The Effect of Authentic Leadership on New Graduate Nurses’ Organizational Identification, Trust in the Manager, Patient Safety Climate, and Willingness to Report Errors

Abstract

Background: Error reporting has been identified as an important approach to improve delivery of both safe and quality care. However, existing evidence suggests that nurses are reluctant to report errors they make or fail to speak up about mistakes committed by others. Authentic leadership has been linked to improved work environments for nurses and enhanced quality of care but the question of how authentic leaders influence new graduate nurses’ willingness to report errors has received minimal attention. Purpose: The aim of this study was to test a theoretical model that examined the influence of authentic leadership on new graduate nurses’ personal identification with the leader, organizational identification, trust in the manager, climate factors of judgment-free environment and job repercussions of error, error communication, error strain, and covering up error. Methods: Employing a predictive non-experimental cross-sectional design, a self-administrated survey was mailed to a random sample of 1275 registered new graduate nurses practicing in acute care settings in Ontario. The final sample size was 178 participants (response rate of 15.8%). Results: The structural model had an acceptable fit: χ 2 (140) = 253.248, p < .001; CFI = .950 TLI = .938; RMSEA = .068(CI = .054, .081); SRMR = .060. Authentic leadership was positively associated with personal identification, which in turn was positively associated with organizational identification and trust in the manager. Trust in the manager was positively associated with judgment-free environment and job repercussions of error. Judgment-free environment was positively associated with error communication and job repercussions of error was positively associated with covering up error. Conclusions: Findings provide empirical support for the influence of authentic leadership on new graduate nurses’ attitudes toward error reporting. Authentic leaders are able to create work environments that support new graduate nurses error reporting by strengthening their personal identification with the leader and building trusting relationships. Healthcare organizations should invest in leadership-training and development programs that focus on building authentic leadership dimensions among nursing managers.