Electronic Thesis and Dissertation Repository

Thesis Format

Monograph

Degree

Doctor of Philosophy

Program

Nursing

Supervisor

Wong, Carol A.

Abstract

Background: Error reporting has been identified as an important approach to improve delivery of both safe and quality care. However, existing evidence suggests that nurses are reluctant to report errors they make or fail to speak up about mistakes committed by others. Authentic leadership has been linked to improved work environments for nurses and enhanced quality of care. However, the question of how authentic leaders influence new graduate nurses’ willingness to report errors has received minimal attention.

Purpose: The aim of this study was to test a theoretical model that examined the influence of authentic leadership on new graduate nurses’ personal identification with the leader, organizational identification, trust in the manager, climate factors of judgment-free environment and job repercussions of error, error communication, error strain, and covering up error.

Methods: Employing a predictive non-experimental cross-sectional design, a self-administrated survey was mailed to a random sample of 1275 registered new graduate nurses practicing in acute care settings in Ontario. The final sample size was 178 participants (response rate of 15.8%).

Results: The structural model had an acceptable fit: χ 2(140) = 253.248, p < .001; CFI = .950 TLI = .938; RMSEA = .068(CI = .054, .081); SRMR = .060. Authentic leadership was positively associated with personal identification, which in turn was positively associated with organizational identification and trust in the manager. Trust in the manager was positively associated with judgment-free environment and job repercussions of error. Judgment-free environment was positively associated with error communication and job repercussions of error was positively associated with covering up error.

Conclusions: Findings provide empirical support for the influence of authentic leadership on new graduate nurses’ attitudes toward error reporting. Authentic leaders are able to create work environments that support new graduate nurses error reporting by strengthening their personal identification with the leader and building trusting relationships. Healthcare organizations should invest in leadership-training and development programs that focus on building authentic leadership dimensions among nursing managers.

Summary for Lay Audience

Error reporting is one of the most important strategies to improve the delivery of safe patient care. However, current research suggests that nurses are afraid to report errors due to the negative responses towards error reporting. Studies have suggested that authentic leadership may improve nurses’ workplace environment. It is important to know the way authentic leaders influence new graduate nurses’ willingness to report errors.

The current study investigate the influence of authentic leadership on new graduate nurses’ personal identification with the leader, organizational identification, trust in the manager, climate factors of judgment-free environment and job repercussions of error, error communication, error strain, and covering up error. This study used data from 178 new graduate nurses with less than three years of nursing experience working in hospitals across Ontario. We had new graduate nurses rate their nursing manager’s leadership style, their perceptions about their healthcare organization, work environment, and errors within their nursing units.

Overall, we found that authentic leadership style positively influence new graduate nurses’ attitudes toward error reporting. Authentic leaders are able to create work environments that support new graduate nurses error reporting by strengthening their’ personal identification with the leader and building trusting relationships. Healthcare organizations should invest in leadership-training and development programs that focus on building authentic leadership dimensions among nursing managers.

Available for download on Friday, April 02, 2021

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