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Influence of nurse managers' toxic leadership behaviours on nurse‐reported adverse events and quality of care
Author(s) -
Labrague Leodoro J.
Publication year - 2021
Publication title -
journal of nursing management
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.925
H-Index - 76
eISSN - 1365-2834
pISSN - 0966-0429
DOI - 10.1111/jonm.13228
Subject(s) - nursing , medicine , nursing management , scale (ratio) , adverse effect , quality (philosophy) , health care , nurse administrator , nurse manager , patient safety , family medicine , medline , epistemology , political science , law , philosophy , physics , quantum mechanics , economics , economic growth
Aim To assess the impact of toxic leadership behaviours among nurse managers on nurse‐reported adverse events and quality of care. Background Toxic leadership, a form of ineffective leadership, is increasingly becoming rampant in the field of nursing and has been strongly linked to poor nurse job outcomes including job dissatisfaction, higher stress levels, and increased turnover intention. To date, no studies have been conducted to examine how this type of leadership behaviours affects patient outcomes and care quality. Methods A multicentre, cross‐sectional study. This study involved a sample of 1,053 registered nurses working in 20 hospitals in the Philippines. Three standardized scales were deployed, including the Toxic Leadership Behaviors of Nurse Managers Scale, the Adverse Patient Events Scale and the single‐item quality‐of‐care‐measure. Results Overall, nurses (96.2%) appraised the quality of care of their respective units as ‘good to excellent’ and cited complaints from patients and their families as the most commonly reported adverse events. Toxic leadership behaviours in nurse managers were strongly associated with increased nurse‐reported adverse events including reports of complaints ( β = .619; p < .001) and verbal mistreatment from patients and their families ( β = .407; p < .001), patient falls ( β = .834; p < .001), health care–associated infections ( β = .629; p < .001) and errors in administering medication ( β = .708; p < .001) and with decreased quality of care ( β = −.216; p < .001). Conclusion Nurses who experience working under a nurse manager exhibiting toxic behaviours reported an increased frequency of nurse‐reported adverse events and poorer quality of care in the unit. Implications for Nursing Management Organizational measure to reduce the occurrence of adverse events and enhance the quality of care provided in medical units may include intervention to develop positive leadership practices among nurse managers.