Evidence map›Paper›PMID 41729137›Full record

SynthesisInternational nursing review2026

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

Hasan Fehmi Dirik, Chrysanthi Theiakouli, Nikolaos Efstathiou

Abstract readSystematic Review
In one paragraph

Synthesis in International nursing review, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Hasan Fehmi DirikFaculty of Nursing, Dokuz Eylul University, Izmir, Turkey.ORCID https://orcid.org/0000-0003-4606-4942
Chrysanthi TheiakouliDepartment of Nursing, National and Kapodistrian University of Athens, Athens, Greece.
Nikolaos EfstathiouDepartment of Nursing and Midwifery, University of Birmingham, Edgbaston, Birmingham, UK.ORCID https://orcid.org/0000-0001-5811-8982

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimTo synthesise evidence on the impact of nursing leadership styles on medication errors.

backgroundLeadership plays a critical role in medication safety by shaping staff behaviour, promoting adherence to clinical guidelines and fostering a safety-oriented culture. However, the effects of specific leadership styles on medication safety have not yet been comprehensively synthesised.

methodsThe Joanna Briggs Institute convergent segregated approach for mixed-method systematic reviews was employed and reported in accordance with PRISMA guidelines. Searches were conducted in MEDLINE, CINAHL, Scopus, PubMed, Web of Science, EMBASE, PsycINFO and Google Scholar, encompassing literature published from January 2014 to April 2025.

resultsThe review includes 15 papers: 11 cross-sectional, 2 quality improvement, 1 quasi-experimental and 1 mixed-methods study. Transformational (n = 11) and ethical leadership styles were associated with enhanced medication safety, as evidenced by increased error reporting and greater adherence to medication protocols. Situational leadership was linked to gradual improvements in self-reporting behaviours. In contrast, passive-avoidant and toxic leadership styles correlated with higher rates of medication errors and decreased willingness to report errors. The effects of transactional leadership (n = 5) were mixed and appeared to be influenced by contextual factors. DISCUSSION: Synthesising both consistent and divergent findings clarified the complex dynamics through which leadership can mitigate or exacerbate medication errors, and offered guidance for the development of innovative and integrated leadership approaches.

conclusionTransformational, ethical and situational leadership styles contribute to improved medication safety, whereas passive-avoidant and toxic leadership styles lead to increased medication errors. IMPLICATIONS FOR NURSING AND NURSING POLICY: This review highlights the relevance of leadership approaches associated with safety-oriented behaviours. Understanding the effects of different leadership styles will inform and support decision-making, enabling nurse leaders to implement more effective strategies to reduce medication-related risks. Investment in leadership development, particularly programmes based on transformational and ethical principles, has the potential to strengthen safe medication practices. PROSPERO REGISTRATION: This systematic review's protocol was registered in PROSPERO (registration number CRD42023380426).

Indexed as

LeadershipMedication ErrorsPatient SafetyHumansLeadershipmedication errorsnursingsystematic review

Identifiers

PMID41729137
PMCPMC12927690

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.