Moral sensitivity mediates autonomy and safety attitudes in ICU nurses

Background Previous studies have confirmed a connection between nurses’ professional autonomy and their attitudes toward patient safety. However, no research has investigated the indirect mediating role of moral sensitivity in this relationship. It is crucial to address this gap to enhance nursing care outcomes. Research aim To investigate the mediating role of moral sensitivity in the relationship between professional autonomy and patient safety attitudes among ICU nurses. Research design Cross-sectional study. Participants and research context Nurses working in ICUs affiliated to Urmia teaching Hospitals. Ethical considerations Ethics approval for this study was obtained from the Urmia University of Medical Sciences committee (Code: IR.UMSU.REC.1401.400). Findings/results A positive and moderate relationship was found between nurses’ professional autonomy and their attitudes toward patient safety (β = 0.367, t-value = 2.130, p = .033). The nurses’ professional autonomy had a positive and strong relationship with their moral sensitivity (β = 0.944, t-value = 15.568, p = .001), and nurses’ moral sensitivity was positively and moderately related to their attitude toward patient safety (β = 0.380, t-value = 7.154, p = .001). Moral sensitivity served as a mediator between professional autonomy and patient safety attitudes (β = 0.787, 95% CI: 0.598, 1.114). Conclusions Professional autonomy was positively associated with nurses’ attitudes toward patient safety, with moral sensitivity acting as a significant mediator. These findings highlight the importance of both factors in shaping patient safety attitudes among ICU nurses. Nursing managers must prioritize developing moral sensitivity to enhance care quality, increase patient satisfaction, and reduce errors. In-service education should include training on ethical issues, and managers should educate nurses on ethical codes and foster moral courage. Involving nurses in decision-making processes is crucial for patient safety.