Nurse leader behavior and patient safety.

Abstract

The incidence and significance of harm that occurs to patients while in the hospital setting continues to be alarming despite decades of efforts to produce safer healthcare systems. Leaders have a role in ensuring staff provide safe care to patients. The literature supports that certain leadership styles promote interactions with healthcare staff that produce work climates conducive to positive patient outcomes. It is not clear what types of activities conducted by nurse leaders have the most impact on nursing unit patient safety. The purpose of this study was to explore the relationships between nurse leader characteristics (nurse leader behavior, educational level, and experience level) and patient safety (perceived patient safety culture, patient safety grade, number of patient safety events reported, and patient safety event rates) in the acute care hospital. The objective of this study was to more clearly describe the types of observable, actionable, leadership behaviors that are perceived as most beneficial to patient safety. Several existing data sources were combined to explore the relationships between nurse leader characteristics, leader patient safety behaviors, patient safety culture and patient safety events across a large health system in Eastern North Carolina. Nurse leader patient safety behavior was significantly associated with staff perceptions of patient safety culture. Nurse leader patient safety rounding was a safety behavior found to be associated with higher rating of patient safety culture including an improved culture of non-punitive response to error. This study has implications for nurse leaders, educators, and researchers. The study adds valuable information about safety behaviors that are associated with nurse leadership practice. Specifically, this study will move the current literature forward by exploring observable, repeatable, and replicable behaviors of nurse leaders in acute care nursing units with lower levels of patient safety events.