Safety Leadership of Head Nurses and Safety Culture Perceived by Registered Nurses in General Hospitals, Southern Thailand

Authors

  • Montira Ruensirikul Faculty of Nursing, Prince of Songkla University
  • Pratyanan Thiangchanya Faculty of Nursing, Prince of Songkla University
  • Shutiwan Purinthrapibal Faculty of Nursing, Prince of Songkla University

Keywords:

Head nurses, Safety culture, Safety leadership

Abstract

The head nurse is the primary nursing administrator who plays a key role in systematically implementing safety management policies. The purpose of this descriptive correlational research was to study the level of safety leadership of head nurses, the safety culture as perceived by registered nurses, and the relationship between head nurses’ safety leadership and safety culture as perceived by registered nurses in general hospitals in the southern region of Thailand. The participants consisted of 132 registered nurses. Data were collected using a QR code-based questionnaire divided into three parts: (1) general information, (2) a safety culture questionnaire, and (3) a head nurse safety leadership questionnaire. Data were analyzed using descriptive statistics and Spearman’s rank correlation coefficient.

The results revealed that the overall level of safety leadership of head nurses was at a very high level (M = 4.31, SD = 0.51). The dimension with the highest mean score was safety coaching leadership (M = 4.34, SD = 0.61). The overall level of safety culture was also at a very high level (M = 4.31, SD = 0.51), with information culture showing the highest mean score (M = 4.36, SD = 0.60). The relationship between head nurses’ safety leadership and safety culture as perceived by registered nurses in general hospitals in the southern region of Thailand showed a strong positive correlation that was statistically significant (rs = .778, p < .01).

Nursing administrators can utilize these research findings to promote a culture of safety, focusing on developing safety leadership among head nurses.

References

Burns, N., & Grove, S. K. (2005). The practice of nursing research: Conduct, critique, and utilization (5th ed.). Elsevier Saunders.

Carolynn, B. (2025). What is safety leadership? (And 8 ways to promote it). Indeed Career Development. https://www.indeed.com/career-advice/career-development/safety-leadership

Congchinsatthiti, P. (2019). Characteristics of head nurse as perceived by health care team at police general hospital. Journal of The Royal Thai Army Nurses, 20(2), 225-232. (in Thai)

Cooper, M. D. (2000). Towards a model of safety culture. Safety Science, 36(2), 111–136. https://doi.org/10.1016/S0925-7535(00)00035-7

Cooper, M. D. (2010). Safety leadership. https://www.behavioral-safety.com/behavior-based-safety-solution-center/safety-coaching-and-training/safety-leadership

Healthcare Accreditation Institute (Public Organisation). (2022). Annual report 2022. Decembery. Healthcare Accreditation Institute.

Healthcare Accreditation Institute (Public Organisation), (2023). Strategy for driving policy implementation on patient, public health personnel and people Phase 2 (2024-2027) (Patient, Personnel and People Safety (3P Safety)). Ministry of Public Health. https://backend.ha.or.th/fileupload/DOCUMENT/00201/15afd03d-b50e-44a6-98ba-5ee82c5e445e.pdf (in Thai)

Jantiya, S. (2020). A structural equation model of the relationship among safety leadership, safety management, safety culture on safety performance of head nurses at regional hospitals under Ministry of Public Health [Doctor dissertation, Christian University of Thailand]. http://library.christian.ac.th/thesis/document/T043876.pdf

Muwannasin, H., Putkheaw, S., Sahmaae, N., Jehheng, F., Nawsuwan, K., & Singweratham, N. (2023). Development of incidence and adverse event management model under 9 standards for the safety of patients and public health personnel. Journal of Council of Community Public Health, 5(2), 12–24. (in Thai)

National Reporting and learning System. (2024). Incident reports. National Reporting and learning System.

Nuchanart, C., & Boriraj, J. (2020). Factors affecting safety culture of steel industry operators in Wha Eastern industrial estate (Map Ta Phut) Rayong Province. Journal of Graduate School of Commerce-Burapha Review, 15(2), 106-120. (in Thai)

Nursing Division, Ministry of Public Health, (2017). Guidelines for succession planning for the nursing profession based on good governance principles. Suetawan Publishing.

Reason, J. (1997). Managing the risks of organizational accidents. Ashgate.

Reason, J. (1998). Achieving a safe culture: Theory and practice. Work & Stress, 12(3), 293–306. https://doi.org/10.1080/02678379808256868

Reason, J. (2000). Human error: Models and management. BMJ, 320, 768. https://doi.org/10.1136/bmj.320.7237.768

Silanoi, L., & Chindaprasert, K. (2019). The Use of Rating Scale in quantitative research on social sciences, humanities, hotel and tourism study. Journal of Management Science, Ubon Ratchathani University, 8(15), 112-126. (in Thai)

Srisatidnarakul, B. (2020). Effect size, power analysis, optimal sample size calculations using G*Power software. Chulalongkorn University Press. (in Thai)

Tharaphiromrak, S. (2021). Guideline on safety management of emergence ward nursing personnel of a Government Hospital in Bangkok. The Journal of Research and Academics, 4(3), 137-146. (in Thai)

Wei, S. Y., & Kuo, Y. K. (2023). The relationship among safety leadership, risk perception, safety culture, and safety performance: Military volunteer soldiers as a case study. Frontiers in Psychology, 14(1), 1000331. https://doi.org/10.3389/fpsyg.2023.1000331

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Published

2026-09-29

How to Cite

Ruensirikul, M., Thiangchanya, P., & Purinthrapibal, S. (2026). Safety Leadership of Head Nurses and Safety Culture Perceived by Registered Nurses in General Hospitals, Southern Thailand. Nursing Journal CMU, 53(3), 167–178. retrieved from https://he02.tci-thaijo.org/index.php/cmunursing/article/view/279320

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Section

RESEARCH  ARTICLES