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目的 探讨领导-成员交换关系、差错管理氛围在变革型领导对护士给药接近失误报告障碍影响机制中的多重中介作用。方法 采用便利抽样方法,应用一般资料调查表、变革型领导量表、领导-成员交换关系量表、差错管理氛围量表、给药接近失误报告障碍量表对唐山市4所三级甲等医院的877名护士进行问卷调查,构建并检验链式中介模型。结果 变革型领导对给药接近失误报告障碍的间接效应成立,总的间接效应值为0.126。领导-成员交换关系和差错管理氛围在变革型领导与给药接近失误报告障碍中的链式中介效应为0.011,占总间接效应的8.73%。结论 领导-成员交换关系、差错管理氛围在变革型领导与给药接近失误报告障碍间的多重中介作用成立。护理管理者在工作中应重视塑造自身的变革型领导风格,改善与护士之间的关系,营造积极的差错管理氛围,降低护士给药接近失误报告障碍。
Objective To explore the multiple mediating roles of Leadership-Member Exchange(LMX)and error management climate in the influence mechanism of transformational leadership on nurses’ medication near-miss reporting barriers.Methods A total of 877 nurses in 4 tertiary hospitals in Tangshan were investigated by general information questionnaire,transformational leadership scale,leader-member exchange relationship scale,error management climate scale and the barriers to medication near-miss reporting scale. The chain mediation model was constructed and verified.Results The indirect effect of transformational leadership on the barriers to medication near-miss reporting was established,and the total indirect effect value was 0.126. The chain mediating effect of LMX and error management climate in transformational leadership and barriers to medication near-miss reporting was 0.011,accounting for 8.73% of the total indirect effect.Conclusion The LMX and error management climate were found with multiple mediating effects between transformational leaders and medication near-miss reporting barriers. The head nurses should pay attention to the shaping of their own transformational leadership style,improve the relationship with nurses,create a positive error management climate,and reduce the barriers to medication near-miss reporting.