The influence of nurse manager competency on practice environment, missed nursing care, and patient care quality: A cross-sectional study of nurse managers in U.S. hospitals

Educational needs for nursing manager competency in Korean hospitals: multi-center cross-sectional study

BACKGROUND

Nursing managers have a critical responsibility for high-quality care, nursing staff support, and business operations for hospital outcomes. As the healthcare environment has changed, the role of nursing managers and the competencies required have evolved. This study aims to assess the educational needs for nursing management competency among 155 nursing managers in one tertiary and six general hospitals in South Korea.

METHODS

Data were collected from April 1 to May 20, 2023, using self-reported questionnaires. The Borich needs assessment and locus for focus model were used to analyze educational needs.

RESULTS

The results revealed that key components in the administrative manager (ensuring a safe working environment) and leader (fostering a positive workplace atmosphere) domains were most important. The lowest-scored item for performance was "Completing education to enhance competency as a manager and participating in external activities" in the educator domain. The most difficult item was "Allocation of appropriate nursing staff based on nursing requirements and adjustment of tasks" in the administrative manager domain. The top-priority items in administrative manager competencies were "Allocation of appropriate nursing staff based on nursing requirements, and adjustment of tasks" and "Development and implementation of plans for securing resources (staff, equipment, space, budget, etc.) necessary for nursing tasks."

CONCLUSIONS

These findings underscore the necessity for nursing organizations to provide specialized training modules that address the identified needs, especially focusing on human resource management skills, the allocation of nursing staff, and resource acquisition and management for nursing managers. Furthermore, nursing organizations should support ongoing education and professional development activities through recognition, financial support, or career progression opportunities.

Path Analysis: Interrelationships Between Nurse Manager Competencies, Practice Environment Perceptions, and Frontline Nurses' Intent to Stay

OBJECTIVE

To examine the correlation between nurse manager (NM) competencies, work environment (Practice Environment Scale of the Nursing Work Index [PES-NWI]), and frontline nurses' intent to stay; the direct effect of NM competency on frontline nurses' intent to stay; and the indirect effect of NM competency on frontline nurses' intent to stay, mediated by PES-NWI.

BACKGROUND

PES-NWI and NMs' competency can impact frontline nurses' intent to stay.

METHODS

Cross-sectional study with secondary analysis of NM Competency and NDNQI ® (National Database of Nursing Quality Indicators ® ) RN Survey data with path analysis for effects of the model's variables.

RESULTS

Positive, weak correlations between NM competencies and frontline nurses' practice environments were found; NM competencies and frontline nurses' intent to stay were not correlated. Paths were NM competency/PES-NWI ( β = 0.20, P = 0.001) and PES-NWI/intent to stay ( β = 0.55, P < 0.001); NM competency/intent to stay was not significant. Indirect effect of NM competency on frontline nurses' intent to stay was mediated through PES-NWI ( β = 0.11, P = 0.002; 95% confidence interval, 0.05-0.17).

CONCLUSIONS

Investing in NMs' competency can help create supportive work environments and frontline nurses' intent to stay.

Nursing categories' perceptions of the practice environment and quality of care in North West Province: a cross-sectional survey design

BACKGROUND

There is a substantial amount of literature on the perception of the practice environment and quality of care as perceived by registered nurses and community services nurses in South Africa and worldwide, but there is little to no research that could be found regarding other categories of nurses, and how these perceptions differ between the different categories. Therefore, the aim of this study is to describe the different nursing categories' perceptions of the practice environment and quality of care and the association between the variables.

METHODS

This study applied a cross-sectional survey design. Data were collected in April 2021 in the public sector of the North West Province. Multiphase sampling was applied to all categories of nurses who worked in an in-patient unit in the selected hospital for at least 3 months (n = 236).

RESULTS

All nursing categories perceived the practice environment as negative, regarding nurse participation in hospital affairs; nurse manager ability, leadership, and support of nurses and staffing and resource adequacy. Perceived quality of care and patient safety items were perceived as neutral and good. However, in all instances, the perceptions of community service nurses and registered nurses were most negative, and enrolled nurse assistants most positive. Adverse events towards patients and nurses were perceived to only occur a few times a year. Overall, nurse perceptions of quality of care and patient safety were most correlated with the subscale of nurse foundations of quality of care and nurse manager ability, leadership, and support of nurses. Adverse events towards patients were most correlated with the collegial nurse-physician relationship subscale, while adverse events towards nurses were correlated with the foundations of quality of care subscale.

CONCLUSION

Improving the practice environment, especially regarding the subscale nurse foundations of quality of care and nurse manager ability, leadership, and support of nurses, is associated with improved quality of care. Nurses with higher qualifications, registered nurses and community service nurses rated quality of care lower than other categories of nurses, contributing to literature that higher qualified staff are more competent to assess the practice environment and quality of care.

Clinical nurse managers' leadership styles and staff nurses' work engagement in Saudi Arabia: A cross-sectional study

BACKGROUND

Effective nurse leadership enhances nurse welfare, improves patient care, and increases organisational success. A lack of adequate, supportive leadership significantly contributes to many nurses leaving the profession. Nurse managers need to prioritise engagement and retention as significant focus areas to address the nursing shortage in Saudi Arabia and accomplish the national program's objectives.

AIM

To examine the correlation between the leadership styles of clinical nurse managers and staff engagement.

METHOD

This study used a descriptive, cross-sectional, correlational design. The leadership styles of clinical nurse managers were evaluated using the Multifactor Leadership Questionnaire (MLQ-5X). Work engagement was assessed using the Utrecht Work Engagement Scale (UWES). Questionnaires were distributed to 450 nurses in four public hospitals in western Saudi Arabia. Non-probability convenience sampling was used to collect the data.

RESULTS

A total of 278 nurses from a range of clinical areas participated in the survey, which revealed that the leadership styles of clinical nurse managers positively or negatively impact nurse work engagement. Most clinical nurse managers exhibit transformational leadership, followed by transactional, then passive-avoidant styles. Respondents displayed a high level of work engagement, emphasising the positive impact of transformational and transactional leadership on work engagement outcomes. The findings showed significant differences in leadership styles and work engagement levels between Saudi and non-Saudi nurses across various dimensions.

CONCLUSION

Understanding the effect of leadership styles employed by nurse managers on work engagement can positively impact staff retention rates and the quality of patient care. Nurse managers should participate in training programs to enhance their practical leadership skills to enhance the work engagement levels of nurses.

IMPLICATION

Nurse work engagement can be improved by establishing training programs that promote effective leadership and highlight the significance of various leadership styles and their subsequent impact on nurse work engagement. Nursing students should receive education on leadership styles. Nursing leaders should be given access to mentoring programs and opportunities for career advancement to support the introduction of effective leadership styles.

Individual and Organizational Factors Associated With Nurse Manager Success

OBJECTIVE

The aim of this study was to synthesize previous findings and provide practical guidance for maximizing nurse manager and nurse performance.

BACKGROUND

Two recent studies have linked nurse manager job design factors and individual differences to a variety of valued outcomes, but practical implications remain unclear.

METHODS

A large US sample of nurse managers was divided on the basis of nurse and patient outcomes. Various characteristics are compared across the highest and lowest performers.

RESULTS

Wider nurse manager span of control is associated with negative outcomes; the availability of support positions does not fully alleviate the consequences of wide spans. Nurse managers with fewer subordinates can effectively manage multiple units. Nurse manager experience is critical for success and cannot be fully replaced by leadership training programs.

CONCLUSIONS

Staffing and job design decisions have critical downstream implications. The present research provides guidance for effective staffing and job design.

Competencies of Nurse Managers as Predictors of Staff Nurses' Job Satisfaction and Turnover Intention

Nurse managers have played an integral role in stabilizing the nursing work environment and workforce in the face of the COVID-19 pandemic, yet the competencies required for such a feat are largely unknown. This study was conducted during the pandemic to identify the specific domains of nurse manager competencies that associate with nurse outcomes. A cross-sectional survey was conducted on a convenience sample of 698 staff nurses to measure the perceived competence of their nurse managers and their job satisfaction and turnover intention levels. The overall perceived nurse manager competency level in our sample was 3.15 out of 5 (SD = 0.859). The findings indicated that 34.3% of nurses were dissatisfied with their current jobs, and 36.3% of nurses were considering leaving their current workplace. Regression analyses identified "Team Communication and Collaboration" (β = 0.289; p = 0.002), "Staff Advocacy and Development" (β = 0.229; p = 0.019), and "Quality Monitoring and Pursuance" (β = 0.213; p = 0.031) as significant predictors of staff nurses' job satisfaction and "Staff Advocacy and Development" (β = -0.347; p < 0.000) and "Team Communication and Collaboration" (β = -0.243; p = 0.012) as significant predictors of nurses' turnover intention. The findings of the study have implications for the future recruitment, training, and performance evaluation of nurse managers.