The Impact of Psychological Capital on Nurses' Perception of Quality of Care and Adverse Events

Psychological capital (PsyCap) is a valuable psychological resource that is associated with improved job performance and reduced stress in the workplace. Despite its importance, the relationship between nurses' PsyCap, perceived quality of care and adverse events (AEs) is poorly understood. The aim of this study was therefore to investigate the effects of PsyCap on nurses' perceptions of the quality of care and AEs. A cross-sectional survey was conducted at Buraidah Central Hospital in the Qassim region of Saudi Arabia, in which 169 nurses took part. The data were collected using sociodemographic data and working conditions, the Psychological Capital Questionnaire (PCQ-12), self-rated quality of patient care (5 items) and estimates of AEs. Pearson correlation and binary logistic regression were used to analyse the associations between study variables. A significant proportion of studied nurses reported high perceived quality of care, with 82.7% never making mistakes with negative consequences and 66.1% maintaining consistent care quality. The least reported AEs included patient falls (22.6%) and infusion/transfusion reactions (26.2%), while pressure ulcers (45.8%) and verbal abuse (42.3%) were the most frequent. Significant negative correlations were observed between PsyCap and AEs (e.g., pressure ulcers: r = -0.350, p < 0.001; medication errors: r = -0.405, p < 0.001). PsyCap was also positively related to indicators of quality of care (p ≤ 0.001). Logistic regression showed that higher PsyCap was associated with a reduced odds of AEs such as pressure ulcers (OR = 0.927, 95% CI = 0.885-0.970) and medication errors (OR = 0.884, 95% CI = 0.835-0.937) (p ≤ 0.001). The results show that higher PsyCap in nurses is associated with better perceptions of the quality of patient care and fewer reported AEs. Targeted interventions to improve psychological resources such as stress management programmes, self-efficacy workshops and resilience training have significant potential to strengthen nurses' mental health, increase resilience in the workplace and improve the quality of patient care while reducing the incidence of AEs.