Implementation of Safety Leadership in Nursing Management: A Systematic Mixed Studies Review

Authors

  • Lusianah Lusianah Student of Doctoral Program, Faculty of Nursing, University of Indonesia, Jakarta, Indonesia https://orcid.org/0000-0002-1732-2917
  • Ratna Sitorus Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
  • Fatma Lestari Faculty of Public Health, University Indonesia, Depok, Indonesia
  • Toha Muhaimin Faculty of Public Health, University Indonesia, Depok, Indonesia
  • Dyah Juliastuti Nursing Program, Sekolah Tinggi Ilmu Kesehatan IMC Bintaro, South Tangerang, Indonesia https://orcid.org/0000-0002-4159-9166

DOI:

https://doi.org/10.3889/oamjms.2022.9455

Keywords:

Head nurse, Management, Safety leadership, Systematic review

Abstract

Background: Safety leadership positively influence safety compliance amongst employees in health care. It is necessary to understand how far nursing management has played its roles in attaining safety leadership.

Objective: This study is aimed to explore the safety leadership implemented by nursing management in enhancing the health care system.

Methods: This study conducted a systematic mixed studies review of current literature focusing on nursing managerial and safety leadership. Five key terms, safety leadership and head nurse or headward, first-line nurse manager, nurse leader, or nurse administrator, were used to retrieve relevant articles. Potential articles were found in seven extensive databases (EBSCO, Sage Publication, Scopus, JSTOR, Wiley online, ProQuest and Emerald). We included English research articles or review papers, available full-text, and published from September 2010 to September 2020. Irrelevant and redundant articles were excluded. Two data extractors analyzed the relevant reports.

Results: The search yielded 40 articles. But, after duplicates were removed, eleven full-text articles involving 5361 respondents were reviewed. The review papers included qualitative studies (n = 3), cross-sectional survey (n = 6), and (quasi) experiments (n = 2). The most significant proportion (40%) of the study was conducted in the American region. Four themes were generated, including role of safety leadership, development of safety leadership, support, and barriers. The review highlights that the nurse leaders play essential role in the development and implementation of safety leaderships in the hospital wards though they face challenges which need supporting team works, professionals, and standards.

Conclusion: Adopting safety leadership as a part of nursing management requires support from policymakers, institutions, and nursing leaders. The leaders should understand the complexities of the institutional structures and functional relationships in the health care system to meet patient safety standards

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References

Zhao Y, Zhang M, Liu T, Mebarki A. Impact of safety attitude, safety knowledge and safety leadership on chemical industry workers’ risk perception based on structural equation modelling and system dynamics. J Loss Prev Process. 2021;72(2):104542. https://doi.org/10.1016/j.jlp.2021.104542 DOI: https://doi.org/10.1016/j.jlp.2021.104542

Wu T, Li C, Chen C, Shu C. Interaction effects of organizational and individual factors on safety leadership in college and university laboratories. J Loss Prev Proc Ind. 2008;21:239-54. https://doi.org/10.1016/j.jlp.2007.04.011 DOI: https://doi.org/10.1016/j.jlp.2007.04.011

Eklöf M, Törner M, Pousette A. Organizational and socialpsychological conditions in healthcare and their importance for patient and staff safety: A critical incident study among doctors and nurses. Saf Sci. 2014;70:211-2. https://doi.org/10.1016/j.ssci.2014.06.007 DOI: https://doi.org/10.1016/j.ssci.2014.06.007

McFadden KL, Stock GN, Gowen CR. Leadership, safety climate, and continuous quality improvement: Impact on process quality and patient safety. Health Care Manage Rev. 2015;40(1):24-34. https://doi.org/10.1097/HMR.0000000000000006 PMid:24566246 DOI: https://doi.org/10.1097/HMR.0000000000000006

Rekleiti M, Kyloudis P, Toska A, Saridi M. Patient safety and healthcare quality. Int J Caring Sci. 2012;5(2):74-9.

Kim T, Gausdal AH. Leading for safety: A weighted safety leadership model in shipping. Reliab Eng Syst Saf. 2017;165:458-66. https://doi.org/10.1016/j.ress.2017.05.002 DOI: https://doi.org/10.1016/j.ress.2017.05.002

Griffin MA, Hu X. How leaders differentially motivate safety compliance and safety participation : The role of monitoring, inspiring, and learning. Saf Sci. 2013;60:196-202. https://doi.org/10.1016/j.ssci.2013.07.019 DOI: https://doi.org/10.1016/j.ssci.2013.07.019

Bloemhof J, Knol J, Van Rijn M, Buurman BM. The implementation of a professional practice model to improve the nurse work environment in a Dutch hospital: A quasi‐experimental study. J Adv Nurs. 2021;77(12):1-16. https://doi.org/10.1111/jan.15052 DOI: https://doi.org/10.1111/jan.15052

García-Sierra R, Fernández-Castro J. Relationships between leadership, structural empowerment, and engagement in nurses. J Adv Nurs. 2018;74(12):2809-2819. https://doi.org/10.1111/jan.13805. PMid: 30019477. DOI: https://doi.org/10.1111/jan.13805

Setiowati D, Allenidekania, Sabri L. Effective leadership of the head nurse in improving the implementation of patient safety culture by implementing nurses at RSUPN Cipto Mangunkusumo Jakarta. Makara J Health Res. 2013;17:55-56. https://doi/org/10.7454/msk.v17i2.3027 DOI: https://doi.org/10.7454/msk.v17i2.3027

Jeffs L, Baker GR, Taggar R, Hubley P, Richards J, Merkley J, et al. Attributes and actions required to advance quality and safety in hospitals: Insights from nurse executives. Nurs Leadersh (Tor Ont). 2018;31(2):20-31. https://doi.org/10.12927/cjnl.2018.25606 PMid:30339122 DOI: https://doi.org/10.12927/cjnl.2018.25606

Mcauliffe E, De Brún A, Ward M, Shea MO, Cunningham U, Donovan RO, et al. Collective leadership and safety cultures [Co-Lead]: Protocol for a mixed-methods pilot evaluation of the impact of a co-designed collective leadership intervention on team performance and safety culture in a hospital group in Ireland. 2017;7(11):e0175691. BMJ Open. 2017;7(11):e017569. https://doi.org/10.1136/bmjopen-2017-017569 PMid:29101137 DOI: https://doi.org/10.1136/bmjopen-2017-017569

Kristensen S, Christensen KB, Jaquet A, Beck CM, Sabroe S, Bartels P, et al. Strengthening leadership as a catalyst for enhanced patient safety culture: A repeated cross-sectional experimental study. BMJ Open. 2016;6(5):e010180. https://doi.org/10.1136/bmjopen-2015-010180 DOI: https://doi.org/10.1136/bmjopen-2015-010180

Cziraki K, Read E, Laschinger HK, Wong C, Cziraki K, Read E, et al. Nurses’ leadership self-efficacy, motivation, and career aspirations. Leadersh Health Serv (Bradf Engl). 2018;31(1):47-61. https://doi.org/10.1108/LHS-02-2017-0003 PMid:29412096 DOI: https://doi.org/10.1108/LHS-02-2017-0003

Huang CY, Weng RH, Chen YT. Investigating the relationship among transformational leadership, interpersonal interaction and mentoring functions. J Clin Nurs. 2016;25(15-16):2144-55. https://doi.org/10.1111/jocn.13153 PMid:27108764 DOI: https://doi.org/10.1111/jocn.13153

Mashi MS, Subramaniam C, Johari J. The effect of management commitment to safety, and safety communication and feedback on safety behavior of nurses: The moderating role of consideration of future safety consequences. Int J Hum Resour Manag. 2018;31(20):2565-94. https://doi.org/10.1080/09585192.2018.1454491 DOI: https://doi.org/10.1080/09585192.2018.1454491

Fardellone C, Musil CM, Smith E, Click ER. Leadership behaviors of frontline staff nurses. J Contin Educ Nurs. 2014;45(11):506-13. https://doi.org/10.3928/00220124-20141023-05 PMid:25347089 DOI: https://doi.org/10.3928/00220124-20141023-05

Al-Ahmadi S. Patient Safety Climate and Leadership in the Emergency Department. A thesis submitted to the Faculty of Graduate Studies and Research. Health Policy Research. Thesis. Department of Public Health Sciences University of Alberta; 2011.

Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev. 2015;4:1. https://doi.org/10.1186/2046-4053-4-1 PMid:25554246 DOI: https://doi.org/10.1186/2046-4053-4-1

Sirriyeh R, Lawton R, Gardner P, Armitage G. Reviewing studies with diverse designs: the development and evaluation of a new tool. J Eval Clin Pract. 2012;18(4):746-52. https://doi.org/10.1111/j.1365-2753.2011.01662.x PMid:21410846 DOI: https://doi.org/10.1111/j.1365-2753.2011.01662.x

Castel ES, Ginsburg LR, Zaheer S, Tamim H. Understanding nurses’ and physicians’fear of repercussions for reporting errors: Clinician characteristics, organization demographics,or leadership factors? BMC Health Serv Res. 2015;15:326. https://doi.org/10.1186/s12913-015-0987-9 DOI: https://doi.org/10.1186/s12913-015-0987-9

Enwereuzor IK, Onyishi IE, Albi-Oparaocha FC, Amaeshi K. Perceived leader integrity as a mediator between ethical leadership and ethical climate in a teaching context. BMC Psychol. 2020;8(1):52. https://doi.org/10.1186/s40359-020-00420-6 PMid:32434553 DOI: https://doi.org/10.1186/s40359-020-00420-6

Halbesleben JR, Leroy H, Dierynck B, Simons T, Savage GT, McCaughey D, et al. Living up to safety values in health care: The effect of leader behavioral integrity on occupational safety. J Occup Health Psychol. 2013;18(4):395-405. https://doi.org/10.1037/a0034086 DOI: https://doi.org/10.1037/a0034086

Kanerva A, Kivinen T, Lammintakanen J. Collaborating with nurse leaders to develop patient safety practices. Leadersh Health Serv. 2017;3:30(3):249-62. https://doi.org/10.1108/LHS-05-2016-0022 PMid:28693390 DOI: https://doi.org/10.1108/LHS-05-2016-0022

Kim MY, Kang S, Kim YM, You M. Nurses’willingness to report near misses: A multilevel analysis of contributing factors. Soc Behav Pers. 2014;42(7):1133-46. https://doi.org/10.2224/sbp.2014.42.7.1133 DOI: https://doi.org/10.2224/sbp.2014.42.7.1133

Leroy H, Dierynck B, Anseel F, Simons T, Halbesleben JR, McCaughey D, et al. Behavioral integrity for safety, priority of safety, psychological safety, and patient safety: A teamlevel study. J Appl Psychol. 2012;97(6):1273-81. https://doi.org/10.1037/a0030076 PMid:22985115 DOI: https://doi.org/10.1037/a0030076

Nene SE, Ally H, Nkosi E. Nurse managers experiences of their leadership roles in a specific mining primary healthcare service in the West Rand. Curationis. 2020;43(1):e1-8. https://doi.org/10.4102/curationis.v43i1.2129 PMid:32787428 DOI: https://doi.org/10.4102/curationis.v43i1.2129

Renolen Å, Hjälmhult E, Høye S, Danbolt LJ. Creating room for evidence based practice : Leader behavior in hospital wards. Res Nurs Health. 2020;43(1):90-102. https://doi.org/10.1002/nur.21981 PMid:31544967 DOI: https://doi.org/10.1002/nur.21981

Webb S, Mckeon L. A model for preparing faculty to teach model c clinical nurse leader students. J Nurs Educ. 2014;53(7):421-6. https://doi.org/10.3928/01484834-20140617-05 PMid:24971734 DOI: https://doi.org/10.3928/01484834-20140617-05

Vanderboom CE, Scherb CA, Kirchner RB, Kohler CM, Ferrier JJ, Suther TW, et al. Leadership strategies, an interdisciplinary team, and ongoing nurse feedback: Ingredients for a successful BCMA project. Nurs Econ. 2016;34(3):117-26. PMid:27439248

Zohar D. Thirty years of safety climate research: Reflections and future directions. Accid Anal Prev. 2010;42(5):1517-22. https://doi.org/10.1016/j.aap.2009.12.019 PMid:20538108 DOI: https://doi.org/10.1016/j.aap.2009.12.019

Asrar-Ul-Haq M, Anwar S. The many faces of leadership: Proposing research agenda through a review of literature. Futur Bus J. 2018;4:179-88. https://doi.org/10.1016/j.fbj.2018.06.002 DOI: https://doi.org/10.1016/j.fbj.2018.06.002

Auer C. How hospital leaders contribute to patient safety through the development of trust. 2014;44(1):23-9. https://doi.org/10.1097/NNA.0000000000000017 PMid:24316615 DOI: https://doi.org/10.1097/NNA.0000000000000017

Barkhordari-Sharifabad M, Ashktorab T, Atashzadeh-Shoorideh F. Ethical leadership outcomes in nursing: A qualitative study. Nurs Ethics. 2018;25(8):1051-63. https://doi.org/10.1177/0969733016687157 PMid:28095757 DOI: https://doi.org/10.1177/0969733016687157

Clarke S. Safety leadership : A meta-analytic review of transformational and transactional leadership styles as antecedents of safety behaviours. J Occup Organ Psychol. 2013;86:22-49. https://doi.org/10.1111/j.2044-8325.2012.02064.x DOI: https://doi.org/10.1111/j.2044-8325.2012.02064.x

Agnew C, Flin R, Reid J. Nurse leadership and patient safety. BMJ. 2012;345:e4589. https://doi.org/10.1136/bmj.e4589 PMid:22879634 DOI: https://doi.org/10.1136/bmj.e4589

Day DV, Dragoni L. Leadership development: an outcomeoriented review based on time and levels of analyses. Ann Rev Organ Psychol Organ Behav. 2015;2(1):133-56. https://doi.org/10.1146/annurev-orgpsych-032414-111328 DOI: https://doi.org/10.1146/annurev-orgpsych-032414-111328

Mattson M, Hellgren J. Leader communication approaches and patient safety: An integrated model. J Safety Res. 2015;53:53-62. http://doi.org/10.1016/j.jsr.2015.03.008 PMid:25933998 DOI: https://doi.org/10.1016/j.jsr.2015.03.008

Goldstein DH, Nyce JM, Van Den Kerkhof EG. Safety perceptions of health care leaders in 2 Canadian academic acute care centers. J Patient Saf. 2017;13(2):62-8. https://doi.org/10.1097/PTS.0000000000000112 PMid:25526371 DOI: https://doi.org/10.1097/PTS.0000000000000112

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Published

2022-01-03

How to Cite

1.
Lusianah L, Sitorus R, Lestari F, Muhaimin T, Juliastuti D. Implementation of Safety Leadership in Nursing Management: A Systematic Mixed Studies Review. Open Access Maced J Med Sci [Internet]. 2022 Jan. 3 [cited 2024 Mar. 28];10(T8):5-10. Available from: https://oamjms.eu/index.php/mjms/article/view/9455

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