Nurses intervene in situations where patients may be at risk for harm, particularly in critical care units where risk due to severity of illness and complexity of treatment is higher. Although safety improvements have been made, nurses still report barriers to speaking-up. Improvement in skilled communication and true collaboration among health care professionals begins with assessment of the problem. Attitudes and beliefs that influence speaking-up behaviors among critical care nurses have not been well-documented. This research study utilized a mixed-method design framed by the Theory of Planned Behavior to explore factors associated with intention to speak up among critical care nurses when patients are at risk for harm. Following principal component factor analysis, total variance explained was 68.79%, Cronbach's alpha for the scale was 0.859, and values for the four sub-factors ranged between 0.750 and 0.916.

Date of publication

Fall 12-1-2015

Document Type




Persistent identifier


Included in

Nursing Commons