The Influence of Nursing Leadership Styles on Medication Safety: A Mixed-Methods Systematic Review

Area of Science:

• Nursing
• Healthcare Management
• Patient Safety

Background:

• Leadership significantly influences medication safety by shaping staff behavior and fostering a safety culture.
• Specific leadership styles' impact on medication safety requires comprehensive synthesis.

Purpose of the Study:

• To synthesize evidence on the impact of nursing leadership styles on medication errors.
• To clarify how leadership dynamics mitigate or exacerbate medication errors.

Main Methods:

• Systematic review using the Joanna Briggs Institute convergent segregated approach.
• Searches conducted across 8 major databases (MEDLINE, CINAHL, Scopus, PubMed, Web of Science, EMBASE, PsycINFO, Google Scholar) from January 2014 to April 2025.
• PRISMA guidelines followed for reporting.

Main Results:

• Transformational (11 studies) and ethical leadership styles correlate with enhanced medication safety, evidenced by increased error reporting and protocol adherence.
• Situational leadership showed gradual improvements in self-reporting behaviors.
• Passive-avoidant and toxic leadership styles were linked to higher medication errors and decreased error reporting; transactional leadership effects were mixed.

Conclusions:

• Transformational, ethical, and situational leadership styles positively impact medication safety.
• Passive-avoidant and toxic leadership styles are associated with increased medication errors.
• Understanding leadership's role is crucial for developing effective strategies to reduce medication risks and inform nursing policy.