The Association of Transformational Leadership on Safety Practices Among Nurses: The Mediating Role of Patient Safety Culture.

Background: To ensure best possible patient outcomes, patient safety is a major component of healthcare delivery system that needs to be prioritized. Safety practices among nurses are essential to maintain patient safety, especially the practices of medication administration, handover, patient falls and unplanned extubations prevention. Purpose: To investigate the mediating effect of patient safety culture between the relationship of transformational leadership and safety practices among nurses. Methods: The data in this cross-sectional study were gathered from a survey targeted clinical nurses using a random sampling technique. The study was conducted in a medical city in Saudi Arabia, and two hundred nurses were surveyed. The Multifactor Leadership, Hospital Survey on Patient Safety Culture, and Nursing Safety Practice questionnaires were used in the study. Results: The results revealed significant positive associations between transformational leadership, patient safety culture, and nursing safety practices. Moreover, patient safety culture mediates the association between transformational leadership and safety practices among nurses. Conclusion: Enhancing transformational leadership capabilities among nurse managers should be considered in order to improve nursing safety practices. Additionally, patient safety culture should be measured and improved periodically to ensure better nursing safety practices.

Embracing Transformational Leadership in Nephrology Nursing.

In nephrology nursing, effective leadership ensures optimal patient care and cohesive teamwork. Despite this, nurses often overlook their leadership potential, leading to underrepresentation in health care leadership roles. This article explores the significance of nursing leadership in nephrology care and delves into the principles of transformational leadership as a fitting approach. Transformational leadership emphasizes inspiring and motivating teams toward shared goals, fostering innovation, and individualized consideration. Each aspect of transformational leadership is discussed, including how it can be applied to nephrology nursing leaders, emphasizing their role in shaping organizational culture, promoting home modalities, and fostering professional development. By embracing transformational leadership, nephrology nursing can enhance patient outcomes, address workforce challenges, and cultivate a new generation of influential leaders. This article advocates for adopting transformational leadership to meet the evolving needs of nephrology care and supporting the professional growth of nephrology nurses in leadership roles.

A systematic review of leadership styles in healthcare sector: Insights and future directions.

In light of the ongoing global health crisis, the significance of leadership within the healthcare sector has intensified. Given this consideration, the significance of appropriate leadership styles cannot be overstated. The objective of this paper is to critically review published studies on leadership elements in the healthcare sector. Using Bibliometrix R package and VOS viewer, we conducted bibliometric and network analyses on publications retrieved from the Web of Science (WOS) database, with content analysis integrated throughout the paper to deepen understanding. Ultimately, 243 articles were identified as relevant. The findings revealed transformational leadership emerges as the most extensively discussed leadership style. 91% of the articles' theme focus on quantitative research methods. This study synthesizes the influencing factors of the three most frequently discussed leadership styles-transformational, authentic, and ethical leadership-emphasizing the importance of job satisfaction and organizational citizenship behavior. And provides direction for future research through thematic analysis.

The Global Intellectual Disability Nursing Research Collaboratory: Forming an international transformational nursing network.

AIM: This paper explains how we created the Global Intellectual Disability Nurse Research Collaboratory (GIDNRC), a transformative network. The GIDNRC aims to make improvements in the understanding, research, policy, clinical care, and support provided to people with an intellectual disability. BACKGROUND: In 2022, the World Health Organization (WHO) called upon healthcare leaders internationally to take actions to promote more equal healthcare for disabled persons. This paper promotes the GIDNRC as a way for professionals to work together to make more equal healthcare throughout the world for people with intellectual disabilities. SOURCES OF EVIDENCE: We created this paper by reviewing peer-reviewed literature and research, international policies, and nursing networking initiatives. DISCUSSION: This paper explores current policy, research, and practice issues that formed the basis of beginning the GIDNRC, including how the COVID-19 pandemic changed care. CONCLUSION: Nurses are over 50% of the world's health workforce. Therefore, they have the potential to make a large impact in making care for people with intellectual disability much more equal than currently exists throughout the world. However, barriers exist. Forming the GIDNRC, as well as using the World Wide Web, offers an opportunity to address barriers to this goal. IMPLICATIONS FOR NURSING PRACTICE: Nurses can address the needs of people with intellectual disability in their daily nursing practice. The GIDNRC aims to strengthen these clinical skills, understand how care may vary throughout the world, and share knowledge, good practices, and new ways to approach care for people with an intellectual disability worldwide. IMPLICATIONS FOR NURSING POLICY: International nursing policy should actively focus on the needs of people with intellectual disabilities and the role nurses play in addressing these health needs. The GIDNRC may provide an important way to achieve developments in this policy.

Factors influencing work engagement of nurses in general hospitals: A cross-sectional study.

AIM: This study aimed to examine the level of work engagement and to identify the factors influencing the work engagement of nurses. BACKGROUND: Work engagement plays a crucial role in enhancing the efficiency of outcomes and the standard of care in nursing and healthcare services. METHODS: A descriptive predictive design and stratified random sampling was used to select 206 nurses from three general hospitals in Naypyitaw, Myanmar.. Research instruments consisted of the demographic data form, the Utrecht Work Engagement Scale, the Global Transformational Leadership Scale, the Survey of Perceived Organizational Support, and the Psychological Capital Questionnaire. The results were explored by applying descriptive statistics and stepwise multiple regression. RESULTS: Overall work engagement was at an average level. Transformational leadership and psychological capital could affect work engagement, explaining 19.34% of the total variance; however, perceived organizational support, age, and work experience did not show any impact on it. CONCLUSIONS: The findings recommend that nurse administrators should focus on transformational leadership and psychological capital in formulating strategies to increase nurses' work engagement. IMPLICATIONS FOR NURSING AND HEALTH POLICY: The outcomes might provide baseline information for nurse administrators and policymakers by formulating management strategies to enhance nursing leaders' awareness, knowledge, and skills about transformational leadership behaviors and to keep nurses holding self-efficacy, hope, optimism, and resilience of psychological capital in healthcare organizations, which ultimately increase nurses' engagement at work.

Fostering green transformational leadership: the influence of green educational intervention on nurse managers' green behavior and creativity.

AIM: This study aimed to investigate the influence of green transformational leadership educational intervention on nurse managers' green behavior and creativity. BACKGROUND: Organizational creativity is greatly influenced by leaders and their personality attributes. Additionally, innovative employee behavior is crucial for organizational performance and survival, which in turn promotes long-term organizational growth. METHOD: A quasi-experimental design was conducted by using pre-test, post-test, and follow-up for a group that included 116 nurse managers who completed the intervention. Data were collected through the green transformational leadership knowledge questionnaire, green transformational leadership scale, green behavior questionnaire, and green creativity scale. RESULTS: Following the implementation of the Green Transformational Leadership educational intervention, there was an improvement in responses connected to the nurse manager's use of green behavior and creativity. Three months after the intervention ended, the improvement was still present. CONCLUSION: Nurse managers who had good knowledge about green transformational leadership showed increased green behavior and green creativity, which enhanced the organization's success. This study showed the significance of developing and improving the skills of managerial creativity for the nurse supervisor of a hospital through training in transformational leadership. IMPLICATIONS FOR NURSING MANAGEMENT: The concept of "green transformational leadership" refers to leadership behaviors and strategies aimed at promoting environmental sustainability and responsibility within an organization or a specific context. In the case we mentioned, it involves implementing educational interventions targeted at nurse managers to enhance their understanding and adoption of green practices, as well as fostering green behavior and creativity among them.

Influence of transformational leadership on innovative work behavior and task performance of individuals: The mediating role of knowledge sharing.

This research tries to investigate the dynamic link between higher education institution (HEIs) transformational leaders (TFL) and follower's outcome innovative work behavior (IWB) and Task Performance) through Knowledge sharing (KNS) in Pakistan. Using quantitative design an adopted construct was used to obtain response from HEIs leaders and employees behavior. The obtained information was analyzed through structural equation modeling (SEM) technique via Smart PLS. Results depict that direct link between University Transformational leadership and employees Innovative work behavior as well as Task Performance. The results further postulate that KNS mediate the relationship between Transformational leadership and employees TSP in the context of HEIs. Surprisingly, KNS could not evident to become a mediating variable to strengthen the relationship between transformational Leadership and employees IWB in the HEIs sector of Pakistan. In addition to enhancing the theoretical comprehension of higher education leadership, the outcomes of this article provide that promoting knowledge sharing culture is valuable asset for both existing and future HEIs leaders in order to promote the culture of innovation and creativity. Although recent studies investigate the role of KNS as a mediator, however the current study use KNS as contemporaneous intervening variable for IWB and Task Performance for the first time. The study also confirms theoretical underpinning of social exchange mechanism in strengthening the relationship between leader member's continuum.

Before and during COVID-19: the roles of transformational leadership, organizational culture and work-life balance in healthcare.

PURPOSE: This research aims to investigate the role of transformational leadership and organizational culture - encompassing Clan, Adhocracy, Hierarchical and Market Cultures - in the context of work-life balance for healthcare workers. It aims to present a comparison of observations made pre and mid-pandemic. DESIGN/METHODOLOGY/APPROACH: A structured questionnaire was utilized to collect data from a varied sample of 355 employees (258 before and 97 during the pandemic) representing multiple sectors and positions within a hospital. The interpretation of the data was accomplished using Partial Least Squares Structural Equation Modeling (PLS-SEM). FINDINGS: Findings reveal that prior to the pandemic, transformational leadership significantly influenced all forms of organizational culture perceptions, with a strong influence on Clan Culture. Clan Culture displayed a consistent positive correlation with WLB both before and during the pandemic. During the pandemic, Market Culture exhibited a negative effect on WLB and Adhocracy Culture demonstrated a positive effect, impacts which were absent before the pandemic. Transformational leadership had a positive impact on WLB before the pandemic, but no discernible effect during the pandemic was observed. ORIGINALITY/VALUE: The results indicate that the dynamics between transformational leadership, organizational culture and work-life balance are susceptible to alterations in the face of external crisis events. This study offers a unique exploration of these dynamics in the healthcare sector during the ongoing global pandemic.

Transformational Leadership, Secondary Traumatic Stress, and Burnout of Child Welfare Workers: Multilevel Moderation Effects.

This study examines the moderating effects of distant leader's practice of transformational leadership on the relationship between secondary traumatic stress (STS) and burnout among child welfare workers. Caseworkers and supervisors in a Midwest U.S. state (N = 210) rated their regional director's use of transformational leadership skills using a survey. Given the nature of the clustered data, multilevel modeling was employed to examine the main effects of transformational leadership on worker burnout and its cross-level interaction effect on the association between worker STS and burnout. Multilevel modeling demonstrated that worker burnout was positively associated with STS and negatively associated with organizational-level transformational leadership. The cross-level interaction between transformational leadership and STS was significant. Specifically, the positive association between workers' STS and burnout decreased as transformational leadership increased. These findings suggest that organizational approaches such as transformational leadership can influence workforce results. Further research will guide child welfare policymakers to develop more sophisticated training programs in leadership skills and strategies.

Delving into the link between employee proactivity and knowledge sharing: A multilevel mediated moderation investigation.

This study examines why and when proactive employees share knowledge. By integrating the Motivation-Opportunity-Ability Framework and Trait Activation Theory, and incorporating Mindsponge Theory, our multi-level model proposed that job autonomy moderates the impact of proactive personality on knowledge sharing (KS) within and between teams. Transformational leadership exhibits a cross-level effect on job autonomy. Utilizing a two-source, three-time-point research design, we collected data from 63 team leaders and 241 team members across six Chinese companies. Multilevel regression analysis revealed that within teams, increased job autonomy coupled with a proactive personality significantly enhanced KS. Between teams, job autonomy had a positive moderating effect. When job autonomy was low, more proactive teams exhibited less KS, whereas this negative effect was mitigated when job autonomy was high. The cross-level effect of transformational leadership on job autonomy was demonstrated. The theoretical and practical implications of these findings are discussed.

Transformational nurse leadership attributes in German hospitals pursuing organization-wide change via Magnet® or Pathway® principles: results from a qualitative study.

BACKGROUND: Budget constraints, staff shortages and high workloads pose challenges for German hospitals. Magnet® and Pathway® are concepts for implementing organization-wide change and redesigning work environments. There is limited research on the key elements that characterize nurse leaders driving the implementation of Magnet®/Pathway® principles outside the U.S. We explored the key attributes of nurse leaders driving organization-wide change through Magnet®/Pathway® principles in German hospitals. METHODS: Using a qualitative study design, semi-structured interviews (n = 18) were conducted with nurse leaders, managers, and clinicians, in five German hospitals known as having started implementing Magnet® or Pathway® principles. The interviews were recorded and transcribed verbatim. Data were analyzed in Atlas.ti using content analysis. For the analysis, a category system was created using a deductive-inductive approach. RESULTS: Five leadership attributes and eleven sub-attributes were identified as main themes and sub-themes: Visionary leaders who possess and communicate a strong vision and serve as role models to inspire change. Strategic leaders who focus on strategic planning and securing top management support. Supportive leaders who empower, emphasizing employee motivation, individualized support, and team collaboration. Stamina highlights courage, assertiveness, and resilience in the face of challenges. Finally, agility which addresses a leader's presence, accessibility, and rapid responsiveness, fostering adaptability. CONCLUSIONS: The study demonstrates leadership attributes explicitly focusing on instigating and driving organization-wide change through Magnet®/Pathway® principles in five German hospitals. The findings suggest a need for comprehensive preparation and ongoing development of nurse leaders aimed at establishing and sustaining a positive hospital work environment.

Psychometric Support and Measurement Invariance of a Turkish Version of the Transformational Parenting Questionnaire.

Our primary objective in this study was to psychometrically evaluate the Transformational Parenting Questionnaire (TPQ) within the Turkish context. Secondarily, we aimed to determine whether the questionnaire demonstrated measurement invariance across children's genders and grade levels. We included 950 participants, aged 11-18 years (446 girls, 498 boys, 6 unspecified gender identity; Mage = 14.73, SD = 1.85 years). Confirmatory factor analysis provided support for the original 4-factor structure of the TPQ, and there was satisfactory criterion-related correlational validity between this instrument and the Satisfaction with Life Scale. The TPQ exhibited robust internal item reliability coefficients, and respondent's test-retest correlations over a 15-day interval suggested adequate item response consistency. Importantly, we confirmed measurement invariance of the scale across participants gender and educational grade levels. In summary, we found that the TPQ was a valid and reliable tool for assessing Turkish children's perceptions of transformative parenting behaviors.

Teachers' Emotional Intelligence and Organizational Commitment: A Moderated Mediation Model of Teachers' Psychological Well-Being and Principal Transformational Leadership.

Given the global challenge of increasing teacher attrition and turnover rates, the exploration of factors and mechanisms that improve teachers' organizational commitment has become a pivotal topic in educational research. In this context, the present study examines the influence of teachers' emotional intelligence on their organizational commitment, with a specific inquiry into the mediating role of teachers' psychological well-being and the moderating role of principal transformational leadership, as informed by the broaden-and-build theory of positive emotions and the trait activation theory. We verified this study's hypotheses based on 768 valid questionnaires collected from Chinese primary and secondary school teachers. The results reveal that teachers' emotional intelligence can predict their organizational commitment both directly and indirectly through the mediating role of psychological well-being. Additionally, principal transformational leadership amplifies the positive effect of teachers' emotional intelligence on psychological well-being and, subsequently, organizational commitment. These findings theoretically deepen our understanding of the psychological pathways and the boundary conditions linking teachers' emotional intelligence to their organizational commitment, while also offering valuable practical implications for building a stable and effective teaching workforce.

How relational leadership can enhance nurses' well-being and productivity.

Leadership is an essential skill in nursing and has a fundamental role in ensuring high-quality patient care and the effective functioning of healthcare systems. Effective nursing leadership is vital to support nursing teams as they negotiate the challenges confronting the profession, such as ageing populations and the increased use of healthcare technology. This article discusses various relational leadership styles that can be used to promote nurses' health and well-being and enhance productivity. The author also explores the benefits and challenges of implementing relational leadership in nursing.

The prolificacy of green transformational leadership in shaping employee green behavior during times of crises in small and medium enterprises: a moderated mediation model.

Besides various other potent efforts to contain and consolidate, post-pandemic crisis management requires an adequate display of green transformational leadership. Green transformational leaders exhibit a formidable commitment to sustainability in making managerial choices and subsequently inspiring and motivating their employees to participate vigorously in the ensuing green initiatives. Such initiatives could profoundly help organizations adjust to shifting market situations, follow requirements, and preserve stakeholder trust. While making appeals to the central tenants of the transformation leadership theory, social exchange theory, and the social cognition theory, the study examines the impact of green transformational leadership on employees' green behaviors during times of crises using employees' self-esteem as a mediator and work engagement as the critical moderator. The relevant context of the study has been the small and medium enterprises of Saudi Arabia. Data from 232 SMEs employing less than 250 employees selected through convenience sampling was collected using structured questionnaires. After performing hierarchical regression modeling using SPSS 23, macro V4 model 58, and Amos 24, it has been found that green transformational leadership is positively associated with employees' green behaviors, with self-esteem and work engagement acting as significant mediating and moderating conditions, respectively. Besides, providing firsthand empirical evidence on the impact of green transformational leadership on employees' green behaviors, in unique industrial (SMEs), contextual (times of crises), and regional (Middle Eastern) settings, the study offers useful implications to the managers aspiring to enhance the sustainable performance of their firms through maturing green behaviors among their employees.

Multidisciplinary First-Line Healthcare Leaders' Roles and Experiences During the COVID-19 Pandemic in Ontario Canada.

BACKGROUND: Throughout the COVID-19 pandemic, first-line healthcare leaders across the healthcare system played crucial roles leading, motivating, and supporting staff. PURPOSE: This study aims to describe multidisciplinary first-line healthcare leaders' experiences during the COVID-19 pandemic in Ontario, Canada using transformational and crisis leadership theory. METHODS: A descriptive two-phase (quantitative & qualitative) design was conducted in the spring of 2021. Phase 1 employed an online survey sent via email to first-line leaders from various sectors who were members of healthcare professional associations in Ontario. Participants included nurse managers, professional practice leaders (e.g., occupational and physiotherapists), advanced practice nurses, and clinical educators. In Phase 2, a subset (n = 19) of the Phase 1 participants were interviewed to gain a deeper understanding of these leaders' experiences including role impact and support available. Semistructured individual interviews were conducted and recorded via Zoom©. Inductive and deductive analysis approaches identified key themes. This paper reports the qualitative findings from Phase 2. RESULTS: Leaders' behaviors were representative of the key dimensions of transformational and complexity leadership theories. Recommendations for leading during a crisis included: engaging in self-care activities to manage the personal impact of the crisis; teamwork and collaborative leadership; and support from fellow first-line leaders and senior leaders. Findings can inform healthcare leadership education programs designed to manage future crises for both academic and practice settings. CONCLUSION: Descriptions of first-line healthcare leaders' roles and experiences during multiple waves of the COVID-19 pandemic validated their important contributions within various health sectors.

Individual-level positive psychological capital that enhances managers' transformational leadership effectiveness on nurse career success.

AIMS: This study investigated the impact of nurse managers' transformational leadership on the subjective career success of staff nurses, particularly through exploring potential variations in this relationship based on nurses' positive psychological capital. BACKGROUND: Amid a challenging nursing environment, nurses' perceptions of career success affect their individual psychological satisfaction and improve work performance. Human resource strategies often include factors for workers' subjective career success, e.g., managers' transformational leadership and individual-level positive psychological capital. METHODS: This cross-sectional study collected survey data in 2021 from 348 staff nurses in 40 wards of a Korean tertiary hospital. The survey instruments included the Transformational Leadership tool, the Subjective Career Success Inventory, and the Psychological Capital Questionnaire. Multilevel hierarchical regression analysis and a simple slope test were used to examine moderating effects. The STROBE checklist was used for reporting. RESULTS: Nurses reported significantly higher subjective career success when they worked in units where unit managers' transformational leadership was greater. This relationship strengthened when nurses had high positive psychological capital. DISCUSSION: To enhance staff nurses' perceptions of career success, both managers' transformational leadership and individual nurses' positivity should be emphasized in nursing practice and education. IMPLICATIONS FOR NURSING AND NURSING POLICY: Comprehensive efforts to highlight managers' transformational leadership and staff nurses' positive psychological capital can enhance subjective career success, which in turn improve nurses' job performance and intention to stay. Nursing policymakers should value transformational leadership among managers so nurses can achieve their subjective goals. An organization-wide institutional system should be developed so nurses can receive support to strengthen their positivity. Future research should include interventions to foster managers' leadership and nurses' positive capital.

The Effect of Emotional Labor on Psychological Well-Being in the Context of South Korean Firefighters: The Moderating Role of Transformational Leadership.

Drawing on insights from the conservation of resources theory and the job demands-resources theory, our study investigates the association between two types of emotional labor-surface and deep acting-and the psychological well-being of firefighters. In addition, it investigates the moderating effect of transformational leadership within this context. To this end, this study utilizes ordinary least squares models to analyze survey data from 1453 firefighters in Gyeonggi-do, South Korea's largest province by population. The findings reveal a negative association between both types of emotional labor and the psychological well-being of firefighters. The study further demonstrates that transformational leadership mitigates the adverse effects of surface acting on psychological well-being. Our research indicates that transformational leadership plays a pivotal role in replenishing lost emotional resources, thereby enhancing the mental and emotional health of those engaged in demanding roles such as firefighting and emergency medical services. Accordingly, the study highlights a vital strategy for maintaining the psychological well-being of firefighters.

Enhancing Inclusive Teaching in China: Examining the Effects of Principal Transformational Leadership, Teachers' Inclusive Role Identity, and Efficacy.

This research examined the effects of principal transformational leadership on teachers' inclusive teaching behaviour, with a particular inquiry into the mediating effects of teachers' inclusive role identity and efficacy for inclusive practice, as informed by identity theory and social cognitive theory. Structural equation modelling with bootstrapping estimation was conducted using data from 712 teachers delivering inclusive teaching in primary or secondary schools in China. The results revealed the sequentially mediating mechanisms of teachers' inclusive role identity and efficacy underlying the principal transformational leadership effects on teachers' inclusive teaching behaviour. Research implications are also discussed.

Competencies for Transformational Leadership in Public Health-An International Delphi Consensus Study.

Objectives: This Delphi study intended to develop competencies for transformational leadership in public health, including behavioral descriptions (descriptors) tailored to individuals and their contexts. Methods: The study involved five rounds, including online "e-Delphi" consultations and real-time online workshops with experts from diverse sectors. Relevant competencies were identified through a literature review, and experts rated, ranked, rephrased, and proposed descriptors. The study followed the Guidance on Conducting and REporting DElphi Studies (CREDES) and the COmpeteNcy FramEwoRk Development in Health Professions (CONFERD-HP) reporting guidelines. Results: Our framework comprises ten competencies for transformational public health leadership (each with its descriptors) within four categories, and also describes a four-stage model for developing relevant competencies tailored to different contexts. Conclusion: Educators responsible for curriculum design, particularly those aiming to align curricula with local goals, making leadership education context-specific and -sensitive, may benefit from the proposed framework. Additionally, it can help strengthen links between education and workforce sectors, address competency gaps, and potentially reduce the out-migration of graduates in the health professions.