Empowerment, respect, physical work environment, and safety performance: the mediation role of perceived management commitment to safety

Safety performance has become a vital issue for healthcare organizations, particularly in Intensive Care Units (ICUs) to ensure enhanced health and safety outcomes, not just for the patients, but also for the staff nurses, as they are considered as an integral part to achieve high quality of care. However, a dearth of research was noted in this domain. As a consequence, to maximize empirical data on antecedent factors to safety performance, this study intends to investigate the relationships between psychological empowerment, respect to the employees’ rights and needs, physical work environment, and safety performance among ICU nurses. The study also intends to determine whether the perceived management commitment to safety has a mediating role in these relationships. This study adopted the social cognitive theory and organizational support theory as the underpinning theories to develop its research model. Cross-sectional study by using survey was conducted, and 551 questionnaires were distributed to
the ICU nurses in the Hashemite Kingdom of Jordan with a response rate of 52%. This study used the Partial Least Squares-Structural Equation Modelling (PLS-SEM) to establish the validity and reliability of the measurement model and to test the study hypotheses. The results supported the theoretical model; they revealed that psychological empowerment and perceived respect had significant relationships with safety performance, while the nurses’ satisfaction with their physical work environment had a significant effect on safety performance through perceived management commitment to safety. In addition, the mediating effect of perceived management commitment to safety was also empirically justified. A model for improving the safety performance was proposed. The practical implications indicated that safety management commitment plays a significant importance in safety outcomes. For future research, further mediators are recommended. Finally, the study is useful and important to policy makers, academicians and practitioners to further improve and develop safety performance at healthcare organizations.