Search

Leader affective presence, the tendency of leaders to consistently evoke feelings in team members, has gained prominence in the context of leadership and teamwork. However, prior research lacks a comprehensive theoretical framework, focuses on limited team processes, and relies mainly on cross sectional designs to study this construct. Building upon theories of the social functions of affect, this study examines the relationship between leaders' affective presence and team member behaviour, specifically focusing on team proactive problem prevention and examining whether this relationship is mediated by team psychological safety. Using a two‐wave panel model with 504 professionals in 134 teams, our findings revealed that positive leader affective presence, characterized by instilling enthusiasm, joy and inspiration among team members, was positively associated with perceptions of team psychological safety. In turn, team psychological safety was positively related to leaders' assessments of proactive problem prevention. Interestingly, negative leader affective presence, which triggers worry, tension and stress, was not related to team psychological safety but was positively associated with team proactive problem prevention. These results highlight the importance of leader affective presence in shaping emergent team states and team member behaviour. Researchers and practitioners should thus consider these insights when assessing and intervening in leadership and teamwork processes in organizations. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to extend safety climate research by considering perceptions across the following three hierarchical levels within a workplace: (1) senior leaders/executives, (2) field leaders/supervisors, and (3) front-line employees. Methods: We conducted a quantitative survey study at a US utility company where we collected data related to safety climate perceptions and employee-reported safety behaviors across the different levels of organizational hierarchy. Results: The findings revealed the highest safety climate scores among senior leaders/executives, followed by field leaders/supervisors, and then employees, suggesting potential discrepancies between espoused and enacted safety values in the workplace. Conclusions: These results suggest that supervisors and top managers may have different mental models of workplace safety compared with employees. Consequently, assessing perceptions at different organizational levels provides a fuller picture of safety in the workplace. [ABSTRACT FROM AUTHOR]

Violence against employees in human services is a widespread problem worldwide and is reportedly on the rise. The topic in this article is organizational factors in preventing and managing violence against employees executed by service users. Data comes from 86 semi-structured and structured interviews with 101 employees and managers in one of Norway's most extensive national government agencies. The interviews were conducted in a study of an initiative against violence after an employee was murdered at work. The identified factors are related to (1) recognition of employees´ needs to feel safe and acknowledged, (2) project administration and leadership involvement and anchoring, (3) organizationally aligned and adjusted routines and understandings, (4) a generally increased focus on prevention and management of violence, (5) specific measures and (6) service delivery. The study also disclosed essential relationships between these factors, which must be acknowledged in the work to counteract violence. Workplace violence should be an issue of concern for all levels of management. Recognition of employees´ needs and anchoring in the entire organization are just as important as specific measures against violence. A good delivery of services is an important but sometimes neglected factor in the work against violence. The mentioned elements indicate that several equal organizational factors and measurements must be combined to counteract workplace violence. [ABSTRACT FROM AUTHOR]

The article announces winners of the 2023 Pathway Nurse of the Year Award which includes Holly Weaver, and Rebekah Mitchell.

We assessed how hospitalists frame workplace safety, health, and well-being (SHW); their perception of hospital supports for SHW; and whether and how they are sharing leadership responsibility for each other's SHW. Our findings highlight the important role of local support for hospitalist SHW and reveal the systemic, hospital-wide problems that may impede their SHW. We believe that positioning hospitalists as leaders for SHW will result in systems-wide changes in practices to support the SHW of all care team members. (Am J Public Health. 2024;114(S2):S162–S166. https://doi.org/10.2105/AJPH.2024.307573) [ABSTRACT FROM AUTHOR]

• Safety is a competency, rooted in interactions and embedded in everyday practices. • Standardized and non-contextualized OHS-management tend to lead to unsafe practices. • Developing a safety culture at work requires a responsive leadership style. Introduction: Organizations place strong emphasis on the standardized occupational health and safety procedures to reduce work-related illnesses and workplace accidents. However, standardized procedures are not always followed up in daily work practices. Organizations must cope with the differences between standardized procedures and local adaptation by employees. Methods: This ethnographic field study at an industrial workplace in the Netherlands provides insights into employees' everyday work practices, how these work practices are shaped, and how they relate to local occupational health and safety procedures. Acknowledging safety as a competency embedded in work practices, as introduced by Gherardi and Nicolini (2002), offers a theoretical point of view for looking beyond the dichotomy of standardization and local adaptations. Results: The results show that a standardized and noncontextualized occupational health and safety management system that focuses on accident-free days and compliance actually leads to ignorance of practical and tacit competences of workers and no learning and improvement of safety procedures can take place. However, our findings also illustrate how employees in their informal everyday work practices reduce the risks produced by the safety system itself. Conclusion: Overall, the results indicate that social interactions among employees, leaders, and management within the organization play an important role in workplace safety. The analysis highlights the value of vulnerability and trust in relationships at work to be able to learn and develop safety procedures that align with local demands. Practical applications: This study emphasizes the need for participatory approaches in creating safer and healthier workplaces. The cocreation of occupational health and safety (OHS) rules and procedures, however, can only function if they are combined with a responsive leadership style. [ABSTRACT FROM AUTHOR]

Current evidence suggests understaffing is related to poor quality and missed care in a global context, but this relationship is complex. There is also a research gap for quality in mental health care in the United Kingdom that includes a wider set of patient outcomes. This paper aims to investigate RMN's perception of quality of care on their last shift, their self‐reported reasons for compromised care and potential impact on patient outcomes. A mixed methods approach, we used descriptive statistics to create a framework within which to qualitatively analyse data from the 2017 Royal College of Nursing (RCN) employment survey to consider the complex relationship between understaffing and care quality. We established three themes: 'Understaffing', 'Professional Code Expectations and Moral Distress' and 'Management'. In line with the current evidence; lack of resources and understaffing were consistently present throughout. Nurses also felt pressure from the Nursing and Midwifery Council (NMC) code of conduct which in turn instilled shame and fear for their registration when they were unable to achieve the standards expected. This was further exacerbated by poor management and supervision; leading nurses to reflect on poor outcomes for patients which compromised not only legal rights but safety of patients and staff alike. We conclude that focusing on staffing numbers alone is unlikely to improve care quality. [ABSTRACT FROM AUTHOR]

COVID-19 presents unique and complex challenges to the Scottish National Health Service (NHS). As COVID-19 preventative measures are effective at reducing disease spread, promoting staff adherence in high-risk workplaces is vital. The present research explored the role of identity leadership on (a) staff's appraisals of leadership and (b) staff's adherence to and attitudes towards COVID-19 guidance. Semi-structured interviews (N = 25) were conducted with NHS staff across two Scottish hospitals. Using Reflexive Thematic Analysis, two over-arching themes were generated: leadership presence and approachable leadership who act on group concerns, where both created positive appraisals of leadership and were seen to facilitate adherence. Guidance from present leaders was perceived as both practical and applicable. Approachable leaders were viewed to facilitate information sharing, clarify guidance, and allow staff to raise concerns. Leaders who were seen to act on group concerns provided resources or updated guidance to promote adherence. The present study provides theoretical and practical advancements to (a) expand the known role of identity leadership in promoting safety in workplaces and (b) facilitate routes for adherence to safety guidance beyond COVID-19. [ABSTRACT FROM AUTHOR]

Purpose: To assess the potential of workplace support to protect public health equity workers against job burnout and to identify key workplace support components. Description: This mixed-methods, explanatory sequential study analyzed survey and interview data collected between August 2020 and June 2021. Participants included governmental and non-governmental public health employees whose programs largely focus on Maternal and Child Health populations and who reported that their jobs involved working to reduce health inequities ("equity work"). Regression analysis tested the effect of emotional labor on job burnout, and whether workplace support modified that effect. Qualitative analysis of interview transcripts explored possible components of needed workplace support. Assessment: Emotional labor was positively associated with job burnout (p <.001), and there was a significant negative interaction between emotional labor and workplace support, meaning workplace support appeared to reduce the effect of emotional labor on burnout (p =.036). Qualitative analysis identified four support components: peer-to-peer mentoring connections, workplace accommodations, engaged and empathetic supervision, and mental health resources. Conclusion: Workplace support is associated with reduced job burnout for public health equity workers, especially those whose jobs involve high levels of emotional labor. Few public health employers are providing needed emotional supports for their equity workers, but certain supports appear to be helpful in reducing job burnout. Significance: Stressful work environments can impact emotional well-being and lead to job burnout. Since the 1980s, research has explored emotional labor (i.e., self-management of emotions for effective job performance) as a contributor to burnout, including new studies in the healthcare and public health sectors. The recent focus of MCH on equity requires workers to address emotion-laden topics with partners and the public. Past research had not focused on the public health sector and had emphasized personal coping strategies. Our study adds to the literature by examining emotional labor in MCH equity work and considering the protective potential of workplace supports. [ABSTRACT FROM AUTHOR]

Workplace violence in healthcare settings is alarmingly common and represents significant financial and human cost. The aim of this scoping review was to identify and summarize evidence on strategies to prevent and/or manage workplace violence in healthcare settings. Searches were limited to evidence-based clinical practice guidelines and systematic reviews published between 2015 and 2021. Multiple databases were searched and screened. Quality of the included guidelines and reviews was also assessed. Three guidelines and 33 systematic reviews were included. Both the Occupational Safety and Health Administration 2015 and Registered Nurses' Association of Ontario 2019 guidelines provided useful recommendations for building a comprehensive prevention program. Evidence-based risk assessment, prevention and management, and education and training are all central components. Regular reassessment and adjustment is required. Included reviews (n = 33) were grouped into five main categories: violence toward nurses (n = 10); violence toward healthcare workers in general (n = 8); violence in the emergency department (n = 5); violence related to mental health (n = 5); and measurement related to workplace violence (n = 5). Multicomponent interventions were often more effective than those applied in isolation. We found consistent support for certain strategies including education and training, post-incident debriefing, multidisciplinary rapid response teams, and environmental modifications; however, the strength of evidence and certainty of conclusions were limited across reviews. This scoping review found that strong leadership that cultivates and enforces a culture of inclusivity, support, and respect is a prerequisite for a successful workplace violence prevention program. Rigorous comparative effectiveness research testing interventions are needed. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this research is to understand the importance of female career mentors, research mentors, co-residents, and program directors/chairs to current female otolaryngology residents when applying to residency. The importance of safety in the workplace was also investigated. Methods: Surveys were sent via electronic mail to 119 programs, and program directors were asked to distribute them to female residents. Using the Likert scale, participants ranked the importance of various factors when creating a rank list, in particular, importance of safety in the workplace and importance of female mentors in various leadership positions. Demographic information, geographic location, LGBTQ identification, and fellowship plans were also collected. Results: There were 62 participants nationally. Eighty-seven percent (n = 54) of participants stated that having at least 1 female attending and having female co-residents was "very important" or "important" when ranking programs. A number of respondents replied that having a female career development mentor (38.7% [n = 24] and 43.5% [n = 27]), female program director or chair (4.8% [n = 3] and 16.1% [n = 10]), and female research mentor (12.9% [n = 8] and 29% [n = 18]) was "very important" or "important," respectively. Ninety-three percent (n = 58) replied that feeling safe in their training environment was "very important" or "important." Conclusion: Having female mentors as well as safety in the workplace in residency is important to a vast majority of residents and applicants when creating a rank list. Programs with women in these roles may gain a disproportionate number of female residents because they may be more desirable places than those without women in these roles. [ABSTRACT FROM AUTHOR]

Background: Nursing practice environment has impact on the quality of nursing care and on patients' and nurses' outcomes, namely better performances of these healthcare workers. Improving the nursing practice environment is a low-cost organizational strategy to achieve better patients' outcomes and retain qualified nurses, thus improving nursing care of units, healthcare organizations and healthcare system. This study aims to analyse the relationship between nursing practice environment and the nurses' perception of quality of care, patient safety, and safety culture in Primary Health Care in Portugal. Methods: We conducted a descriptive, analytical, and cross-sectional study using data from RN4CAST Portugal. The sample was composed of 1059 nurses from 55 Health Center Groups of the mainland Portugal, 15 Health Centers of the Autonomous Region of Madeira and 6 Health Centers of the Autonomous Region of the Azores. Multivariate analysis and correlation analysis methods were used for data processing. Results: Nurses consider that, in the Portuguese Primary Health Care, there is a mixed and unfavourable nursing practice environment, with a perception of a good quality of care, and both acceptable patients' safety and safety culture. The Collegial Nurse-Physician Relations and Nursing Foundations for Quality of Care dimensions to have the best ratings. The perception of Primary Health Care nurses on the dimension Nurse Participation in Organization Affairs was the one that showed the lowest score, followed by Staffing and Resource Adequacy and Nurse Manager Ability, Leadership, and Support of Nurses. Based on perception of nurses, the relationship between the nursing practice environment and the safety culture is higher, followed by the quality of care and patients' safety. Conclusions: The perception of Primary Health Care nurses is that there is an unfavourable and mixed nursing practice environment, with good quality of care, and acceptable patient safety and safety culture. The quality of the nursing practice environments is associated to better quality and safety of care. Thus, improving the nursing practice environments in healthcare organizations is a low-cost organizational strategy to achieve greater patients and nurses' outcomes, improving the quality of nursing care to patients in the Primary Health Care units. [ABSTRACT FROM AUTHOR]

The article describes how a collaborative, interdisciplinary leadership team within the hospital designed and implemented a Behavioral Emergency Response Team (BERT) to continue efforts toward the goal of zero employee and patient harm, and its impact, utilization, and successes. Topics discussed include healthcare worker incidence rate of nonfatal workplace violence from 2011 to 2018, reasons for BERT activations, and benefits of BERT to patients.

AIM: The purpose of this article is to describe how regional community assessment survey data specific to healthcare workers' (HCWs') attitudes and actions related to workplace violence (WPV) from 1 participating urban tertiary hospital was compared with current evidence to identify evidence-based interventions to promote a safer work environment. The regional survey assessed real-time data regarding the state of WPV and its impact on HCWs, and to drive proposed interventions to prevent and reduce WPV in the healthcare community. BACKGROUND: Incidents of WPV in healthcare continue to increase, resulting in calls for action from staff, leadership, and regulatory organizations. METHODS: Data were collected from the HCWs who completed the survey. Experiences with WPV were analyzed. Qualitative data were evaluated for themes. A review of external evidence was conducted to identify best practices in preparing proposed next steps for the organization. RESULTS: Healthcare worker attitudes and practices related to WPV were described as unreported and not addressed. Violence was more readily perceived as a part of the job. External evidence indicated that education and training alone seemed to have minimal effect on preventing WPV. Evidence from best practices and staff feedback were recommended to be incorporated into plans for the organization. [ABSTRACT FROM AUTHOR]

An editorial is presented that profiles Stephen Reynolds, a significant figure in agricultural health and safety, tracing his illustrious career from his academic journey to his impactful contributions in occupational health and safety issues within agricultural settings. It mentions that his global collaborations and mentorship have not only shaped policy discussions but also earned him prestigious awards and recognition.

• The paper conceptualizes safety voice climate and presents a measurement tool named the "Safety Voice Climate Scale" (SVCS) • The SVCS consists of the two theoretical dimensions "Work colleagues' encouragement of safety voice" and "Leaders' attitudes towards safety voice". • The paper presents initial evidence for SVCS' validity. • The paper assessed the associations between safety voice climate and safety voice behavior. • The sample included 7624 employees from the Norwegian petroleum sector. • Confirmatory factor analyses supported the proposed two-factor model, and the internal consistency of the factors was good. • A SEM model including the SVCS as predictor of safety voice behavior showed good fit, indicating acceptable criterion validity. Introduction : Speaking up about safety issues, termed "safety voice," is a proactive response where people across all levels of the organization express their concerns to prevent physical hazards. An understanding of safety voice requires insight into its antecedents. A perceived need to fit in with the organization and fear of consequences can trump the courage to speak out about safety concerns. Safety voice climate can be seen as a manifestation of the social exchanges in an organization and functions as a roadmap of which speaking out behaviors are encouraged and which behaviors are not. This study conceptualizes safety voice climate, presents the Safety Voice Climate Scale (SVCS) as a measurement tool, and gathers initial evidence for its validity. The study also assesses the associations between the SVCS and safety voice behavior. Method : The SVCS and the measurement of safety voice behavior were derived from the Trends in Risk Level in the Norwegian Petroleum Activity questionnaire. The SVCS includes the two theoretical dimensions Work colleagues' encouragement of safety voice and Leaders' attitudes towards safety voice. Psychometric properties were tested with a representative sample from the Norwegian petroleum sector (n = 7,624). Results : Confirmatory factor analyses supported the proposed two-factor model, and the internal consistency of the factors was good. Furthermore, a structural equation model including the SVCS as predictors of safety voice behavior showed a good fit, indicating acceptable criterion validity, although only the Work colleagues' encouragement of safety voice variable was significantly associated with safety voice behavior. Conclusion and practical application : The SVCS can be used as a tool to detect some of the barriers and supporting elements relating to safety voice and guidance on the efforts needed to foster work climates that promote communication of safety issues. [ABSTRACT FROM AUTHOR]

Background: Healthcare leaders play an important and complex role in managing and handling the dual responsibility of both Health, Safety and Environment (HSE) for workers and quality and patient safety (QPS). There is a need for better understanding of how healthcare leaders and decision makers organize and create support structures to handle these combined responsibilities in practice. The aim of this study was to explore how healthcare leaders and elected politicians organize, control, and follow up the work of HSE and QPS in a Norwegian nursing home context. Moreover, we explore how they interpret, negotiate, and manage the dual responsibility and possible tensions between employee health and safety, and patient safety and quality of service delivery. Methods: The study was conducted in 2022 as a case study exploring the experience of healthcare leaders and elected politicians in five municipalities responsible for providing nursing homes services in Norway. Elected politicians (18) and healthcare leaders (11) participated in focus group interviews (5) and individual interviews (11). Data were analyzed using inductive thematic analysis. Results: The analysis identified five main themes explaining how the healthcare leaders and elected politicians organize, control, and follow up the work of HSE and QPS: 1. Establish frameworks and room for maneuver in the work with HSE and QPS. 2. Create good routines and channels for communication and collaboration. 3. Build a culture for a health-promoting work environment and patient safety. 4. Create systems to handle the possible tensions in the dual responsibility between caring for employees and quality and safety in service delivery. 5. Define clear boundaries in responsibility between politics and administration. Conclusions: The study showed that healthcare leaders and elected politicians who are responsible for ensuring sound systems for quality and safety for both patients and staff, do experience tensions in handling this dual responsibility. They acknowledge the need to create systems and awareness for the responsibility and argue that there is a need to better separate the roles and boundaries between elected politicians and the healthcare administration in the execution of HSE and QPS. [ABSTRACT FROM AUTHOR]

An effective safety leader is more than a job or position in an organisation. Safety leaders must understand and mitigate workplace risks and difficulties for themselves, their team and their organisation. One of the essential aspects of Process Safety Management (PSM) is that leaders and managers understand the qualities and safety behaviour of all chemicals utilised in the process. This paper emphasises that leaders and managers promote a positive safety culture by showing safety commitment; they have more influence to pave all activities while ensuring it is conducted safely within the organisation. Due to human characteristics, it may be challenging to obtain all 'perfect' leadership and management traits. But leadership is a skill that anyone can develop. Competency, empowerment, compliance, governance and dedication to safety are more important than leadership styles in a small organisation. The most exemplary leaders are articulate and can adapt their style to the situation. [ABSTRACT FROM AUTHOR]

Background: Creating a healthy, decent and safe workplace and designing quality jobs are ways to eliminate precarious work in organisations and industries. This review aimed at mapping evidence on how psychosocial safety climate (PSC) influence health, safety and performance of workers. Methods: A literature search was conducted in four main databases (PubMed, Scopus, Central and Web of Science) and other online sources like Google Scholar. A reference list of eligible studies was also checked for additional papers. Only full-text peer-reviewed papers published in English were eligible for this review. Results: A search in the databases produced 13,711 records, and through a rigorous screening process, 93 papers were included in this review. PSC is found to directly affect job demands, job insecurity, effort-reward imbalance, work-family conflict, job resources, job control and quality leadership. Moreover, PSC directly affects social relations at work, including workplace abuse, violence, discrimination and harassment. Again, PSC has a direct effect on health, safety and performance outcomes because it moderates the impact of excessive job demands on workers' health and safety. Finally, PSC boosts job resources' effect on improving workers' well-being, safety and performance. Conclusion: Managers' efforts directed towards designing quality jobs, prioritising the well-being of workers, and fostering a bottom-up communication through robust organisational policies, practices, and procedures may help create a high organisational PSC that, in turn, promotes a healthy and decent work environment. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to compile, assess and synthesise empirical research on violence by social and healthcare clients or patients against staff and its connections to staff's well‐being at work, implementation of work and activities of leaders related to it. Background: Workplace violence against social and healthcare staff is a global and daily problem. One in three employees encounters violence from patients or clients and the risk of this is 16 times higher compared to other professions. None of the recent reviews on this topic were focused on the well‐being at work, implementation of work or leaders' role in the cases of violence of clients or patients against the staff. Design: An integrative review reported according to PRISMA Checklist. Methods: The search was conducted to CINAHL, PubMed, PsychINFO and Scopus databases resulting in 21 articles. The quality of the articles was evaluated, and the data were analysed narratively. Results: The workplace violence committed by clients and patients was negatively connected to staff's psychological, emotional and physical well‐being at work and to their work performance and commitment. The leaders found this form of workplace violence challenging and ethically conflicted and felt that they were left alone without training and support. The employees expressed disappointment with their leaders' activities and suggested many measures to make environment safer to staff and patients. Conclusions: In future, intervention studies are needed for prevention of workplace violence by patients and clients against staff and for supporting the well‐being at work of staff in relation to violent incidents. Relevance to clinical practice: Workplaces should introduce uniform protocols for reporting, preventing and processing workplace violence committed by clients and patients. An open dialogue with leaders and co‐workers of the cases is of high importance. Leaders and staff need training that ensure patient and work safety. [ABSTRACT FROM AUTHOR]

While there is a lot of emphasis on the need for good infection prevention and control practices and acute care, the increasing complexity of patients being cared for in their own homes means that there is an increased risk for infection. Good practice is required by community nurses to minimise this risk. Patients' own homes can present particular challenges in complying with good practice and this article looks at some of the barriers to optimum infection prevention and control precautions in this setting. [ABSTRACT FROM AUTHOR]

In the article, the author discusses how the coronavirus pandemic has allowed nurse leaders in fostering positive, creative and effective leadership and showed their hidden abilities. Also cited are the need for leaders to continue using the tools and leadership behaviors they show during normal times, and the set of organized strategies developed by the author to promote personal and team joy.

[Display omitted] • A survey study with junior leaders and front-line workers at a petroleum company. • Benevolent (humane, kindly) leadership was positively related to safety behavior. • Subordinates' moqi was positively correlated with safety behavior. • Benevolent leadership affected safety behavior via Subordinates' moqi. • Safety climate moderated the link between subordinates' moqi and safety behavior. Introduction : While high quality leadership is of great importance for enhancing safety behavior in the workplace, there has been a lack of research on how benevolent leadership influences such behavior. Subordinates' moqi (i.e., their unspoken understanding of the work expectations, intentions, and requirements of their superiors) and safety climate were introduced to examine this relationship. Method: Based on implicit followership theory, this study explores the relationship between benevolent (well meaning, kindly) leadership and employees' safety behavior, as well as the mediating role of subordinates' moqi and the moderating role of safety climate. 608 employees of a petroleum company in China were randomly selected as participants, and the data were collected in two stages. Results: The results showed that: (1) Benevolent leadership is positively correlated with employees' safety behavior. (2) Subordinates' moqi mediates between benevolent leadership and employees' safety behavior. (3) Safety climate moderates the mediating role of subordinates' moqi between benevolent leadership and employees' safety behavior. (4) The positive effect of subordinates' moqi on employees' safety behavior is enhanced under a positive safety climate. Conclusions: Benevolent leadership is an effective leadership style that enhances employees' safety behaviors by promoting a moqi state between supervisors and subordinates. The invisible environmental climate, in particular, the safety climate, should be a key focus in the promotion of safety behaviors. Practical Applications: This study further broadens the research perspective of employee safety behavior from the perspective of implicit followership theory. It also provides practical guidance for improving employee safety behavior, namely selecting and cultivating benevolent leaders, enhancing subordinates' moqi, and actively fostering a positive organizational safety climate. [ABSTRACT FROM AUTHOR]

Much recent literature has highlighted the stressful nature of teaching and its relations with teacher and student well-being. The present study extended this literature to focus on special education teachers. We first conducted a latent class analysis to characterize patterns of stress and coping among special education teachers (N = 404). Consistent with several prior studies with general education teachers and principals, we found three profiles: normative (high stress/high coping), maladaptive (high stress/low coping), and adaptive (low stress/high coping). Next, we examined school contextual predictors of these profiles including leadership characteristics (collegial, instructional), density of special education teachers (an indicator of professional isolation), and climate factors (teacher affiliation, school structure and support, safety, expectations). The maladaptive class was distinguished by a lower proportion of special education teachers, worse perceptions of school disciplinary structure and school safety, and higher academic expectations. The findings have implications for improving the burnout model presented in the special series overview and for creating school contexts that improve special education teacher well-being, persistence, and implementation fidelity. [ABSTRACT FROM AUTHOR]

The article discusses the high-reliability principles and practices at the U.S. Veterans Health Administration (VHA). Topics include the launch by the VHA of an array of supports to strengthen high-reliability organizations (HRO) capabilities across the largest integrated healthcare system in the U.S., the VHA's assessment process, and how the VHA boosts HRO improvement initiatives and leadership practices that support a safety culture.

When organizational attributes like management commitment and communication are favorable, they are known to positively influence safety behaviors, morale, and well-being. Fire departments should focus on improving overall safety culture as a way to address the mental health burden of fire and rescue service work. Objective: This study aimed to examine the COVID-19 pandemic's impact on fire service safety culture, behavior and morale, levers of well-being, and well-being outcomes. Methods: Two samples (Stress and Violence against fire-based EMS Responders [SAVER], consisting of 3 metropolitan departments, and Fire service Organizational Culture of Safety [FOCUS], a geographically stratified random sample of 17 departments) were assessed monthly from May to October 2020. Fire department–specific and pooled scores were calculated. Linear regression was used to model trends. Results: We observed concerningly low and decreasing scores on management commitment to safety, leadership communication, supervisor sensegiving, and decision-making. We observed increasing and concerning scores for burnout, intent to leave the profession, and percentage at high risk for anxiety and depression. Conclusions: Our findings suggest that organizational attributes remained generally stable but low during the pandemic and impacted well-being outcomes, job satisfaction, and engagement. Improving safety culture can address the mental health burden of this work. [ABSTRACT FROM AUTHOR]

Non-technical skills, the social and cognitive skills thought necessary for safe and effective working, have been studied within the farming context over the past six years. However, these skills are not yet taught as part of a safety curriculum for farmers, due, in part, to a lack of defined framework and assessment system. The current paper describes the development of the FLINTS behavioral marker system for discussion, observation, evaluation and feedback on non-technical skills for farmers. The development of the behavioral marker system proceeded through three key stages. First, the current research knowledge on non-technical skills was synthesized to compile a list of non-technical skill categories and elements. Second, a series of discussion groups with subject matter experts was conducted to develop behavioral markers for each element. Lastly, refinement and review of the system was undertaken by academics and experts. The prototype FLINTS taxonomy containing five non-technical skill categories and 16 elements was produced. The non-technical skill categories comprised situation awareness, teamwork & communication, leadership, task management and decision-making each with specific elements and behavioral markers. FLINTS represents the first behavioral marker system for farmer non-technical skills, constructed through expert knowledge and advice via discussion and review groups, combined with underpinning research findings. This represents the first step towards the development of non-technical training and assessment for farmers. The current version of the FLINTS system is freely available to all potential users (). [ABSTRACT FROM AUTHOR]

Research on the correlation between personality traits and safety behaviors has been thoroughly explored in previous literature. However, most of these studies are based on explaining the relationship between the Big Five personality traits and safety behavior, with few explaining the relationship between proactive personality and safety behavior. This study relies on trait activation theory, social cognitive theory, and social exchange theory to understand the relationship between proactive personality and safety behavior (safety participation and safety compliance) by using safety self-efficacy and team member exchange as mediating variables and safety-specific transformational leadership as moderating variables. Method: Considering the issue of common method bias, a multi-source and multi-stage data collection research design was used to collect 287 valid questionnaires from construction workers in 10 construction projects and apply regression analysis for hypothesis testing. Conclusions: Research results indicated that proactive personality positively and significantly influenced construction workers' safety behaviors, while safety self-efficacy and team member exchange partially mediated the relationship between proactive personality and safety behaviors. In addition, safety-specific transformational leadership enhanced the positive relationship between proactive personality and safety behavior. These findings enrich the research on the correlation between personality traits and safety behaviors of construction workers in a safety context. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the effects of supportive leadership and psychosocial safety climate on personal hope and resilience among nurses during the pandemic. Conservation of resource theory was employed to explain the effects of psychosocial safety climate and supportive leadership on nurses' hope and resilience. A cross‐sectional design was employed to collect data. Six‐hundred and twenty‐three nurses across 68 hospitals who were in direct contact with COVID‐19 patients during the fifth wave of the pandemic in Iran were recruited. Hierarchical Linear Modelling (HLM) and Structural Equation Modelling using Amos were used to analyze the data. Results revealed that both psychosocial safety climate and supportive leadership improved personal resilience through personal hope. Findings showed that the positive relationship between supportive leadership and personal hope was stronger when the hospital‐level psychosocial safety climate was high. To improve personal hope and resilience among nurses during critical times, hospital management must ensure consistent supportive leadership and establish policies, practices and procedures that support nurses' psychosocial health and safety at the hospital level. [ABSTRACT FROM AUTHOR]

Facing pressure to train for victory, warfighters and athletes encounter numerous health risks that are directly related to their regular physical training. The concept of universal training precautions (UTPs) signifies universal processes designed to prevent unnecessary bodily harm, including injury, illness, and death, during physical training programs. Although no formal guidelines exist for collectively implementing a defined set of UTPs to address a broad scope of exercise-related health risks, recommendations and guidelines have been published relating to preventing sudden death during high school sports and collegiate conditioning sessions. A long list of critical topics must be considered as UTPs, including physical fitness factors, transition-period accommodation, hydration, environmental factors and acclimatization, appropriate recovery, use of medications and dietary supplements, and importantly, leadership. In this article, we outline in detail, with corresponding Strength of Recommendation Taxonomy ratings, what should be considered universal recommendations to minimize the risk of warfighters and athletes coming to harm when participating in group physical activities. [ABSTRACT FROM AUTHOR]

An organization is responsible for reducing incident and fatality risks among employees. Supervisory figures also play an important role in achieving organizational security goals. Therefore, a study was conducted to analyse the employee safety climate assessment level of supervisors. The study involved quantitative methods using questionnaire. A total of 441 randomly selected respondents among the employees of the operations and maintenance department of city rail transport organizations were involved in this study. Descriptive and inferential tests through t-tests involving dependent variables (operations and maintenance workers) and independent variables (supervisor safety climate dimension) were applied in this study. Results show that the supervisor safety climate assessment is at a moderate level. The competency and reaction dimensions towards employee behaviour is at the highest assessment level (mean = 3.69 and mean = 3.71) compared to the other two dimensions, namely leadership and effort towards improving employee safety respectively (mean = 3.57, mean = 3.62). The study also found that there was a significant difference between the employees in the operating and the maintenance departments for assessment of the supervisor safety climate levels (t = 2.116, p = 0.035) with a small impact magnitude of difference (eta squared = 0.01). This is a challenge for the organization, as the supervisor should be the best example for the employee suitable with the role of the supervisor as the mediator between the higher management and the employee. These results should serve as a reference for the organization in enhancing the supervisory integrity and commitment in improving the level of safety and health of the organization especially for urban rail transport management system. [ABSTRACT FROM AUTHOR]

Low‐ and no‐calorie sweeteners (LNCS) as a category are one of the most thoroughly evaluated additives, and thus their safety has been largely recognised. However, their potential risks and benefits generate great controversy and discussion within countries' food policies and public debate. The goal of this study was to evaluate the degree of knowledge and the perception of key Spanish stakeholders about the role of LNCS in diet, their safety, regulatory issues and their impact on health and wellness, as well as to complete a SWOT analysis of the Strengths, Weaknesses, Opportunities and Threats regarding this topic from their perspective. Participants (n = 45 stakeholders) completed an anonymous survey about their knowledge and perception of LNCS, their role in the diet, safety and legislation, as well as health issues and completed a SWOT analysis. Most of them agreed with aspects related to safety guarantees and authorisation procedure of LNCS; however, certain disparity in their opinion in relation to several of the topics was observed, especially regarding the possible role of LNCS in diet quality and health. Effective communication strategies to inform professionals and the general population, as well as new research that deepens our knowledge of the role of LNCS in weight management and other health outcomes seem to be urgently needed. [ABSTRACT FROM AUTHOR]

Introduction: Antineoplastic drugs are widely used in the treatment of cancer. However, some are known carcinogens and reproductive toxins, and incidental low-level exposure to workers is a health concern. CAREX Canada estimated that approximately 75,000 Canadians are exposed to antineoplastic drugs in workplace settings. While policies and guidelines on safe handling of antineoplastic drugs are available, evidence suggests that compliance is low. In this paper, we identify barriers and facilitators for safe handling of antineoplastic drugs in workplace settings. Methods: We utilized a unique method to study public policy which involved compiling policy levers, developing a logic model, conducting a literature review, and contextualizing data through a deliberative process with stakeholders to explore in-depth contextual factors and experiences for the safe handling of antineoplastic drugs. Results: The most common barriers identified in the literature were: poor training (46%), poor safety culture (41%), and inconsistent policies (36%). The most common facilitators were: adequate safety training (41%), leadership support (23%), and consistent policies (21%). Several of these factors are intertwined and while this means one barrier can cause other barriers, it also allows healthcare employers to mitigate these barriers by implementing small but meaningful changes in the workplace. Conclusion: The combination of barriers and facilitators identified in our review highlight the importance of creating work environments where safety is a priority for the safe handling of antineoplastic drugs. The results of this study will assist policy makers and managers in identifying gaps and enhancing strategies that reduce occupational exposure to antineoplastic drugs. [ABSTRACT FROM AUTHOR]

This article suggests that risk management should be addressed and prioritized to improve the social environment at work among employees in the eldercare and other frontline workers during health crises and thereby, build up the 'social resilience' of workplaces and prevent possible implications for their mental health and (clinical) practice. Objective: To investigate the association between workplace COVID-19 (coronavirus disease 2019) risk management and eldercare workers' perception of their social environment at work. Methods: Cross-sectional questionnaire data from 952 participants were collected by the Danish labor union, FOA, and analyzed using multinomial logistic regression. Results: Unclear guidelines, insecurity regarding organization of work, lack of attention to vulnerable employees, and lack of instruction in the use of personal protective equipment were associated with perceived negative changes in the social environment at work. Also, higher local incidence rates of SARS-CoV-2 infections were associated with a weaker sense of community (odds ratio, 1.18; 95% confidence interval, 1.04–1.36). Conclusions: These findings indicate that risk management is important not only for prevention of infection but also for individual and workplace resilience toward external demands and health threats. [ABSTRACT FROM AUTHOR]

Background: Growing evidence supports the integration and coordination of occupational health and safety and workplace health promotion activities instead of these coexisting as siloed efforts. Identifying implementation challenges and how these can be overcome is an important step to achieving truly integrated worker health efforts. We conducted a scoping review to identify the barriers and facilitators to integrated worker health approaches and described recommendations for implementing these efforts. Method: Peer-reviewed articles and gray literature from 2008 to 2019 were searched from the following electronic databases: EMBASE, Ovid Medline, PsycINFO, and ABI/INFORM. References from relevant articles and key informant suggestions also were collected. Data were extracted from documents if they focused on the occupational health and safety and health promotion of workers and described outcomes associated with integrated worker health approaches or outlined considerations relevant to the implementation of these approaches. Results: Fifty-one documents met the inclusion criteria and were reviewed. Barriers and facilitators to implementing integrated worker health approaches were found at the extraorganizational, organizational, worker, and program levels, with limited resource availability the most reported barrier and support from leadership the most reported facilitator. Ten broad recommendations were identified and highlighted gaining leadership support, demonstrating leadership commitment, developing worker-centric approaches, and building capacity for workers. Conclusion: In reviewing the literature, we found clear and consistent recommendations relevant for integrated worker health approaches. Further research is needed to better understand how these recommendations apply to diverse workforces and organizations with varied resources. [ABSTRACT FROM AUTHOR]

Aim(s): The study aimed to test a model that examined the relationships between authentic leadership, psychological safety, work engagement and team effectiveness and subsequent effects of team effectiveness on job turnover intentions and nurse satisfaction with quality of care. Background: Nurse leaders who exhibit authentic leadership have been shown to contribute to the development of healthy work environments. In workplaces with demonstrated authentic leadership, nurses are more engaged and have lower job turnover intentions. Method(s): A non‐experimental, cross‐sectional design was used to test the hypothesized model via structural equation modelling. A total of 456 nurses were included. Results: Structural equation modelling analysis indicated a good fit for the hypothesized model. Authentic leadership had a positive, significant and direct relationship with team effectiveness, nurses' work engagement and psychological safety. Team effectiveness was found to be negatively related to job turnover intentions but positively related to nurse satisfaction with quality of care. Conclusion(s): Results of this study may help nursing leaders have a better understanding of the essential role of leadership style in increasing healthy work environments. Implications for Nursing Management: Applying authentic leadership style in nursing practice could help to reduce the shortage of nurses stemming from the high turnover intentions of nurses. [ABSTRACT FROM AUTHOR]

Aims: This study investigates the effects of ethical climate and innovative culture on the hospital nurses' job performance and innovative behaviour with the mediating factor of psychological empowerment. Background: Hospital nurses have an opportunity to embrace innovative behaviours and increase their performance through a positive ethical climate and innovative culture. Understanding nurses' psychological empowerment in the workspace context that impacts innovation has not been a focus for hospital leadership. Methods: A cross‐sectional study based on a questionnaire design was used for data collection and analysis. The data are collected through a voluntary survey—selected by a convenience sampling method—of 393 nurses from University Hospital. The Structural Equation Model and Bootstrap method test the study's hypotheses. A STROBE checklist was used for reporting. Results: Ethical climate and innovative culture predict job performance and innovative behaviour with the mediating role of psychological empowerment. Moreover, psychological empowerment decreases the predictive power of ethical climate and innovative culture separately but increases the nurses' job performance and innovative culture. Conclusions: Ethical climate and innovative culture significantly positively affect job performance and innovative behaviour. Additionally, the mediating effect of psychological empowerment increases job performance and innovative behaviour more than the effects of ethical climate and innovative culture. Implications for Nursing Management: Nurses need to be prepared to practice safely, accurately and compassionately by translating moral values into rules of the nursing profession, where innovation increases at an astonishing rate. Nurse leaders and hospital managers should establish ethical norms as the consensus of ultimate criteria of validity of the rational analysis of tasks or particular nursing practice concepts, with an innovative culture by empowering nurses exceedingly in their workplace. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to (a) elucidate the effects of hospital management and unit supervisor support for patient safety on nurse speaking‐up behaviours and (b) identify potential mediators of this relationship. Background: Speaking‐up behaviour among nurses has emerged as a critical source of patient safety. Fuller understanding of the developmental mechanisms contributing to nurses' speaking‐up behaviours could help to enhance patient safety in health care organisations. Methods: A correlational approach was used to conduct a secondary analysis of cross‐sectional survey data collected from 450 staff nurses in Korea. Path analysis was performed to test potential mediation effects. Results: After controlling for nurses' hospital and unit tenure, hospital management and supervisor support for patient safety had significant direct and indirect effects on nurses' speaking‐up (promotive and prohibitive voice) behaviours through their perceptions of response to error and communication openness. Conclusions: Study findings indicate that when hospital management and supervisors emphasize patient safety and provide necessary resources, nurses are likely to perceive the hospital's safety culture more positively, in turn enhancing their speaking‐up behaviours. Implications for Nursing Management: Hospital administrators and nurse managers should clearly display hospital management and supervisory support for patient safety through implementation of related policies, resources, and communication standards. [ABSTRACT FROM AUTHOR]

The article presents a framework for achieving the recommendations of the National Plan for Health Workforce Well-Being. Cited are the seven priorities of the plan that further strengthens its potential to positively impact the well-being of the healthcare workforce, and the findings of a crosswalk comparing the alignment between the National Plan for Health Work-force Well-Being's recommendations and the American Nurses Credentialing Center (ANCC) Pathway to Excellence Program requirements.

Background: The health of nurse work environments has been shown to affect both patient and nurse outcomes. In 2005, the American Association of Critical-Care Nurses published the AACN Standards for Establishing and Sustaining Healthy Work Environments: A Journey to Excellence, and a second edition was published in 2016. The American Association of Critical-Care Nurses conducted critical care nurse work environment studies in 2006, 2008, 2013, 2018, and, most recently, October 2021, which was expanded to include registered nurses in all areas of practice. Objective: To report the results of the October 2021 study with comparisons to previous studies and recommendations for continued improvement and to evaluate the current state of nurse work environments. Methods: An online survey was used. A total of 9862 registered nurses responded to the survey; 9335 met the study criteria of currently practicing as a registered nurse. Results: The health of nurse work environments has declined dramatically since the 2018 study. However, as in 2018, evidence of a positive relationship exists between implementation of the American Association of Critical-Care Nurses Healthy Work Environment Standards and the health of nurse work environments, between the health of nurse work environments and job satisfaction, and between job satisfaction and the intent of nurses to leave their current positions or to stay. Conclusion: It is time for bold, intentional, and relentless efforts to create and sustain healthy work environments that foster excellence in patient care and optimal outcomes for patients, nurses, and other members of the health care team. [ABSTRACT FROM AUTHOR]

Aim: The aims of the study are to explore workplace violence perpetrated by patients or visitors from the perspective of hospital ward managers and to describe how ward managers perceive their leadership role and manage related incidents. Background: Few studies focus on workplace violence from the perspective of ward managers even though they are the closest managers to the operational staff. Method: Fifteen semistructured interviews were analysed using qualitative content analysis. Results: Four categories emerged: the face of workplace violence, a two‐fold assignment, strive towards readiness to act, and managing incidents. Conclusion: While the most common acts of workplace violence are considered less serious and related to patients' medical conditions or dissatisfied visitors, hospital organizations focus on serious but rarely occurring incidents. Consequently, ward managers have limited opportunities to ensure a safe work environment on an everyday basis. Implications for nursing management: To support ward managers' occupational safety and health management, workplace violence prevention and management should be acknowledged as an important responsibility for senior management in hospitals. It is important to identify incidents that most likely will occur at the wards and to create strategies related to those incidents. Strategies could include risk assessments, prevention, evaluation, education and reflection combined with, for example, scenario training. [ABSTRACT FROM AUTHOR]

During the COVID‐19 pandemic, teachers in the United States, an already at‐risk occupation group, experienced new work‐related stressors, safety concerns, and work‐life challenges, magnifying on‐going retention concerns. Integrating the crisis management literature with the unfolding model of turnover, we theorize that leader actions trigger initial employee responses but also set the stage for on‐going crisis response that influence changes in teachers' turnover intentions. We apply latent growth curve modelling to test our hypotheses based on a sample of 617 K‐12 teachers using nine waves of data, including a baseline survey at the start of the 2020–2021 school year and eight follow‐up surveys (2‐week lags) through the Fall 2020 semester. In terms of overall adaptation, teachers on average, experienced an increase in work‐life balance and a decrease in turnover intentions over the course of the semester. Results also suggest that district and school leadership provide unique and complementary resources, but leader behaviours that shape initial crisis responses do not similarly affect employee responses during crisis, contrary to theory. Instead, teachers' adaptive crisis response trajectories were triggered by continued resource provision over the semester; increasing provision of valued resources (i.e., continued refinement of safety practices) and improvements in work‐life balance prevented turnover intentions from spiralling throughout the crisis. Crisis management theory and research should continue to incorporate temporal dynamics and identify factors that contribute to crisis response trajectories, using designs and analyses that allow for examination as crises unfold in real time. [ABSTRACT FROM AUTHOR]

The article discusses mental health stigma in nursing and healthcare in 2022. Topics covered include nurses' burnout due to work stressors, the stigma phenomenon, nurses' deficient use of mental health resources that was heightened during the pandemic, and the pitfalls of employee assistance programs (EAP). Also noted are such strategies for addressing stigma as looking within, and viewing of support reach-out as an act of integrity, and recommendations for fighting mental health stigma.

We investigate the extent to which transformational leadership behaviours enacted by team members – shared transformational leadership – relate to safety behaviours of team members, teams, and team leaders. We also consider the role of perceived organizational support in moderating the relationships between shared transformational leadership and safety behaviours. We collected data from 2,139 crew members ('team members') and 98 chief engineers ('team leaders') working on merchant shipping vessels ('teams'). Team members' perceptions of shared transformational leadership positively related to team members' safety compliance and safety participation. Shared transformational leadership became less effective in relation to team members' safety compliance under conditions of high levels of perceived organizational support. Shared transformational leadership at the team level related to higher levels of safety participation of teams. Teams' shared transformational leadership was positively related to team leaders' safety participation, but only under low levels of perceived organizational support. Taken together, our findings demonstrate the important role of shared transformational leadership in relation to safety behaviours and suggest that the effectiveness of shared transformational leadership might vary depending on perceived organizational support. Practitioner points: Transformational leadership behaviours exercised by team members – shared transformational leadership – are associated with higher levels of mandated and discretionary safety behaviours of team members.Teams that have higher levels of shared transformational leadership demonstrate higher levels of team‐level discretionary safety behaviours.Shared transformational leadership is more strongly associated with employees' mandated safety behaviours under low levels of perceived organizational support.When leaders perceive low levels of organizational support, their teams' shared transformational leadership becomes a more important correlate of leaders' discretionary safety behaviours.In addition to traditional leadership training that involves formal leaders only, organizations should consider implementing activities that foster shared leadership behaviours. [ABSTRACT FROM AUTHOR]

Although workplace bullying has been long recognised as an organisational level phenomenon, few studies have explored how different organisational factors come together to influence bullying risk. In this study, we integrate theories on organisational psychosocial safety climate (PSC) and social information processing to understand how PSC is related to bullying exposure, mediated through leadership. We conceptualise and find support for how both organisational and supervisory factors align to shape the likelihood of bullying. Both constructive and laissez-faire leadership are incorporated into the model to explore the positive and negative pathways from PSC to bullying in a high-risk sample: 1,231 employees from 47 New Zealand public sector agencies who face high levels of emotional labour demands in their work. Findings from multilevel modelling corroborate the direct negative effect of PSC on bullying and confirm the predicted mediated pathways through both types of leadership to bullying, which is negatively associated with job satisfaction. Our findings shed light on how organisational factors at different levels combine to influence bullying, highlighting the potential (and need) for a multi-faceted approach to the prevention of bullying and mitigation of its negative effects. [ABSTRACT FROM AUTHOR]

Based on the social information processing theory and impression management theory, we construct a moderated mediation model to explore how and when subordinates' moqi affects safety behaviour. A questionnaire study was conducted, using cluster random sampling, to select 841 employees from a state-owned petrochemical enterprise in Chinese as the subjects, data was collected in two stages. Subordinates' moqi, job satisfaction, team psychological safety, and safety behaviour scales are chosen as measuring tools. Subordinates' moqi has positive effects on safety compliance and safety participation; job satisfaction mediates the relationship of subordinates' moqi and safety compliance, and safety participation; when team psychological safety is at a lower level, subordinates' moqi has a stronger promotion effect on safety compliance and safety participation through job satisfaction. Subordinates' moqi can be an effect way to promote safety behaviour, and job satisfaction might be a psychological process in the above relation. Team psychological safety plays a moderating role in this mediation process. KEY POINTS What is already known about this topic: There is a limit on the extent to which employees' safety behaviour can be improved through physical factors (such as safety equipment). Soft factors in organizations, such as leadership styles, leaders' behaviours, and safety culture have effects on safety behaviour. Subordinates who have a state of moqi with their supervisors can implicitly understand the intention and expectation of their supervisors, and ultimately perform behaviours expected by the supervisors. What this topic adds: The positive relationship between subordinates' moil and employee safety behaviour is discussed for the first time. We uncovered the psychological process of subordinates' moqi affecting safety behaviour, that is, the indirect role of job satisfaction. Team psychological safety can moderate the indirect effect of subordinates' moqi on safety behaviour through job satisfaction. [ABSTRACT FROM AUTHOR]

The article presents the discussion on improving the working conditions and safety for the million garment workers. Topics include impact and effectiveness of worker-focused initiatives at the community level overlooked with all the attention and resources; and increasing attention to OHS issues by the participating non-governmental organizations (NGOs).

My experiences as a legitimate informal whistle-blower have afforded me an understanding of the dichotomy that is Trust allegiance and misplaced brand loyalty over and above both patient and staff safety, such that when poor care is spoken of as a potential or experienced from either angle, the general rule within healthcare management is not to acknowledge, reflect, mitigate and learn in order to improve, but instead to gaslight, deny and subordinate such that from a staff safety perspective they are caught between a rock and a hard place. This paper explores some of the opportunities which healthcare organizations could embrace to positively influence the effects of power and hierarchy on staff safety. Aims: This paper discusses the bigger picture of maternity services safety. Methods: This is a discussion piece. Findings: For some healthcare staff it is preferable to remain quiet, not rock the proverbial boat, and maintain deeply loyal allegiances to their employers over and above public protection. For others, the journey of honesty, integrity and tenacity carries a high price in terms of personal energy, health and financial compromise. Conclusion: This exploration into how power & hierarchy influence both staff and patient safety has identified and briefly explored some of the tensions created by misplaced brand loyalty inherent within healthcare institutions, and the legacy of harms resulting. [ABSTRACT FROM AUTHOR]

Occupational accidents in the construction sector are still a major concern with relevant costs at different levels, both individually and socially. We developed and tested two structural equation models to study, from the workers' point of view, the mediator role of working conditions and safety leadership on the relationship between safety culture and safety performance, in a Portuguese firm. This quantitative and correlational case study applied a questionnaire to a convenience sample of 320 workers. A structural equation modeling analysis showed that safety culture was predominant in predicting safety performance and that working conditions mediated this relationship, but safety leadership did not. The results allow company's managers gaining certain insights about the role of safety culture, working conditions and safety leadership on safety performance prediction and in the work accidents' prevention. Furthermore, likely may help to understand what is going on in other firms, in construction sector in Portugal, and to identify problematic areas needing to be addressed. [ABSTRACT FROM AUTHOR]