Effect of on-The-Job versus off-the-Job ‎Training Related to Patient Safety Goals on ‎Staff Nurses' Performance

Abstract

Background: Training is essential to improve care providers’ particularly for nurses in patient safety. Aim of study: to measure the effect of on-the-job versus off-the-job training related to international patient safety goals (IPSGs) on staff nurses’ performance. Subjects and Methods: The study was conducted in medical wards and critical care units of Ain Shams University Hospital using a quasi-experimental design. Subjects consist of two groups namely the on-the-job (study group) and off-the-job group (control group). Each group has 116 staff nurses. Data were collected using a patient safety knowledge questionnaire and an observation checklist for performance. The researchers developed a training program and implemented it for each group using related approach and evaluated it at post- and follow-up (FU) phases. Results: The two groups the on-the-job (study group) and off-the-job group (control group) had similar characteristics with mean age, 29.8 and 29.0 years respectively. Slightly more than one-third of nurses in both groups had satisfactory pre-intervention knowledge, with no significant difference. At post-intervention, 91.4% of study group and 98.3% of control had satisfactory knowledge (p=0.018). At FU, these were 89.7% and 83.6% respectively (p=0.177). As for pre-intervention performance, it was adequate in 3.4% in study group and none in control group. At post-intervention, these were 94.0% in study group and 96.6% in control group (p=0.354). At FU, these were 67.2% in study group and 58.6% in control group (p=0.174). In multivariate analysis, the study intervention was a positive predictor of knowledge and performance scores, while off-the-job approach was a negative predictor. Conclusion and Recommendations: The implementation of the on-the-job and off-the-job training interventions is effective in improving knowledge and performances, with slight superiority of on-the-job approach. The study recommends intensive training in IPSGs for staff nurses using “on-the-job” training approach, with periodic refreshing through workshops. Their performances should be closely supervised. Future research on the impact of staff nurses’ “on-the-job” training in IPSGs on patients’ safety indicators.