title: Authentic leadership and nurse-assessed adverse patient outcomes.
abstract: OBJECTIVE
  Our purpose was to test a model examining relationships among authentic leadership, nurses' trust in their manager, areas of work life and nurse-assessed adverse patient outcomes.
  
  
  BACKGROUND
  Although several work environment factors have been cited as critical to patient outcomes, studies linking nursing leadership styles with patient outcomes are limited suggesting the need for additional research to investigate the mechanisms by which leadership may influence patient outcomes.
  
  
  METHODS
  Secondary analysis of data collected in a cross-sectional survey of 280 (48% response rate) registered nurses working in acute care hospitals in Ontario was conducted using structural equation modelling.
  
  
  RESULTS
  The final model fit the data acceptably (χ(2) = 1.30, df = 2, P = 0.52, IFI = 0.99, CFI = 1.00, RMSEA = 0.00). Authentic leadership was significantly associated with decreased adverse patient outcomes through trust in the manager and areas of work life.
  
  
  CONCLUSIONS
  The findings suggest that nurses who see their managers as demonstrating high levels of authentic leadership report increased trust, greater congruence in the areas of work life and lower frequencies of adverse patient outcomes.
  
  
  CONCLUSIONS
  Managers who emphasize transparency, balanced processing, self-awareness and high ethical standards in their interactions with nurses may contribute to safer work environments for patients and nurses.
authors.affiliation: Arthur Labatt Family School of Nursing, Faculty of Health Sciences, Health Sciences Addition (HSA), The University of Western Ontario, London, ON, Canada. cwong2@uwo.ca
authors.forename: Carol A
authors.initials: CA
authors.lastname: Wong
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Giallonardo
mesh_terms: D000328:Adult; D001364:Awareness; D005260:Female; D006801:Humans; D007400:Interprofessional Relations; D007857:Leadership; D008297:Male; D008875:Middle Aged; D009718:Nurse Administrators; D015401:Nursing Administration Research; D009730:Nursing Assessment; D017063:Outcome Assessment, Health Care; D035502:Trust; D017132:Workplace
keywords: areas of worklife; authentic leadership; quality and patient outcomes; trust