Purpose
This study examined the double mediating effects of positive psychological capital and work engagement on the relationship between nurse unit managers’ empowering leadership and nurses’ patient safety nursing activities. Methods: Data were collected from 217 ward nurses employed at a tertiary hospital. Statistical analyses were conducted using SPSS version 29.0. Differences between groups were tested using independent t-tests, one-way analysis of variance, and the Duncan method. When normality assumptions were violated, the Mann–Whitney U and Kruskal–Wallis tests with Bonferroni correction were applied. Pearson correlation coefficients were computed, and mediation analysis was performed using Hayes’ PROCESS macro model 6. Results: Empowering leadership among nurse unit managers had a significantly positive effect on ‘nurses’ patient safety nursing activities. Furthermore, positive psychological capital and work engagement demonstrated significant double mediating effects on the relationship between empowering leadership and patient safety nursing activities. Conclusion: Enhancing patient safety nursing activities requires the establishment of a safety culture and institutional framework, the development of leadership training programs, and provision of systematic education.