Errors in Clinical Practice and Organizational Constraints: The Role of Leadership in Improving Patients’ Safety

Background: Organizational constraints in healthcare organizations influence nursing performance and patient outcomes. Head nurses’ leadership style might mitigate these effects and improve patient safety. This study aims to evaluate the role of ethical and authentic leadership styles in the relationship between organizational constraints and errors. Methods: A nationwide multicenter cross-sectional study evaluated nurses’ organizational constraints, errors, and leadership styles. A structural equation model tested the hypothesized relationship. Results: In total, 2349 nurses working in Italian healthcare organizations were enrolled. Negative associations were found between organizational constraints and leadership styles, and a positive relation with errors. Errors were negatively associated with both leadership styles. The structural equation model showed that leadership styles partially mediated the relationship between organizational constraints and errors. Conclusion: Healthcare organizations should promote and support head nurses in the adoption of ethical and authentic leadership to mediate organizational constraint effects, reduce errors, and enhance the caring quality. The head nurse plays a crucial role within healthcare organizations in mitigating the impact of organizational constraints and enhancing patient safety. Developing a leadership style means improving nurses’ well-being and reducing clinical errors for patients.