Abstract
In 2024, the GLINT survey conducted in our neonatal intensive care unit (NICU) showed a psychological safety score of 61 out of 100, with nurses reporting avoidance of speaking up because they feared negative reactions from physicians and leadership. These results identified a critical need for leadership interventions.
NICU nursing leaders (nurse managers and director of nursing) implemented evidence-based leadership rounds which have been shown to enhance communication and psychological safety in critical care environments (Diabes et al., 2021). Rounds were conducted on all shifts and included five main components: workflow assessment, concern identification, immediate need evaluation, staff recognition for good work, and evaluation of quality protocols. Leaders used standardized questions and visibly responded to concerns in real time including intervening in physician-nurse conflicts, support of proper discharge procedures, and escalation of reports of unprofessional conduct to medical supervisors. Psychological safety was added as a standing agenda item during monthly staff meetings to allow ongoing discussion, provide progress updates, and reinforce a culture of open communication. Feedback and follow-up were provided, promoting transparency and trust. Meeting minutes tracked issues and actions, supporting the sustained impact of leadership rounds on safety culture and evidence-based care (Pfeifer et al., 2023).
Following implementation, staff reported greater trust and support. In the May 2025 GLINT survey, psychological safety scores rose from 61 to 78, while direct manager-specific scores reached 85. Nurses reported increased confidence in raising concerns, attributing it to consistent advocacy and follow-up from leaders.
The combination of daily rounding with visible advocacy and meeting-based psychological safety promotion led to substantial growth in staff willingness to express their concerns. These findings align with evidence that leadership visibility, responsiveness, and open communication enhance psychological safety in nursing teams.
Implications extend to nursing education and administration. Incorporating leader-driven rounding and consistent follow-up into leadership training and policy can strengthen workforce engagement and build a culture of psychological safety.
Limitations include voluntary survey participation, potential differences in respondents between pre- and post-implementation surveys, and single-site implementation.
Sigma Membership
Psi Upsilon
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Other
Keywords:
Mentoring/Coaching, Workforce, Interprofessional/Interdisciplinary, Neonatal Intensive Care Units, Patient Rounds, Patient Rounds--Methods, Psychological Safety, Leadership, Mentorship, Interprofessional Relations
Recommended Citation
Huckaby, Erica; Veselinovic, Julie; and Franklin, Tomica, "Building a Culture of Psychological Safety in the NICU Through Leadership Rounds" (2026). Creating Healthy Work Environments (CHWE). 62.
https://www.sigmarepository.org/chwe/2026/presentations_2026/62
Conference Name
Creating Healthy Work Environments
Conference Host
Sigma Theta Tau International
Conference Location
Washington, DC, USA
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-04-30
Building a Culture of Psychological Safety in the NICU Through Leadership Rounds
Washington, DC, USA
In 2024, the GLINT survey conducted in our neonatal intensive care unit (NICU) showed a psychological safety score of 61 out of 100, with nurses reporting avoidance of speaking up because they feared negative reactions from physicians and leadership. These results identified a critical need for leadership interventions.
NICU nursing leaders (nurse managers and director of nursing) implemented evidence-based leadership rounds which have been shown to enhance communication and psychological safety in critical care environments (Diabes et al., 2021). Rounds were conducted on all shifts and included five main components: workflow assessment, concern identification, immediate need evaluation, staff recognition for good work, and evaluation of quality protocols. Leaders used standardized questions and visibly responded to concerns in real time including intervening in physician-nurse conflicts, support of proper discharge procedures, and escalation of reports of unprofessional conduct to medical supervisors. Psychological safety was added as a standing agenda item during monthly staff meetings to allow ongoing discussion, provide progress updates, and reinforce a culture of open communication. Feedback and follow-up were provided, promoting transparency and trust. Meeting minutes tracked issues and actions, supporting the sustained impact of leadership rounds on safety culture and evidence-based care (Pfeifer et al., 2023).
Following implementation, staff reported greater trust and support. In the May 2025 GLINT survey, psychological safety scores rose from 61 to 78, while direct manager-specific scores reached 85. Nurses reported increased confidence in raising concerns, attributing it to consistent advocacy and follow-up from leaders.
The combination of daily rounding with visible advocacy and meeting-based psychological safety promotion led to substantial growth in staff willingness to express their concerns. These findings align with evidence that leadership visibility, responsiveness, and open communication enhance psychological safety in nursing teams.
Implications extend to nursing education and administration. Incorporating leader-driven rounding and consistent follow-up into leadership training and policy can strengthen workforce engagement and build a culture of psychological safety.
Limitations include voluntary survey participation, potential differences in respondents between pre- and post-implementation surveys, and single-site implementation.
Description
A NICU leadership initiative used structured rounding with visible advocacy and consistent meeting promotion to improve psychological safety. GLINT survey scores rose from 61 to 78, with direct manager scores reaching 85. Nurses gained confidence to voice concerns supported by consistent leader presence and follow-up. This model demonstrated measurable workforce benefits within the unit.