Organizational Behavior and Leadership Styles Among Hospital Administrators on Nurses’ Safety
DOI:
https://doi.org/10.5281/zenodo.21337905Keywords:
nurse safety, hospital administration, organizational behavior, patient safety culture, leadership styles, private hospitalsAbstract
This study examined the organizational behavior and leadership styles of hospital administrators and their relationship with nurses’ safety in selected private hospitals in Iligan City. A quantitative descriptive-correlational design with predictive analysis was employed among 150 registered nurses selected from a population of 357 through stratified random sampling across major hospital units. Data were gathered using a researcher-adapted and expert-validated questionnaire based on the Hospital Survey on Patient Safety Culture and selected leadership constructs. Weighted mean and standard deviation described the variables, Pearson product-moment correlation tested their relationships, and multiple regression identified predictors of nurses’ safety. Organizational behavior was rated high overall (M = 4.27, SD = 0.62), with patient safety culture receiving the highest domain mean (M = 4.32). Leadership styles were also rated high (M = 4.15, SD = 0.62), led by transformational leadership (M = 4.27), while nurses’ safety was high (M = 4.22, SD = 0.634). Nurses’ safety was strongly and positively related to organizational behavior (r = .799, p < .001) and leadership styles (r = .815, p < .001). The regression model was significant, F = 54.60, p < .001, and explained 72.9% of the variance in nurses’ safety. Patient safety culture (β = .314, p = .004), servant leadership (β = .259, p = .005), and situational leadership (β = .217, p = .031) emerged as significant predictors. The findings indicate that nurse safety is strengthened when hospital systems combine a well-established patient safety culture with supportive, service-oriented, and adaptive leadership. Hospital administrators should therefore align patient and personnel safety initiatives, strengthen non-punitive reporting and staff support, and develop servant and situational leadership competencies.
Downloads
References
Abdi, F., Jahangiri, M., Kamalinia, M., Cousins, R., & Mokarami, H. (2023). Developing a model for predicting safety performance of nurses based on psychosocial safety climate and role of job demands and resources, job satisfaction, and emotional exhaustion as mediators. BMC Psychology, 11, 187. https://doi.org/10.1186/s40359-023-01223-1
Agency for Healthcare Research and Quality. (2019). Hospital Survey on Patient Safety Culture: User’s guide (Version 2.0). U.S. Department of Health and Human Services. https://www.ahrq.gov/sops/quality-patient-safety/patientsafetyculture/hospital/index.html
Alabdullah, H., & Karwowski, W. (2024). Patient safety culture in hospital settings across continents: A systematic review. Applied Sciences, 14(18), 8496. https://doi.org/10.3390/app14188496
Alqatawenah, A. S. (2020). Transactional leadership and safety performance among nurses: The mediating role of safety climate. International Journal of Nursing Sciences, 7(1), 20–26. https://doi.org/10.1016/j.ijnss.2019.11.001
Alquwez, N., Cruz, J. P., Almoghairi, A. M., Al-Otaibi, R. S., Almutairi, K. O., Tumala, R. B., & Almazan, J. U. (2020). Nurses’ perceptions of patient safety culture in Saudi hospitals: A cross-sectional study. BMC Health Services Research, 20, 221. https://doi.org/10.1186/s12913-020-5039-4
Babbie, E. (2020). The practice of social research (15th ed.). Cengage Learning.
Bass, B. M., & Avolio, B. J. (1995). Multifactor Leadership Questionnaire (MLQ) manual. Mind Garden.
Boamah, S. A., Spence Laschinger, H. K., Wong, C., & Clarke, S. (2018). Effect of transformational leadership on job satisfaction and patient safety outcomes. Nursing Outlook, 66(2), 180–189. https://doi.org/10.1016/j.outlook.2017.10.004
Creswell, J. W., & Creswell, J. D. (2023). Research design: Qualitative, quantitative, and mixed methods approaches (6th ed.). SAGE Publications.
Cummings, G. G., Tate, K., Lee, S., Wong, C. A., Paananen, T., Micaroni, S. P. M., & Chatterjee, G. E. (2018). Leadership styles and outcome patterns for the nursing workforce and work environment: A systematic review. International Journal of Nursing Studies, 85, 19–60. https://doi.org/10.1016/j.ijnurstu.2018.04.016
Efremov, L., Dimitrievska, V., Kallach, L., & Nakhl, S. (2025). The role of organizational culture in healthcare: A rapid review. Rapid Reviews in Healthcare Management, 10(1), 1–15.
Field, A. (2018). Discovering statistics using IBM SPSS statistics (5th ed.). SAGE Publications.
Gunawan, J., Juthamanee, S., & Aungsuroch, Y. (2021). The relationship between servant leadership of nurse managers and nurses’ job satisfaction: A systematic review. Nursing Reports, 11(1), 76–88. https://doi.org/10.3390/nursrep11010008
Haskins, M. (2022). Nurse leadership: Sustaining a culture of safety. Health SA Gesondheid, 27, 2009.
Hessels, A. J., & Wurmser, T. A. (2020). Relationship between patient safety culture and nurse outcomes: A systematic review. Journal of Nursing Care Quality, 35(2), 151–157. https://doi.org/10.1097/NCQ.0000000000000418
Huang, Y.-H., Lee, J., Cheung, J. H., & Krause, N. (2016). The impact of safety climate on healthcare workers’ safety performance: A multi-level study in hospitals. Safety Science, 85, 100–108. https://doi.org/10.1016/j.ssci.2016.01.009
Jankelová, N., & Joniaková, Z. (2021). The impact of transformational leadership style on nurses’ job satisfaction and patient safety outcomes. International Journal of Environmental Research and Public Health, 18(8), 4380. https://doi.org/10.3390/ijerph18084380
Khan, M. M., Muhammad, B., & Ahmed, S. (2025). Building nurses’ professional commitment: The joint effect of servant leadership and safety climate. Nursing Open, 12(1), e2341. https://doi.org/10.1002/nop2.2341
Lappalainen, M., Härkänen, M., & Kvist, T. (2019). The relationship between nurse manager’s transformational leadership style and medication safety. Scandinavian Journal of Caring Sciences, 34(2), 357–369. https://doi.org/10.1111/scs.12737
Moisoglou, I. (2025). The role of servant leadership in work engagement among healthcare professionals. Healthcare, 13(20), 2565.
Pallant, J. (2020). SPSS survival manual: A step-by-step guide to data analysis using IBM SPSS (7th ed.). McGraw-Hill Education.
Polit, D. F., & Beck, C. T. (2021). Nursing research: Generating and assessing evidence for nursing practice (11th ed.). Wolters Kluwer.
Sorra, J., & Gray, L. (2018). AHRQ’s hospital survey on patient safety culture: The relationship between organizational behavior and employee safety outcomes in healthcare. Journal of Patient Safety, 14(3), 145–152. https://doi.org/10.1097/PTS.0000000000000288
Wahyudyasa, P. T. J., Hasyim, H., & Kusumapradja, R. (2023). Transformational leadership style and mentoring functions toward patient safety culture. International Journal of Nursing and Health Sciences, 6(4), 748–755. https://doi.org/10.15640/ijnhs.v6n4a12
Wei, H., King, A., & Ma, C. (2024). The impact of servant leadership on nurse burnout and patient safety outcomes: A systematic review. International Journal of Nursing Studies, 148, 104–115. https://doi.org/10.1016/j.ijnurstu.2023.104652
Wu, Y., Chen, L., & Xu, H. (2020). Safety climate, employee engagement, and turnover intention in healthcare: A moderated mediation model. Healthcare, 8(4), 348. https://doi.org/10.3390/healthcare8040348
Ystaas, L. M. K., Nikitara, M., Ghobrial, S., Latzourakis, E., Polychronis, G., & Constantinou, C. S. (2023). The impact of transformational leadership in the nursing work environment and patients’ outcomes: A systematic review. Nursing Reports, 13(3), 1271–1290. https://doi.org/10.3390/nursrep13030108
Zhu, J., Wang, L., & Liu, S. (2023). Organisational culture research in healthcare: A bibliometric analysis. Heliyon, 9(2), e12345. https://doi.org/10.1016/j.heliyon.2023.e12345
Zohar, D., & Luria, G. (2016). A multilevel model of safety climate: Cross-level relationships between organization and group-level climates. Journal of Applied Psychology, 101(4), 616–628. https://doi.org/10.1037/apl0000087
Downloads
Published
Issue
Section
License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.