The Role of Individual and Collective Mindfulness in Promoting Occupational Safety in Health Care.

Although the importance of safety regulations is highly emphasized in hospitals, nurses frequently work around, or intentionally bypass, safety regulations. We argue that work-arounds occur because adhering to safety regulations usually requires more time and work process design often lacks complementarity with safety regulations. Our main proposition is that mindfulness is associated with a decrease in occupational safety failures through a decrease in work-arounds. First, we propose that individual mindfulness may prevent the depletion of motivational resources caused by worrying about the consequences of time lost when adhering to safety regulations. Second, we argue that collective mindfulness may provide nursing teams with a cognitive infrastructure that facilitates the detection and adaptation of work processes. The results of a multilevel analysis of 580 survey responses from nurses are consistent with our propositions. Our multilevel analytic approach enables us to account for the unique variance in work-arounds that individual and collective mindfulness explain.

Living up to safety values in health care: the effect of leader behavioral integrity on occupational safety.

While previous research has identified that leaders' safety expectations and safety actions are important in fostering occupational safety, research has yet to demonstrate the importance of leader alignment between safety expectations and actions for improving occupational safety. We build on safety climate literature and theory on behavioral integrity to better understand the relationship between the leader's behavioral integrity regarding safety and work-related injuries. In a time-lagged study of 658 nurses, we find that behavioral integrity for high safety values is positively associated with greater reporting of fewer and less severe occupational injuries. The effects of behavioral integrity regarding safety can be better understood through the mediating mechanisms of safety compliance and psychological safety toward one's supervisor. We discuss the implications of our findings for future research on safety climate.

Behavioral integrity for safety, priority of safety, psychological safety, and patient safety: a team-level study.

This article clarifies how leader behavioral integrity for safety helps solve follower's double bind between adhering to safety protocols and speaking up about mistakes against protocols. Path modeling of survey data in 54 nursing teams showed that head nurse behavioral integrity for safety positively relates to both team priority of safety and psychological safety. In turn, team priority of safety and team psychological safety were, respectively, negatively and positively related with the number of treatment errors that were reported to head nurses. We further demonstrated an interaction effect between team priority of safety and psychological safety on reported errors such that the relationship between team priority of safety and the number of errors was stronger for higher levels of team psychological safety. Finally, we showed that both team priority of safety and team psychological safety mediated the relationship between leader behavioral integrity for safety and reported treatment errors. These results suggest that although adhering to safety protocols and admitting mistakes against those protocols show opposite relations to reported treatment errors, both are important to improving patient safety and both are fostered by leaders who walk their safety talk.