Nurse safety outcomes: old problem, new solution – the differentiating roles of nurses’ psychological capital and managerial support

Aim: The aim of this study was to examine the impacts of nurses’ psychological capital and managerial support, plus specific safety interventions (managerial safety priorities, safety training satisfaction), on nurses’ in-role safety performance. Background: Most hospitals in industrialized countries have adopted selective (often the least costly) aspects of safety, usually related to safety policies. However, patient safety remains a challenge in many countries. Research shows that training can be used to upskill employees in psychological capital, with statistically significant organizational and employee benefits, but this area is under-researched in nursing. Design: Data were collected using a survey-based, self-report strategy. The emerging patterns of data were then compared with the findings of previous research. Methods: Quantitative survey data were collected during 2014 from 242 nurses working in six Australian hospitals. Two models were tested and analysed using covariance-based Structural Equation Modelling. Results: Psychological capital and safety training satisfaction were important predictors of nurses’ in-role safety performance and as predictors of nurses’ perceptions of whether management implements what it espouses about safety (‘managerial safety priorities’). Managerial support accounted for just under a third of psychological capital and together, psychological capital and managerial support, plus satisfaction with safety training, were important to nurses’ perceptions of in-role safety performance. Conclusion: Organizations are likely to benefit from upskilling nurses and their managers to increase nurses’ psychological capital and managerial support, which then will enhance nurses’ satisfaction with training and in-role safety performance perceptions.