Safety attitudes among pediatric nurses in a Chinese tertiary hospital: a cross-sectional study of multilevel factors

Nurses’ safety attitudes are a pivotal determinant of medical safety and a key facilitator of high-quality care delivery. This study was conducted to evaluate the current status of safety attitudes among pediatric nurses and pinpoint the key factors that modulate these attitudes. A cross-sectional survey was performed among pediatric nurses affiliated with a Grade A tertiary children’s hospital in Nanjing, China. Data were collected using two standardized instruments: a General Information Questionnaire (capturing demographic and professional characteristics) and the Safety Attitudes Questionnaire (SAQ), a validated tool widely employed to assess safety attitudes in healthcare professionals. A total of 280 pediatric nurses were recruited and included in the analysis. The mean overall safety attitude score of the participants was 120.45 ± 20.18. Among all dimensions of the SAQ, “Teamwork” achieved the lowest scores (22.48 ± 4.00), with items related to work-related stress and fatigue identified as the primary contributors to the low performance in this domain. Multiple linear regression analysis further identified five independent factors associated with lower safety attitude scores: age < 30 years (β = − 0.215, P = 0.008), lower educational background (β = − 0.243, P = 0.003), work experience < 5 years (β = − 0.230, P = 0.001), lower professional title (β = − 0.192, P = 0.004), and non-participation in safety training (β = − 0.305, P = 0.001). Collectively, these factors explained 52.6% of the variance in safety attitude scores (R² = 0.526, F = 28.753, P < 0.001). The findings of this study suggest that pediatric nurses demonstrate moderately positive safety attitudes. Team collaboration and fatigue management emerged as critical areas warranting targeted interventions for improvement.