Date of Conferral







Leslie Hussey


Healthcare leaders must establish a just culture to mitigate preventable medical deaths that occur at 250,000 per year, making medical errors the 3rd leading cause of death in the United States. However, there is a gap in knowledge regarding the attributes of nurse manager leadership styles that contribute to promoting a just culture at the unit level. Guided by the full range leadership theory and the just culture model, the purpose of this descriptive correlational study was to determine the relationship between nurse manager transformational, transactional, and laissez-faire leadership styles and unit level just culture perceptions and the differences between staff nurses’ and nurse managers’ perceptions of leadership styles and just culture. The Multifactorial Leadership Questionnaire and the Just Culture Assessment tool were administered to 165 U.S. hospital-based staff nurses and nurse managers. ANOVA revealed a statistically significant difference in the mean just culture scores between transformational, transactional, and/or laissez-faire leadership styles (p < .01). MANOVA outcomes were significant for the difference between the nursing staff’s and nurse managers’ perceptions of nurse managers’ leadership styles (p < .01). This study promotes positive social change identifying transformational and transactional nurse manager leadership skills as a predictor for maintaining a unit level just culture and clarifying the impact of nurse managers’ leadership styles on perceptions of patient safety among frontline nurses and hospital safety. Future research should focus on exploring the relationship between nurse-sensitive patient outcomes such as pressure injuries and hospital-acquired infections along with the unit level just culture and nurse manager leadership styles.