A review on leadership of head nurses and patient safety and quality of care

Povezava lastnosti vodje in vodenja s kakovostjo storitev v zdravstveni negi

Uvod: Vodenje je proces, ki se nanaša na zmožnost vplivati na zaposlene, jih usmerjati in motivirati. Namen članka je bil raziskati povezavo med kakovostjo zdravstvene nege z vodenjem in lastnostmi vodje tima zdravstvene nege.Metode: Uporabljena je bila opisna metoda dela, s katero je bil med 2018 in 2020 izveden sistematični pregled literature po bazah podatkov Medline, CINAHL, Cochrane Library in PubMed. Iskalna strategija je sledila protokolu PICO. Iskalni pojmi so bili: leader, leadership, leaders competencies, quality indicators, health care, nursing leadership, patient outcomes, personnel management, outcome assesment, patient satisfaction.Rezultati: Identificiranih je bilo 462 zadetkov, med katerimi je bilo za analizo izbranih 20 prispevkov, objavljenih med letoma 2010 in 2020. Deset raziskav je bilo sistematičnih pregledov literature, devet kvantitativno presečnih ter ena eksperimentalna raziskava. Prispevki so bili kritično ovrednoteni z orodji JBI. V analizi je bilo identificiranih 163 kod, ki so bile združene v šest kategorij: slogi vodenja v zdravstvu; lastnosti dobrega vodje v zdravstvu; učinkovitost zdravstvenega tima, dejavniki, ki vplivajo na kakovost zdravstvene nege; izidi zdravstvene nege; izidi negativnega delovnega okolja.Diskusija in zaključek: V kliničnem okolju je najpogosteje omenjen in priporočen transformacijski slog vodenja, v katerem ima vodja posluh za zaposlene, vodenje je usmerjeno v odnose. Med zaposlenimi se ustvarja klima zaupanja, ki vpliva na zadovoljstvo zaposlenih in posledično pozitivno tudi na kakovost zdravstvene nege.

How nurses in a developing country perceive and experience leadership: A qualitative study

BACKGROUND

In Indonesia, information on and research into how Indonesian nurses perceive and experience leadership and leadership roles is limited.

AIMS

This study was designed to identify Indonesian nurses' perceptions and experiences of leadership and nurse leadership roles in the hospital setting.

DESIGN

A qualitative study with semi-structured interviews.

METHODS

The study was conducted in a large, urban hospital in Indonesia. Twenty nurses who had worked in this hospital for more than a year were interviewed. A thematic approach was used for data analysis. This study is conducted and reported according to the SRQR checklist.

RESULTS

The participants' perceptions and experiences of leadership were organized within three themes: searching for a description of leadership, viewing leadership and management as the same, and experiencing limited leadership opportunities.

IMPACT STATEMENTS

The study revealed little evidence that nurses were being empowered to provide leadership within the organization. Although nurses in many developed countries now serve on governing boards, this is not immediately foreseeable for nurses in Indonesia.

CONCLUSIONS

The participants' view of leadership in nursing was not overtly critical. Perhaps they did not understand that leadership is a dynamic concept and that it might be perceived differently depending on the context.

"Navigation to prioritizing the patient" - first-line nurse managers' experiences of participating in a quality improvement collaborative

Background

First-line nurse managers are central to quality improvement work when changing work practices into better patient outcomes. Quality improvement collaboratives have been adopted widely to support quality management in healthcare services and shared learning. We have little knowledge of the first-line nurse managers’ own perspectives concerning their need for support and knowledge in quality improvement work. Therefore, the aim of this study was to gain understanding of first line nurse managers’ experiences in leading quality improvement work in their own organization when participating in a quality improvement collaborative.

Methods

An interpretive approach was chosen following Graneheim and Lundman’s qualitative content analysis. Data was collected through three focus group interviews with first-line nurse managers representing different workplaces: the local hospital, a nursing home, and a homecare service in a rural area of Norway.

Results

“Navigation to prioritizing the patient” emerged as an overarching metaphor to describe the first-line nurse managers experiences of leading quality improvement work, based on three themes: 1) fellowship for critical thinking and prioritizing the patient; 2) mastering the processes in quality improvement work; and 3) the everyday reality of leadership as a complex context.

Conclusions

A quality improvement collaborative encompassing knowledge transfer and reflection may create an important fellowship for health care leaders, encouraging and enabling quality improvement work in their own organization. It is crucial to invite all leaders from an organization to be able to share the experience and continue their collaboration with their staff in the organization. Continuity over time, following up elements of the quality improvement work at joint meetings, involvement by users, and self-development of and voluntary involvement in the quality improvement collaborative seem to be important for knowledge development in quality improvement. The supportive elements of the quality improvement collaborative fellowship were crucial to critical thinking and to the first-line nurse managers’ own development and security in mastering the quality improvement work processes. They preferred prioritizing the patients in quality improvement work, despite haste and obstructive situations in an everyday context.

The impact of contextual factors on nursing outcomes and the role of placebo/nocebo effects: a discussion paper

INTRODUCTION

Placebo and nocebo effects represent one of the most fascinating topics in the health care field.

OBJECTIVES

the aims of this discussion paper were (1) to briefly introduce the placebo and nocebo effects, (2) to elucidate the contextual factors able to trigger placebo and nocebo effects in the nursing field, and (3) to debate the impact of contextual factors on nursing education, practice, organisation, and research.

METHODS

a narrative review was conducted based on the available evidence.

RESULTS

Placebo responses (from Latin "I shall please") are a beneficial outcome(s) triggered by a positive context. The opposite are the nocebo effects (from Latin "I shall harm"), which indicates an undesirable outcome(s) caused by a negative context. Both are complex and distinct psychoneurobiological phenomena in which behavioural and neurophysiological changes arise subsequent to an interaction between the patient and the health care context.

CONCLUSION

Placebo and nocebo concepts have been recently introduced in the nursing discipline, generating a wide debate on ethical issues; however, the impact on nursing education, clinical practice, nursing administration, and research regarding contextual factors triggering nocebo and placebo effects has not been debated to date.

Learning to lead: a review and synthesis of literature examining health care managers' use of knowledge

Background

Scholarship cites health care managers (HCMs) as not using research evidence in their management practice. The purpose of this review was to evaluate the effectiveness of interventions to enhance HCMs use of research evidence in practice.

Methods

We carried out a systematic review and focus groups to validate the review findings. We searched 10 electronic databases for studies reporting on interventions for HCMs to enhance research utilization in their practice. Qualitative studies were analysed using Hoon’s approach to meta-synthesis.

Results

Seven, primarily qualitative, studies of varying quality (reported in 11 articles) met our inclusion criteria. Interventions to enhance research use by HCMs included: informal and formal training, computer-based application, executive-level knowledge translation activities and residency programmes. Studies did not report efficacy of interventions or impacts of increasing managers’ use of research on staff or patient outcomes. Meta-synthesis yielded four contextual factors influencing the perceived effectiveness of interventions to enhance research use by HCMs: organizational culture, competing priorities, time as a resource and capacity building. Included studies differed in how they defined research and demonstrated varying understandings of research among HCMs, limiting the generalizability of work in this field.

Conclusions

Healthcare managers are increasingly called upon to make evidence-based decisions in practice, but the small number of studies and diverse strategies employed hinder our ability to identify any intervention to increase use of evidence as superior. Future studies in this area should clearly articulate the definition of research evidence they base their decisions on. Registration: PROSPERO (CRD42014006256)

Evaluating performance of the operational managers of obstetrics and gynecology service providing wards

BACKGROUND

The goal of hospitals, as the most important health care providing centers, is to improve the health level of the society. Achieving this goal is directly related with performance of the managers. This study was conducted to evaluate the performance of operational managers of obstetrics and gynecology service providing wards from the point of view of the staff at educational hospitals of Isfahan University of Medical Sciences in 2015.

MATERIALS AND METHODS

In this descriptive study, target population comprised all supervisors and the staff working at obstetrics and gynecology and maternity wards. Data were collected through a researcher-made questionnaire after evaluation of its reliability and validity using questions on managerial performance (planning, organizing, leadership, and control dimensions) and demographic characteristics of the managers and staff. Data were analyzed using independent t-test, one sample t-test, Spearman and Pearson coefficient tests, and one-way analysis of variance.

RESULTS

The total mean score of staff's point of view toward performance of managers' performance was significantly higher than the average level (P < 0.001, t = 13.2). In addition, mean scores of managerial performance in planning (P < 0.001, t = 14.93), organizing (P < 0.001, t = 11.64), leadership (P < 0.001, t = 11.16), and control (P < 0.001, t = 13.75) dimensions were significantly higher than the moderate level.

CONCLUSIONS

With respect to the fact that maintaining and improving the health of mothers and neonates depends on the management and managers' performance in obstetrics and gynecology service providing wards, more than moderate managers' performance need to be improved. It is recommended that higher-level managers pay special attention to the empowerment of managerial skills among operational managers.

Issues in researching leadership in health care organizations

PURPOSE

We provide a review of the research in this volume and suggest avenues for future research.

DESIGN/METHODOLOGY/APPROACH

Review of the research in this volume and unstructured interviews with health care executives.

FINDINGS

We identified the three central themes: (1) trust in leadership, (2) leading by example, and (3) multi-level leadership. For each of these themes, we highlight the shared concerns and findings, and provide commentary about the contribution to the literature on leadership.

RESEARCH IMPLICATIONS

While relation-oriented leadership is important in health care, there is a danger of too much emphasis on relations in an already caring profession. Moreover, in most health care organizations, leadership is distributed and scholars need to adopt the appropriate methods to investigate these multi-level phenomena.

PRACTICAL IMPLICATIONS

In health care organizations, hands-on leadership, through role modeling, may be necessary to promote change. However, practicing what you preach is not as easy as it may seem.

VALUE/ORIGINALITY

We provide a framework for understanding current research on leadership in health care organizations.