Effect of Nursing Leaders' Moral Leadership on Nurses' and Teams' Psychological Safety: A Cross-Sectional Online Study.

Introduction: Although leaders can foster psychological safety by encouraging moral behaviors, the link between the two remains unclear. Despite its importance in clinical education and patient safety, empirical research has not adequately explored the unique impact of nursing leaders' moral character and actions. Objectives: This study not only examined the relationships between nursing leaders' moral leadership, nurses' psychological safety, team learning behaviors, and teams' psychological safety but also assessed whether moral leadership and sample characteristics predict nurses' and teams' psychological safety. Methods: A quantitative cross-sectional design was employed. After a pilot study, an online survey using Google Forms was conducted over 1 month in 2024. To assess the concepts studied, 365 nurses were recruited from different hospitals using convenience snowball sampling, yielding a response rate of 73%. Results: Responses were rated on a 5-point Likert scale. Nurses rated their leaders as moral. Individualized means varied across variables. Most leaders showed high integrity and temperament, but moderate courage and prudence. Nurses' respect was the highest moral subscale, followed by team learning. Teams' psychological safety was high, especially in risk-taking and expectations, but moderate in learning from failure and support. Moral leadership correlated with nurses' psychological safety and teams' safety. Moral leadership and work area predicted nurses' and teams' psychological safety. Conclusions: These findings suggest that although moral leadership is perceived positively, its impact on psychological safety may vary depending on contextual factors such as organizational culture and leadership style. Nursing leaders' moral leadership and area of work were the shared determinants of nurses' and teams' psychological safety. Moral nursing leaders make a difference in the work environment. When nurses and nursing teams admire the qualities of their moral leaders, their psychological safety, including team learning behaviors, improves, resulting in several positive outcomes. Moral leadership contributes to psychologically safe environments by promoting openness, respect, and learning from failure. Future research should explore cross-cultural applications of moral leadership and its impact on team dynamics.