Dissertations / Theses on the topic 'Nurse leader'

Frontline nurse leaders are expected to lead staff while managing the work systems and processes on their units in addition to ensuring high quality and safe patient care is being delivered. It is not known if frontline nurse leaders who have been oriented with only onthe-job-training are competent and if a professional development program will improve their competencies and confidence. This project used a quantitative quasi-experimental design. The basic design elements for this project were the PCC curriculum and completion of the survey pre-and post-attendance. This project was conducted at an acute care, Magnet facility and included 20 frontline patient care coordinators. Data from the surveys were analyzed using SPSS 23. Spearman’s rho was used, a nonparametric test which determines the strength and significance of the correlation between two measures, and ANOVA, a parametric method which determines whether there is a significant mean difference in some measure between two or more groups. The initial average competency ranking of the participants was 2.91, which reflects a just below competent ranking; paired-samples ttests were conducted which resulted with the average self-rated competency level of participants increasing by 27% to 3.69 post intervention. Implications for this research is far reaching, considering the impact frontline nurses have on nurse satisfaction and engagement, in addition to improved quality of care, patient satisfaction, and patient outcomes.

Within the health care system, patient safety outcomes have been criticized for many years. Medical malpractice, common errors, and nosocomial infections (i.e., hospital-acquired infections) are safety concerns, and represent a public health problem. Since the Institute of Medicine (1999) published To Err is Human: Building a Safer Health System in 1999, changes have been made to improve the use of technology and leverage advancements in research that improve patient safety. Nurse leaders can also help to facilitate process improvements in the patient safety culture. The purpose of this capstone project was to explore the nursing leader role in improving patient safety in a hospital setting. The method utilized for this study was a literature review. Prominent articles identifying the role of nursing leadership were included. Seven drivers of patient safety were identified (Sammer, Lyken, Singh, Mains, & Lackan (2011), and subsequently informed this project. The targeted populations were patients, families, nurses, nurse administrators, and medical personnel. Findings regarding the nurse leader role, patient improvements, and barriers to improvements were reviewed. Nurse leaders were found to be of critical importance to patients, medical personnel, and the health care system. The limitations of this review and implications for policy and practice are discussed.

Incivility, also known as bullying or horizontal violence, can take many forms from derogatory statements to physical harm. Incivility can create physical, emotional, and psychological symptoms leading to job dissatisfaction and increased turnover. Incivility can impact patient care and patient safety. Organizational impacts include increased turnover and decreased productivity. Regulatory and professional agencies have issued recommendations for leaders of organizations to address incivility in the workplace. The purpose of the study was to determine if an educational program for nurse leaders can improve the perceived ability of the leaders to act with moral courage to address uncivil behavior. Two theories identified as relevant to incivility in the workplace, Freire’s Oppression Theory and Kanter’s Structural Theory of Power. A quasi experimental design, one group pretest-posttest, was used. The study took place in a 363-bed tertiary care facility. A convenience sample of nurse leaders completed a pre-survey, education, and post-survey. Analysis was conducted on 37 matched pairs of surveys. The tool, the Professional Moral Courage (PMC) Scale, is comprised of fifteen statements divided into five themes; three statements per theme. Three areas of statistical significance were found using a paired t-test comparing the pre-survey to the post-survey scores. The results indicated improvement in two out of five themes, acting morally and proactive approach, and the overall score. Leaders need to utilize moral and address incivility. By witnessing the leaders’ role modeling civil behaviors and taking action in the face of incivility, staff should also demonstrate the same behaviors.

Leadership is essential for the survival of the healthcare organization in the midst of challenging times due to health care reform and the public's desire for transparency and improved quality outcomes. Transformational leadership is desirable for nurse leaders in a rapidly changing environment, but nurse leaders are often challenged with the inability to meet the demands of this complex environment for a variety of reasons. The increasing competition for resources, both human and fiscal, leading to wider spans of control is one of those challenges. The purpose of this quantitative, correlational research study was to explore the relationship between span of control and the leadership style of nurse leaders. The setting for the study was a multi-facility healthcare system in the Midwest. Avolio and Bass' (2004) Multifactor Leadership Questionnaire Form 5X Short (MLQ) was utilized to determine the nurse leader's leadership style along the full range of leadership continuum. The span of control or number of direct reports each nurse leader had was collected along with other demographic data.

The Pearson product moment correlation was utilized to analyze the relationship between span of control and transformational leadership, and span of control and transactional leadership. The Spearman's rho correlation coefficient was utilized to analyze the relationship between span of control and passive/avoidant behavior. The data suggest that there is no relationship between span of control and the leadership style of nurse leaders. While no relationship was found, the findings remain significant to nurse leaders as they navigate the complex territory of healthcare and make strategic decisions about organizational structures.

The specific problem under study results from the growth of multinational workforces in U.S. hospitals and the gap in the literature explaining how the presence of these workforces impacts hospital leadership, decision-making, and financial performance. The purpose of this qualitative embedded multi-case study was to discover and describe hospital nursing leader’s beliefs from their experiences about how having employees from multiple national cultures affects nursing leadership, decision-making, and departmental financial performance in the hospital. The challenge faced by many hospitals is that the U.S. workforce is becoming culturally diverse as the global workforce increases its geographical mobility. The current research was important because results revealed nurse leaders’ beliefs about a link between the cultural dimensions of a multinational workforce and the decision-making, financial performance, and patient care within a hospital nursing department. The sample included eight nursing leaders from seven hospitals where the workforces are multinational and culturally diverse. The cultural dimensions by Hofstede were used to study the impact of a multinational workforce on the organizational practices of a nursing department in a hospital setting. Results revealed nine core themes, expected from the literature, and two emerging themes provided answers to the research questions. The nine core themes were Hofstede’s cultural dimensions, workforce values, nursing organization impact, immigration/migration, nursing leadership, nursing workforce, organization culture, change, and develop multicultural organization attributes. The two emerging themes were familismo (family loyalty influences multinational workforce decision making) and hospital refusal to hire multicultural nurses whose national culture conflict with the organization’s culture.

As ardent import is recognized for collaborative decision making (DM) generating effectual patient care, minimal investigation has been allotted to consider what health professionals inherently bring to decision forums. The purpose of this pilot study is to examine the capacity to enhance decision making collaboration of nurse leaders in a community hospital through Myers-Briggs Type Indicator (MBTI) application. Personality influence is vital for self-awareness and colleague appreciation. True collaboration transcends cooperation to embrace mutual respect and goals for ethical decisions (Barrett, Piatek, Korber, & Padula, 2009). By four educational modules, designed to explicate type influence upon recognized leadership constructs, aligned with a defined DM process, nurse leaders of a Shared Governance Council were assessed to discern collaborative DM. A convenience sample of eight nurses completed the study. The targeted sample size enabled deep investigation of skill development and teamwork through MBTI application, explored by descriptive content analysis. The assessment tool, developed from a collaborative training survey, appraised seven constructs of nurse leadership and three definers of decision evaluation, incorporating MBTI influences. Outcomes, measured by self-reported pre/post survey methodology, revealed an overall 87.5% improvement in collaboration, 62.5% improvement in team trust, decision expediency and pragmatism. A 50% improvement was reported in colleague understanding and communication skills. There remains much to be discovered about personality impacts upon nurse leadership for augmenting collaboration. Bringing empowered nurses to decision making tables is critical for accomplished investment, improved teamwork, and professional accountability for decisions, from bedside to boardroom. It is the focus of this study.

There is a demand for nursing leadership to create a healthy work environment for nursing practice, which is crucial for maintaining an adequate workforce (Shirey, 2006). Rother and Lavizzo-Mourey (2009) predicted that by 2025 the nursing shortage may reach as high as 500,000 U.S. nursing vacancies. The purpose of this study was to examine the relationship between servant leadership (SL) characteristics of nurse leaders and the perceptions of empowerment among their followers. Servant leadership has emerged as an effective leadership style that prioritizes developing the full potential of followers (Liden, 2013). Current research suggests an empirical link exists between servant leadership and empowerment (Liden, Panaccio, Meuser, Hu, & Wayne, 2011; Van Dierendonck, 2011). An empowered workforce is able to handle unstable environments (Liden, 2013) such as the nursing shortage.

In 2015, 51 nurse leaders and 237 direct-reports from workplace units in a multifacility health system completed the Servant Leadership Scale (SLS) and a demographic questionnaire. In addition, the direct-reports completed the Psychological Empowerment Inventory (PEI). A convenience sampling technique was utilized to assist in obtaining participants for this quantitative study. An independent samples t-test was used to analyze the data. It was found that a relationship existed between nurse leaders that were rated as servant-leaders by their direct-reports, and the direct-reports’ perception of empowerment. However, it was found that no relationship existed between the nurse leaders’ self-evaluation on the SLS and the direct-reports’ evaluation of their nurse leaders on the SLS.