Participative leadership and nurses’ error reporting: psychological safety as a mediator in multi-hospital data

BACKGROUND: Nurses' willingness to report medication-related events is central to organizational learning, yet speaking up still varies across units and leadership climates. This study examined whether psychological safety mediates the association between participative leadership and nurses' intentions to report medication errors. METHODS: We analyzed data from a cross-sectional survey of staff nurses in South Korea (n = 200). Participative leadership (6 items, 5-point scale), psychological safety (7 items, 5-point scale), and reporting intentions (9 items, 6-point scale) were measured using validated instruments. Mediation was examined using regression-based analyses with bias-corrected bootstrap confidence intervals (5000 resamples), adjusting for relevant covariates. RESULTS: Participative leadership was positively related to psychological safety (a = 0.443, P