Publication Date




Embargo Period


Degree Type


Degree Name

Doctor of Philosophy (PHD)


Nursing (Nursing)

Date of Defense


First Committee Member

Rosina Cianelli

Second Committee Member

Deborah Saber

Third Committee Member

Andrew Wawrzyniak

Fourth Committee Member

David J. Birnbach


Improved patient safety has been one of the most critical issues facing the healthcare industry. The 1999 IOM report To Err Is Human stated avoidable medical errors contributed to 44,000 to 98,000 deaths in the United States. Current estimates are now between 210,000 and 440,000 patients annually. This study aimed: To examine the relationships between: a) inpatient nursing units’ patient safety culture (PSC), b) nurse compassion fatigue (CF), c) nurse compassion satisfaction (CS), and d) the impact on nurse-sensitive patient outcomes. Bronfenbrenner’s bioecological model guided this quantitative descriptive correlational design, which used primary and secondary data. Primary data were collected through a convenience sampling of registered nurses (N = 127), employed at a teaching hospital in South Florida, who responded to a self-administered electronic survey. The hospital provided secondary administrative 2013 data on nurse-sensitive patient outcomes. Pearson’s correlations, three-way ANOVA, and multiple regression statistical analyses were used to analyze the data. Of the total participants, the two components of CF, burnout (BO) and secondary traumatic stress (STS), were present, with 29.1% of the nurses at risk for BO, and 19.7% were at risk for STS. Significant correlations were found between PSC, CF, and CS. Inclusion of demographic variables, covariates, and additional patient safety culture variables did explain variances in the sample. This study was a unique exploration of PSC, CF, and CS. The study results demonstrates the need for further nursing research to better understand these constructs which would lead to development of effective strategies to improve patient safety outcomes.


Patient Safety Culture; Compassion Fatigue; Compassion Satisfaction; Nurse-Sensitive Patient Outcomes; Burnout; Secondary Traumatic Stress