Council News

ABSTRACT

Increasingly, leadership is being acknowledged as a shared responsibility across a professional team, rather than being reserved for those in a position of authority. There is support for team members becoming leaders within their own areas of expertise with the aim of supporting the broader leadership of an organisation. This approach can be a valuable opportunity for veterinary nurses to learn and practise leadership skills. This article addresses some of the theoretical concepts of leadership and aims to explain why learning and practising leadership behaviours at all levels of veterinary nursing can benefit the individual, the veterinary team and ultimately the veterinary nursing profession.     

A New Leadership Development Model for Nursing Education

Background

Leadership competency is required throughout nursing. Students have difficulty understanding leadership as integral to education and practice. A consistent framework for nursing leadership education, strong scholarship and an evidence base are limited.

Exploring the contribution and impact of master’s education for leadership development in adult general nursing: A scoping review

AimThe aim of this scoping review was to explore the evidence relating to master’s education for leadership development in adult/general nurses who are not in advanced practice or leadership roles and its impact on practice.BackgroundThe importance of effective, clinical leadership in nursing and health care, has been highlighted following failings reported by Public Inquiries both nationally and internationally. While initiatives have been implemented to address these, the provision of safe, quality care remains problematic. Complex care requires highly skilled professionals to challenge and lead improvements in practice. Master’s education results in graduates with the skills and confidence to make these changes and to become the clinical leaders of the future.MethodsAn a priori scoping review protocol was developed by the review team. This was used to undertake searches across CINAHL Ultimate; Medline (Ovid), Scopus and ProQuest Complete databases, chosen due to their relevance to the subject area. Articles were limited to those in the English Language, peer reviewed and published since 2009. Citation chaining via the reference lists of frequently identified articles were also searched. A further search for relevant grey material using the same relevant keywords and phrases was performed using the limited, Trip Database and Google Scholar.ResultsEight articles were selected for data extraction, and these were published between 2011 and 2019. The articles were predominantly from the UK and Europe, with a focus either on master’s education or on aspects of leadership in nursing and healthcare. Themes identified: a) The need for clinical leadership; b) master’s education for clinical leadership skills; and c) master’s education for professional and organisational outcomes.ConclusionsThe scoping review identified that there is a need for strong clinical leadership in the practice setting. Evidence shows that effective nursing leadership can improve patient outcomes as well as enhancing workplace culture and staff retention. The review has shown that the skills required for clinical leadership are those produced by master’s education. Studies of the impact of master’s education are often self reported and tend to focus on nurses in advanced practice roles. More research is required into master’s education for adult/general nurses not in advanced roles and in examining the link between master’s education and improved patient, professional and organisational outcomes.     

Psychometric testing of the Leadership and Management Inventory: a tool to measure the skills and abilities of first‐line nurse managers

Aim To estimate the validity and reliability of the Leadership and Management Inventory, a tool to measure the skills and abilities of first‐line nurse managers. Background The decision to develop an inventory reflects the need for an instrument that can measure the various skills and abilities first‐line nurse managers should possess. Method Factor analysis was conducted and internal consistency initially estimated on data from 149 registered nurses; a second sample of 197 health care personnel was used to test these results. Results Principal component analysis of the first sample resulted in a preferred three‐factor solution that explained 65.8% of the variance; Cronbach’s alpha coefficient varied between 0.90 and 0.95. Analysis of the second sample also resulted in a three‐factor solution that explained 64.2% of the variance; Cronbach’s alpha coefficient varied from 0.88 to 0.96. For both samples, the factors were labelled ‘interpersonal skills and group management’, ‘achievement orientation’ and ‘overall organizational view and political savvy’. Conclusion Results indicate that estimates of validity and reliability for the Leadership and Management Inventory can be considered acceptable. Implications for nursing management The Leadership and Management Inventory can be used when first‐line nurse managers’ leadership and management skills and abilities are to be measured.     

Clinical Development Units (Nursing): the western Sydney approach

On 24 September 1997 Western Sydney Area Health Service and the University of Western Sydney, Nepean (Australia) launched a network of nine Clinical Development Units (Nursing). The approach taken towards the development of CDU(N)s in western Sydney differs substantially from those taken elsewhere in terms of preparation for CDU(N) leadership and the role of CDU(N) criteria in the designation ('accreditation') process. The rationale underpinning the western Sydney approach, together with details of a leadership preparation programme, are discussed.     

Clustering excellence to exert transformative change: the Hartford Geriatric Nursing Initiative (HGNI)

This paper describes how the John A. Hartford Foundation sought to maximize the influence of its various geriatric nursing projects by organizing and managing them collectively as the Hartford Geriatric Nursing Initiative (HGNI). This initiative aimed to develop a shared identity, encouraged cross-pollination of efforts, convened project leaders to address opportunities and problems, launched across-project collaborations, and created tools and resources to support overall efforts. This paper ends with some reflections on the processes implemented to maximize HGNI effectiveness, particularly the importance of forging a common identity in order to encourage expanded solutions. The HGNI can serve as an example of how intersecting interests can fuel new ideas, thus helping others think more strategically about change efforts in the future.     

Factors of importance for work satisfaction among nurses in a university hospital in Sweden

The shortage of registered nurses in the healthcare sector is a problem in most countries. Swedish nurses tend to leave or seek new positions. However, few Swedish studies have addressed questions regarding what factors are of importance for nurses to perceive work satisfaction although satisfied nurses are linked to many positive organizational outcomes, e.g. improved quality of patient care. The aim of this study was to investigate what factors are of importance for nurses at a university hospital to perceive work satisfaction. Eight hundred and thirty-three nurses responded to the mailed Quality Work Competence questionnaire and the Huddinge University Hospital Model Questionnaire. Regression analyses identifies five factors linked to the head nurses leadership contributing to the nurses' feelings of work satisfaction: 'professional competence is made good use of', 'feeling of satisfaction with immediate superior regarding support for nursing research and development', 'opportunities for developing one's own competence for the current job', 'career opportunities in one's own profession' and 'yearly dialogue for performance appraisal with immediate superior'. The nurses also reported work-related exhaustion. Few saw opportunities for making a career as a nurse. In conclusion, the study identified specific amenable factors linked to the head nurses leadership that are of importance in creating attractive workplaces for nurses.     

A short,structured skills training course for critical care physiotherapists in a lower-middle income country

Objectives: The aim of this article is to describe the delivery and acceptability of a short, structured training course for critical care physiotherapy and its effects on the knowledge and skills of the participants in Sri Lanka, a lower-middle income country.

Methods: The two-day program combining short didactic sessions with small group workshops and skills stations was developed and delivered by local facilitators in partnership with an overseas specialist physiotherapist trainer. The impact was assessed using pre/post-course self-assessment, pre/post-course multiple-choice-question (MCQ) papers, and an end-of-course feedback questionnaire.

Results: Fifty-six physiotherapists (26% of critical care physiotherapists in Sri Lanka) participated. Overall confidence in common critical care physiotherapy skills improved from 11.6% to 59.2% in pre/post-training self-assessments, respectively. Post-course MCQ scores (mean score = 63.2) and percentage of passes (87.5%) were higher than pre-course scores (mean score = 36.6; percentage of passes = 12.5%). Overall feedback was very positive as 75% of the participants were highly satisfied with the course’s contribution to improved critical care knowledge.

Conclusions: This short, structured, critical care focused physiotherapy training has potential benefit to participating physiotherapists. Further, it provides an evidence that collaborative program can be planned and conducted successfully in a resource poor setting. This sustainable short course model may be adaptable to other resource-limited settings.     

The professional socialization of diploma of higher education in nursing students (Project 2000): a longitudinal qualitative study

This paper presents a new theory of professional socialization in relation to diploma of higher education in nursing students (Project 2000). It was derived from a 3-year, grounded theory, longitudinal study exploring the effects of supernumerary status and mentorship on students undertaking practice placements. A purposive sample of 17 students was used. Ten students volunteered to be interviewed on five separate occasions throughout their course and to keep a diary to record their experiences of mentorship during their practice placements. Their diary acted as an aide memoir during their tape-recorded interviews. The other seven students participated by diary only and kept written accounts of their experiences of being supernumerary and having a mentor whilst on practice placements. Data were analysed with the aid of NUD.IST and subjected to the constant comparative method of analysis. Findings indicate that the mentor is the linchpin of the students' experience and that some students develop intuition much earlier than previous work has stated.     

Entrustables and Entrustment: Through the Looking Glass at the Clinical Making of a Nurse Practitioner

Entrustable professional activities (EPAs) formally address the supervision level required for nurse practitioner (NP) skills of students and fellows. Entrustment is the decision to entrust students and fellows with the responsibility to practice professional skills without direct supervision. EPAs offer the promise of consistency within and among NP programs about the expected skills of NP students and fellows and how and when they are acquired. EPAs highlight how and when the supervision and entrustment decisions are made. Their use in medical and graduate medical education suggests that EPAs would provide a common vocabulary among NP students, fellows, and physician colleagues.