Patient Safety and Quality Improvement in Nursing Practice through the Mediating Role of Occupational Coping Self-Efficacy in Preventing Medical Device–Related Pressure Injury

Background/Objectives: Medical device–related pressure injury (MDRPI) is a significant patient safety issue associated with increased morbidity, prolonged hospitalization, and healthcare costs. Although evidence-based guidelines for MDRPI prevention exist, nurses’ prevention performance remains suboptimal, and the mechanisms linking workload to preventive practice remain insufficiently elucidated. Within a patient safety and quality improvement framework, this study aimed to examine whether occupational coping self-efficacy (OCSE) mediates the relationship between nurses’ workload and MDRPI prevention performance across the nursing practice continuum. Methods: This descriptive correlational study used a mediation model with data from 181 registered nurses working in intensive care units, general wards, and integrated nursing care wards in South Korea. Workload, occupational coping self-efficacy, and MDRPI prevention performance were measured using validated instruments. Mediation was tested using hierarchical regression and bootstrapped analysis (PROCESS macro Model 4, 5,000 resamples), controlling for demographic and work-related variables. Results: Workload was negatively associated with occupational coping self-efficacy (β = −.392, p < .001) and MDRPI prevention performance (β = −.229, p < .001), whereas occupational coping self-efficacy was positively associated with prevention performance (β = .336, p < .001). When occupational coping self-efficacy was included in the model, the direct association between workload and prevention performance became non-significant (β = −.097, p = .201). Bootstrapping confirmed a significant indirect effect of workload on prevention performance through occupational coping self-efficacy (95% CI: −.006 to −.002). Conclusions: The association between nurses’ workload and MDRPI prevention performance appears to operate indirectly through occupational coping self-efficacy. These findings suggest that improving MDRPI prevention as a patient safety outcome requires more than workload-focused structural interventions. Strengthening nurses’ coping self-efficacy through organizational and educational strategies may enhance the sustainability of preventive nursing practices across the nursing practice continuum.