Factors influencing advanced practitioners' ability to enact leadership: a case study within Irish healthcare (original) (raw)
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Journal of Nursing Management, 2019
Aim. To explore the differences in perceived importance and actual performance of clinical leadership for all grades of nurses and midwives engaged in clinical practice. Background. Clinical leadership is central to the provision of person-centred care. However, little is known about how nurses and midwives perceive this in practice. Methods. Data were collected on a sample of nurses and midwives in the Republic of Ireland, using a cross-sectional study design (n=324). The Clinical Leadership Needs Analysis Instrument (CLeeNA) was used to measure perceived importance and performance of clinical leadership in practice. Grades of nurses/midwives included; staff, manager, advanced practitioner and senior manager. Results. Senior managers were more likely to report significantly higher scores than staff grades for perceived importance of Technology & Care Initiatives (p<0.01) and Financial & Service Management (p=0.02). Performance of Staff & Care Delivery was significantly higher for senior managers than staff grades [F(5,309)=6.06 p<0.01]. Conclusion. There was a mismatch between the perceived importance and actual performance of clinical leadership in practice between different grades of staff. Implications for Nursing Management. Leadership training for all grades and mentoring of staff grades can promote the building of confidence and empower staff in leading clinical practice.
International Journal of Nursing Studies, 2016
Background: Advanced roles such as nurse practitioner, nurse consultant and advanced nurse or midwife practitioner are increasing across the world. In most countries, clinical practice, education, leadership and research are the four components that define the advanced practitioner's role. Of these, leadership is perhaps the most important part of the role, but its study has largely been neglected. There is a risk that failure to identify and respond to barriers to enacting the advanced practitioners' leadership role will limit the extent to which they can become strategic leaders for professional development, and jeopardise the long-term sustainability of the role. Objectives: To identify the barriers and enablers to advanced practitioner's ability to enact their leadership role. Data sources: A search of the research literature was undertaken in electronic databases (PubMed, CINAHL, PsycINFO, ProQuest Dissertation and Theses, from inception to 4-6 th June 2015), unpublished research in seventeen online research repositories and institutes, and hand search of 2 leadership journals (March/April 2010-4 th June 2015). Review methods: Using pre-set inclusion criteria, the 1506 titles found were screened by two authors working independently. The 140 full text reports selected were reviewed by two authors separately and 34 were included, and data extracted and cross-checked. Any A c c e p t e d M a n u s c r i p t 4 Title: Barriers and enablers to advanced practitioners' ability to enact their leadership role: A scoping review.
An integrative review of Leadership Competencies and Attributes in Advanced Nursing Practice
Journal of Advanced Nursing
Aim: To establish what leadership competencies are expected of Master level educated nurses like the Advanced Practice Nurses and the Clinical Nurse Leaders as described in the international literature. Background: Developments in healthcare ask for well trained nurse leaders. Advanced Practice Nurses and Clinical Nurse Leaders are ideally positioned to lead health care reform in nursing. Nurses should be adequately equipped for this role based on internationally defined leadership competencies. Therefore, identifying leadership competencies and related attributes internationally is needed Design: Integrative review Methods: Embase, Medline and CINAHL databases were searched (January 2005-December 2018). Also, websites of international professional nursing organizations were searched for frameworks on leadership competencies. Study and framework selection, identification of competencies, quality appraisal of included studies and analysis of data were independently conducted by two researchers. Results: Fifteen studies and seven competency frameworks were included. Synthesis of 150 identified competencies led to a set of 30 core competencies in the clinical, professional, health systems and health policy leadership domains. Most competencies fitted in one single domain the health policy domain contained the least competencies. Conclusions: This synthesis of 30 core competencies within four leadership domains can be used for further development of evidence-based curricula on leadership. Next steps include further refining of competencies, addressing gaps and the linking of knowledge, skills and attributes. Impact: These findings contribute to leadership development for Advanced Practice Nurses and Clinical Nurse Leaders while aiming at improved health service delivery and guiding of health policies and reforms.
Clinical leadership in contemporary clinical practice: implications for nursing in Australia
Journal of Nursing Management, 2006
Background Leadership in the clinical practice environment is important to ensure both optimal patient outcomes and successive generations of motivated and enthusiastic clinicians. Aim The present paper seeks to define and describe clinical leadership and identify the facilitators and barriers to clinical leadership. We also describe strategies to develop clinical leaders in Australia. Key drivers to the development of nursing leaders are strategies that recognize and value clinical expertise. These include models of care that highlight the importance of the nursing role; evidence-based practice and measurement of clinical outcomes; strategies to empower clinicians and mechanisms to ensure participation in clinical decision-making. Key issues Significant barriers to clinical leadership are organizational structures that preclude nurses from clinical decision making; the national shortage of nurses; fiscal constraints; absence of well evaluated models of care and trends towards less skilled clinicians. Conclusions Systematic, strategic initiatives are required to nurture and develop clinical leaders. These strategies need to be collegial collaborations between the academic and health care sectors in order to provide a united voice for advancing the nursing profession.
Leadership as part of the nurse consultant role: banging the drum for patient care
Journal of Clinical Nursing, 2009
Aims and objectives. This paper draws upon an evaluation of the first group of nurse consultants in Scotland. The evaluation aimed to identify the extent to which they fulfilled the remit of their posts which comprised four core functions. One of these functions was to provide professional leadership and this paper focuses on this element of the role and aims to explore it in relation to the attributes of transformational leadership. Background. Nurse consultants were introduced in the UK in 2000. Their purpose was to achieve better outcomes for patients and strengthen leadership. Nursing research identifies leadership as a key element of the role, with postholders adopting transformational leadership approaches. Research from the fields of sociology and psychology identifies difficulties in formulating a coherent theory of leadership, arguing for better understanding of leadership processes. Design. Qualitative.
A survey identifying leadership and research activities among Nurse Practitioners
Contemporary Nurse, 2020
Background: Nurse Practitioners are identified as the ideal conduit to transform healthcare delivery internationally. Healthcare transformation requires the application of leadership and research skills. Current literature has limited information on NPs as leaders or researchers in the nursing profession. Objectives: Determine if Nurse Practitioners identify themselves as leaders in nursing. Identify the leadership and research activities and influencing characteristics of Nurse Practitioners in Ireland and Australia. Establish similarities in leadership and research activities between Nurse Practitioners in Ireland and Australia. To identify if there is a relationship between leadership and research activities. Design: A quantitative electronic survey. Methods: A survey instrument was developed by combining two previously validated instruments. Nurse Practitioners in Ireland or Australia that had practiced within the last five years, and members of the respective professional association were included. Descriptive statistics were used to describe the findings and explore relationships in the data. Results: Nurse Practitioners in Ireland and Australia identified themselves as leaders of the nursing profession. Nurse Practitioners work practices, leadership and research activities are similar in Ireland and Australia. The majority (55%), of participants reported being research active. There was an association between perceived leadership and research activities among participants. Conclusion: Nurse Practitioners in both Ireland and Australia identify themselves as leaders of the nursing profession. There is no difference in reported work practices, leadership or research activities of Nurse Practitioners in both Ireland and Australia. There is an association between perceived leadership and research activity. 2 Impact Statement: Nurse Practitioners in Ireland and Australia are clinical leaders who require more research support.