title: An educational intervention to enhance nurse leaders' perceptions of patient safety culture.
abstract: OBJECTIVE
  To design a training intervention and then test its effect on nurse leaders' perceptions of patient safety culture.
  
  
  METHODS
  Three hundred and fifty-six nurses in clinical leadership roles (nurse managers and educators/CNSs) in two Canadian multi-site teaching hospitals (study and control).
  
  
  METHODS
  A prospective evaluation of a patient safety training intervention using a quasi-experimental untreated control group design with pretest and posttest. Nurses in clinical leadership roles in the study group were invited to participate in two patient safety workshops over a 6-month period. Individuals in the study and control groups completed surveys measuring patient safety culture and leadership for improvement prior to training and 4 months following the second workshop.
  
  
  METHODS
  Individual nurse clinical leaders were the unit of analysis. Exploratory factor analysis of the safety culture items was conducted; repeated-measures analysis of variance and paired t-tests were used to evaluate the effect of the training intervention on perceived safety culture (three factors). Hierarchical regression analyses looked at the influence of demographics, leadership for improvement, and the training intervention on nurse leaders' perceptions of safety culture.
  
  
  RESULTS
  A statistically significant improvement in one of three safety culture measures was shown for the study group (p<.001) and a significant decline was seen on one of the safety culture measures for the control group (p<.05). Leadership support for improvement was found to explain significant amounts of variance in all three patient safety culture measures; workshop attendance explained significant amounts of variance in one of the three safety culture measures. The total R(2) for the three full hierarchical regression models ranged from 0.338 and 0.554.
  
  
  CONCLUSIONS
  Sensitively delivered training initiatives for nurse leaders can help to foster a safety culture. Organizational leadership support for improvement is, however, also critical for fostering a culture of safety. Together, training interventions and leadership support may have the most significant impact on patient safety culture.
authors: School of Health Policy and Management, York University, Toronto, ON, Canada.
authors: Liane
authors: L
authors: Ginsburg
authors: Peter G
authors: PG
authors: Norton
authors: Ann
authors: A
authors: Casebeer
authors: Steven
authors: S
authors: Lewis
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D002170:Canada; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D007318:Inservice Training; D007857:Leadership; D008297:Male; D019300:Medical Errors / Q000517:prevention & control; D008875:Middle Aged; D009741:Nursing Staff, Hospital / Q000193:education* / Q000458:organization & administration; D015279:Organizational Culture; D011785:Quality Assurance, Health Care / Q000379:methods; D012044:Regression Analysis; D017751:Safety Management / Q000458:organization & administration*