questions: The 1st question was what is the level of systems thinking among studied nurses? The 2nd question was what is the level of safe nursing care among studied nurses? The 3rd question was what is the relation between systems thinking and safe nursing care among studied nurses at Menoufia University Hospital?
The study was conducted at critical care units of Menoufia University Hospital at Shebin El Kom city. A correlational research design was used in the conduction of this study. A simple random sample technique was used to achieve the study purpose and was involving studied nurses working in critical care units (Intensive care unit, Cardiac care unit, Neurology, Nursery unit, and Surgical ICU units). A list of critical units’ nurses working in Menoufia University Hospital was prepared. Each studied nurse was marked with a specific number (from 1 to 600). Nurses have at least one year of experience were included. The desired sample size (250 nurses).
Data was collected using two different self-administered questionnaires. Personal characteristics of studied nurses including age, sex, marital status, educational level and years of experience were collected too. The first instrument was the systems thinking scale which adopted from Moore et al., (2010) and used to assess nurses’ ability to recognize, understand and synthesize the sequence of events, causal sequences, possible multiple causes, different types of events, feedback and interrelated factors. The STS is a 20-item instrument that uses a 5-point Likert scale.
The second instrument, assessment of safe nursing care questionnaire which adopted from Rashvand et al., (2017). It used to assess nurses’ practices in preventing harm to patients and maximizing early detection of errors. The assessment of safe nursing care questionnaire (ASNC) includes 34 items divided to four dimensions (nursing skills item (15 items), patient’s psychological needs (7items), and the patient’s physical needs (7items) and assessing nurses’ teamwork (5items).
The instruments were translated into Arabic language to be clear for all participants’ educational levels and reviewed by a panel of five experts, one professor and two assistant professors in nursing administration from Menoufia University & two assistant professors in nursing administration from Benha University. The study instruments were examined for reliability by measuring the internal consistency of items using Cronbach’s alpha coefficient test. Cronbach’s alpha of systems thinking scale was equal 0. 74. Cronbach’s alpha of safe nursing scale care was equal 0.90. These values indicated that the two instruments were highly reliable.
Results of the current study could be summarized as the following:
The current study finding revealed that the highest percentage of the studied nurses was ranged 20- ≤ 30 years old, female, married and have a bachelor’s degree of nursing.
The current study finding revealed that less than two thirds (61.2%) of the studied nurses had high level of total systems thinking, while, the minority of them had low level of system thinking.
The current study finding revealed that more than two thirds (70.4%) of the studied nurses had a high level of total safe nursing care. While, only (2%) of them had low level of safe nursing care.
The current study finding revealed that there was a highly statistically significant positive strong correlation between total score of systems thinking and safe nursing care among the studied nurses.
The present study finding demonstrated that there was a highly statistically significant positive strong correlation between systems thinking and all safe nursing care dimensions (evaluation of nursing skills, patient’s psychological needs, patient’s physical needs and nurses’ teamwork) among the studied nurses, at r ranged from 0.947 to 0.970 and P = 0.000.
The current study finding revealed that there was a highly statistically significant relation between all personal data as (marital status, age, years of experience, education and area for work except sex), and level of total systems thinking among the studied nurses at P = 0.000.
The current study finding revealed that there was a highly statistically significant relation between all personal data (marital status, age, years of experience, education and area for work, except sex), and level of total safe nursing care among the studied nurses, at P = 0.000.
The current study finding revealed that the systems thinking is a predictor of safe nursing care among studied nurses.
According to the study finding, the following recommendations are suggested through three level:
(1) At practical level:
Conduct workshop and training programs to enhance nurses’ knowledge about the benefits, challenges, and problems concerning implementation of systems thinking in health care settings to enhance efficiencies of health care professionals.
Develop training programs to enhance nurses’ knowledge and skills related to systems thinking and safe nursing care.
II. At educational level:
Update nursing curricula for including all new trends in systems thinking and using evidence-based practices technologies for improving safe nursing care and patient outcomes.
Provide collaboration protocols between college of nursing and the hospital to increase perception level of systems thinking and safe nursing care.
At research level:
Replicate this study in different health care sectors using larger probability sample with all healthcare professionals for generalization.
Further study needs to be conducted about barriers affecting uses of system thinking and safe nursing care in health care settings.