الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Training is essential for human resources development. It helps employees to improve their performance to provide quality care and manage conflicts, with increased job engagement and organizational commitment. This is of particular importance for nurses in the area of patient safety as they are expected to be highly proficient in the related competencies. Both on-the-job and off-the-job training approaches are effective, but they are different in their implementation. Since patient safety is still an ongoing and critical challenge for the national health service, it is deemed important to focus on how education and training interventions can improve nurses’ related performance.
This study was aimed at measuring the effect of on- the-job versus off-the-job training related to patient safety goals on staff nurses’ performance. The research hypothesis was that the performance of staff nurses who receive on- the-job training will be better compared with who receive off-the-job training related to patient safety goals.
The study was conducted at the medical wards and critical care units of Ain Shams University Hospital, affiliated to Ain shams University Hospitals using a quasi- experimental design with non-equivalent control. The study subjects consisted of two equal groups of 116 staff nurses each one for on-the-job (study) and the other for off-the-job (control) training. The data were collected using a self- administered questionnaire to assess nurses’ knowledge related to patient safety goals; and an observation checklist to assess their performance of these goals.
The fieldwork was carried out through assessment, planning, implementation, and evaluation phases. The researcher developed a training program based on analysis of assessment phase data and related literature to improve nurses’ knowledge and skills regarding the International Patient Safety Goals (IPSGs). The program was implemented for each of the two groups in small subgroups over 6 sessions for each subgroup. The changes in nurses’ knowledge and performance were assessed using the same questionnaire and observation checklist.
The main study results were as following.
The study (on-the-job) and control (off-the-job) groups had similar characteristics with almost equal mean ages,
29.8 and 29.0 years respectively, with a majority of females in both. The highest percentages had a bachelor or higher degree; their median experience years were
7.0 and 6.0.
Only around one-fourth of the nurses in both groups had previously attended training courses in patient safety.
Staff nurses’ pre-intervention knowledge of IPSGs were generally low in both groups, particularly regarding safety aims.
Slightly more than one-third of the staff nurses in both groups had satisfactory pre-intervention total knowledge, with no statistically significant difference.
At post-intervention, 98.3% of staff nurses in the control group had total satisfactory knowledge compared with 91.4% in the study group, and the difference was statistically significant (p=0.018).
At follow-up, more staff nurses in the study group had total satisfactory knowledge (89.7%) compared with
83.6% of those in the control group, but the difference however was not statistically significant (p=0.177).
As for pre-intervention practice, it was very low in both groups except for hand hygiene in Goal IV, with no differences of statistical significance between groups.
In total, only four (3.4%) of the staff nurses in the study group and none in the control group had adequate total practice of IPSGs before the intervention.
At post-intervention, the majority of staff nurses in both groups had adequate practice of all five IPSGs.
Overall, 94.0% of the staff nurses in the study group and 96.6% in the control group had adequate total post- intervention practice of IPSGs, with no statistically significant difference (p=0.354).
At follow-up, the study group staff nurses had more adequate practice, and the differences were of statistical significance in Goals I, II, one area of Goal III, and Goal V.
In total, more staff nurses in the study group had adequate total FU practice (67.2%) compared with
58.6% in the control group, but the difference was not statistically significant (p=0.174).
Statistically significant positive correlations were revealed between staff nurses’ scores of knowledge and practice in both groups.
In multivariate analysis:
o Knowledge score: main positive predictor was the study intervention, in addition to qualification and experience years, while being in the control group was a negative predictor, in addition to age.
o Practice score: main positive predictor was the study intervention, in addition to qualification and knowledge score, whereas being in the control group, as well as age and attendance of training courses were negative predictors.