Perceptions Of Staff Nurse Clinical Leadership And Its Influence On Patient Safety And Quality Of Care In Hospitals In Central Texas
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Perceptions Of Staff Nurse Clinical Leadership And Its Influence On Patient Safety And Quality Of Care In Hospitals In Central Texas
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Author : Eduardo Che Chávez
language : en
Publisher:
Release Date : 2019
Perceptions Of Staff Nurse Clinical Leadership And Its Influence On Patient Safety And Quality Of Care In Hospitals In Central Texas written by Eduardo Che Chávez and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2019 with categories.
The purpose of this qualitative descriptive study was to explore staff nurse and clinical manager perspectives of staff nurse clinical leadership in hospitals in Central Texas. The Institute of Medicine called for leadership throughout all areas and at every level of the nursing profession to help lead the transformation of healthcare in the United States. Frontline staff nurses have the most frequent and extended contact with patients and are uniquely positioned to be leaders in the advancement of patient care. However, there is a significant gap in the literature about staff nurse clinical leadership. Face-to-face semi-structured interviews were used to interview nine staff nurses and ten clinical managers to explore how staff nurse clinical leadership was perceived by nurses at the frontlines of patient care. Content analysis was used to analyze the interview transcripts. The data were coded to create categories of information from which common themes emerged. A total of seven themes emerged from the staff nurse interview data, these included: (1) Characteristics of the individual, (2) Human relation skills, (3) Build trust, (4) Unity, (5) Speaking-up, (6) Awareness, and (7) Role-modeling. In addition, nine distinct themes emerged from the clinical manager data, these included: (1) Characteristics of the individual, (2) Human relation skills, (3) Contribute to the team, (4) Speak-out, (5) Advocate for patients, (6) Generate followership, (7) Do the right thing, (8) Take the extra steps, and (9) Problem-solve. Moreover, the theme speak-out emerged twice as a theme from the clinical manager data. Although there were a few similarities between the staff nurse and manager themes, there were fundamental differences in how they perceived staff nurse clinical leadership. The staff nurse themes emphasized leadership qualities that favored teamwork and specific team-player qualities. In contrast, the manager themes emphasized leadership qualities that were more focused on staff nurses’ self-management and problem-solving abilities in their work environment. Therefore, the findings of this study suggested that while staff nurses were perceived as clinical leaders by their peers and managers, there were different perceptions of how they demonstrated those leadership qualities in their work environment
Factors Impacting On The Clinical Leadership Behaviours Of Staff Nurses At The Point Of Care
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Author : Romana Raby
language : en
Publisher:
Release Date : 2014
Factors Impacting On The Clinical Leadership Behaviours Of Staff Nurses At The Point Of Care written by Romana Raby and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2014 with categories.
Nursing leadership, combined with psychological and structural empowerment has been linked to improved patient safety and outcome as well as increased job satisfaction and job effectiveness for employees. A nurses ability to operate as a clinical leader is affected by their workplace. Organisations that empower nurses to practice their profession optimally are organisations which optimise conditions for providing safe patient care. In the New Zealand (NZ) context, there appears to be minimal research regarding nursing empowerment, as well as negligible anecdotal evidence of the practical application of concepts such as transformation. This research sought to identify the clinical leadership behaviours of nurses, their current level of empowerment and the factors that influence their work effectiveness. Staff nurses at NZ's dedicated tertiary children's hospital were invited to complete a survey. Multinomial logistic modelling was used to determine the factors that influence the respondents' perception of their structural empowerment (Conditions of Work Effectiveness Questionnaire [CWEQII]), psychological empowerment (Psychological Empowerment Scale [PES]) and their clinical leadership (Clinical Leadership Inventory [CLI]) behaviours. Of the 542 nurses invited to participate, 224 responded. Nurses scored moderately high to high on both structural (CWEQ-II, M = 20.07) and psychological empowerment instruments (PES, M = 15.17). Overall they showed high levels of clinical leadership, identifying that clinical leadership behaviours were used most of the time (4.4) (>4 on a 5 point scale). Nurses who perceived they were structurally empowered (had access to information, support, resources and opportunities) also experienced psychological empowerment (found meaning, competence, selfdetermination and impact in their practice) (correlation between the total scores of CWEQ-II and PES; 0.53). The more supported they were by the organisation, the more able they were to operate as clinical leaders (correlation between CWEQ-II and CLI; 0.73). It was also found that NZ trained nurses were more psychologically empowered than those trained elsewhere and furthermore, nurses with greater than ten years clinical experience and who possessed a higher education were at greater risk of perceived structural and psychological disempowerment. This study showed that overall, staff nurses within NZ's children's hospital perform well as clinical leaders with good structural empowerment from hospital management. Management could sustain and even improve nurse empowerment by auditing the provision of structural empowerment, as all elements played an equal part in supporting clinical leadership, as well as providing extra support for nurses trained abroad and identifying the support needs of nurses with greater than six years' experience. These findings assist understanding on how best to develop and support nurses so they are enabled to provide the clinical leadership essential for optimising care and improving patient outcomes.
Nursing Leadership And Management
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Author : Elizabeth Murray
language : en
Publisher: F.A. Davis
Release Date : 2017-02-17
Nursing Leadership And Management written by Elizabeth Murray and has been published by F.A. Davis this book supported file pdf, txt, epub, kindle and other format this book has been release on 2017-02-17 with Medical categories.
Take an evidence-based approach to leadership. Learn the skills you need to lead and succeed in the dynamic healthcare environments in which you will practice. From leadership and management theories through their application, you’ll develop the core competences you need to provide and manage care of the highest quality to your patients. You’ll also be prepared for the initiatives that are transforming the delivery and cost effectiveness of health care today.
The Influence Of Nurse Manager Transformational Leadership On Nurse And Patient Outcomes
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Author : Ann Elizabeth Higgins
language : en
Publisher:
Release Date : 2015
The Influence Of Nurse Manager Transformational Leadership On Nurse And Patient Outcomes written by Ann Elizabeth Higgins and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2015 with categories.
The Canadian Adverse Events Study (Baker, et al., 2004) revealed that the rate of adverse events in Canadian hospitals is 7.5 percent and almost 37% of these are preventable. Given these statistics, it is essential that healthcare organizations develop strategies and engage in leadership practices, which will address the complexity of healthcare processes and ensure that care is provided in a consistent, reliable manner in order to achieve the desired outcomes (Frankel, Gandhi & Bates, 2003). It is equally vital that leaders create supportive practice environments that promote a non-punitive culture of learning, continuous improvement, inter professional collaboration, and professional autonomy, thus engaging nurses in safe practice aimed at improving patient outcomes (Aiken, 2008; Pronovost et al., 2003). In order to understand how nursing leadership affects outcomes, it is important to assess what leadership behaviours are most effective in promoting a patient safety culture. This study tested a hypothetical model which predicted the influence of nurse manager Transformational Leadership behaviour on staff nurse perceptions of supportive practice environments, organizational citizenship behaviours, patient safety culture, job satisfaction and objective measures of selected nurse sensitive outcomes. Findings supported the hypothesized model 2 (df = 22) = 40.72, p = .008; CFI = .958; TLI = .916; RMSEA = .079; SRMR = .045 linking transformational leadership to nurse and patient outcomes through supportive practice environments, organizational citizenship behaviours, safety culture and job satisfaction. Transformational Leadership had a significant indirect effect on patient falls (= -.08, p
The Influence Of Perceived Fairness And Relational Leadership On Nursing Safety Climate And Work Environment
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Author : Mae Ellen Squires
language : en
Publisher:
Release Date : 2010
The Influence Of Perceived Fairness And Relational Leadership On Nursing Safety Climate And Work Environment written by Mae Ellen Squires and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2010 with categories.
Patient Safety And Quality
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Author : Ronda Hughes
language : en
Publisher: Department of Health and Human Services
Release Date : 2008
Patient Safety And Quality written by Ronda Hughes and has been published by Department of Health and Human Services this book supported file pdf, txt, epub, kindle and other format this book has been release on 2008 with Medical categories.
"Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043)." - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/
Exploring The Role Of Climate For Innovation On The Relationship Between Leadership Style And Nurses Perception Of Patient Safety
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Author : Samuel Younger (Ph.D.)
language : en
Publisher:
Release Date : 2019
Exploring The Role Of Climate For Innovation On The Relationship Between Leadership Style And Nurses Perception Of Patient Safety written by Samuel Younger (Ph.D.) and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2019 with Health care teams categories.
Harm to patients remains high in US hospitals despite significant progress to improve the quality of care in our health systems. Leadership, a culture of patient safety, and a climate conducive to innovation in patient care are necessary to advance positive patient safety outcomes. Yet, little is known about how leadership can impact patient safety within a climate of innovation. This study examines the effects of transformational and transactional leadership (singularly and with transactional augmenting transformational leadership) as related to nurses' perception of patient safety, how communication elements of a culture of patient safety may strengthen that relationship, and how the mediating role of team innovation climate may help explain the relationship between transformational and transactional leadership and nurses' perception of patient safety. The variables were measured using three validated and reliable survey instruments: The Multifactor Leadership Questionnaire (MLQ Form 5X), the Team Climate Inventory-short (TCI), the Agency for Healthcare Research and Quality (AHRQ) Hospital Survey on Patient Safety Culture. A convenience sample of all staff registered nurses (N=952) from the single academic medical center with direct patient care responsibility was surveyed via e-mail for this research. A total of 210 surveys were returned, 157 met inclusion criteria for a response rate of 16%. Transformational leadership had a statistically significant relationship with patient safety perception, while the relationship of transactional leadership with patient safety perceptions was not significant. The results of the regression analysis that tested the effect of communication elements of a culture of patient safety on the relationship between transactional and transformational leadership and patient safety perception were not significant. Transformational leadership was significantly related with team innovation climate after controlling the effect of transactional leadership supporting the augmentation effect. Mediation analysis showed that team innovation climate had a significant mediating effect on the relationship between transformational leadership and patient safety perception. Team innovation climate had a significant mediating effect on the relationship between managers' transformational leadership and patient safety perception after controlling for transactional leadership supporting the augmentation effect. This is the first study known to test the augmentation of transformational leadership related to patient safety and the role of team innovation climate.
Clinical Leadership Of Registered Nurses Working In An Emergency Department
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Author : Megan J. Connolly
language : en
Publisher:
Release Date : 2015
Clinical Leadership Of Registered Nurses Working In An Emergency Department written by Megan J. Connolly and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2015 with categories.
Aim To examine clinical leadership of registered nurses (RN) in an Adult Emergency Department (AED), based on the evidence that it is important for nurses to feel psychologically and structurally empowered in order to be able to act as clinical leaders (Laschinger, Gilbert, Smith & Leslie, 2010). Background Every registered nurse is a clinical leader (Patrick, Laschinger, Wong & Finegan, 2011). Clinical leadership is defined as staff nurse behaviours that provide direction and support to patients and the healthcare team in the delivery of patient care (Patrick et al., 2011). Clinical leadership is important for patient safety and improves patient outcomes (DeVivo, Quinn Griffin, Donahue & Fitzpatrick, 2013). The Emergency Department (ED) is an ever-changing criticalcare environment that requires every nurse directly caring for patients to be empowered to act as a leader (Raup, 2008). However, research on leadership in nursing mostly focuses on delegated leader roles, with some focus on all nurses as leaders, but little on clinical leadership by nurses in ED. Methods A non-experimental survey design was used to examine the psychological empowerment, structural empowerment and clinical leadership of RN’s working in an AED in a large tertiary hospital in Auckland City. Qualitative questions relating to factors that support and inhibit their clinical leadership abilities were also included. Results The response rate was low at 33%. However the ED nurses that responded felt as though they showed clinical leadership behaviours most of the time, even though their sense of being psychologically empowered was only moderate, with improvements possible in structural empowerment. Conclusion This research portfolio highlights the need for further research on the phenomenon of clinical leadership at the point of care (Patrick, 2010). The overall results, albeit not statistically significant, showed that staff nurses feel they perform clinical leadership behaviours, but that structural and psychological empowerment have an impact on their ability to act as clinical leaders. Implications for Nursing Management Ways in which management within the hospital can support clinical leadership behaviours by nurses in ED have been identified in this research. The results support the literature that states management must create empowering environments for nurses to be able to provide clinical leadership to their patients and colleagues. Other research identifies that providing an empowering environment will improve patient outcomes and quality of care (Patrick, 2010). Keywords: clinical leadership, psychological empowerment, structural empowerment.
Clinical Manager Perceptions Of New Nurse Preparation For Clinical Leadership
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Author : Nickolaus Miehl
language : en
Publisher:
Release Date : 2018
Clinical Manager Perceptions Of New Nurse Preparation For Clinical Leadership written by Nickolaus Miehl and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2018 with Electronic dissertations categories.
Nurses are ideally positioned to lead the transformation of healthcare delivery in the United States, however they must be prepared to do so. The Institute of Medicine has called for nurses to become change agents and assume leadership positions across all levels in order to become full partners with physicians and other health care providers. While clinical leadership is a responsibility for all nurses, expectations for new nurse clinical leadership have not been well studied. This study sought to determine the nursing leadership competencies clinical managers expect of new nurses in an acute care setting and to identify gaps between end-of-program nursing leadership competencies, as outlined in The Essentials of Baccalaureate Education for Professional Nursing Practice, with leadership competencies identified by clinical managers in an acute-care setting. A single, bounded case study approach was used to collect data from nurse managers and assistant nurse managers at one acute care hospital. Data from intensive interviews, focus groups, and archival records were analyzed. Seven major themes related to clinical leadership emerged, including intentional learning, communication, professional practice, advocacy, teamwork, influencing practice, and systems thinking. Traits, mentoring, and generational differences emerged as secondary themes. Data from this study revealed a developmental sequence for clinical leadership. Certain expectations identified as antecedent to clinical leadership emerged initially, whereas other aspects of clinical leadership, developed later in the career trajectory. It was clear that accomplishing nursing care tasks was a fundamental expectation for professional nursing practice. Communication, teamwork and advocacy are crucial leadership competencies which help the new nurse to effectively manage time and provide safe, high-quality nursing care. As the new nurse continues to develop, systems thinking and influencing nursing practice emerge as significant expectations. Nurse managers have clear expectations for how new nurses should be prepared for clinical leadership. The degree to which clinical practice partners employing new nurses and academic nursing programs educating future nurses collaborate to establish expected outcomes is variable; however, academic-practice collaborations are crucial in developing educational standards for entry to practice in complex healthcare delivery systems.
Examining Nurses Perception Of Practice Practice Environment And Leadership In Primary Care
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Author : Sarah Brzozowski
language : en
Publisher:
Release Date : 2021
Examining Nurses Perception Of Practice Practice Environment And Leadership In Primary Care written by Sarah Brzozowski and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2021 with categories.
Formal nursing leadership influences many positive patient, nursing workforce, and organizational outcomes and has been heavily studied in hospital settings. Achieving leadership effectiveness and positive outcomes requires a leader to adjust their behaviors to both staff and work environment characteristics. A nurse's professional identity, including their values and beliefs, is also critical when evaluating nursing leadership. Yet, research of nursing leadership and the influence of staff and work environment characteristics has been predominately explored in hospital settings and little is known about nursing leadership in primary care settings. Primary care settings are an essential component of the healthcare system with nursing responsibilities expanding as new care models are developed that align with value-based payments and population health. This dissertation aimed to address identified gaps in the literature and increase the understanding of nurse identity and leadership needs, and the influence of the environmental context (staff and work environment characteristics) on leadership effectiveness in primary care settings. Two studies comprise this dissertation. The first study is a descriptive qualitative study of primary care direct care registered nurses exploring their perception of professional identity, components of their professional practice, and the support they need to function as a registered nurse and provide high quality patient care. The second study is an online survey study of primary care direct care registered nurses, which had two aims: 1) to explore differences in nurses' perceptions of their leaders' leadership behaviors and outcomes based upon registered nurses' individual and work setting characteristics; and 2) to explore effects of leadership styles, practice environment, and generational differences on nurse job satisfaction. Results of the first study indicate that a primary care nurse's identity and practice include unique characteristics and, to support nurses in this setting, it is necessary to recognize the needs of new nurses and ongoing support for all nurses. Results from the second study suggest individual and work setting characteristics influence nurses' perception of a leader's behaviors and outcomes. Furthermore, the study suggests practice environment and generational differences influence the relationship between perceived leadership style and job satisfaction. Findings from this dissertation provide additional knowledge to guide leadership training and inform future studies to create a more complete understanding of how the environmental context influences nurse leadership effectiveness.