Leadership in Nursing

Embedding collective leadership to foster collaborative inter-professional working in the care of older people (ECLECTIC): Study protocol.

HRB Open Res. 2020;3:8

Authors: Anjara SG, Ní Shé É, O'Shea M, O'Donoghue G, Donnelly S, Brennan J, Whitty H, Maloney P, Claffey A, Quinn S, McMahon N, Bourke N, Lang D, Reilly P, McGuigan C, Cosgrave S, Lawlor L, O'Shea D, McAuliffe E, O'Donnell D

Background: The National Integrated Care Programme for Older People (NICPOP), formerly NCPOP aims to support older people to live well in their homes by developing primary and secondary care services for older people, especially those with complex needs. The programme develops integrated intermediate care which traverses both hospital and community settings through multidisciplinary and interagency teams. This team-based approach to the integration of health services is a novel innovation in Irish health service delivery and will require, over time, a shift in cultures of care to allow for the development of competencies for inter-professional collaboration across the care continuum. The ECLECTIC project will develop an implementation framework for achieving, maintaining and monitoring competencies for interprofessional collaboration among multi-disciplinary teams charged with delivering care for older people across the continuum from acute to community settings. Design: The ECLECTIC research design has been developed in collaboration with the NICPOP. In phase one of the project, a co-design team will collaborate to define and shape competencies for interprofessional collaboration. Phase two will involve the delivery of a collective leadership intervention over a 10-month period with multidisciplinary professionals working with older people across two geographical regions (Mullingar/Midlands and Beaumont/Dublin North). Each group will comprise of members of two multidisciplinary teams charged with coordinating and delivering care to older people across the continuum of acute to community care. Observations of collaborative inter-professional working will take place before, during, and after intervention. In phase three of the study, analysis of the interview and observation data will be presented to the co-design team in order to develop an implementation framework for future teams. Discussion: The co-design process will develop core competencies and performance indicators for collaborative interprofessional working. The resulting implementation framework will be implemented nationally as part of the NICPOP.

PMID: 32789287 [PubMed - as supplied by publisher]

Nurse managers experiences of their leadership roles in a specific mining primary healthcare service in the West Rand.

Curationis. 2020 Jul 23;43(1):e1-e8

Authors: Nene SE, Ally H, Nkosi E

BACKGROUND: Nurse managers are leaders in mining primary healthcare. Their leadership roles include inspiring and empowering operational managers and nursing personnel, by leading with competence developing them to become followers with insight and direction. However, these leadership roles are not clearly defined, and are negatively influenced by the traditional mining leadership style.
OBJECTIVES: The aim of this study was to explore and describe the nurse managers' experiences of their leadership roles in a specific mining primary healthcare service on the West Rand, to develop recommendations to enhance these roles.
METHOD: A qualitative, exploratory, descriptive and contextual research design was used in this study, following a phenomenological approach as a research method. A non-probability purposive sampling method was used. Nurse managers described experiences of their leadership roles during individual phenomenological interviews. Data saturation was reached on participant number 7. To analyse data, four stages of Giorgi's descriptive phenomenological data analysis was used. An independent coder coded the data and a consensus meeting was held. The study was guided by the theoretical framework of Winkler's role theory.
RESULTS: The following subthemes emanated from data analysis: (1) leadership role ambiguity, (2) leadership roles experienced and (3) challenges experienced in leadership roles.
CONCLUSION: This study revealed that the leadership roles for nurse managers in a specific mining primary healthcare service are not clearly defined. Hence enhancements and expansions of these leadership roles remained stagnant. A clearly defined policy on leadership roles for nurse managers should be developed.

PMID: 32787428 [PubMed - as supplied by publisher]

Related Articles

Predictors of toxic leadership behaviour among nurse managers: A cross-sectional study.

J Nurs Manag. 2020 Aug 12;:

Authors: Labrague LJ, Lorica J, Nwafor CE, Cummings GG

AIM: To identify predictors of toxic leadership behaviour in nurse managers.
BACKGROUND: Toxic leadership is becoming increasingly prevalent in nursing; however, the literature provides very limited evidence of the different factors that promote toxic leadership behaviour in nurse managers.
METHODS: A descriptive, cross-sectional design was used. Two hundred and forty nurse managers from ten hospitals in Central Philippines were included in the study. Data were collected using the Nurse Information Form and the Toxic Leadership Behaviours of Nurse Managers Scale (ToxBH-NM). Hierarchical multiple regression was used to analyse the data collected.
RESULTS: The mean of average item score of the ToxBH-NM was 1.250 (SD = 0.470). Multiple regression analyses identified the years of experience in a managerial role (β = -0.165, p = 0.031), job status (part time) (β = 0.177, p = 0.002), ward census (30 patients, 40 patients, and above 40 patients) [(β = 0.231, p = 0.005); (β = 0.345, p < 0.004); (β = 0.262, p = 0.012)], number of unit managed (2 units, and > 3 units) [(β = 0.292, p < 0.001); (β = 0.235, p < 0.001), hospital type (private hospital) (β = 0.271, p = 0.007), and hospital level (secondary hospitals) (β = 0.226, p = 0.036) predicted toxic leadership behaviour in nurse managers.
CONCLUSIONS: Overall, nurse managers were appraised as non-toxic leaders. Nurse Managers who held part time job status, had lower experience in the managerial role, and those who were assigned in wards or units with high patient admission reported increased toxic leadership behaviours. Further, nurse managers who managed more than 2 units, those who were employed in private hospitals, and those who worked in secondary hospitals reported increased toxic leadership behaviours.
IMPLICATIONS FOR NURSING MANAGEMENT: Nurse administrators can consider the different predictors identified when planning and developing leadership interventions and organizational strategies (e.g., limiting the number of units per nurse manager, provision of full time job employment, assignment of assistant nurse managers, formulation of policy specific to managing toxic behaviours) may assist in the determent of toxic behaviours in nurse managers.

PMID: 32786116 [PubMed - as supplied by publisher]

Related Articles

Impact of a Formal Educational Skill-Building Program Based on the ARCC Model to Enhance Evidence-Based Practice Competency in Nurse Teams.

Worldviews Evid Based Nurs. 2020 Aug 12;:

Authors: Gorsuch CRPF, Gallagher Ford L, Koshy Thomas B, Melnyk BM, Connor L

BACKGROUND: Implementation of evidence-based practice (EBP) is necessary for healthcare systems to improve quality, safety, patient outcomes, and costs. Yet, EBP competency is lacking in many nurses and clinicians across the country.
AIM: The purpose of this initiative was to determine whether nursing teams (Executive Leader, Clinical/Mid-level Leader, and Direct Care Nurse) attending a 5-day EBP continuing education skill-building program (immersion) was an effective strategy to build EBP competence, practice, and culture sustainability over time. The Advancing Research and Clinical Practice Through Close Collaboration Model was used to guide this initiative.
METHODS: A project team was assembled, including leaders with EBP expertise from the Air Force Medical Service and The Helene Fuld Health Trust National Institute for EBP in Nursing and Healthcare at The Ohio State University. Five survey instruments were used to evaluate outcomes, including Organizational Culture and Readiness for System-Wide Implementation of Evidence-Based Practice, Evidence-Based Practice Beliefs, Evidence-Based Practice Implementation, and Evidence-Based Practice Competencies, as well as the Knowledge Assessment Questionnaire test. Nursing teams were invited to participate and complete the program with the implementation of EBP projects over the following year.
RESULTS: Participants' EBP knowledge, skills, competencies, and beliefs were significantly improved and sustained over 12 months.
LINKING EVIDENCE TO ACTION: A team-based EBP skill-building program was an effective strategy for building EBP competence, practice, and culture. This initiative demonstrated that the direct involvement of leadership and infrastructure to support EBP were crucial factors for building and sustaining an EBP culture.

PMID: 32786053 [PubMed - as supplied by publisher]

Related Articles

Transformational leadership in nursing practice: challenges and strategies.

Rev Bras Enferm. 2020;73(6):e20190364

Authors: Ferreira VB, Amestoy SC, Silva GTRD, Trindade LL, Santos IARD, Varanda PAG

OBJECTIVE: to understand the challenges and strategies adopted by nurses for the exercise of Transformational Leadership in a university hospital.
METHODS: qualitative and exploratory study, in which 25 nurses working in a university hospital in the state of Bahia, Brazil participated. Data collection took place through semi-structured interviews and categorized according to Thematic Analysis, using Nvivo software.
RESULTS: The prevalent challenges involved: lack of encouragement from the institution for the training of leaders; professional inexperience and young age; resistance to leadership and insubordination. The strategies adopted by nurses consist of acting as team examples and establishing dialogic relationships. Final considerations: The practice of Transformational Leadership has been relevant in the daily lives of nurses and contributes to the quality of care.

PMID: 32785519 [PubMed - in process]

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