Nurses are more likely to report errors when they feel safe with their supervisors, leading to a stronger commitment to safer practices and a lower error rate, according to a recent study published in the Journal of Applied Psychology.

The study looked at the relationship between what nurse supervisors say and what they do, and how that affects their staff. Researchers examined the potential conflict between enforcing strict safety protocols and the need to admit to errors.

The study looked at whether the leadership actions of head nurses were aligned with the verbal expectations conveyed to their staff nurses. The investigators looked at 54 nursing teams (a head nurse and at least three staff nurses) in four hospitals in Belgium. They administered surveys to examine the behavioral integrity of head nurses, the psychological safety felt by staff nurses, and the nursing team’s commitment to safety. 

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Survey participants were asked to agree or disagree with certain statements. Statements such as “my head nurse always practices the safety protocols he/she preaches” were designed to examine the head nurses’ behavioral integrity. Statements such as “if you make a mistake on this team, it is often held against you,” were designed to examine the psychological safety felt by staff nurses.

When nurse supervisors had spoken expectations that matched their commitment to safety, their teams had a stronger commitment to acting safely in practice as well as a greater rate of reporting medical errors that did happen. The study authors noted that the results demonstrate “the importance of leadership in promoting a work environment in which employees feel it is safe to reveal performance errors… This benefits patients because work environments in which error is identified offer employees the opportunity to learn from those errors and, ultimately, prevent similar errors from occurring.”