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Predictors of nurses’ response to informal carers’ interventions in medication safety and their collaboration with nurse colleagues and physicians: a cross-sectional factorial survey from Switzerland / Prädiktoren der Reaktion von Pflegefachpersonen auf Interventionen von betreuenden Angehörigen zur Medikationssicherheit und ihre Zusammenarbeit mit pflegerischem und ärztlichem Personal: eine faktorielle Querschnittstudie aus der Schweiz

Marco Riguzzi
Marco Riguzzi
, 
Anke Jähnke
Anke Jähnke
 y 
Iren Bischofberger
Iren Bischofberger
   | 30 sept 2021
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Publicado en línea: 30 sept 2021
Páginas: 72 - 85
Recibido: 26 feb 2021
Aceptado: 24 jul 2021
DOI: https://doi.org/10.2478/ijhp-2021-0007
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© 2021 Marco Riguzzi et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Figure 1

Odds and probabilities of verbal replies.
Odds and probabilities of verbal replies.

Figure 2

Odds and probabilities of collaboration.
Odds and probabilities of collaboration.

Models 7 and 8 on situational and individual determinants of collaboration.

Model/predictors Odds f. Coeff. (95% CI) p-Value
Model 7 – situational (vignettes)
Collaboration with physician (reference: verification by oneself):
Verbal intervention occurred in the presence of the patient (in patient's room) instead of in the absence of the patient (corridor) 0.26 −1.35 (−2.03, −0.66) 0.007
The intervening person (carer) is 75 years of age (instead of 50 or 25 years) 0.30 −1.19 (−2.00, −0.37) 0.004
Intervention mentions ‘I am a professional in the field myself’ -a 0.259 (−0.44, 0.95) 0.354
Collaboration with nurse colleague (reference: verification by oneself):
Verbal intervention occurred in the presence of the patient (in patient's room) instead of in the absence of the patient (corridor) 0.28 −1.27 (−1.74, −0.81) 0.000
The intervening person (carer) is 75 years of age (instead of 55 or 25 years) -a −0.31 (−0.84, 0.22) 0.26
Intervention mentions ‘I am a professional in the field myself’ 1.67 0.52 (0.05, 0.98) 0.029
Model 8 – individual
Collaboration with physician (reference: verification by oneself):
Proportion of working time regularly spent with informal/family carers (coefficient/odds factor per 10 percentage point increase) 1.18 0.17 (0.09, 0.25) 0.000
Age of the nurse (coefficient/odds factor per 10-year increase) 1.74 0.56 (0.31, 0.80) 0.000
Nurse is a double-duty caregiver (currently) -a 0.19 (−0.31, 0.68) 0.459
Nurse holds an MSc degreeb 3.49 1.25 (0.26, 2.24) 0.013
Nurse holds a BSc degreeb -a −0.23 (−1.23, 0.78) 0.658
Nurse does not hold an Advanced Federal Diploma of Higher Education in Nursing (‘Höhere Fachschule’)b,c 5.75 1.75 (0.74, 2.76) 0.001
Nurse works in paediatrics -a 0.07 (−0.94, 1.09) 0.887
Nurse was educated in Germanyd 3.19 1.16 (0.43, 1.89) 0.002
Nurse was educated in another country (other than Germany)d 5.28 1.66 (0.69, 2.63) 0.001
Nurse has been a member of SBK/ASI for >20 years (up to 30 years) -a −0.23 (−0.80, 0.35) 0.438
Nurse has been a member of SBK/ASI for >30 years 0.27 −1.31 (−2.60, −0.008) 0.049
Nurse is male 0.10 −2.35 (−4.28, −0.42) 0.017
Collaboration with nurse colleague (reference: verification by oneself):
Proportion of working time regularly spent with informal/family carers (coefficient/odds factor per 10 percentage point increase) 1.17 0.15 (0.11, 0.20) 0.000
Age of the nurse (coefficient/odds factor per 10-year increase) 1.29 0.26 (0.95, 0.42) 0.002
Nurse is a double-duty caregiver (currently) 1.47 0.38 (0.06, 0.71) 0.021
Nurse holds an MSc degreeb 2.27 0.82 (0.17, 1.47) 0.014
Nurse holds a BSc degreeb 0.45 −0.81 (−1.36, −0.25) 0.005
Nurse does not hold a Diploma of Higher Education in Nursing (‘Höhere Fachschule’) or professional development educationb -a −0.99 (−2.45, 0.46) 0.180
Nurse works in paediatrics 0.43 −0.85 (−1.55, −0.16) 0.016
Nurse was educated in Germanyc -a −0.16 (−0.78, 0.47) 0.626
Nurse was educated in another country (not Germany)c 3.42 1.23 (0.58, 1.88) 0.000
Nurse has been a member of SBK/ASI for >20 years (up to 30 years) 0.47 −0.75 (−1.19, −0.30) 0.001
Nurse has been a member of SBK/ASI for >30 years 0.40 −0.91 (−1.53, −0.29) 0.004
Nurse is male 2.41 0.88 (0.29, 1.47) 0.004
(Vignette parameters used as further controls)

Models 1 and 2 on situational determinants of perceived appropriateness.

Predictors Model 1 Model 2
AME (95% CI) p-Value AME (95% CI) p-Value
Relationship between intervening person and patient is unclear to the nurse −0.75 (−0.94, −0.55) 0.000 −0.70 (−0.94, −0.46) 0.000
Verbal address:
‘Excuse me. Could you please check the tablets?’ 1.00 (reference) - 1.00 (reference) -
‘There is something wrong with the tablets’ −0.39 (−0.57, −0.20) 0.000 −0.45 (−0.66, −0.24) 0.000
‘Hello you! You have made a mistake here’ −1.86 (−2.10, −1.63) 0.000 −1.80 (−2.07, −1.53) 0.000
Intervention mentions ‘I am a professional in the field myself’ −0.18 (−0.02, −0.34) 0.032 −0.17 (−0.01, −0.33) 0.043
Nurse had already experienced a situation similar to the vignette before 1.01 (0.72, 1.30) 0.000 0.92 (0.55, 1.28) 0.000

Models 5 and 6 on the situational and individual determinants of verbal replies.

Model/predictors Odds factor Coeff. (95% CI) p-Value
Model 5 – situational (vignettes)
Nurse had already experienced a situation similar to the vignette before 3.40 1.23 (0.34, 2.11) 0.007
Relationship between intervening person and patient is unclear to nurse 0.07 −2.66 (−3.41, −1.92) 0.000
Verbal intervention occurred in the presence of the patient (in patient's room) instead of in the absence of the patient (corridor) 0.17 −1.80 (−2.46, −1.14) 0.000
Patient had just been hospitalised as an emergency the day beforea 0.47 −0.76 (−1.42, −0.11) 0.023
Verbal address: ‘Hello you! You have made a mistake here’b 0.35 −1.05 (−1.73, −0.37) 0.002
Model 6 – individual
Nurse is 30 years of age or younger 2.76 1.02 (0.45, 1.58) 0.000
Nurse has professional experience in patient care of 10 years or less 0.59 −0.53 (−0.97, −0.09) 0.018
Nurse holds a BSc or MSc degree 1.95 0.67 (0.14, 1.20) 0.013
Nurse works in home care 1.90 0.64 (0.20, 1.08) 0.004
Nurse is freelancing 0.26 −1.35 (−1.91, −0.78) 0.000
Nurse was educated in Germanyc 9.54 2.26 (0.94, 3.57) 0.001
Nurse had been a double-duty caregiver in the past, but is not any mored 0.57 −0.57 (−0.94, −0.19) 0.003
Nurse has been a member of SBK/ASI for >10 years (up to 20) 2.20 0.79 (0.25, 1.35) 0.004
(Vignette parameters used as further controls)

Models 3 and 4 on the individual determinants of perceived appropriateness.

Predictors Model 3 Model 4
AME (95% CI) p-Value Coeff. (95% CI) p-Valuea
Nurse is 30 years of age or younger −0.69 (−1.12, −0.26) 0.002 −0.71 (−1.11, −0.30) 0.001
Nurse had more than 40 years of experience in healthcare (up to 45 years) −1.29 (−2.02, −0.56) 0.001 −1.38 (−2.05, −0.71) 0.000
Nurse holds a BSc degreeb 0.43 (0.06, 0.82) 0.022 0.42 (0.01, 0.83) 0.045
Nurse has completed a professional development educationb 0.81 (0.49, 1.12) 0.000 0.82 (0.45, 1.18) 0.000
Nurse has a position as a care expert (‘Pflegeexpertise’) 1.19 (0.87, 1.51) 0.000 1.28 (0.82, 1.74) 0.000
Nurse has a non-standard position (residual group)c −2.61 (−4.14, −1.08) 0.001 −2.06 (−3.68, −0.43) 0.013
Nurse works in home care −0.49 (−0.86, −0.12) 0.009 −0.48 (−0.84, −0.12) 0.009
Nurse works in a nursing home −0.62 (−1.03, −0.21) 0.003 −0.63 (−1.03, −0.24) 0.002
Nurse works in health consulting −1.90 (−3.53, −0.27) 0.022 −1.88 (−3.13, −0.63) 0.003
Nurse is freelancing −2.61 (−3.46, −1.75) 0.000 −2.54 (−3.37, −1.71) 0.000
Nurse works in somatic care for adultsd −1.23 (−1.63, −0.83) 0.000 −1.14 (−1.51, −0.77) 0.000
Nurse was educated in Germanye 1.18 (0.72, 1.63) 0.000 1.11 (0.61, 1.60) 0.000
Nurse was educated in another country (Serbia, Austria, Bulgaria, Slovenia, Turkey or Romania)e,f −1.03 (−2.12, 0.06) 0.065 −1.07 (−1.84, −0.29) 0.007
Nurse had been a double-duty caregiver in the past, but is not any moreg −0.39 (−0.66, −0.12) 0.005 −0.38 (−0.65, −0.12) 0.004
Vignette parameters (as further controls):
Relationship between intervening person and patient is unclear to nurse −0.71 (−1.02, −0.41) 0.000 −0.74 (−1.02, −0.45) 0.000
‘There is something wrong with the tablets’h −0.57 (−0.85, −0.29) 0.000 −0.59 (−0.90, −0.29) 0.000
‘Hello you! You have made a mistake here’h −1.83 (−2.14, −1.53) 0.000 −1.86 (−2.16, −1.56) 0.000
Intervention mentions ‘I am a professional in the field myself’ −0.15 (−0.40, 0.10) 0.232 −0.17 (−0.42, 0.08) 0.172
Nurse had already experienced a situation similar to the vignette before 0.74 (0.45, 1.04) 0.000 0.72 (0.44, 1.01) 0.000

Characteristics of the participating nurses (N = 285).

Gender % (n)
Female 93.0 (265)
Male 7.0 (20)
Age (years)
Mean ± SD 46.2 ± 11.8
Median (min–max) 49 (21–69)
Professional experience in nursing (years)
Mean ± SD 23.0 ± 11.3
Median (min–max) 23 (1–45)
Education % (n)
MSc in Nursing 4.2 (12)
BSc in Nursing 12.3 (35)
No BSc/MSc degree 83.5 (238)
Country in which education was passed % (n)
Switzerland 88.1 (251)
Germany 7.4 (21)
The Netherlands 1.8 (5)
Other 2.8 (8)
Healthcare sector % (n)
Acute care (incl. psychiatry, outpatient clinics) 45.3 (129)
Home care 27.0 (77)
Nursing homes 20.7 (59)
Freelancing nurses 2.5 (7)
Health consulting 1.8 (5)
General practitioner's practice 1.1 (3)
Other 1.8 (5)
Hierarchical level % (n)
Leading position 19.0 (54)
Position as a care expert (‘Pflegeexpertise’) 8.8 (25)
Provides occupational training 9.5 (27)
Additional responsibility such as quality management 6.7 (19)
None of the above 56.1 (160)
Share of working time spent with carers %
Mean ± SD 34.2 ± 30.3
Median (min–max) 20 (0–100)
Has role as double-duty caregiver % (n)
Yes, presently 35.1 (100)
Formerly, but not presently 41.8 (119)
No, never so far 23.2 (66)
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