Study On The Effect Of Transformational Leadership On Nurses’ Barriers To Medication Near-miss Reporting

Objectives To explore the influence mechanism of transformational leadership on the barrier of nurses’ medication near-miss reporting barriers and the multiple mediating roles of leader-member exchange(LMX)and error management climate in the above relationship.Methods 1 The scale was revised based on the based on the literature review results,preliminary experiment and interviews of experts.Convenient sampling method was used.Totally 540 nurses in a tertiary hospital in Tangshan City was investigated to test the reliability and validity of the scale.2 A total of 877 nurses in 4 tertiary hospitals in Tangshan were investigate by using general information questionnaire,transformational leadership scale,leader-member exchange relationship scale,error management climate scale and the barriers to medication near-miss reporting scale.Construct and verify the chain mediation model.3 Frequency and composition ratios were used to describe general information about nurses.Independent sample t test or one-way ANOVA were used to determine the factors that affected themedication near-miss reporting barriersin nurses.Pearson correlation analysis was used to analyze the relationship between transformational leadership,LMX,error management climate and the barriers to medication near-miss reporting.Multiple linear regression was used to analyze the influencing factors of the barriers to medication near-miss reporting.Bootstrap method was used to test the mediating effect and analyze the influence process and mechanism of transformational leadership on the barriers to medication near-miss reporting.Results 1 The I-CVI was 0.833~1,and the S-CVI/Ave was 0.960.The extracted 6 factors by exploratory factor analysis explained 76.389% of the total variation.The overall Cronbach’s α coefficient of the scale was 0.870,the Cronbach’s α coefficient of each dimension ranged from 0.832 to 0.918.The test-retest reliability of each dimension was between 0.608~0.944 and the total test-retest reliability was 0.802.2 Independent sample t test and one-way ANOVA showed that there were statistically significant differences in the barriers to medication near-miss reportinguse in gender,age,marriage,education,working years and professional title(P<0.05).3 Multiple linear regression analysis showed that transformational leadership,LMX and error management climate jointly accounted for17.8% of the total variation in the barriers to medication near-miss reporting.4 Pearson correlation analysis showed that the barriers to medication near-miss reporting was negatively correlated with transformational leadership(r=-0.480,P<0.01).There was a significant negative correlation between the barriers to medication near-miss reporting and LMX(r=-0.490,P<0.01).Medication proximity error reporting disorder was negatively correlated with error management climat(r=-0.530,P<0.01).There was a significant positive correlation between transformational leadership and LMX(r=0.386,P<0.01).There was a significant positive correlation between transformational leadership and error management climate(r=0.457,P<0.01).There was a significant positive correlation between LMX and error management climate(r=0.397,P<0.01).5 The indirect effect of transformational leadership on the barriers to medication near-miss reporting was established,and the total indirect effect value was 0.126.The chain mediating effect of LMX and error management climate in transformational leadership and barriers to medication near-miss reporting was 0.011,accounting for 8.73% of the total indirect effect.Conclusions 1 The barriers to medication near-miss reporting scale has good reliability and validity,and high acceptability among nurses,which is easy to understand.It is suitable for evaluating the barriers to medication near-miss reporting among nurses in China,and can fully understand the reasons for the failure of nurses to report medication near-miss.2 Multiple linear regression analysis showed that years of service,spouse or absence,education,professional title,error management climate,LMX and transformational leadership were the factors that affected the reporting barriers of nurses’ medication near-miss.3 Transformational leadership not only negative affect the barriers to medication near-miss reporting,also through the mediating role of LMX and error management climate affect the barriers to medication near-miss reporting,the transformational leadership by improving the quality of LMX relationship between each other,promote the improvement of the error management climate,thereby reducing the barriers to medication near-miss reporting.Figure 4;Table 28;Reference 126...