Relationships between nursing leadership and organizational, staff and patient outcomes: A systematic review of reviews.
Marja Hult, Anja Terkamo-Moisio, Pirjo Kaakinen and 5 others
PMID 37306328WHAT IT FOUND
Relational leadership styles, especially transformational leadership, were associated with better staff well-being and patient outcomes like safety and satisfaction.
Passive and destructive styles linked to burnout and turnover. Most evidence was cross-sectional and self-reported.
Key findings
01Relational leadership styles were associated with positive organizational, staff and patient outcomes, including better patient satisfaction and safety.
02Passive and destructive leadership styles were associated with negative outcomes such as increased burnout, stress and intent to leave among nurses.
03The included reviews primarily reported staff outcomes, with job satisfaction being the most significant finding, while patient outcomes were less frequently studied.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The underlying original studies were mostly cross-sectional and relied on self-reported measures, which limits causal inference. There was significant heterogeneity in how leadership styles were defined and measured across the included reviews. Patient outcomes were less frequently reported than staff outcomes, and the specific patient metrics varied. The quality of the included reviews varied, with some having methodological shortcomings in data extraction and appraisal. Financial outcomes were not directly measured in the included reviews, despite the authors proposing a hypothetical model for them.
Declared interests
No external funding. No conflicts of interest declared.
The easy way to misread this
Do not interpret these associations as proof that changing a leader's style will directly cause specific patient outcomes to improve. The evidence is largely cross-sectional and self-reported, meaning it shows correlation, not causation, and relies on perceptions rather than objective clinical data.