Nurses' systems thinking competency, medical error reporting, and the occurrence of adverse events: a cross-sectional study

Background: Healthcare professionals' systems thinking is emphasized for patient safety. Aims: To report nurses' systems thinking competency, and its relationship with medical error reporting and the occurrence of adverse events. Design: A cross-sectional survey using a previously validated Systems Thinking Scale (STS), was conducted. Methods: Nurses from two teaching hospitals were invited to participate in the survey. There were 407 (60.3%) completed surveys. Results: The mean STS score was 54.5 (SD 7.3) out of 80. Nurses with higher STS scores were more likely to report medical errors (odds ratio (OR) = 1.05; 95% confidence interval (CI) = 1.02-1.08) and were less likely to be involved in the occurrence of adverse events (OR = 0.96; 95% CI = 0.93-0.98). Conclusions: Nurses showed moderate systems thinking competency. Systems thinking was a significant factor associated with patient safety.