Fischer Shelly A, Jones Jacqueline, Verran Joyce A
Fay W. Whitney School of Nursing, University of Wyoming, Laramie, WY, USA.
College of Nursing, University of Colorado, Aurora, CO, USA.
J Nurs Manag. 2018 Jan;26(1):50-58. doi: 10.1111/jonm.12519. Epub 2017 Sep 21.
To validate a framework of factors that influence the relationship of transformational leadership and safety climate, and to enable testing of safety chain factors by generating hypotheses regarding their mediating and moderating effects.
Understanding the patient safety chain and mechanisms by which leaders affect a strong climate of safety is essential to transformational leadership practice, education, and research.
A systematic review of leadership and safety literature was used to develop an organising framework of factors proposed to influence the climate of safety. A panel of 25 international experts in leadership and safety engaged a three-round modified Delphi study with Likert-scored surveys.
Eighty per cent of participating experts from six countries were retained to the final survey round. Consensus (>66% agreement) was achieved on 40 factors believed to influence safety climate in the acute care setting.
Consensus regarding specific factors that play important roles in an organisation's climate of safety can be reached. Generally, the demonstration of leadership commitment to safety is key to cultivating a culture of patient safety.
Transformational nurse leaders should consider and employ all three categories of factors in daily leadership activities and decision-making to drive a strong climate of patient safety.
验证一个影响变革型领导与安全氛围关系的因素框架，并通过生成关于其中介和调节作用的假设来对安全链因素进行检验。
了解患者安全链以及领导者影响强大安全氛围的机制对于变革型领导实践、教育和研究至关重要。
对领导力与安全方面的文献进行系统综述，以构建一个拟影响安全氛围的因素组织框架。由25名领导力与安全领域的国际专家组成的小组开展了三轮采用李克特评分调查的改良德尔菲研究。
来自六个国家的80%参与专家进入了最终调查轮次。就40个被认为影响急症护理环境中安全氛围的因素达成了共识（>66%的一致意见）。
可以就特定因素在组织安全氛围中发挥的重要作用达成共识。一般而言，展现出对安全的领导承诺是培养患者安全文化的关键。
变革型护士领导者在日常领导活动和决策中应考虑并运用所有三类因素，以营造强大的患者安全氛围。
