Purpose This study aimed to explore the mediating role of organizational silence in the effect of leader-member exchange on patient safety culture among perioperative nurses. Methods This descriptive study surveyed 201 perioperative nurses from five university hospitals. Data were collected via online questionnaires from November 8, 2022, to February 6, 2023, measuring demographics, work-related factors, leader-member exchange, organizational silence, and patient safety culture. The Data were analyzed using SPSS 26.0 and PROCESS Macro model 4. Results Leader-member exchange showed a significant direct effect on patient safety culture (β=.44, p<.001). The indirect effect of leader-member exchange on patient safety culture through acquiescent silence was also significant (β=.05, 95% CI: 0.02 to 0.13).
The total effect of leader-member exchange on patient safety culture (β=.52, p<.001) was larger than its direct effect, indicating that acquiescent silence partially mediated the relationship between leader-member exchange and patient safety culture. Conclusion To improve perioperative nurses perception of patient safety culture, healthcare organizations should enhance leader-member exchange by promoting strong emotional connections and open communication between nurse managers and staff nurses. Additionally, encouraging autonomous decision-making and reducing acquiescent silence are essential to facilitate the active expression of patient safety concerns.
Purpose This study is a descriptive research study conducted for the perioperative nurses of operating room to strengthen their capacity for patient safety and use them as basic data for sustainable surgical nursing practice education.
Methods: This study adopted a cross-sectional survey design using a self-report questionnaire. Data were collected from January 25 to February 15, 2019 from 142 nurses in the operating rooms of four university hospitals in Seoul and Gyeonggi Province. For data analysis, mean, standard deviation, frequency, percentage, independent t-test, one-way ANOVA, Pearson's Correlation Coefficient, and hierarchical multiple regression analysis were used using SPSS version 24.0.
Results: The variables affecting the patient safety management activities of the subjects were operating room safety management education experience (once or more in 3 months) (β=.15, p=.034), perception of patient safety atmosphere (β=.23, p=.022), and safety control (β=.46, p<.001), and the total explanatory power of these variables was 39% (Adjusted R 2 =.39, F=6.41, p<.001).
Conclusion: It was found that for positive patient safety management activities of perioperative nurses, it is necessary to develop and apply an operating room safety management education program that includes patient safety atmosphere awareness and safety control as components.
Citations
Citations to this article as recorded by
The Impact of the Nursing Professionalism and Triage Competency of Emergency Department Nurses on Disaster Nursing Competency Hyo Jin Im, Ju Young Ha Journal of Korean Public Health Nursing.2025; 39(1): 19. CrossRef
Factors affecting pediatric nurses’ development of partnerships with parents of hospitalized children: An evaluation based on the stress-coping adaptation model In Young Cho, So Hyoung Hong, Ji Yeong Yun Journal of Child Health Care.2025; 29(1): 53. CrossRef
Acuquisition of Professional Nursing Intuition: A Grounded Theory Approach Hwa-Young Ahn, Sung-Bok Kwon Journal of Korean Academy of Nursing Administration.2025; 31(1): 1. CrossRef
The Safety Climate and Patient Safety Activities in Mental Health Nurses: The Mediating Effect of Safety Control Jiyeong No, Kyoungsook Lee Healthcare.2024; 12(12): 1181. CrossRef
Effects of Patient Safety Management System, Leadership, and Communication Types on Nurse’ Patient Safety Management Activities Eunji Lee, Haejung Lee Journal of Korean Academy of Nursing Administration.2024; 30(4): 367. CrossRef
Effect of Counting Error Prevention Training on Operating Room Nurses’ Counting Error Prevention Awareness and Perceptions of Patient Safety Myung Jin JANG, Mi Kyung HONG, Mi Jeong LEE, Kyung A LEE, Yang Ok KIM, Jin A JEON, Hana KO Korean Journal of Health Promotion.2024; 24(1): 20. CrossRef
Factors Related to the Severity of Patient Safety Incidents in Operating Rooms in South Korea Minjung Ryu, Jun Su Park, Bomgyeol Kim, Suk-Yong Jang, Sang Gyu Lee, Tae Hyun Kim Health Insurance Review & Assessment Service Research.2024; 4(2): 149. CrossRef
Importance-Performance Analysis of Patient-Safety Nursing in the Operating Room: A Cross-Sectional Study Jieun Shin, Nam-Yi Kim Risk Management and Healthcare Policy.2024; Volume 17: 715. CrossRef
Effect of Leader-Member Exchange on Patient Safety Culture in Perioperative Nurses: The Mediating Role of Organizational Silence Nayeop Lee, Yoonju Lee Journal of Korean Academy of Nursing Administration.2024; 30(5): 462. CrossRef
Effects of Grit, Patient Safety Competence, and Patient Safety Culture on the Patient Safety Nursing Activities of Nurses in Comprehensive Nursing Service Wards Ji Hyun Kim, Haena Jang Journal of Korean Critical Care Nursing.2024; 17(3): 62. CrossRef
The Effects of Patient Safety Culture Perception and Safety Control on the Patient Safety Management Activities of Psychiatric Ward Nurses Dea-Gyu Park, Hyo-Ja An Journal of Korean Academy of psychiatric and Mental Health Nursing.2023; 32(2): 138. CrossRef
Effects of Self-leadership, Professional Self-concept, Emotional Labor on Professional Quality of Life in Hospital Nurses Yu-Yeong Kyun, Mi-Aie Lee Journal of Korean Academy of Nursing Administration.2020; 26(5): 447. CrossRef
Specialty satisfaction, positive psychological capital, and nursing professional values in nursing students: A cross-sectional survey Chung Hee Woo, Ju Young Park Nurse Education Today.2017; 57: 24. CrossRef
Effects of a Refresher Program for Inactive Nurses on Nursing Professionalism and Nursing Clinical Self-Efficacy Mi Ra Han, Smi Choi-Kwon Journal of Korean Academy of Nursing Administration.2011; 17(1): 44. CrossRef
An international comparison of Korean and Chinese nursing students with nursing curricula and educational outcomes Hyang-Yeon Lee, YoonHee Kim, HyunSook Kang, Xiuzhen Fan, Min Ling, Qiuhuan Yuan, Jia Lee Nurse Education Today.2011; 31(5): 450. CrossRef
Purpose The purpose of this study was to investigate workplace bullying, job satisfaction, and happiness among perioperative nurses.
Methods: Participants were 194 nurses who worked in hospitals with over 100 beds and located in G city and J Province. Data collection was conducted from May 4 to June 4, 2020. Descriptive statistics, independent t-test, one-way ANOVA, and stepwise multiple regression were used with IBM SPSS Statistics 26 program for data analysis.
Results: The mean score were, for workplace bullying, 1.87, for job satisfaction, 3.50, and for happiness, 3.87. Happiness of perioperative nurses was significantly influenced by job satisfaction (β=.52, p<.001), leisure time (β=.16, p=.008), and marital status (β=.13, p=.026).
Conclusion: The results show that job satisfaction of perioperative nurses is important for happiness. Therefore, there is a need to develop programs to increase job satisfaction to improve happiness in perioperative nurses.
Citations
Citations to this article as recorded by
Investigating the Level of Happiness and Its Relationship with Demographic Variables in Nurses of Educational-therapeutic Centers in Ardabil in 2022 Kimia Faridi, Mohammad Ail Mohamadi, Behrouz Dadkhah, Saeid Mehri Journal of Health and Care.2024; 26(4): 418. CrossRef
Decent work and subjective well-being in Mexico Hugo Briseño, Lourdes Maisterrena, Manuel Soto-Pérez International Journal of Sociology and Social Policy.2024; 44(1/2): 171. CrossRef
Effects of perceived spiritual management, work engagement, and organizational commitment on job satisfaction among clinical nurses: the mediating role of perceived spiritual management Eun-Hye Lee, Hea-Jin Yu BMC Nursing.2023;[Epub] CrossRef
A Systematic Review on Nurse-Physician Collaboration and Its Relationship With Nursing Workforce Outcomes Leodoro J. Labrague JONA: The Journal of Nursing Administration.2025; 55(3): 157. CrossRef
Effects of Verbal Abuse Experience and Communication Competence on Burnout among Operating Room Nurses Yesol Byon, Yoon Goo Noh Journal of Health Informatics and Statistics.2024; 49(2): 117. CrossRef
The effect of dental hygienist work cooperation and compensation satisfaction on job embeddedness: mediating effect of positive psychological capital Ju-Eon Kim, Seon-Yeong Kim Journal of Korean Society of Dental Hygiene.2024; 24(3): 263. CrossRef
Effects of Nurse-Nurse Collaboration and Nurse-Physician Collaboration on Nursing Performance in Nurses: The Mediating Effect of Patient Safety Management Activities JaHyun Kim, Seok Hee Jeong, Hee Sun Kim, Sunmi Kim Journal of Korean Academy of Nursing Administration.2024; 30(4): 343. CrossRef
Factors affecting triage competence among emergency room nurses: A cross‐sectional study Seokhwa Hwang, Sujin Shin Journal of Clinical Nursing.2023; 32(13-14): 3589. CrossRef
Impact of Role Conflict, Nursing Organizational Culture, and Nurse-Physician Collaboration on Job Embeddedness of Intensive Care Unit Nurses Young Eun Jin, Yun Mi Lee, Hyo Jin Park Journal of Korean Critical Care Nursing.2023; 16(1): 15. CrossRef
Physician–Nurse and Nurse–Nurse Collaboration From the Perspective of Nurses Ebru Şahin, Aslıhan Çatıker, Kamuran Özdil Journal for Nurses in Professional Development.2023; 39(1): E8. CrossRef
Nurse–nurse collaboration and performance among nurses in intensive care units Dalia O. Al‐Ajarmeh, Ahmad H. Rayan, Nidal F. Eshah, Zaid M. Al‐Hamdan Nursing in Critical Care.2022; 27(6): 747. CrossRef
A Study the Relationships among Verbal Violence Experience, Job Stress, and Resilience and the Communication Ability of Operating Room Nurses Hyejung Jung, Yoonshin Lee, Sung Hee Shin Journal of Korean Academy of Nursing Administration.2020; 26(2): 120. CrossRef
Effects of Nurse-Physician Collaboration on Nursing Performance and Organizational Commitment in Intensive Care Unit Nurses Eui Ok Kwon, Myung Ha Lee, Seok Hee Jeong, Hee Sun Kim Journal of Korean Academy of Nursing Administration.2019; 25(3): 186. CrossRef
Types of Perception toward Ethical Issues in Perioperative Nurses: Q-Methodological Approach Jin Nam Kim, Seok Hee Jeong Journal of Korean Academy of Nursing.2018; 48(6): 679. CrossRef
PURPOSE This was a correlational study to identify effects of perception of clinical ladder system on job satisfaction and intention to leave in perioperative nurses. METHODS Participants were 154 of perioperative nurses from larger general hospitals in Seoul. Data were collected from April, 16 to 22, 2013 using self-report questionnaires which included items on perception of clinical ladder system, job satisfaction, and intention to leave. Data were analyzed using frequency, t-test, ANOVA, Scheffe? test, Pearson correlation coefficients, and multiple stepwise regression. RESULTS The average mean score for perception of clinical ladder system was midline at 2.69 point out of 4 point. Perception of clinical ladder system correlated positively with job satisfaction (r=.38, p<.01) and negatively with intention to leave (r=-.88, p<.01). Perception of clinical ladder system was the factor which most influenced job satisfaction explaining 17.1% of the variance, also perception of clinical ladder system was the factor which most influenced intention to leave, explaining 12.7% of the variance. CONCLUSION Results of this study suggest that there is a need to enhance the perception of the clinical ladder system and to find ways to fulfill the expected effects for improving perioperative nurses' job satisfaction and reducing the intention to leave.
Citations
Citations to this article as recorded by
Clinical nurses’ experience of participating in a career ladder system: A qualitative study using focus group interviews Myoung-sook Kim, Ae-ju Noh, Young-sun Jung, Hye-jin Lee, Kyoung-eun Lee The Journal of Korean Academic Society of Nursing Education.2025; 31(1): 53. CrossRef
Effect of a Nursing Practice Environment, Nursing Performance on Retention Intention: Focused on the Mediating Effects of Nursing Professional Pride Shin Hee Kim, Mi Sook Oh, Yun Bok Kwak Journal of Korean Academy of Nursing Administration.2025; 31(1): 64. CrossRef
The Impact of Clinical Competence and Perception of Clinical Ladder System on Organizational Commitment among Nurses at a General Tertiary Hospital Yeon Hee Shin, Mi Ra Lee, Sung Nam Kim, Min Jung Kim, Ae Jin Kim, Hyun Ja Kim, Ji Yoon Kang Journal of Korean Academy of Nursing Administration.2025; 31(1): 120. CrossRef
Experience of Nurses Promoted to Clinical Nurse III through the Career Ladder System Bo Kyung Kim, Yeon Hee Kim, Jeong Hye Kim Journal of Korean Association for Qualitative Research.2024; 9(3): 227. CrossRef
Legal and Practical Solutions for the Expanding the Roles of Medical Support Staff Nurses Su Jung Choi, Min Young Kim Journal of Korean Academy of Nursing.2024; 54(3): 300. CrossRef
Nurses' perceptions of career ladder systems, job satisfaction and turnover intention: A cross‐sectional study Young Seon Ahn, Jeong Sil Choi Nursing Open.2023; 10(1): 195. CrossRef
Effect of the Nursing Work Environment on Turnover Intention: Serial Mediation Effects of Career Motivation and Job Satisfaction Young Deok Park, Sun Ju You Journal of Korean Academy of Nursing Administration.2023; 29(5): 529. CrossRef
Perception of Clinical Ladder System, Professional Self-Concept, Self-Efficacy, and Organizational Commitment by the Level of Clinical ladder among Intensive Care Unit Nurses Ji Hyun Lee, Su Jung Choi Journal of Korean Critical Care Nursing.2022; 15(3): 51. CrossRef
Effect of Verbal Violence on the Turnover Intention among Operating Room Nurses: Focusing on the Moderating Effects of Social Support and Coping Ae-Sook Kim, Eun Hee Jang Journal of Korean Academy of Nursing Administration.2021; 27(5): 433. CrossRef
THE RELATIONSHIP BETWEEN CAREER LADDER AND NURSES JOB SATISFACTION AT A HOSPITAL Ekawati Saputri, Syahrir A Pasinringi, Julianus Ake Jurnal Administrasi Kesehatan Indonesia.2021; 9(1): 55. CrossRef
Influences of Workplace Bullying and Job Satisfaction on Happiness among Perioperative Nurses Song I Park, Key Ha Kim Journal of Korean Academy of Nursing Administration.2021; 27(1): 54. CrossRef
A Hierarchical Model of Occupational Burnout in Nurses Associated With Job-Induced Stress, Self-Concept, and Work Environment Ru-Wen LIAO, Mei-Ling YEH, Kuan-Chia LIN, Kwua-Yun WANG Journal of Nursing Research.2020; 28(2): e79. CrossRef
The Impact of Nurse Scheduling Management on Nurses’ Job Satisfaction in Army Hospital: A Cross-Sectional Research Ichsan Rizany, Rr. Tutik Sri Hariyati, Efy Afifah, Rusdiyansyah Sage Open.2019;[Epub] CrossRef
Trends in Turnover Research on Korean Nurses: Based on 8 Journals Published by Member Societies under the Korean Academy of Nursing Science, 2006-2015 Hyo Geun Geun The Open Nursing Journal.2019; 13(1): 92. CrossRef
The impacts of career ladder system for nurses in hospital Bela Pertiwi, Rr. Tutik Sri Hariyati Enfermería Clínica.2019; 29: 106. CrossRef
Nurses’ understanding and perception of career ladder system are related to work motivation: A multicenter cross-sectional study in Aceh, Indonesia Mela Filani, Enie Novieastari, Tuti Nuraini Enfermería Clínica.2019; 29: 434. CrossRef
Factors Affecting on Turnover Intentions among Operating Room Nurses Yeo-Jin Kim, Keum-Sook Park, Eun-Ja Yang Journal of the Korea Academia-Industrial cooperation Society.2016; 17(12): 352. CrossRef
Effect of Career Development and Career Plateau on Career Satisfaction of Nurses Yo Na Kim Journal of Korean Public Health Nursing.2016; 30(1): 83. CrossRef
First
Prev
