Systematic Review of Authentic Leadership Effects on Patient, Nurse, and System Outcomes

Area of Science:

• Nursing
• Healthcare Management
• Leadership Studies

Background:

• Authentic leadership is globally linked to positive nurse outcomes.
• Previous reviews indicated limited U.S. evidence and no impact on patient/system outcomes.

Purpose of the Study:

• To systematically review and synthesize evidence on authentic leadership's effect on nurse, patient, and system outcomes.
• Focus on acute care hospitals within the United States.

Main Methods:

• Systematic search of six databases for quantitative, peer-reviewed nursing research (2004-2025).
• Inclusion of studies on registered nurses in acute care settings; exclusion of non-RNs.
• Quality appraisal using Joanna Briggs Institute tools; narrative synthesis due to heterogeneity.

Main Results:

• Included studies (2017-2025) were primarily descriptive cross-sectional surveys with small sample sizes.
• Authentic leadership showed a negative predictive relationship with burnout (small to moderate effect).
• Authentic leadership predicted compassion satisfaction (small to moderate effect).

Conclusions:

• Authentic leadership may reduce burnout and enhance compassion satisfaction among U.S. acute care nurses.
• No evidence supports a link between authentic leadership and patient or system outcomes.
• Further research is crucial to explore authentic leadership's broader impact in U.S. healthcare settings.