Aims: To evaluate the mechanism through which nursing leadership impacts patient safety.
Background: Patient safety has received considerable attention among policymakers, governments and public sectors with the emphasis in health care settings on minimizing the risk to patients. Claims are made leadership plays a crucial role in patient safety. However, the incidents of adverse events are consistently high in hospitals.
Evaluation: Published English-only research articles that examine the mechanism by which nursing leadership impacts patient safety were selected from seven electronic databases and manual searches. Data extraction, quality assessments and analysis were completed for ten research studies.
Key issues: There is evidence of significant mediating effects between nursing leadership and decreased adverse patient outcomes specifically with regard to workplace empowerment, leader-nurse relationship and the quality of the care environment.
Conclusion: The findings suggest that nursing leadership has a significant indirect impact on patient safety outcomes. From a person-centred perspective, the care environment requires workplace empowerment and effective relationships between leaders and nurses.
Implications for nursing management: To improve patient safety outcomes, managers must strive to emphasize workplace empowerment, leader-nurse relationship and the quality of the care environment. Managers must consider these domains as part of an effective workplace culture.
Keywords: care environment; empowerment; nursing leadership; outcome; patient safety; person-centred; safety indicators.
© 2020 John Wiley & Sons Ltd.