Enablers and barriers to clinical leadership in the labour ward of district hospitals in KwaZulu-Natal, South Africa

Effective clinical nursing leadership in hospitals: barriers from the perspectives of nurse managers

AIM

The purpose of this study was to identify barriers to effective clinical nursing leadership in Jordanian hospitals from the perspectives of nurse managers (NMs).

BACKGROUND

Clinical leadership is about expertise in specialised fields and involving professionals in clinical care. Even though leadership terminology has been used in nursing and healthcare business literature, clinical leadership is still misunderstood, including its barriers.

METHOD

This study adopted a qualitative narrative approach and recruited a purposive sample of 19 NMs and two associate executive directors of nursing from two hospitals. Data were collected through two focus group discussions and in-depth interviews and were analysed using content analysis. The study was guided by the 'Consolidated Criteria for Reporting Qualitative Research'.

RESULT

Four themes emerged regarding barriers to effective clinical nursing leadership: (1) power differential, (2) inconsistent connectedness with physicians, (3) lack of early socialisation experiences and (4) clinical practice reform is a mutual responsibility.

CONCLUSION AND RELEVANCE TO CLINICAL PRACTICE

Barriers are detrimental to effective clinical leadership; they are associated with interdisciplinary and professional socialisation factors. Managers and academicians at all levels should immediately consider these barriers as a priority. Innovative clinical leaders should identify barriers to effective clinical leadership at the early stages. Thus, innovative clinical leadership programmes are warranted.

Clinical leadership behaviors among critical care nurses in private and governmental hospital: A cross-sectional survey

Objectives

This study aimed to investigate clinical leadership behaviors among critical care nurses and compare the differences between nurses in private and public hospitals.

Methods

A cross-sectional survey including 365 critical care nurses with a bachelor’s degree in nursing science were recruited in two Egyptian hospitals (a government teaching hospital and one private hospital from January to March 2019. A socio-demographic characteristics form and the Clinical Leadership Behaviors Questionnaire (CLB-Q) were used to collect data. For comparison and analysis, the mean score was calculated and converted to a percentage value.

Results

Results showed that the overall mean score of nurses’ clinical leadership behaviors was 77.11 ± 11.87, the level was higher, and the highest score of the communication dimension was 91.84 ± 7.38. The mean score of nurses at a private hospital (90.48 ± 5.53) was higher than that at a government teaching hospital (68.29 ± 4.21) (P < 0.001). On nursing experience, nurses with 5–10 years had higher mean score in self-awareness, advocacy and empowerment, decision making, quality and safety, teamwork, and clinical excellence dimension of clinical leadership behavior than those who worked less than 5 years or more than 10 years (P < 0.01). Single nurses had higher mean score in advocacy and empowerment, decision making, quality and safety, and clinical excellence dimension of clinical leadership behavior than those who married (P < 0.01).

Conclusions

Nurse managers should foster clinical leadership by enabling critical care nurses to practice clinical excellence and encouraging their attendance in training programs on quality and safety. Nurses in government hospitals need improvement in clinical leadership behaviors regarding all dimensions.