Association Between Nursing Experience and Harm Risk in Paediatric Adverse Nursing Events: Modification by Standard Operating Procedure Accessibility in a Retrospective Cohort Study
Liping Wu, Na Zhou, Juan Huang, Haimei Duan, Congyu You, Bingqing Wu, Bin YangABSTRACT
Aim
To examine the association between nursing experience and paediatric adverse nursing event (ANE) harm risk, and whether SOP accessibility modifies this association.
Design
Retrospective cohort study, 2015–2024.
Methods
We analysed paediatric ANEs reported from 2015 to 2024 at a tertiary children's hospital in western China. The primary outcome was whether an ANE resulted in harm (yes/no). The exposure was years of nursing experience, grouped into five categories (< 1, 1–< 3, 3–< 5, 5–< 10 and ≥ 10 years), and SOP accessibility served as an effect modifier. Multivariable logistic regression models and stratified analysis with interaction tests were applied.
Results
Among the 3199 paediatric ANEs, 1341 (41.92%) resulted in harm. Harm risk was highest among nurses with ≥ 10 years of experience (adjusted OR = 1.93, 95% CI: 1.33–2.81 vs. < 1 year), with no significant elevation in the intermediate nurses (1–10 years). SOP accessibility modified this association ( p for interaction = 0.004). When SOPs were accessible, the elevated risk in the ≥ 10‐year group persisted (adjusted OR = 1.95, 95% CI: 1.33–2.87); when SOPs were inaccessible, it was no longer evident, and a protective association appeared in the 3–< 5‐year group (adjusted OR = 0.15, 95% CI: 0.03–0.76).
Conclusions
Nursing experience exhibited nonlinear association with paediatric ANE harm risk, and this relationship was significantly modified by SOP accessibility. Harm risk was highest among nurses with ≥ 10 years of experience. However, given the retrospective observational design, causal inference is precluded, and the underlying mechanisms remain to be elucidated.
Patient or Public Contribution
No patient or public contribution.