Linking Transformational Leadership with Nurse-Assessed Adverse Patient Outcomes and the Quality of Care: Assessing the Role of Job Satisfaction and Structural Empowerment

doi:10.3390/ijerph16132381

. 2019 Jul 4;16(13):2381.

doi: 10.3390/ijerph16132381.

Linking Transformational Leadership with Nurse-Assessed Adverse Patient Outcomes and the Quality of Care: Assessing the Role of Job Satisfaction and Structural Empowerment

Muhammad Asif¹, Arif Jameel¹, Abid Hussain¹, Jinsoo Hwang², Noman Sahito³

Affiliations

¹ School of Public Affairs, Zijingang Campus, Zhejiang University, Hangzhou 310058, China.
² The College of Hospitality and Tourism Management, Sejong University, 98 Gunja-Dong, Gwanjin-Gu, Seoul 143-747, Korea. jhwang@sejong.ac.kr.
³ Department of City & Regional Planning, Mehran University of Engineering & Technology, Jamshoro 76062, Pakistan.

PMID: 31277478
PMCID: PMC6651060
DOI: 10.3390/ijerph16132381

Linking Transformational Leadership with Nurse-Assessed Adverse Patient Outcomes and the Quality of Care: Assessing the Role of Job Satisfaction and Structural Empowerment

Muhammad Asif et al. Int J Environ Res Public Health. 2019.

. 2019 Jul 4;16(13):2381.

doi: 10.3390/ijerph16132381.

Authors

Muhammad Asif¹, Arif Jameel¹, Abid Hussain¹, Jinsoo Hwang², Noman Sahito³

Affiliations

¹ School of Public Affairs, Zijingang Campus, Zhejiang University, Hangzhou 310058, China.
² The College of Hospitality and Tourism Management, Sejong University, 98 Gunja-Dong, Gwanjin-Gu, Seoul 143-747, Korea. jhwang@sejong.ac.kr.
³ Department of City & Regional Planning, Mehran University of Engineering & Technology, Jamshoro 76062, Pakistan.

PMID: 31277478
PMCID: PMC6651060
DOI: 10.3390/ijerph16132381

Abstract

The purpose of this study was to examine the relationships between transformational leadership (TL), structural empowerment (SE), job satisfaction (JS), nurse-assessed adverse patient outcomes (APO), and the quality of care (QOC). The study further investigates the mediating effects of SE and JS on TL-APO and TL-QOC relationships. A total of 600 nurses working at 17 government hospitals in Pakistan completed the survey. The hypothesized model was tested using a confirmatory factor analysis and structural equation modeling. We found a positive relationship between TL, SE, JS, and QOC but negative relationships between TL and APO, SE and APO, and JS and APO. Our study further suggests that SE and JS strongly mediate both TL-APO and TL-QOC relationships.

Keywords: Pakistan; government hospitals; job satisfaction; nurse-assessed adverse patient outcomes; quality of care; structural empowerment; transformational leadership.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

**Figure 1**
The results of the structural equation modeling (SEM) for mediation effects.

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References

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[1] De Vries E.N., Ramrattan M.A., Smorenburg S.M., Gouma D.J., Boermeester M.A. The incidence and nature of in-hospital adverse events: A systematic review. BMJ Qual. Saf. 2008;17:216–223. doi: 10.1136/qshc.2007.023622. - DOI - PMC - PubMed

[2] De Vries E.N., Ramrattan M.A., Smorenburg S.M., Gouma D.J., Boermeester M.A. The incidence and nature of in-hospital adverse events: A systematic review. BMJ Qual. Saf. 2008;17:216–223. doi: 10.1136/qshc.2007.023622. - DOI - PMC - PubMed

[3] Kohn L.T., Corrigan J., Donaldson M.S. To Err is Human: Building a Safer Health System. Volume 6 National Academy Press; Washington, DC, USA: 2000. - PubMed

[4] Kohn L.T., Corrigan J., Donaldson M.S. To Err is Human: Building a Safer Health System. Volume 6 National Academy Press; Washington, DC, USA: 2000. - PubMed

[5] Baker G.R., Norton P.G., Flintoft V., Blais R., Brown A., Cox J., Etchells E., Ghali W.A., Hébert P., Majumdar S.R. The Canadian Adverse Events Study: The incidence of adverse events among hospital patients in Canada. Can. Med. Assoc. J. 2004;170:1678–1686. doi: 10.1503/cmaj.1040498. - DOI - PMC - PubMed

[6] Baker G.R., Norton P.G., Flintoft V., Blais R., Brown A., Cox J., Etchells E., Ghali W.A., Hébert P., Majumdar S.R. The Canadian Adverse Events Study: The incidence of adverse events among hospital patients in Canada. Can. Med. Assoc. J. 2004;170:1678–1686. doi: 10.1503/cmaj.1040498. - DOI - PMC - PubMed

[7] CIHI I. Measuring Patient Harm in Canadian Hospitals. What Can be Done to Improve Patient Safety. CIHI; Ottawa, ON, Canada: 2016.

[8] CIHI I. Measuring Patient Harm in Canadian Hospitals. What Can be Done to Improve Patient Safety. CIHI; Ottawa, ON, Canada: 2016.

[9] Dawn Medication Errors Cause Half a Million Deaths in Pakistan, Say Pharmacists. [(accessed on 26 May 2019)]; Available online: https://www.dawn.com/news/1362951.

[10] Dawn Medication Errors Cause Half a Million Deaths in Pakistan, Say Pharmacists. [(accessed on 26 May 2019)]; Available online: https://www.dawn.com/news/1362951.

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Linking Transformational Leadership with Nurse-Assessed Adverse Patient Outcomes and the Quality of Care: Assessing the Role of Job Satisfaction and Structural Empowerment

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Linking Transformational Leadership with Nurse-Assessed Adverse Patient Outcomes and the Quality of Care: Assessing the Role of Job Satisfaction and Structural Empowerment

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Conflict of interest statement

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