Organizational Culture among Nurses Working in the Public Health Sector on the Island of Crete - GreeceRunning Title: Nurses’ Organizational Culture

Background: Organizational culture has been defined as an important characteristic that influences the effectiveness or ineffectiveness of providing quality health care services. Nurses are an important group that can influence the overall culture of a health organization positively or negatively. Objectives: To identify the organizational operating culture in total and within levels of the public health care organizations in Crete as perceived by nurses. Methods and material: A descriptive comparative study was conducted at seven of the fourteen public Health Centers, which were randomly selected, four General Hospitals and the only available tertiary hospital on the island of Crete, Greece. A multistage random sampling design was applied based on health care level of organizations. The sample consisted of 81 nurses. The Organizational Culture Inventory® from Human Synergistics International was administered. Descriptive statistics were used to analyze the data. Mean score for each of the twelve culture styles were converted to percentile scores. Results: Nurses’ perception of operational culture in total and within health care level in the public health organizations of Crete is the Aggressive/Defensive culture (total 86.5 %ile, primary 85.25 %ile, secondary 87.75 %ile and tertiary 84.25 %ile), whereas Constructive culture styles are the least present. The analysis per health care level reveals that Avoidance is encouraged by all health organizations either as primary style or as secondary style, whereas Oppositional is present as secondary culture style in Health Centers and as primary culture style in the University Hospital. Conclusion: Nurses' perception of Organizational culture must be radically altered, as nurses influence the quality of care provided. Consequently nurse leaders should design educational programs as well as interventions for organizational changes towards Constructive culture styles, whilst Aggressive/Defensive behaviors should be minimized.