Impact of Clinical Nurses' Patient Safety Competency, Psychological Safety, and Nursing Unit Manager's Safety-Specific Transformational Leadership on Intention to Report Near Misses

Purpose: This study examined the associations of clinical nurses’ patient safety competency, psychological safety, and nurse managers’ safety-specific transformational leadership with intention to report near-misses.Methods: A cross-sectional descriptive study was conducted with 225 clinical nurses from three tertiary hospitals in Korea. Data were collected between July 17 and 26, 2024, using a questionnaire. Data were analyzed using descriptive statistics, one-way ANOVA, Pearson’s correlations, and multiple linear regression, controlling for total clinical experience and completion of any near-miss-related education within the past year.Results: After adjustment for covariates, patient safety competency (β=.18, <i>p</i><.05), and psychological safety(β=.18, <i>p</i><.05) were positively associated with intention to report near-misses. Although safety-specific transformational leadership showed a positive correlation with the intention to report near-misses (r=.24, <i>p</i><.001), it was not a significant predictor in the adjusted model.Conclusion: To enhance clinical nurses’intention to report near-misses, organizations should support the development of patient safety competency through structured training, simulation-based learning, and competency-based assessment and feedback. In addition, psychological safety should be fostered by cultivating a non-punitive reporting culture, building trust, and ensuring open communication.