Akademik Veri Yönetim Sistemi
International Nursing Review, cilt.73, sa.1, 2026 (SCI-Expanded, SSCI, Scopus)
Aim: To synthesise evidence on the impact of nursing leadership styles on medication errors. Background: Leadership 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. Methods: The 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. Results: The 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. Conclusion: Transformational, 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).