Organizational Silence as a Mediator Between Ethical Nursing Competence and Perceptions of Open Disclosure in Patient Safety Incidents.

backgroundOpen disclosure of patient safety incidents (PSIs) is essential for patient safety, but organizational silence may inhibit nurses from speaking up. However, the influence of ethical competence on the perception of open disclosure and the role of organizational silence remain unclear. This study aimed to examine the relationships among nurses' ethical competence, organizational silence, and perceptions of open disclosure in PSIs and whether organizational silence mediates the effect of ethical competence on perceptions of open disclosure.

methodsA cross-sectional survey of 303 nurses in South Korea measured their ethical competence, organizational silence, and perceptions of open disclosure. Data were collected between October 14 and November 8, 2024, via an online nursing community. Multiple regression and mediation analyses were used to test for direct and indirect effects while adjusting for covariates.

resultsEthical competence was significantly associated with lower organizational silence and higher open disclosure perception, whereas organizational silence was associated with lower open disclosure perception. Mediation analysis confirmed that organizational silence had a significant indirect effect.

conclusionsHigher ethical competence is linked to lower organizational silence and greater support for the perception of open disclosure. Enhancing nurses' ethical competence and reducing silence may foster a more transparent patient safety culture. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers should strengthen nurses' ethical competence, encourage open communication to reduce silence, and promote transparent disclosure of PSIs.