Perceived Leader-Member Exchange and Patient Safety Culture among Nurses in Tertiary Hospitals, Kunming, the People’s Republic of China

Authors

  • Ling Zhang Staff Nurse, The Third People’s Hospital of Yunnan Province, Kunming, P. R. China
  • เพชรสุนีย์ ทั้งเจริญกุล Assistant Professor, Faculty of Nursing, Chiang Mai University
  • บุญพิชชา จิตต์ภักดี Lecturer, Faculty of Nursing, Chiang Mai University, Thailand

Keywords:

Leader-Member Exchange, Patient Safety Culture, Tertiary Hospital, China

Abstract

Patient safety culture is critical for hospitals to prevent adverse events occurring.  However, gaps still remain regarding the relationship between leader-member exchange and patient safety culture in China.  The purposes of this study were to describe leader-member exchange and patient safety culture in China, and to examine the relationship between leader-member exchange and each dimension of patient safety culture in tertiary hospitals in Kunming, the People’s Republic of China.  The research sample consisted of 315 nurses, representing 105 wards.  The research instruments included: 1) Demographic Data Form, 2) the Multi-Dimensional Leader-Member Exchange Scale (LMX-MDM) developed by Liden and Maslyn (1998), and 3) Hospital Survey on Patient Safety Culture (HSOPSC) developed by Sorra and Nieva (2004).  The Cronbach's alpha coefficients for LMX-MDM and HSOPSC were .98 and .91 respectively.  Data were analyzed using descriptive statistics and Spearman’s Rank-Order Correlation Coefficient.

             The findings of this study were as follows:

  1. Approximately 77% of the wards had a high level of leader-member exchange, while the rest had a moderate level of leader-member exchange.    
  2. Approximately 22% of the wards had a strength area in overall patient safety culture. About 65% had a moderate area in overall patient safety culture, while 13% of the wards need improve in overall patient safety culture.
  3. There was a positive relationship between leader-member exchange and the subscales of patient safety culture, except in the case of the subscale of hospital handoffs and transition. 

             The results of this study could provide valuable information for hospital administration and nurse managers to be aware of the importance of patient safety culture and to set up interventions to enhance leader-member exchange in order to promote patient safety culture.

Downloads

Download data is not yet available.

References

Blegen, M. A., Pepper, G. A., & Joseph, R. (2005). Safety climate on hospital units: A new measure. Advances in Patient Safety: From Research to Implementation, 4, 429-443.

Cao, R. (2007). Medical quality and patient safety in China [in Chinese]. Chinese Hospitals, 11(11), 1-4.

D’Amour, D., Dubois, C.-A., Tchouaket, É., Clarke, S., & Blais, R. (2014). The occurrence of adverse events potentially attributable to nursing care in medical units: Cross sectional record review. International Journal of Nursing Studies, 51, 882–891.

Dai, H., Shi, Y., & Mao, Y. (2009). Research status quo and thinking of nursing adverse events reporting system [in Chinese]. Nursing Research, 23(8), 2137-2138.

Department of Medical Administration. (2012). Outline of development plan for nursing in China (2011-2015) [in Chinese]. Ministry of Health. Retrieved from http://www.moh.gov.cn/mohyzs/s3593/201201/53897.shtml

Erdogan, B., Liden , R., & Kraimer, M. (2006). Justice and leader-member exchange: The moderating role of organizational culture. Academy of Management Journal, 49 (2), 395–406.

Feng, X., Bobay, K., Krejci, J., & McCormick, B. (2012). Factors associated with nurses’ perceptions of patient safety culture in China: A cross-sectional survey study. Journal of Evidence-Based Medicine, 5, 50–56. doi: 10.1111/j.1756-5391.2012.01177.x

Ferris, G. (1985). Role of leadership in the employee withdrawal process: A constructive replication. Journal of Applied Psychology, 70(4), 777-781.

Friesen, M. A., White, S. V., & Byers, J. F. (2008). Chapter 34. Handoffs: Implications for Nurses. In K. Alden, K. Alster, L. Antle, E. Ayello, J. Barnsteiner, & A. Bemis, Patient Safety and Quality: An Evidence-Based Handbook for Nurses (pp. 1-48). Rockville: AHRQ Publication No. 08-0043.

Fujita, S., Seto, K., Kitazawa, T., Matsumoto, K., & Hasegawa, T. (2014). Characteristics of unit-level patient safety culture in hospitals in Japan: A cross-sectional study. BioMed Central Health Services Research, 14(508), 1-9.

Halligan, M., & Zecevic, A. (2011). Safety culture in healthcare: a review of concepts, dimensions, measures and progress. British Medical Journal Quality & Safety, 20(4), 338-343.

Hofmann, D., & Morgeson, F. (1999). Safety-related behavior as a social exchange: The role of perceived organizational support and leader-member exchange. Journal of Applied Psychology, 84(2), 286-296.

Hofmann, D., Morgeson, F., & Gerras, S. (2003). Climate as a moderator of the relationship between leader–member exchange and content specific citizenship: Safety climate as an exemplar. Journal of Applied Psychology, 88(1), 170–178.

Hu, J., & Liden, R. (2013). Relative leader-member exchange within team contexts: How and when social comparison impacts individual effectiveness. Personnel Psychology, 66, 127-172.

Khairullah, D., & Khairullah, Z. (2013). Cultural values and decision-making in China. International Journal of Business, Humanities and Technology, 3(2), 1-12.

Laschinger, H. K., Finegan, J., & Wilk, P. (2009). The impact of unit leadership and empowerment on nurses’ organizational commitment. The Journal of Nursing Administration, 39(5), 228-235.

Laschinger, H. K., Finegan, J., & Wilk, P. (2011). Situational and dispositional influences on nurses’ workplace well-being. Nursing Research, 60(2), 124-131.

Li, L., & Liu, X. (2009). Analysis of nurses’ assessment of the patient safety culture in hospital [in Chinese]. Chinese Journal of Nursing, 44(4), 304-307.

Liden, R., & Maslyn, J. (1998). Multidimensionafity of leader-member exchange: An empirical assessment through scale development. Journal of Management, 24(1), 43-72.

Liu, C., Liu, W., Wang, Y., Zhang, Z., & Wang, P. (2013). Patient safety culture in China: A case study in an outpatient setting in Beijing. British Medivcal Journal Quality & Safety Published Online First 18 December 2013, 1-9.

Luo, Y. (2011). Conflict management and burnout among nurses in university hospitals, the People's Republic of China . Chiangmai [unpublished thesis]: The graduate school, Chiang Mai university.

Mardon, R. E., Khanna, K., Sorra, J., Dyer, N., & Famolaro, T. (2010). Exploring relationships between hospital patient safety culture and adverse events. Journal of Patient safety, 6(4), 226-232.

Moody, R., Pesut, D., & Harrington, C. (2006). Creating safety culture on nursing units: Human performance and organizational system factors that make a difference. Journal of Patient Safety, 2(4), 198-206.

Nahrgang, J., Morgeson, F., & Ilies, R. (2009). The development of leader–member exchanges: Exploring how personality and performance influence leader and member relationships over time. Organizational Behavior and Human Decision Processes, 108, 256–266.

National Bureau of Statistics of China. (2014). China Statistical Yearbook-2014 [in Chinese]. Beijing: China Statistics Press. Retrieved from http://www.stats.gov.cn/tjsj/ndsj/2014/indexeh.htm

Nieva, V., & Sorra, J. (2003). Safety culture assessment: A tool for improving patient safety in healthcare organizations. British Medical Journal Quality & Safety, 12, ii17-ii23.

Sorra , J., & Nieva, V. (2004). Hospital Survey on Patient Safety Culture. (Prepared by Westat, under Contract No. 290-96-0004). Rockville, MD: Agency for Healthcare Research and Quality: AHRQ Publication No. 04-0041.

The Research Priority Setting Working Group. (2008). Global Priorities for Research in Patient Safety. World Health Organization. Retrieved from http://www.who.int/patientsafety/research/priorities/global_priorities_patient_safety_research.pdf

Thompson, D., Hoffman, L., Sereika, S., & Lorenz, H. (2011). A relational leadership perspective on unit-level safety climate. The Journal of Nursing Administration, 41(11), 479-487.

Tregunno, D., Jeffs, L., Baker, G., Doran, D., McGillis-Hall, L., & Affonso, D. (2009). Leadership to promote patient safety culture and learning in critical care. Ottawa: Canadian Health Services Research Foundation.

Wang, J. (2011). Hot spots of society. Retrieved from www.yunnan.cn: http://society.yunnan.cn/html/2011-07/22/content_1734082.htm

Wang, X., Liu, K., You, L., Xiang, J., Hud, H., Zhang, L., . . . Zhu, X. (2014). The relationship between patient safety culture and adverse events: A questionnaire survey. International Journal of Nursing Studies, 51, 1114-1122.

Wei, B., & Tian, Z. (2011). SH9 classification of medical adverse event and its practical significance [in Chinese]. Chinese Hospitals, 15(1), 44-45.

Yamane, T. (1973). Statistic: An introductory analysis. Tokyo: Harper International.

Yukl, G., O’Donnell, M., & Taber, T. (2009). Influence of leader behaviors on the leader-member exchange relationship. Journal of Managerial Psychology, 24(4), 289-299.

Zhang, M., & Li, Y. (2008). Patient safety — global challenges for health care service [in Chinese]. Chinese Journal of Evidence-based Medicine, 8(7), 509-512.

Zhao, Y., Wang, L., Mi, W., & Zhou , K. (2014). The reliability and validity analysis of Confucian benevolence behavior questionnaire in head nurse management [in Chinese]. Medical Aesthetics and Cosmetology, 4, 455-455.

Published

2019-06-24