How transformational leadership appears in action with adverse events? A study for Finnish nurse manager

The aim of this study was to determine whether elements of transformational leadership are present in nursing managers' actions following adverse events.

Transformational leadership exerts a positive influence on organisational culture and patient safety.

Eleven nursing managers were interviewed individually using a semi-structured format. Data were analysed using inductive content analysis.

Four themes emerged relating to nursing managers' actions following adverse events: patient-centredness as a principle for common action, courage to reform operational models to prevent future adverse events, nursing staff's encouragement of open and blame-free discussion, and challenge to recognize adverse events.

Nursing managers must understand their responsibilities and the importance of making it clear to staff that patient-centredness should be evident in all health care actions. Nursing managers must also recognize the need to ensure that staff treat patients' interests as the top priority.

If an adverse event occurs, the situation should be discussed with the nursing staff and any unique aspects of the event must be accounted for. Nursing managers must have the skill to motivate and empower staff to find new ways to work, to prevent adverse events and to promote patient safety.