Transformational leadership and safety performance among nurses: the mediating role of knowledge-related job characteristics.

AIMS To report the impact of transformational leadership on two dimensions of nurses' safety performance (i.e. safety compliance and safety participation) and to study the mediating role of knowledge-related job characteristics in this relationship. BACKGROUND Safety performance refers to the behaviours that employees exhibit to adhere to safety guidelines and to promote health and safety at their workplace. Nurses' safety performance is a major challenge for healthcare settings, urging the need to identify the key determinants and psychological mechanisms that influence it. DESIGN A cross-sectional survey study. METHODS The study was carried out in September 2010 in a large Belgian hospital. We used self-administered questionnaires; 152 nurses participated. The hypotheses were tested using hierarchical regression analyses. RESULTS/FINDINGS In line with our first hypothesis, the results show that transformational leadership exerted a significant positive impact on both dimensions of nurses' safety performance. This positive relation was mediated by knowledge-related job characteristics, supporting our second hypothesis. CONCLUSION Head nurses' transformational leadership can enhance nurses' compliance with and participation in safety. Furthermore, transformational head nurses are able to influence the perception that their nurses have about the kind and amount of knowledge in their job, which can also lead to increases in both dimensions of nurses' safety performance. This study therefore demonstrates the key impact that transformational head nurses have, both directly and indirectly, on the safety performance of their nurses.

[1]  Stephen E. Humphrey,et al.  The Work Design Questionnaire (WDQ): developing and validating a comprehensive measure for assessing job design and the nature of work. , 2006, The Journal of applied psychology.

[2]  Jill Scott-Cawiezell,et al.  Keeping patients safe in healthcare organizations: a structuration theory of safety culture. , 2011, Journal of advanced nursing.

[3]  A. Neal,et al.  A study of the lagged relationships among safety climate, safety motivation, safety behavior, and accidents at the individual and group levels. , 2006, The Journal of applied psychology.

[4]  Scott B. MacKenzie,et al.  Common method biases in behavioral research: a critical review of the literature and recommended remedies. , 2003, The Journal of applied psychology.

[5]  Mark R. Leary,et al.  Introduction to behavioral research methods, 4th ed. , 2004 .

[6]  S. J. Motowidlo,et al.  Evidence that task performance should be distinguished from contextual performance. , 1994 .

[7]  Johanne Gagnon,et al.  Using the theory of planned behaviour to predict nurses' intention to integrate research evidence into clinical decision-making. , 2012, Journal of advanced nursing.

[8]  Gil Luria,et al.  Group Leaders as Gatekeepers: Testing Safety Climate Variations across Levels of Analysis , 2010 .

[9]  Michael J. Burke,et al.  GENERAL SAFETY PERFORMANCE: A TEST OF A GROUNDED THEORETICAL MODEL , 2002 .

[10]  S. Hannah,et al.  A multilevel approach to building and leading learning organizations , 2009 .

[11]  C. Stride,et al.  Transformational leadership and employee safety performance: a within-person, between-jobs design. , 2010, Journal of occupational health psychology.

[12]  R. Brislin Back-Translation for Cross-Cultural Research , 1970 .

[13]  B. Bass From transactional to transformational leadership: Learning to share the vision. , 1990 .

[14]  Joyce E. Bono,et al.  Transformational Leadership, Job Characteristics, and Organizational Citizenship Performance , 2006 .

[15]  Willem Verbeke,et al.  Using the job demands‐resources model to predict burnout and performance , 2004 .

[16]  Greta G Cummings,et al.  Leadership styles and outcome patterns for the nursing workforce and work environment: a systematic review. , 2010, International journal of nursing studies.

[17]  D. A. Kenny,et al.  The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. , 1986, Journal of personality and social psychology.

[18]  D. Hofmann,et al.  Safety at work: a meta-analytic investigation of the link between job demands, job resources, burnout, engagement, and safety outcomes. , 2011, The Journal of applied psychology.

[19]  A. Neal,et al.  The impact of organizational climate on safety climate and individual behavior , 2000 .

[20]  Sharon Clarke,et al.  The Role of Leader Influence Tactics and Safety Climate in Engaging Employees' Safety Participation , 2006, Risk analysis : an official publication of the Society for Risk Analysis.

[21]  E. Kelloway,et al.  Safety leadership: A longitudinal study of the effects of transformational leadership on safety outcomes , 2009 .

[22]  Ronald F. Piccolo,et al.  Transformational Leadership and Job Behaviors: The Mediating Role of Core Job Characteristics. , 2006 .

[23]  Deanne N. Den Hartog,et al.  Transactional versus transformational leadership: An analysis of the MLQ. , 1997 .

[24]  Kristopher J Preacher,et al.  SPSS and SAS procedures for estimating indirect effects in simple mediation models , 2004, Behavior research methods, instruments, & computers : a journal of the Psychonomic Society, Inc.

[25]  E. Kelloway,et al.  Development and test of a model linking safety-specific transformational leadership and occupational safety. , 2002, The Journal of applied psychology.

[26]  J. Pokorski,et al.  Working conditions and intent to leave the profession among nursing staff in Europe , 2003 .

[27]  Genevieve L Thyer Dare to be different: transformational leadership may hold the key to reducing the nursing shortage. , 2003, Journal of nursing management.

[28]  Nick Turner,et al.  Job Demands-Control-Support model and employee safety performance. , 2012, Accident; analysis and prevention.

[29]  B. Bass,et al.  Re‐examining the components of transformational and transactional leadership using the Multifactor Leadership , 1999 .

[30]  Jill C. Bradley,et al.  Workplace safety: a meta-analysis of the roles of person and situation factors. , 2009, The Journal of applied psychology.

[31]  B. Bass,et al.  Multifactor Leadership Questionnaire , 2011 .

[32]  B. Bass LEADERSHIP AND PERFORMANCE BEYOND EXPECTATIONS , 1985 .

[33]  Rick D. Hackett,et al.  Further assessments of Bass's (1985) conceptualization of transactional and transformational leadership. , 1995 .

[34]  K. Nielsen,et al.  The effects of transformational leadership on followers’ perceived work characteristics and psychological well-being: A longitudinal study , 2008 .

[35]  Despoina Xanthopoulou,et al.  Working in the sky: a diary study on work engagement among flight attendants. , 2008, Journal of occupational health psychology.

[36]  A Neal,et al.  Perceptions of safety at work: a framework for linking safety climate to safety performance, knowledge, and motivation. , 2000, Journal of occupational health psychology.

[37]  B. Bass,et al.  The Bass handbook of leadership : theory, research, and managerial applications , 2008 .

[38]  A. Saks Antecedents and consequences of employee engagement , 2006 .

[39]  David A. Hofmann,et al.  The role of leadership in safety. , 2004 .

[40]  Gulumser Kublay,et al.  Transformational leadership training programme for charge nurses. , 2011, Journal of advanced nursing.

[41]  G. De Backer,et al.  Job stress and depression symptoms in middle-aged workers--prospective results from the Belstress study. , 2007, Scandinavian journal of work, environment & health.