Nurses’ response to parents’ ‘speaking-up’ efforts to ensure their hospitalized child's safety: an attribution theory perspective

Aim: To understand how attribution processes (control and stability), which the nurse attributes to parental involvement in maintaining child safety, determine the nurse's response to a safety alert. Background: Participation of parents in maintaining their child's safety is shown to reduce the incidence of and risk of clinical errors. Unless nurses respond appropriately to parents’ safety alerts, this potential source of support could diminish. Design: A 2 (controllability: high vs. low) × 2 (consistency: high vs. low) factorial design. Methods: Data were collected during the period 2013–2014 in paediatric wards. Four variants of scenarios were created corresponding to the different combinations of these variables. A total of 126 nurses read a scenario and completed self-report questionnaires measuring their response to the parent's safety alert. Additional data were collected about the manipulation check, safety norms in the ward and demographic variables. Data were analysed using analysis of variance. Findings: Results showed a main effect of stability and a significant two-way interaction effect of stability and controllability, on a nurse's tendency to help the parent and fix the safety problem. Furthermore, safety norms were significantly related to nurses’ response. Conclusion: These findings contribute to the understanding of antecedents that affect nurses’ responses to parents’ speaking-up initiatives: whether nurses will reject or heed the alert. Theoretical and practical implications for promoting parents’ engagement in their safety are discussed.