Elhihi Ebtisam A, Aljarary Khadija Lafi, Alahmadi Maha, Adam Jawaher Bakor, Almwualllad Ohud Atiah, Hawsawei Marwan S, Hamza Abdulmajid Ahmad, Ibrahim Ibrahim Abdullatif
Nursing Research and Evidence-Based Practice Department, King Abdullah Medical City, Makkah, Saudi Arabia.
Nursing Manager of Critical Care Units, King Abdullah Medical City, Makkah, Saudi Arabia.
BMC Nurs. 2025 Apr 8;24(1):392. doi: 10.1186/s12912-025-03043-7.
Ethical leadership in nursing is pivotal for fostering a transparent workplace culture and encouraging error reporting, a critical behavior for enhancing patient safety. In Saudi Arabia, cultural and organizational factors may influence nurses' willingness to report errors, making this an essential area of study. This study investigates the correlation between ethical leadership and error reporting behavior, emphasizing the mediating influence of moral courage among nurses in Saudi Arabia.
This cross-sectional research used a simple random sampling technique to recruit 269 clinical nurses from four specialized medical centers affiliated with King Abdullah Medical City in Makkah, Saudi Arabia. Data was collected between October and December 2024 using online self-reported questionnaires that included validated scales for ethical leadership, moral courage, error reporting, and demographic information form. This study was conducted in accordance with the STROBE guidelines. Structural equation modeling was used to investigate hypothesized relationships.
Ethical leadership significantly impacted error reporting behavior (β = 0.58, p < 0.001) and ethical courage (β = 0.35, p < 0.001). Moral courage was a significant predictor of error reporting behavior (β = 0.30, p = 0.01) and partially mediates the link between ethical leadership and error reporting (β = 0.11, p = 0.01). The total effect of ethical leadership on error reporting behavior was substantial (β = 0.69), with a BC 95% CI of (0.51, 0.89).
The findings highlight the critical role of ethical leadership in fostering moral courage and promoting error reporting behavior among nurses. The mediation effect of moral courage underscores the importance of cultivating an ethical work environment that empowers nurses to act with integrity and report errors without fear of retaliation. These insights emphasize the need for nursing managers to prioritize ethical leadership practices and create transparent workplace cultures that enhance patient safety. By addressing cultural and organizational barriers, healthcare institutions in Saudi Arabia can further encourage error reporting, ultimately improving the quality of care and patient outcomes.
护理中的道德领导对于营造透明的工作场所文化和鼓励错误报告至关重要，而错误报告是提高患者安全的关键行为。在沙特阿拉伯，文化和组织因素可能会影响护士报告错误的意愿，因此这是一个重要的研究领域。本研究调查道德领导与错误报告行为之间的相关性，强调道德勇气在沙特阿拉伯护士中的中介作用。
本横断面研究采用简单随机抽样技术，从沙特阿拉伯麦加阿卜杜拉国王医疗城附属的四个专业医疗中心招募了269名临床护士。2024年10月至12月期间，使用在线自填问卷收集数据，问卷包括经过验证的道德领导、道德勇气、错误报告量表以及人口统计学信息表。本研究按照STROBE指南进行。采用结构方程模型研究假设关系。
道德领导对错误报告行为有显著影响（β = 0.58，p < 0.001），对道德勇气也有显著影响（β = 0.35，p < 0.001）。道德勇气是错误报告行为的显著预测因素（β = 0.30，p = 0.01），并部分中介了道德领导与错误报告之间的联系（β = 0.11，p = 0.01）。道德领导对错误报告行为的总效应显著（β = 0.69），偏差校正95%置信区间为（0.51，0.89）。
研究结果突出了道德领导在培养道德勇气和促进护士错误报告行为方面的关键作用。道德勇气的中介作用强调了营造道德工作环境的重要性，这种环境能使护士正直行事并报告错误而不必担心报复。这些见解强调了护理管理者需要优先考虑道德领导实践，并营造透明的工作场所文化以提高患者安全。通过消除文化和组织障碍，沙特阿拉伯的医疗机构可以进一步鼓励错误报告，最终提高护理质量和患者结局。
