The Relationship of Nursing Deans' Leadership Behaviors With Institutional Characteristics

The essentials of nursing leadership: A systematic review of factors and educational interventions influencing nursing leadership

BACKGROUND

Nursing leadership plays a vital role in shaping outcomes for healthcare organizations, personnel and patients. With much of the leadership workforce set to retire in the near future, identifying factors that positively contribute to the development of leadership in nurses is of utmost importance.

OBJECTIVES

To identify determining factors of nursing leadership, and the effectiveness of interventions to enhance leadership in nurses.

DESIGN

We conducted a systematic review, including a total of nine electronic databases.

DATA SOURCES

Databases included: Medline, Academic Search Premier, Embase, PsychInfo, Sociological Abstracts, ABI, CINAHL, ERIC, and Cochrane.

REVIEW METHODS

Studies were included if they quantitatively examined factors contributing to nursing leadership or educational interventions implemented with the intention of developing leadership practices in nurses. Two research team members independently reviewed each article to determine inclusion. All included studies underwent quality assessment, data extraction and content analysis.

RESULTS

49,502 titles/abstracts were screened resulting in 100 included manuscripts reporting on 93 studies (n=44 correlational studies and n=49 intervention studies). One hundred and five factors examined in correlational studies were categorized into 5 groups experience and education, individuals' traits and characteristics, relationship with work, role in the practice setting, and organizational context. Correlational studies revealed mixed results with some studies finding positive correlations and other non-significant relationships with leadership. Participation in leadership interventions had a positive impact on the development of a variety of leadership styles in 44 of 49 intervention studies, with relational leadership styles being the most common target of interventions.

CONCLUSIONS

The findings of this review make it clear that targeted educational interventions are an effective method of leadership development in nurses. However, due to equivocal results reported in many included studies and heterogeneity of leadership measurement tools, few conclusions can be drawn regarding which specific nurse characteristics and organizational factors most effectively contribute to the development of nursing leadership. Contextual and confounding factors that may mediate the relationships between nursing characteristics, development of leadership and enhancement of leadership development programs also require further examination. Targeted development of nursing leadership will help ensure that nurses of the future are well equipped to tackle the challenges of a burdened health-care system.

The role of leader behaviors in hospital-based emergency departments' unit performance and employee work satisfaction

The role of the leader of a medical unit has evolved over time to expand from simply a medical role to a more managerial one. This study aimed to explore how the behavior of a hospital-based emergency department's (ED's) leader might be related to ED unit performance and ED employees' work satisfaction. One hundred and twelve hospital-based EDs in Taiwan were studied: 10 in medical centers, 32 in regional hospitals, and 70 in district hospitals. Three instruments were designed to assess leader behaviors, unit performance and employee satisfaction in these hospital-based EDs. A mail survey revealed that task-oriented leader behavior was positively related to ED unit performance. Both task- and employee-oriented leader behaviors were found to be positively related to ED nurses' work satisfaction. However, leader behaviors were not shown to be related to ED physicians' work satisfaction at a statistically significant level. Some ED organizational characteristics, however, namely departmentalization and hospital accreditation level, were found to be related to ED physicians' work satisfaction.

Factors contributing to nursing leadership: A systematic review

Objectives:

Leadership practices of health care managers can positively or negatively influence outcomes for organizations, providers and, ultimately, patients. Understanding the factors that contribute to nursing leadership is fundamental to ensuring a future supply of nursing leaders who can positively influence outcomes for health care providers and patients. The purpose of this study was to systematically review the multidisciplinary literature to examine the factors that contribute to nursing leadership and the effectiveness of educational interventions in developing leadership behaviours among nurses.

Methods:

The search strategy began with 10 electronic databases (e.g. CINAHL, Medline). Published quantitative studies were included that examined the factors that contribute to leadership or the development of leadership behaviours in nurse leaders. Quality assessments, data extraction and analysis were completed on all included studies.

Results:

A total of 27,717 titles/abstracts were screened resulting in 26 included manuscripts reporting on 24 studies. Twenty leadership factors were examined and categorized into four groups - behaviours and practices of individual leaders, traits and characteristics of individual leaders, influences of context and practice settings, and leader participation in educational activities. Specific behaviours and practices of individual leaders, such as taking on or practising leadership styles, skills and roles, were reported as significantly influencing leadership in eight studies. Traits and characteristics of individual leaders were examined in six studies with previous leadership experience (three studies) and education levels (two of three studies) having positive effects on observed leadership. Context and practice settings had a moderate influence on leadership effectiveness (three of five studies). Nine studies that examined participation in leadership development programs all reported significant positive influences on observed leadership.

Conclusion:

These findings suggest that leadership can be developed through specific educational activities, and by modelling and practising leadership competencies. However, the relatively weak study designs provide limited evidence for specific factors that could increase the effectiveness of current nursing leadership or guide the identification of future nurse leaders. Robust theory and research on interventions to develop and promote viable nursing leadership for the future are needed to achieve the goal of developing healthy work environments for health care providers and optimizing care for patients.

Career aspirations to higher leadership positions of nurse faculty middle managers

The purpose of this study was to determine the attitudes of nurse faculty who worked full time in midlevel management positions in baccalaureate degree schools of nursing in order to identify those factors related to career aspirations to higher leadership positions such as deanship. Thirty-seven nurse midmanagers from 30 of the 40 baccalaureate degree schools of nursing in the Midwest completed the three-part questionnaire composed of a demographic profile, Johnson's Faculty Satisfaction Instrument, and Guilbert's Health Care Work Powerlessness Scale (revised). Selected results of this study indicated that the majority of nurse faculty middle managers did not view their current position as a career step to deanship (56.76 per cent) nor did they have career aspirations to a higher leadership position (62.16 per cent). The primary reason reported for this lack of career aspiration was family responsibilities. They did not perceive powerlessness or job satisfaction (P < .05) as an issue in their decision. Career aspirations to a higher leadership position was reported greater when the salary was higher and the perception was stronger that the current position was a career step to deanship (P < .05). They reported the lowest degrees of job satisfaction in reference to parking (SD = 1.79) and leadership of the dean (SD = 1.61).

Leadership Behavior and Organizational Characteristics: Implications for Faculty Satisfaction

The purpose of this investigation was to examine the relationships among administrative leadership behaviors, organizational characteristics, and faculty job satisfaction in baccalaureate nursing programs of private colleges. A two-part survey technique included 1) the collection of organizational data from the dean/chair of each nursing program, and 2) the rating of leadership behavior of the dean/chair and faculty job satisfaction by nurse faculty. Fifty-three percent of eligible programs and 77% of nurse faculty participated in the study. The findings indicated that the leadership behaviors of consideration and initiating structure were positively related to nurse faculty job satisfaction. The number of nurse faculty and the number of students in the college were identified as variables moderating the relationship between leadership behavior and job satisfaction. The emergence of a unique pattern of high consideration and high initiating structure leadership behaviors provides a basis for reexamining alternatives to promote the overall job satisfaction of nurse faculty.