Registered Nurses’ Perceptions of Patient Safety Culture:
The Influence of Nursing Unit
Leadership by
Deleise S. Wilson
A dissertation submitted in partial
fulfillment of the requirements for the
degree of
Doctor of Philosophy
(Nursing)
in The University of
Michigan
ii
,To
My parents,
Len and Daphne Cole
and
My family
iii
, Acknowledgements
This dissertation was a journey. Along the way I gathered incredible knowledge
and scientific skills that laid the foundation to answer many questions about the important
work of nurses in the provision of quality and compassionate care for the sick in the
healthcare organizations. I could not have made this journey without the support of
family, friends, peers, and professors. Mentioned below are those who worked tirelessly
to support me through along this journey.
Richard Redman, PhD, RN
In so many ways, this journey was made possible by your insightful and
perceptive attention to the aspirations of your students. More importantly, it is your
wisdom in providing guidance, mentorship, challenges, and support that guaranteed my
timely completion of all of the requirements for this doctoral program. Your
comprehensive leadership of all aspects of my dissertation has certainly enriched and
refined its contribution to the scientific community. Your expertise as an advisor is truly
a model of succession planning for growing the next generation of nurse scientists. You
have set a solid base for my development as a nurse scientist and I am forever indebted to
you for all of my future successes. It is uncontested that you accomplished your goal to
attend to my academic growth. However, you went beyond this and demonstrated
constant concern for the well-being of my family. To my kids and Colwick, your name is
forever etched and positively associated with their memories of my accomplishment. We
thank you for facilitating me as I grew under your direct supervision. You are the advisor
every student deserves. Thank you ever so much!
iv
, Akke Neeltje Talsma, PhD, RN
Thank you ever so much for being my guide from the day I walked in the door.
You are like a mentor on steroids. You not only drove me from deadline to deadline,
which proved to be the secret of success, but you were a healing balm to my inflamed,
downtrodden spirits many times. Your expertise on staffing and patient safety was
invaluable. Thanks for your patience with my “daily 9:15 a.m. calls.” After each call I
felt energized and reassured that I would accomplish my goals. Without the daily dose of
the AkkeNeeloids “how’s it going!” and “you are ahead of the game,” I would have been
totally lost. I am extremely grateful for your extensive support.
Kathleen Sutcliffe
Your mentorship and expertise about the safety culture behaviors is greatly
appreciated. You were very critical in helping me create a precise theoretical
underpinning for the behavior of frontline nursing leaders. This scholarship is very much
needed in nursing and you helped me to make that contribution. I cannot measure in
words my admiration for your model of interdisciplinary collaboration and success. I am
therefore inspired to an academic career that will forge partnerships across relevant
disciplines. As such, you have influenced me for life. Thank you ever so much.
Michelle Aebersold, PhD, RN
You were a wonderful combination of peer mentor and advisor. You were never
too busy to listen to my neophyte ideas which you tactfully refined. Your suggestion
about choosing charge nurses as my study population was tantamount to finding gold. My
appreciation for your wisdom and support knows no end.
v
The Influence of Nursing Unit
Leadership by
Deleise S. Wilson
A dissertation submitted in partial
fulfillment of the requirements for the
degree of
Doctor of Philosophy
(Nursing)
in The University of
Michigan
ii
,To
My parents,
Len and Daphne Cole
and
My family
iii
, Acknowledgements
This dissertation was a journey. Along the way I gathered incredible knowledge
and scientific skills that laid the foundation to answer many questions about the important
work of nurses in the provision of quality and compassionate care for the sick in the
healthcare organizations. I could not have made this journey without the support of
family, friends, peers, and professors. Mentioned below are those who worked tirelessly
to support me through along this journey.
Richard Redman, PhD, RN
In so many ways, this journey was made possible by your insightful and
perceptive attention to the aspirations of your students. More importantly, it is your
wisdom in providing guidance, mentorship, challenges, and support that guaranteed my
timely completion of all of the requirements for this doctoral program. Your
comprehensive leadership of all aspects of my dissertation has certainly enriched and
refined its contribution to the scientific community. Your expertise as an advisor is truly
a model of succession planning for growing the next generation of nurse scientists. You
have set a solid base for my development as a nurse scientist and I am forever indebted to
you for all of my future successes. It is uncontested that you accomplished your goal to
attend to my academic growth. However, you went beyond this and demonstrated
constant concern for the well-being of my family. To my kids and Colwick, your name is
forever etched and positively associated with their memories of my accomplishment. We
thank you for facilitating me as I grew under your direct supervision. You are the advisor
every student deserves. Thank you ever so much!
iv
, Akke Neeltje Talsma, PhD, RN
Thank you ever so much for being my guide from the day I walked in the door.
You are like a mentor on steroids. You not only drove me from deadline to deadline,
which proved to be the secret of success, but you were a healing balm to my inflamed,
downtrodden spirits many times. Your expertise on staffing and patient safety was
invaluable. Thanks for your patience with my “daily 9:15 a.m. calls.” After each call I
felt energized and reassured that I would accomplish my goals. Without the daily dose of
the AkkeNeeloids “how’s it going!” and “you are ahead of the game,” I would have been
totally lost. I am extremely grateful for your extensive support.
Kathleen Sutcliffe
Your mentorship and expertise about the safety culture behaviors is greatly
appreciated. You were very critical in helping me create a precise theoretical
underpinning for the behavior of frontline nursing leaders. This scholarship is very much
needed in nursing and you helped me to make that contribution. I cannot measure in
words my admiration for your model of interdisciplinary collaboration and success. I am
therefore inspired to an academic career that will forge partnerships across relevant
disciplines. As such, you have influenced me for life. Thank you ever so much.
Michelle Aebersold, PhD, RN
You were a wonderful combination of peer mentor and advisor. You were never
too busy to listen to my neophyte ideas which you tactfully refined. Your suggestion
about choosing charge nurses as my study population was tantamount to finding gold. My
appreciation for your wisdom and support knows no end.
v
