Does a Nursing Associate Programme Team Work and Leadership Module Make a Difference to Student Nursing Associate Self-reported Leadership Skills? A Mixed-methods Study

Background:

Leadership is an essential element in the skills of healthcare professionals at all levels. This is true for Registered Nurses as well as Nursing Associates, who are registered professionals with a two-year foundation degree programme as role preparation.

Objective:

This paper reports a study examining potential gains that might accrue from leadership and team-working module in year two of the Nursing Associate Foundation Degree programme at one university in the South West of England.

Methods:

We conducted a mixed-methods study in the summer of 2020, with a pre- and post-module survey using the Student Leadership Inventory – Self, and a virtual focus group on the video conferencing software Zoom ™.

Results:

The survey results showed a statistically significant difference between Student Nurse Associates’ scores before and after the module, with a moderate effect size. The virtual focus group confirmed benefits that included growing personal confidence amongst those that attended and that they could identify leadership styles and team dynamics in practice.

Conclusion:

As effective leadership is associated with patient safety and quality of care, we conclude that not only has this module been effective, but also that such preparation for practice can have important real-world impacts beyond the classroom.

Improvement attributes in healthcare: implications for integrated care

Purpose Healthcare quality improvement is a key concern for policy makers, regulators, carers and service users. Despite a contemporary consensus among policy makers that integrated care represents a means to substantially improve service outcomes, progress has been slow. Difficulties achieving sustained improvement at scale imply that methods employed are not sufficient and that healthcare improvement attributes may be different when compared to prior reference domains. The purpose of this paper is to examine and synthesise key improvement attributes relevant to a complex healthcare change process, specifically integrated care. Design/methodology/approach This study is based on an integrative literature review on systemic improvement in healthcare. Findings A central theme emerging from the literature review indicates that implementing systemic change needs to address the relationship between vision, methods and participant social dynamics. Practical implications Accommodating personal and professional network dynamics is required for systemic improvement, especially among high autonomy individuals. This reinforces the need to recognise the change process as taking place in a complex adaptive system where personal/professional purpose/meaning is central to the process. Originality/value Shared personal/professional narratives are insufficiently recognised as a powerful change force, under-represented in linear and rational empirical improvement approaches.

Disentangling the roles of safety climate and safety culture: Multi-level effects on the relationship between supervisor enforcement and safety compliance

Despite increasing attention to contextual effects on the relationship between supervisor enforcement and employee safety compliance, no study has yet explored the conjoint influence exerted simultaneously by organizational safety climate and safety culture. The present study seeks to address this literature shortcoming. We first begin by briefly discussing the theoretical distinctions between safety climate and culture and the rationale for examining these together. Next, using survey data collected from 1342 employees in 32 Italian organizations, we found that employee-level supervisor enforcement, organizational-level safety climate, and autocratic, bureaucratic, and technocratic safety culture dimensions all predicted individual-level safety compliance behaviors. However, the cross-level moderating effect of safety climate was bounded by certain safety culture dimensions, such that safety climate moderated the supervisor enforcement-compliance relationship only under the clan-patronage culture dimension. Additionally, the autocratic and bureaucratic culture dimensions attenuated the relationship between supervisor enforcement and compliance. Finally, when testing the effects of technocratic safety culture and cooperative safety culture, neither safety culture nor climate moderated the relationship between supervisor enforcement and safety compliance. The results suggest a complex relationship between organizational safety culture and safety climate, indicating that organizations with particular safety cultures may be more likely to develop more (or less) positive safety climates. Moreover, employee safety compliance is a function of supervisor safety leadership, as well as the safety climate and safety culture dimensions prevalent within the organization.