title: Bilateral effects of hospital patient-safety procedures on nurses' job satisfaction.
abstract: OBJECTIVE
  The aim of this study was to examine how hospital patient-safety procedures affect the job satisfaction of hospital nurses. Additionally, we investigated the association between perceived autonomy and hospital patient-safety procedures and job satisfaction.
  
  
  BACKGROUND
  Recently, measures for patient safety have been recognized as an essential requirement in hospitals. Hospital patient-safety procedures may enhance the job satisfaction of nurses by improving the quality of their work. However, such procedures may also decrease their job satisfaction by imposing excessive stress on nurses because they cannot make mistakes.
  
  
  METHODS
  The participants included 537 nurses at 10 private hospitals in Japan (The surveys were collected from March to July 2012). Factors related to hospital patient-safety procedures were demonstrated using factor analysis, and the associations between these factors and nurses' self-perceived autonomy and job satisfaction were examined using structural equation modelling.
  
  
  RESULTS
  Five factors regarding hospital patient-safety procedures were extracted. Additionally, structural equation modelling revealed statistically significant associations between these factors and the nurses' self-perceived autonomy and job satisfaction. The findings showed that nurses' perceived autonomy of the workplace enhanced their job satisfaction and that their perceptions of hospital patient-safety procedures promoted their job satisfaction. However, some styles of chief nurses' leadership regarding patient safety restrict nurses' independent and autonomous decision-making and actions, resulting in a lowering of job satisfaction.
  This study demonstrated that hospital patient-safety procedures have ambiguous effects on nurses' job satisfaction. In particular, chief nurses' leadership relating to patient safety can have a positive or negative effect on nurses' job satisfaction. The findings indicated that hospital managers should demonstrate positive attitudes to improve patient safety for nurses' job satisfaction. In addition, policymakers in the hospitals should consider that chief nurses' leadership styles may reduce autonomy and suppress nurses' job satisfaction.
authors.affiliation: Environmental Science Center, University of Tokyo, Tokyo, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Inoue
authors.affiliation: Environmental Science Center, University of Tokyo, Tokyo, Japan.
authors.forename: R
authors.initials: R
authors.lastname: Karima
authors.affiliation: Health Service Center, Tokyo University of Agriculture and Technology, Tokyo, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Harada
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D005260:Female; D006801:Humans; D007564:Japan; D007588:Job Satisfaction; D008297:Male; D008875:Middle Aged; D009741:Nursing Staff, Hospital / Q000523:psychology* / Q000706:statistics & numerical data*; D061214:Patient Safety / Q000592:standards* / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D017132:Workplace / Q000592:standards* / Q000706:statistics & numerical data*
keywords: Autonomy; Factor analysis; Job satisfaction Japan; Leadership; Nurses; Patient safety; Structural equation modelling; Teamwork