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Chen W, Modanloo S, Graham ID, Hu J, Lewis KB, Gifford W. A mixed-methods systematic review of interventions to improve leadership competencies of managers supervising nurses. J Nurs Manag 2022; 30:4156-4211. [PMID: 36194186 DOI: 10.1111/jonm.13828] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/16/2022] [Accepted: 09/28/2022] [Indexed: 01/04/2023]
Abstract
AIM This study aimed to synthesize evidence on interventions to improve leadership competencies of managers supervising nurses. BACKGROUND In recent years, numerous interventions have been developed to improve the leadership competencies of managers supervising nurses. However, researchers and nursing leaders are unclear about what aspects of interventions are effective for developing which competencies. METHODS We conducted a mixed-methods systematic review following the Joanna Briggs Institute (JBI) approach for evidence synthesis. The Medline (Ovid), CINAHL, Embase, Scopus, Nursing and Allied Health Database were reviewed. Data extraction, quality appraisal and narrative synthesis were conducted in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS A total of 69 studies (35 quantitative, 22 mixed methods, 12 qualitative) evaluating 68 interventions were included. Studies showed that interventions used modal activities such as lectures, group work and mentoring that generally had positive effects on improving leadership competencies such as supporting, developing and recognizing nurses. Opportunities to interact with peers increased managers' engagement in the interventions; however, many barriers existed for managers to use the competencies in practice including understaffing, insufficient time and lack of support from supervisors and staff. CONCLUSIONS Leadership interventions were shown to have beneficial effects on developing different competencies. Managers predominately felt positive about participating in leadership interventions; however, they expressed many difficulties applying what they learned in practice. IMPLICATIONS FOR NURSING MANAGEMENT Leadership interventions should include multimodal activities that give managers opportunities for interaction. When considering interventions for developing the leadership of managers, it is imperative to consider the practice environments for managers to be successful in applying the competencies they learned in practice.
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Affiliation(s)
- Wenjun Chen
- School of Nursing, Faculty of Health Science, University of Ottawa, Ottawa, Ontario, Canada.,Center for Research on Health and Nursing, University of Ottawa, Ottawa, Ontario, Canada
| | - Shokoufeh Modanloo
- Arthur Labatt Family School of Nursing, Western University, London, Ontario, Canada
| | - Ian D Graham
- School of Nursing, Faculty of Health Science, University of Ottawa, Ottawa, Ontario, Canada.,School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.,Clinical Epodemiology, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Jiale Hu
- Department of Nurse Anesthesia, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Krystina B Lewis
- School of Nursing, Faculty of Health Science, University of Ottawa, Ottawa, Ontario, Canada.,Center for Research on Health and Nursing, University of Ottawa, Ottawa, Ontario, Canada
| | - Wendy Gifford
- School of Nursing, Faculty of Health Science, University of Ottawa, Ottawa, Ontario, Canada.,Center for Research on Health and Nursing, University of Ottawa, Ottawa, Ontario, Canada
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Hu S, Chen W, Hu H, Huang W, Chen J, Hu J. Coaching to develop leadership for healthcare managers: a mixed-method systematic review protocol. Syst Rev 2022; 11:67. [PMID: 35418168 PMCID: PMC9008960 DOI: 10.1186/s13643-022-01946-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 04/02/2022] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND An increasing number of interventions have focused on leadership development for healthcare managers, among which coaching is a common strategy. The purpose of the present systematic review is to synthesize evidence on the effect of coaching in developing leadership of healthcare managers. METHODS AND ANALYSIS A literature search will be conducted in six English databases (MEDLINE (Ovid), CINAHL, Embase, Cochrane library, Nursing & Allied Health Premium, and Scopus) and four Chinese databases (Wanfang, CNKI, SinoMed, and VIP) from inception to April 1st, 2022. The titles, abstracts, and full texts of the studies will be screened by two independent researchers to determine their eligibility. The RoB 2, ROBINS-I, CASP, and MMAT will be applied to assess the quality of randomized trials, non-randomized studies, qualitative studies, and mixed-method studies, respectively. We will then extract the study characteristics, participant characteristics, and study outcomes of the reviewed papers. The Aims, Ingredients, Mechanism, and Delivery framework will be used to extract the components of coaching strategies. For quantitative data, a meta-analysis will be performed if sufficient data are available; otherwise, we will conduct a narrative synthesis. Thematic synthesis methods will be used for qualitative data analysis. DISCUSSION By conducting this systematic review, we expect to synthesize evidence regarding the components of coaching for leadership development among healthcare managers; the influence of coaching on leadership development among managers at the individual, unit-wide, or organizational level; and how managers view coaching as a leadership development strategy. TRIAL REGISTRATION PROSPERO registration number: CRD42020194290 .
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Affiliation(s)
- Shuang Hu
- Xiangya School of Nursing, Central South University, Changsha, China
- School of Nursing, Changsha Medical University, Changsha, China
| | - Wenjun Chen
- School of Nursing, Faculty of Health Science, University of Ottawa, Ottawa, Ontario Canada
- Centre for Research on Health and Nursing, University of Ottawa, Ottawa, Ontario Canada
| | | | - Wenqiu Huang
- School of Nursing, Faculty of Health Science, University of Ottawa, Ottawa, Ontario Canada
- Centre for Research on Health and Nursing, University of Ottawa, Ottawa, Ontario Canada
| | - Jia Chen
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Jiale Hu
- Department of Nurse Anesthesia, Virginia Commonwealth University, Richmond, 907 Floyd Ave, Richmond, 23284 USA
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3
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Phillips N, Norman K. A case study of frontline nurse leadership informed by complex responsive processes of relating. J Clin Nurs 2020; 29:2181-2195. [DOI: 10.1111/jocn.15091] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 08/07/2019] [Accepted: 09/24/2019] [Indexed: 12/01/2022]
Affiliation(s)
- Natasha Phillips
- University College Hospitals London NHS Foundation Trust London UK
| | - Karen Norman
- Kingston University and St George's University of London London UK
- Business School University of Hertfordshire Hatfield UK
- Queen Victoria Hospital NHS Foundation TrustEast Grinstead UK
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Lessons learnt from the implementation of same-day discharge after percutaneous coronary intervention. Aust Crit Care 2019; 32:458-464. [PMID: 30638842 DOI: 10.1016/j.aucc.2018.11.066] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 10/02/2018] [Accepted: 11/17/2018] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Change in healthcare organisations is constant and requires adequate resources for effective implementation. Same-day discharge after percutaneous coronary intervention has been found to be no different from the patients who stayed overnight after procedure; however, its uptake remains low. OBJECTIVES The aim of the study was to identify what factors helped or hindered the implementation of same-day discharge. METHODS This interpretive study was conducted in a cardiac catheterisation suite of an Australian tertiary hospital between June and December 2016. Semistructured individual interviews with 26 healthcare professionals were conducted to explore the factors that influenced the implementation. A deductive approach to content analysis was guided by the theoretical domains framework. FINDINGS Five domains, including beliefs about consequences, professional role and identity, resources, behaviour regulation, and optimism, were identified which were strongly related to the factors that impacted the implementation. The findings showed that participants believed same-day discharge benefits while also concerning about its safety and holding different opinions on eligibility criteria. The findings also showed that participants' involvement in the change process varied with no clear roles and responsibilities and that their understanding about same-day discharge evidence and the guideline also differed. Lack of dedicated resources was also identified as the hindrance to the implementation. Behaviour regulation domain depicted how communication was managed and how the care for same-day discharge patients was improved. Despite several issues identified, participants were optimistic with achievement. DISCUSSION AND CONCLUSION This study has provided valuable insight into the factors that influenced the implementation, which will inform policymakers when designing interventions for future improvement. Plan for change and involvement of all stakeholders along with dedicated resources including time, people, and change management expertise are essential if hospitals want to see the success of change.
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Mianda S, Voce A. Developing and evaluating clinical leadership interventions for frontline healthcare providers: a review of the literature. BMC Health Serv Res 2018; 18:747. [PMID: 30285742 PMCID: PMC6167878 DOI: 10.1186/s12913-018-3561-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 09/24/2018] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The importance of clinical leadership in ensuring high quality patient care is emphasized in health systems worldwide. Of particular concern are the high costs to health systems related to clinical litigation settlements. To avoid further cost, healthcare systems particularly in High-Income Countries invest significantly in interventions to develop clinical leadership among frontline healthcare workers at the point of care. In Low-Income Countries however, clinical leadership development is not well established. This review of the literature was conducted towards identifying a model to inform clinical leadership development interventions among frontline healthcare providers, particularly for improved maternal and newborn care. METHODS A structural literature review method was used, articles published between 2004 and 2017 were identified from search engines (Google Scholar and EBSCOhost). Additionally, electronic databases (CINHAL, PubMed, Medline, Academic Search Complete, Health Source: Consumer, Health Source: Nursing/Academic, Science Direct and Ovid®), electronic journals, and reference lists of retrieved published articles were also searched. RESULTS Employing pre-selected criteria, 1675 citations were identified. After screening 50 potentially relevant full-text papers for eligibility, 24 papers were excluded because they did not report on developing and evaluating clinical leadership interventions for frontline healthcare providers, 2 papers did not have full text available. Twenty-four papers met the inclusion criteria for review. Interventions for clinical leadership development involved the development of clinical skills, leadership competencies, teamwork, the environment of care and patient care. Work-based learning with experiential teaching techniques is reported as the most effective, to ensure the clinical leadership development of frontline healthcare providers. CONCLUSIONS All studies reviewed arose in High-Income settings, demonstrating the need for studies on frontline clinical leadership development in Low-and Middle-Income settings. Clinical leadership development is an on-going process and must target both novice and veteran frontline health care providers. The content of clinical leadership development interventions must encompass a holistic conceptualization of clinical leadership, and should use work-based learning, and team-based approaches, to improve clinical leadership competencies of frontline healthcare providers, and overall service delivery.
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Affiliation(s)
- Solange Mianda
- Discipline of Public Health Medicine, Room 236, 2nd floor George Campbell Building, School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Anna Voce
- Discipline of Public Health Medicine, Room 236, 2nd floor George Campbell Building, School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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Bianchi M, Bagnasco A, Bressan V, Barisone M, Timmins F, Rossi S, Pellegrini R, Aleo G, Sasso L. A review of the role of nurse leadership in promoting and sustaining evidence-based practice. J Nurs Manag 2018; 26:918-932. [DOI: 10.1111/jonm.12638] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Monica Bianchi
- Department of Business Economics, Health and Social Care; University of Applied Science and Arts of Southern Switzerland; Manno Switzerland
| | | | - Valentina Bressan
- Department of Otolaryngology / Head and Neck Surgery; University Hospital Santa Maria della Misericordia; Udine Italy
| | | | - Fiona Timmins
- School of Nursing and Midwifery; Trinity College Dublin; Dublin Ireland
| | - Silvia Rossi
- Department of Health Sciences; University of Genoa; Genoa Italy
| | | | - Giuseppe Aleo
- Department of Health Sciences; University of Genoa; Genoa Italy
| | - Loredana Sasso
- Department of Health Sciences; University of Genoa; Genoa Italy
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Giles M, Parker V, Conway J, Mitchell R. Knowing how to get things done: Nurse consultants as clinical leaders. J Clin Nurs 2018; 27:1981-1993. [DOI: 10.1111/jocn.14327] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Michelle Giles
- Hunter New England Local Health District; Newcastle NSW Australia
- School of Health; University of New England; Armidale NSW Australia
| | - Vicki Parker
- Hunter New England Local Health District; Newcastle NSW Australia
- School of Health; University of New England; Armidale NSW Australia
| | - Jane Conway
- School of Health; University of New England; Armidale NSW Australia
| | - Rebecca Mitchell
- School of Business and Law; University of Newcastle; Callaghan NSW Australia
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McCray J, Warwick R, Palmer A. Impressions of action and critical action learning: exploring the leadership development of senior doctors in an English healthcare organization. INTERNATIONAL JOURNAL OF TRAINING AND DEVELOPMENT 2018. [DOI: 10.1111/ijtd.12119] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Janet McCray
- Professor of Social Care and Workforce Development, Department of Childhood Social Work and Social Care; University of Chichester; Chichester, West Sussex UK
| | - Rob Warwick
- Reader in Management and Organisational Learning; University of Chichester Business School, Bognor Regis Campus; Bognor Regis, West Sussex UK
| | - Adam Palmer
- BA MSc PGCE Chartered FCIPD D Prof SFHEA, Head of Department, Department of Responsible Management and Leadership; University of Winchester Business School, University of Winchester; Winchester, Hampshire UK
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Jacob ER, McKenna L, D’Amore A. Role expectations of different levels of nurse on graduation: A mixed methods approach. Collegian 2017. [DOI: 10.1016/j.colegn.2016.01.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Husebø SE, Olsen ØE. Impact of clinical leadership in teams' course on quality, efficiency, responsiveness and trust in the emergency department: study protocol of a trailing research study. BMJ Open 2016; 6:e011899. [PMID: 27515758 PMCID: PMC4985869 DOI: 10.1136/bmjopen-2016-011899] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Clinical leadership has long been recognised as critical for optimising patient safety, quality of care and interprofessional teamwork in busy and stressful healthcare settings. There is a need to compensate for the absence of the conventional mentor-to-apprentice transfer of clinical leadership knowledge and skills. While young doctors and nurses are increasingly proficient in medical, surgical and technical skills, their training in, and knowledge of clinical leadership skills, is not adequate to meet the demands for these non-technical skills in the emergency department. Thus, the purpose of the paper is to present and discuss the study protocol of clinical leadership in a course for teams that aims to improve quality, efficiency, responsiveness of healthcare services and collegial trust in the emergency department. METHODS AND ANALYSIS The study employs a trailing research design using multiple quantitative and qualitative methods in the summative (pretest and post-test) and formative evaluation. Quantitative data have been collected from a patient questionnaire, the emergency departments' database and by the observation of team performance. Qualitative data have been collected by shadowing healthcare professionals and through focus group interviews. To ensure trustworthiness in the data analysis, we will apply member checks and analyst triangulation, in addition to providing contextual and sample description to allow for evaluation of transferability of our results to other contexts and groups. ETHICS AND DISSEMINATION The study is approved by the ethics committee of the western part of Norway and the hospital. The study is based on voluntary participation and informed written consent. Informants can withdraw at any point in time. The results will be disseminated at research conferences, peer review journals and through public presentations to people outside the scientific community.
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Affiliation(s)
- Sissel Eikeland Husebø
- Department of Health Studies, Faculty of Social Science, University of Stavanger, Stavanger, Norway
- Department of Surgery, Stavanger University Hospital, Stavanger, Norway
| | - Øystein Evjen Olsen
- Emergency Department, Stavanger University Hospital, Stavanger, Norway
- Global Health Priorities Research Group, Department of Global Public Health and Primary Care, Center for International Health, University of Bergen, Bergen, Norway
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Hølge-Hazelton B, Kjerholt M, Berthelsen CB, Thomsen TG. Integrating nurse researchers in clinical practice - a challenging, but necessary task for nurse leaders. J Nurs Manag 2015; 24:465-74. [DOI: 10.1111/jonm.12345] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2015] [Indexed: 11/27/2022]
Affiliation(s)
- Bibi Hølge-Hazelton
- Roskilde-Køge Hospitals and The Research Unit for General Practice and Section of General Practice Department of Public Health; University of Copenhagen; Denmark
| | - Mette Kjerholt
- Haematological Unit for Nursing Research; Department of Haematology; Roskilde - Køge Hospitals; Roskilde Denmark
| | | | - Thora Grothe Thomsen
- Roskilde and Køge Hospitals and Institute of Regional Health Services Research; University of Southern Denmark; Roskilde Denmark
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Divall B. Negotiating competing discourses in narratives of midwifery leadership in the English NHS. Midwifery 2015; 31:1060-6. [DOI: 10.1016/j.midw.2015.07.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Revised: 07/15/2015] [Accepted: 07/16/2015] [Indexed: 11/16/2022]
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Hutchinson M, Daly J, Usher K, Jackson D. Editorial: Leadership when there are no easy answers: applying leader moral courage to wicked problems. J Clin Nurs 2015; 24:3021-3. [DOI: 10.1111/jocn.12968] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
| | - John Daly
- University of Technology; Sydney NSW Australia
| | - Kim Usher
- University of New England; Armidale Australia
| | - Debra Jackson
- University of New England; Armidale Australia
- Oxford Brookes University; Oxford UK
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Leggat SG, Balding C, Schiftan D. Developing clinical leaders: the impact of an action learning mentoring programme for advanced practice nurses. J Clin Nurs 2015; 24:1576-84. [DOI: 10.1111/jocn.12757] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2014] [Indexed: 11/28/2022]
Affiliation(s)
| | | | - Dan Schiftan
- Victorian Department of Health; Melbourne Victoria Australia
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Cutcliffe J, Cleary M. Nursing Leadership, Missing Questions, and the Elephant(s) in the Room: Problematizing the Discourse on Nursing Leadership. Issues Ment Health Nurs 2015; 36:817-25. [PMID: 26514260 DOI: 10.3109/01612840.2015.1042176] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
To expose inconsistencies and contradictions in the nurse leadership literature ("text"), this article adopts a deconstructive approach and draws upon the work of Derrida in examining the text or discourse. What is almost entirely missing in the literature are articles that ask difficult, searching questions that challenge some of the taken-for-granted truths or maxims about nursing leadership. The current examination of the literature, described in this article, shows: (a) a lack of convergence of the literature and health care/nursing organizations concerning leadership, (b) a conflation of nursing leadership with managerial or administrative positions, and
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Affiliation(s)
- John Cutcliffe
- a Wright State University, Center for Nursing Research, College of Nursing and Health, Dayton, Ohio, USA, and Cutcliffe Consulting , Hampden , Maine , USA
| | - Michelle Cleary
- b University of Western Sydney, School of Nursing and Midwifery , Sydney , New South Wales , Australia
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