Improving the implementation of patient safety by nursing students using nursing instructors trained in the use of quality circles

Linda Wieke Noviyanti, Hanny Handiyani, Dewi Gayatri

Research output: Contribution to journalArticlepeer-review

8 Citations (Scopus)


Background: It is recognised worldwide that the skills of nursing students concerning patient safety is still not optimal. The role of clinical instructors is to instil in students the importance of patient safety. Therefore, it is important to have competent clinical instructors. Their experience can be enhanced through the application of quality circles. This study identifies the effect of quality circles on improving the safety of patients of nursing students. Patient safety is inseparable from the quality of nursing education. Existing research shows that patient safety should be emphasised at all levels of the healthcare education system. In hospitals, the ratio between nursing students and clinical instructors is disproportionately low. In Indonesia, incident data relating to patient safety involving students is not well documented, and the incidents often occur in the absence of a clinical instructor. Methods: This study used a quasi-experimental research design with pre-test and post-test non-equivalent control groups. The aim of the project was to explore the implications of the quality circle on clinical instructors by comparing the students' knowledge, attitudes, and practices of control and intervention groups. A questionnaire will be conducted to evaluate the implementation of patient safety and the impact of the intervention. The data were statistically analysed using independent t tests. The intervention was the implementation of quality circles that focused on patient safety issues for the use of clinical instructors to assess and guide student nurse behaviour in regard to patient safety. The authors of this study trained the clinical instructors on how to use quality circle methods to solve nursing problems especially with relevance to the patient safety issues of students. Results: The results showed a significant increase in the behaviour of nursing students towards patient safety issues (p < 0.001; α = 0.05). Conclusions: The implementation of quality circles has a significant effect on patient safety. Therefore, it is recommended to implement quality circles as a problem-solving technique to optimize patient safety.

Original languageEnglish
Article number53
JournalBMC Nursing
Publication statusPublished - 19 Dec 2018


  • Clinical instructors
  • Nursing student
  • Patient safety
  • Quality circles


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