Effect of transformational leadership on job satisfaction and patient safety outcomes

Background

Improving patient safety within health care organizations requires effective leadership at all levels.

The relationship between nursing leadership and nurses' job satisfaction in Canadian oncology work environments

Background  Current Canadian oncology work environments are challenged by the same workforce statistics as other nursing specialties: nurses are among the most overworked, stressed and sick workers, and more than 8% of the nursing workforce is absent each week due to illness.
Aim  To develop and estimate a theoretical model of work environment factors affecting oncology nurses' job satisfaction.
Methods  The sample consisted of 515 registered nurses working in oncology settings across Canada. The theoretical model was tested as a structural equation model using LISREL 8.54.
Results  The final model fitted the data acceptably ( χ ² = 58.0, d.f. = 44, P  =   0.08). Relational leadership and physician/nurse relationships significantly influenced opportunities for staff development, RN staffing adequacy, nurse autonomy, participation in policy decisions, support for innovative ideas and supervisor support in managing conflict, which in turn increased nurses' job satisfaction.
Conclusions  These findings suggest that relational leadership and positive relationships among nurses, managers and physicians play an important role in quality oncology nursing environments and nurses' job satisfaction.
Implications for nursing management  Oncology nursing work environments can be improved by focusing on modifiable factors such as leadership, staff development and staffing resources, leading to better job satisfaction and hopefully retention of nurses.     

Relationships among leadership practices, work environments, staff communication and outcomes in long-term care

tourangeau a., cranley l., laschinger h. & pachis j. (2010) Journal of Nursing Management 18, 1060–1072
Relationships among leadership practices, work environments, staff communication and outcomes in long-term care Aim To examine the role that work relationships have on two long-term care outcomes: job satisfaction and turnover intention. Background It is easy to overlook the impact that human relations have in shaping work environments that are conducive to organizational effectiveness. Employee job satisfaction and retention are important organizational outcomes. Methods Six hundred and seventy-five nursing and other staff from 26 long-term care facilities were surveyed about their work environments, work group relationships, observed leadership practices, organizational support, job satisfaction and turnover intention. Results Higher job satisfaction was associated with lower emotional exhaustion burnout, higher global empowerment, higher organizational support, higher psychological empowerment, stronger work group cohesion and higher personal accomplishment. Higher turnover intention was associated with lower job satisfaction, higher emotional exhaustion burnout, more outside job opportunities, weaker work group cohesion, lower personal accomplishment and higher depersonalization. Conclusions No relationship was found between leadership practices and job satisfaction or turnover intention. Stronger work group relationships, stronger sense of personal accomplishment and lower emotional exhaustion have direct effects on increasing job satisfaction and lowering turnover intention. Implications To retain long-term care staff, attention should be paid to fostering positive work group cohesion, supporting and acknowledging staff accomplishments and minimizing staff burnout.     

The uptake of technologies designed to influence medication safety in Canadian hospitals

Background There are many technologies designed to improve medication safety. Although limited evidence supports their use, there are pressures to implement them. Objective To determine the uptake of technologies designed to improve medication safety, plans for adopting technologies, attitudes towards technology use, and perceptions of medication error. Methods We performed a cross‐sectional survey of pharmacy directors at Canada’s 100 largest acute‐care hospitals. Results Seventy‐eight per cent of surveyed hospitals responded. Responding hospitals averaged 499 beds and 29% were teaching facilities. Hospital frequently used clinical pharmacy services (97% of hospitals), pharmacy‐based intravenous admixture services (81%), computerized decision support modules for pharmacy order entry systems (77%), unit‐dose drug distribution systems (75%) and computerized medication administration records (67%). Hospitals infrequently used bar‐coding (9% of hospitals) and computerized physician order entry (9%). A majority of respondents and hospitals favoured expanded use of new technologies and planned for increased uptake. Respondents chose as their hospital’s next investment: automated dispensing (33%), bar‐coding (25%) and computerized physician order entry (12%). Conclusion Canadian hospitals appear poised to make sizeable investments in poorly evaluated technologies that address medication safety.     

The relationship between nursing leadership and patient outcomes: a systematic review

AIM: The purpose of this review was to describe findings of a systematic review of studies that examine the relationship between nursing leadership and patient outcomes. BACKGROUND: With recent attention directed to the creation of safer practice environments for patients, nursing leadership is called on to advance this agenda within organizations. However, surprisingly little is known about the actual association between nursing leadership and patient outcomes. METHODS: Published English-only research articles that examined formal nursing leadership and patient outcomes were selected from computerized databases and manual searches. Data extraction and methodological quality assessment were completed for the final seven quantitative research articles. RESULTS: Evidence of significant associations between positive leadership behaviours, styles or practices and increased patient satisfaction and reduced adverse events were found. Findings relating leadership to patient mortality rates were inconclusive. CONCLUSION: The findings of this review suggest that an emphasis on developing transformational nursing leadership is an important organizational strategy to improve patient outcomes.     

基层医院静脉化疗安全给药情况的调查

目的调查基层医院静脉化疗安全给药情况,并探讨管理对策。方法采用自行设计的基层医院静脉化疗安全用药问卷,对40名护理部主任及200名执行静脉化疗操作的护士和196例接受静脉化疗的患者进行调查。结果仅17．50％的基层医院对静脉化疗患者进行了集中管理;仅8．50％的护士在执行静脉化疗时首选较安全的PICC通路;59．89％的患者因PICC导管维护困难而未选择PICC化疗通路。结论尽快建立健全静脉化疗安全管理制度,规范静脉化疗操作流程及通路的管理,加强静脉化疗专科知识培训,建立肿瘤患者护理管理网络,以保证静脉化疗安全用药。     

Nursing leadership style and psychosocial work environment

malloy t. & penprase b. (2010) Journal of Nursing Management  18 , 715–725
Nursing leadership style and psychosocial work environment Aim This study examines the relationship between leadership style and the psychosocial work environment of registered nurses. Background Research consistently supports the positive relationship between transformational leadership style and job satisfaction. There is less evidence, which identifies the relationship between leadership style and psychosocial work environment. Method The Multifactor Leadership Questionnaire 5× was used to identify the leadership style. The Copenhagen Psychosocial Questionnaire was used to measure psychosocial work environment dimensions. Statistical analysis included Pearson’s r correlation between leadership style and psychosocial work environment and anova to analyse group means. Results There is a significant correlation between leadership style and 22 out of the 37 dimensions of the psychosocial work environment. This correlation was significant ranging from r = 0.88, P < 0.01 to r = 0.18, P < 0.05. Nurses divided into groups based on transformational leadership scores of the immediate supervisor report significant differences in their psychosocial work environment. Conclusion This study supports the significant correlation between leadership style and psychosocial work environment for registered nurses. Implications for nursing management The results of this study suggest that there would be an improvement in the nursing psychosocial work environment by implementation of transformational and contingent reward leadership behaviours.     

The mediating role of organizational justice in the relationship between transformational leadership and nurses’ quality of work life: A cross-sectional questionnaire survey

Background

The importance of transformational leadership for nurses’ well-being is increasingly acknowledged. However, there is a paucity of research examining the mechanisms that may explain the relationships between transformational leadership and nurses’ quality of work life.

Objectives

First, to examine two possible psychological mechanisms that link transformational leadership behaviors to nurses’ quality of work life. Second, to study the relationship between nurses’ quality of work life and their work engagement.

Design

Cross-sectional study design.

Settings

The study took place in 47 different hematology, oncology, and hematology/oncology units in France. Participants were nurses and auxiliary nurses.

Participants

343 nurses completed the questionnaire. Surveys were sent to all nurses working in the units. 95% were female, the average age was 36.30 years.

Methods

Nurses were asked to rate their supervisor's transformational leadership style and their perceptions of distributive and interactional justice in the unit. They were also asked to evaluate their own level of quality of work life and their work engagement.

Results

Distributive justice and interactional justice were found to fully mediate the relationship between transformational leadership and nurses’ quality of work life. In addition, nurses’ quality of work life positively related to their work engagement.

Conclusions

Transformational leaders may help ensure nurses’ quality of work life which in turn increases their work engagement. These leadership practices are thus beneficial for both employees and organization.     

护士长领导方式与其领导行为的关系研究

目的探讨护士长领导方式与其领导行为之间的关系。方法运用多元领导风格量表、医院领导行为评估量表对石家庄市4所三级甲等综合医院198名护士长所在科室的925名护士进行问卷调查。结果护士感知的护士长交易型领导方式较多,护士长领导行为并不乐观;护士长变革型领导方式对其领导行为具有积极正向的影响(P0.01)。结论交易型领导方式、变革型领导方式对护士长领导行为均具有积极的影响,但是变革型领导方式在整体上要优于交易型领导方式,改善护士长领导方式,能够有效提高其领导行为。