Safety self‐efficacy and safety performance: Potential antecedents and the moderation effect of standardization

Purpose – The purpose of this paper is to suggest a new safety self‐efficacy construct and to explore its antecedents and interaction with standardization to influence in‐patient safety. Design/methodology/approach – The paper used a survey of 161 nurses using a self‐administered questionnaire over a 14‐day period in two large Israeli general hospitals. Nurses answered questions relating to four safety self‐efficacy antecedents: enactive mastery experiences; managers as safety role models; verbal persuasion; and safety priority, that relate to the perceived level of standardization and safety self‐efficacy. Confirmatory factor analysis was used to assess the scale's construct validity. Regression models were used to test hypotheses regarding the antecedents and influence of safety self‐efficacy. Findings – Results indicate that: managers as safety role models; distributing safety information; and priority given to safety, contributed to safety self‐efficacy. Additionally, standardization moderated the effects of safety self‐efficacy and patient safety such that safety self‐efficacy was positively associated with patient safety when standardization was low rather than high. Hospital managers should be aware of individual motivations as safety self‐efficacy when evaluating the potential influence of standardization on patient safety. Originality/value – Theoretically, the study introduces a new safety self‐efficacy concept, and captures its antecedents and influence on safety performance. Also, the study suggests safety self‐efficacy as a boundary condition for the influence of standardization on safety performance. Implementing standardization in healthcare is problematic because not all processes can be standardized. In this case, self‐efficacy plays an important role in securing patient safety. Hence, safety self‐efficacy may serve as a “substitute‐for‐standardization,” by promoting staff behaviors that affect patient safety.