Humble leadership and nurses' turnover intention: The moderating effect of leader expertise

Exploring the hidden synergy between system thinking and patient safety competencies among critical care nurses: a cross-sectional study

BACKGROUND

Patient safety remains a global priority, with nurses playing a crucial role in minimizing errors and improving patient outcomes. System thinking, which involves understanding how various components of a healthcare system interact, is increasingly recognized as essential for enhancing patient safety competencies.

AIM

This study investigates the impact of systems thinking on patient safety competencies among nurses in critical care units, exploring the relationship between systems thinking and various subdomains of patient safety competencies.

METHODS

A cross-sectional study was conducted at all critical care units of Alexandria Main University Hospital, Egypt. Data were collected from a convenience sample of 289 nurses using the system thinking scale and the patient safety competency self-evaluation questionnaire. Correlation and regression analyses were performed to examine the relationship between systems thinking and patient safety competencies, controlling for demographic factors such as age, qualifications, and years of experience.

RESULTS

Nurses demonstrated moderate to high levels of systems thinking (mean = 82.36 ± 12.14) and patient safety competencies (mean = 162.74 ± 23.56). Strong positive correlations were found between systems thinking and patient safety competencies (r = 0.605, p < 0.05), particularly in areas such as error reporting, communication, and infection prevention. Regression analysis revealed that systems thinking significantly predicted patient safety competencies, increasing the explained variance from 58.8 to 67.7%.

CONCLUSION

The findings highlight the critical role of systems thinking in enhancing nurses' patient safety competencies. Nurses with higher systems thinking skills are better equipped to prevent errors and improve communication, ultimately enhancing patient care quality.

IMPLICATIONS

Nursing schools should integrate system thinking into nursing curricula to prepare future nurses for complex healthcare environments. Healthcare organizations should incorporate system thinking into professional development programs to enhance the competencies of practicing nurses. Nurse managers can foster a culture of safety by promoting interdisciplinary collaboration and reflective practice. Broader adoption of system thinking can improve patient outcomes, especially in resource-constrained environments.

CLINICAL TRIAL NUMBER

Not applicable.

The impact of nurse managers' boundary spacing leadership on the relationship between nurses' work embeddedness and innovative work behaviors

AIM

This study was designed to examine the nurse managers' boundary-spacing leadership's impact on the relationship between nurses' work embeddedness and innovative work behaviors.

BACKGROUND

In today's evolving healthcare environment, innovation is essential for enhancing patient care, optimizing resources, and supporting healthcare professionals. Nurses are pivotal in driving bedside innovation, but cultivating a culture of innovation within nursing teams involves more than just promoting creative ideas.

METHODS

This is a descriptive correlational study that was conducted at one governmental hospital in Tanta, Egypt. Using Nurse Managers Boundary-Spacing Scale for assessing boundary-spacing leadership, The Global Job Embeddedness Scale for measuring work embeddedness, and Innovative Work Behavior Scale for assessing innovative work behavior, 250 nurses were surveyed. Data analysis was run using descriptive and inferential analysis. Correlation and regression analysis were used to examine the study hypotheses.

RESULTS

There is a statistically significant positive relationship between boundary-spacing leadership and work embeddedness (r = 0.615, p < 0.001). Boundary-spacing leadership accounted for 56% of the variance in work embeddedness and 36% of the variance in nurses' innovative work performance. These results highlight the pivotal role of boundary-spacing leadership in both enhancing nurses' work embeddedness and boosting their innovative behaviors. The substantial variance explained by boundary-spacing leadership underscores its critical influence on fostering a supportive and innovative work environment within the nursing field.

CONCLUSION

Boundary spacing leadership style involves connecting internal and external resources, fostering information exchange, and advocating for the nursing team. While work embeddedness positively correlated with innovative work performance, its impact was less significant than boundary-spacing leadership. This suggests that feeling attached to the organization fosters innovation, but leadership style has a stronger influence. Furthermore, the study found a positive and significant correlation between innovative work performance and both work embeddedness and nurse managers' boundary spacing leadership.

PRACTICAL IMPLICATIONS

The findings emphasize that boundary-spacing leadership is crucial for enhancing both nurses' work embeddedness and innovative behaviors. Healthcare organizations should focus on developing these leadership skills to create a supportive work environment, foster innovation, and improve staff retention.

Leaders development program by 360 degree feedback: reflection on head nurses' leadership practices

BACKGROUND

Leadership in nursing is crucial for delivering high-quality healthcare and ensuring positive outcomes for patients, staff, and institutions. Many nurses in leadership positions lack formal training, which can compromise their effectiveness. This study aims to evaluate the effect of a leadership development program utilizing 360-degree feedback on head nurses' leadership practices.

METHODS

A true-experimental design was employed in three healthcare institutions. The study involved 80 head nurses (40 intervention, 40 control), 240 staff nurses, and 29 supervisors. The intervention group participated in a six-week leadership development program using 360-degree feedback. Data were collected pre- and post-intervention using the Leadership Development and 360-Degree Feedback Knowledge Questionnaire and the Leadership Practices Inventory (LPI).

RESULTS

The intervention group showed significant improvements in leadership knowledge and practices across all dimensions. Knowledge scores increased from 25.1 ± 8.8 to 93.0 ± 5.1 post-intervention, maintaining at 83.2 ± 7.1 at follow-up. Self-assessed leadership scores improved from 88.1 ± 6.0 to 97.5 ± 2.7, and 98.5 ± 2.0 at follow-up. Supervisor and staff assessments also showed substantial increases. Multiple linear regression analyses confirmed the strong positive impact of the intervention on leadership outcomes.

CONCLUSION

The leadership development program using 360-degree feedback significantly enhanced head nurses' leadership knowledge and practices. The results suggest that such programs can improve leadership capabilities in healthcare settings, leading to better patient care and organizational performance. Future research should address group homogeneity and explore long-term impacts on patient outcomes.

The effect of organizational silence on the relationship between workplace ostracism and nurses' procrastination behavior: A structural equation modeling

AIM

This study aims to assess the relationship between workplace ostracism and the procrastination behavior of nurses, as well as examine the effect of organizational silence on this relationship.

BACKGROUND

Controlling workplace ostracism and eradicating time wasters, especially procrastination behavior among nurses, are key strategies that add value to organizational effectiveness. In addition, remaining silent about significant issues facing nurses is a devastating approach to the success of both healthcare organizations and the nursing profession.

METHOD

A cross-sectional descriptive correlational exploratory research design was used to conduct the study. Data were collected from 352 nurses recruited from three large university hospitals in Alexandria, Egypt. Four instruments, namely, the Workplace Ostracism Questionnaire, the Organizational Silence Scale, the Active Procrastination Scale, and the Unintentional Procrastination Scale, were used. Structural equation modeling was used to test the hypothesized relationships among the variables.

RESULTS

The findings demonstrated a significant positive and moderate association between workplace ostracism and both active and passive procrastination behaviors among nurses. Moreover, there was a strong positive and significant correlation between organizational silence and workplace ostracism. The results of mediation revealed that the indirect effect of workplace ostracism on both active and passive procrastination behavior through organizational silence was statistically significant, suggesting that organizational silence partially mediated this relationship.

CONCLUSION

The study highlighted the ongoing challenges posed by toxic workplace issues, such as organizational ostracism and silence, as significant factors contributing to nurses' procrastination behaviors. Not only do these factors directly impact nurses' productivity, but they also interact to exacerbate negative outcomes in nursing care. Addressing these toxic dynamics is critical to improving nurse performance and ensuring quality care in healthcare settings.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

This study offers new insights for navigating toxicity and upgrading nursing productivity in healthcare organizations through fostering a more inclusive and communicative work environment. Promoting team cohesion and ensuring that all staff members feel valued and included can reduce feelings of isolation that may lead to procrastination. Also, creating safe spaces for nurses to voice concerns without fear of reprisal could significantly diminish passive procrastination, which ultimately enhances overall patient care quality and organizational efficiency.