Document Type

Journal Article

Publication Title

Journal of Clinical Nursing


Wiley-Blackwell Publishing Ltd.

Place of Publication

United Kingdom


School of Nursing and Midwifery




This is the peer reviewed version of the following article: Murray, M., Sundin, D., & Cope, V. (2017). The nexus of nursing leadership and a culture of safer patient care. Journal of clinical nursing. 27(5-6), 1287-1293, which has been published in final form at This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.


Aims and objectives: To explore the connection between +6 nursing leadership and enhanced patient safety. Background: Critical reports from the Institute of Medicine in 1999 and Francis QC report of 2013 indicate that healthcare organisations, inclusive of nursing leadership, were remiss or inconsistent in fostering a culture of safety. The factors required to foster organisational safety culture include supportive leadership, effective communication, an orientation programme and ongoing training, appropriate staffing, open communication regarding errors, compliance to policy and procedure, and environmental safety and security. As nurses have the highest patient interaction, and leadership is discernible at all levels of nursing, nurse leaders are the nexus to influencing organisational culture towards safer practices. Design: The position of this article was to explore the need to form a nexus between safety culture and leadership for the provision of safe care. Conclusions: Safety is crucial in health care for patient safety and patient outcomes. A culture of safety has been exposed as a major influence on patient safety practices, heavily influenced by leadership behaviours. The relationship between leadership and safety plays a pivotal role in creating positive safety outcomes for patient care. A safe culture is one nurtured by effective leadership. Relevance to practice: Patient safety is the responsibility of all healthcare workers, from the highest executive to the bedside nurse, thus effective leadership throughout all levels is essential in engaging staff to provide high quality care for the best possible patient outcomes



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