Thesis - Nurses’ Perception of Supervisory Leadership for Patient Safety: A Narrative Synthesis

Academic Events
Trinity Western University
Neufeld Science Centre, Room 39
7600 Glover Road
Langley, BC V2Y 1Y1

by:  Kathleen Samoil
Supervisor:  Dr. Rick Sawatzky
Second Reader:  Dr. Sheryl Reimer-Kirkham
Third Reader:  Dr. Kris Gustavson, Accreditation & Patient Experience, Provincial Health Services Authority
Exam Chair:  Dr. Magdalena Theron
Location:  To be confirmed


                The question that this thesis sought to answer was whether discernible trends could be found in studies that involve the use of questionnaires to ascertain nurses’ perceptions of supervisory leadership for safety in the context of patient safety culture. A focused literature search was conducted to retrieve relevant studies. The resulting 35 studies were analyzed using narrative review. Narrative review was selected on the basis that it would allow for comparisons of studies that used different research designs and questionnaires. The sample of included studies comprised 24 studies that used the Hospital Survey on Patient Safety Culture, 6 studies that used the Safety Attitudes Questionnaire, 2 studies that used the Safety Climate Survey, 1 study that used the Survey on Safety in Nursing Homes and 1 study that used the RN4CAST.  One study used qualitative interviews.

                The result of this thesis was the determination that patient safety culture assessments should be interpreted in relation to the specific context in which the assessment is conducted. Results are therefore not generalizable and discernible trends among the studies could not be identified. Two important themes were identified in the narrative review. The first theme was the importance of the cultural background of the participants, including ethnicity or nationality, organizational culture of the worksite, and cultural milieu of the geographic location. The second theme was that the assessment of patient safety culture should be repeated at intervals and examined in the context of the workplace at the time of each assessment. There is benefit to combining qualitative and quantitative methods to assess patient safety culture.