Implementation of Safety Leadership in Nursing Management: A Systematic Mixed Studies Review


  • Lusianah Lusianah Student of Doctoral Program, Faculty of Nursing, University of Indonesia, Jakarta, Indonesia
  • Ratna Sitorus Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
  • Fatma Lestari Faculty of Public Health, University Indonesia, Depok, Indonesia
  • Toha Muhaimin Faculty of Public Health, University Indonesia, Depok, Indonesia
  • Dyah Juliastuti Nursing Program, Sekolah Tinggi Ilmu Kesehatan IMC Bintaro, South Tangerang, Indonesia



Head nurse, Management, Safety leadership, Systematic review


Background: Safety leadership positively influence safety compliance amongst employees in health care. It is necessary to understand how far nursing management has played its roles in attaining safety leadership.

Objective: This study is aimed to explore the safety leadership implemented by nursing management in enhancing the health care system.

Methods: This study conducted a systematic mixed studies review of current literature focusing on nursing managerial and safety leadership. Five key terms, safety leadership and head nurse or headward, first-line nurse manager, nurse leader, or nurse administrator, were used to retrieve relevant articles. Potential articles were found in seven extensive databases (EBSCO, Sage Publication, Scopus, JSTOR, Wiley online, ProQuest and Emerald). We included English research articles or review papers, available full-text, and published from September 2010 to September 2020. Irrelevant and redundant articles were excluded. Two data extractors analyzed the relevant reports.

Results: The search yielded 40 articles. But, after duplicates were removed, eleven full-text articles involving 5361 respondents were reviewed. The review papers included qualitative studies (n = 3), cross-sectional survey (n = 6), and (quasi) experiments (n = 2). The most significant proportion (40%) of the study was conducted in the American region. Four themes were generated, including role of safety leadership, development of safety leadership, support, and barriers. The review highlights that the nurse leaders play essential role in the development and implementation of safety leaderships in the hospital wards though they face challenges which need supporting team works, professionals, and standards.

Conclusion: Adopting safety leadership as a part of nursing management requires support from policymakers, institutions, and nursing leaders. The leaders should understand the complexities of the institutional structures and functional relationships in the health care system to meet patient safety standards


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How to Cite

Lusianah L, Sitorus R, Lestari F, Muhaimin T, Juliastuti D. Implementation of Safety Leadership in Nursing Management: A Systematic Mixed Studies Review. Open Access Maced J Med Sci [Internet]. 2022 Jan. 3 [cited 2022 Dec. 9];10(T8):5-10. Available from:

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