ABSTRACT
Safety-specific transformational leadership (SSTFL) has been examined in high-risk industries for decades with solid evidence for its effectiveness and influence on safety climates and safety outcomes. The concept has recently been introduced to healthcare, with an operational definition developed through a concept derivation process and the development of a typology of factors that influence the relationship between leadership and safety climate. This article describes the evidence-based behavioral characteristics of leaders practicing SSTFL, which serve as a basis for the development and testing of an instrument to measure the latent variable of SSTFL in interprofessional healthcare leaders.
Subject(s)
Delivery of Health Care , Leadership , Humans , IndustryABSTRACT
OBJECTIVE: To examine and report burnout, secondary trauma, and compassion satisfaction in acute care nurse leaders through a large mixed-methods research study. BACKGROUND: Although nurse leaders are removed from daily patient care activities, the pervasive challenges in the work environment create conditions for professional burnout. Nurse leaders must garner compassion satisfaction from different sources, including peer and staff interactions. METHODS: The Professional Quality of Life scale was given to nurse leaders at 29 hospitals in 1 health system. Sixteen leaders from 2 hospitals participated in qualitative interviews. RESULTS: Six hundred seventy-two nurse leaders from 29 hospitals reported similar levels of burnout across frontline, midlevel, and director-level leadership. Directors demonstrated higher levels of compassion satisfaction and lower levels of work-life balance. Four themes emerged representing areas of professional life that potentiate and alleviate compassion fatigue. CONCLUSIONS: All levels of nurse leaders must address the risk of burnout and can do so through individual and organizational resiliency strategies.
Subject(s)
Burnout, Professional/psychology , Burnout, Psychological , Job Satisfaction , Nurse Administrators/psychology , Personal Satisfaction , Work-Life Balance , Workplace/psychology , Adult , Female , Humans , Male , Middle Aged , Surveys and QuestionnairesABSTRACT
BACKGROUND: Peer review is an essential element of professional nursing practice. LOCAL PROBLEM: Implementing nursing practice peer review is a challenge in any organization; some characteristics of small and rural hospitals can make the task especially daunting. METHODS: A team of nursing leaders and staff nurses from rural and critical access hospitals within 1 health care system was formed to make recommendations about implementing nursing practice peer review in the small rural facilities. Barriers included limited numbers of nurse reviewers by nursing specialty and inherent bias of reviewers due to personal knowledge of cases and nurses involved. INTERVENTIONS: A collaborative rural nursing practice peer review council was created, with staff nurse and leader representation from 6 geographically distinct facilities. RESULTS: The rural collaborative council has developed processes for case referral, reviewer assignment, investigation, and scoring founded on Just Culture principles. Satisfaction among staff nurses, reviewers, and Chief Nursing Officers has been high. CONCLUSIONS: Barriers to implementation of nursing practice peer review in rural hospitals can be mitigated through a collaborative approach, resulting in efficient and effective processes for small, rural, and geographically distinct hospitals.
Subject(s)
Cooperative Behavior , Peer Review , Quality Improvement , Rural Nursing , Hospitals, Rural , Humans , Nurse Administrators , Rural Health Services/organization & administrationABSTRACT
AIM: To validate a framework of factors that influence the relationship of transformational leadership and safety climate, and to enable testing of safety chain factors by generating hypotheses regarding their mediating and moderating effects. BACKGROUND: Understanding the patient safety chain and mechanisms by which leaders affect a strong climate of safety is essential to transformational leadership practice, education, and research. METHODS: A systematic review of leadership and safety literature was used to develop an organising framework of factors proposed to influence the climate of safety. A panel of 25 international experts in leadership and safety engaged a three-round modified Delphi study with Likert-scored surveys. RESULTS: Eighty per cent of participating experts from six countries were retained to the final survey round. Consensus (>66% agreement) was achieved on 40 factors believed to influence safety climate in the acute care setting. CONCLUSIONS: Consensus regarding specific factors that play important roles in an organisation's climate of safety can be reached. Generally, the demonstration of leadership commitment to safety is key to cultivating a culture of patient safety. IMPLICATIONS FOR NURSING MANAGEMENT: Transformational nurse leaders should consider and employ all three categories of factors in daily leadership activities and decision-making to drive a strong climate of patient safety.
Subject(s)
Consensus , Leadership , Organizational Culture , Patient Safety/standards , Adult , Aged , Female , Humans , Internationality , Male , Middle Aged , Nurse Administrators/psychology , Surveys and QuestionnairesABSTRACT
A sample of 1933 registered nurses working in 24 hospitals with shared leadership was surveyed to examine perceptions of nurse decisional involvement. Council participation was associated with higher decisional involvement scores (P = .03), and nurse experience was a statistically significant predictor of decisional involvement (P < .01). Nurse manager and staff registered nurse scores were significantly different (P < .01). Shared leadership may promote staff nurse perceptions of involvement in decision-making.
Subject(s)
Decision Making, Organizational , Leadership , Nurse Administrators/psychology , Nursing Staff, Hospital/psychology , Humans , Perception , Surveys and QuestionnairesABSTRACT
AIM: To analyse the concept of transformational leadership in the nursing context. BACKGROUND: Tasked with improving patient outcomes while decreasing the cost of care provision, nurses need strategies for implementing reform in health care and one promising strategy is transformational leadership. Exploration and greater understanding of transformational leadership and the potential it holds is integral to performance improvement and patient safety. DESIGN: Concept analysis using Walker and Avant's (2005) concept analysis method. DATA SOURCES: PubMed, CINAHL and PsychINFO. METHODS: This report draws on extant literature on transformational leadership, management, and nursing to effectively analyze the concept of transformational leadership in the nursing context. IMPLICATIONS FOR NURSING: This report proposes a new operational definition for transformational leadership and identifies model cases and defining attributes that are specific to the nursing context. The influence of transformational leadership on organizational culture and patient outcomes is evident. Of particular interest is the finding that transformational leadership can be defined as a set of teachable competencies. However, the mechanism by which transformational leadership influences patient outcomes remains unclear. CONCLUSION: Transformational leadership in nursing has been associated with high-performing teams and improved patient care, but rarely has it been considered as a set of competencies that can be taught. Also, further research is warranted to strengthen empirical referents; this can be done by improving the operational definition, reducing ambiguity in key constructs and exploring the specific mechanisms by which transformational leadership influences healthcare outcomes to validate subscale measures.
