DOI: 10.12688/f1000research.186053.2 ISSN: 2046-1402

The Mediating Role of Knowledge Sharing in the Relationship Between Transformational Leadership, Organizational Culture, and Nursing Innovation in the Makkah Health Cluster

Khadija Lafi Aljarary, Hafizah Che Hassan
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Background Nursing innovation is essential for improving healthcare quality, patient safety, and organizational performance. Although transformational leadership and organizational culture have been associated with innovation, the mechanisms linking these organizational factors with nursing innovation remain insufficiently understood, particularly within integrated healthcare systems in Saudi Arabia. This study examined the relationships of transformational leadership and organizational culture with nursing innovation and investigated the mediating role of knowledge sharing among registered nurses in the Makkah Health Cluster, Saudi Arabia. Methods A quantitative analytical cross-sectional study was conducted among 531 registered nurses recruited using proportionate stratified random sampling from six hospitals within the Makkah Health Cluster. Data were collected using standardized self-administered questionnaires assessing transformational leadership, organizational culture, knowledge sharing, and nursing innovation. Partial Least Squares Structural Equation Modelling (PLS-SEM) was used to evaluate the measurement and structural models and examine direct and indirect relationships among the study constructs. Results Transformational leadership was positively associated with nursing innovation (β = 0.313, p  < 0.001) and knowledge sharing (β = 0.573, p  < 0.001). Organizational culture was also positively associated with nursing innovation (β = 0.249, p  < 0.001) and knowledge sharing (β = 0.340, p  < 0.001). Knowledge sharing was positively associated with nursing innovation (β = 0.345, p  < 0.001). Knowledge sharing demonstrated complementary partial mediation in the relationships between transformational leadership and nursing innovation (indirect β = 0.198, p  < 0.001) and between organizational culture and nursing innovation (indirect β = 0.117, p  < 0.001). The model explained 63.1% of the variance in knowledge sharing and 62.0% of the variance in nursing innovation. Conclusions Transformational leadership, organizational culture, and knowledge sharing were significantly associated with nursing innovation, with knowledge sharing representing a complementary pathway linking leadership and organizational culture with innovative nursing behaviour. Healthcare organizations may benefit from integrating leadership development, supportive organizational cultures, and knowledge-sharing strategies to create conditions conducive to nursing innovation and continuous quality improvement within the context of Saudi healthcare transformation.

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