Effective leadership in the health care system is essential for providing holistic and competent patient-centric care since it strengthens the quality and integration care. In the recent era, for exercising evidence-based practices nurses are widely recognized as the effective health professional, which in turn minimizes the prevalence of chronic disease (Balsanelli, 2017). Therefore, leadership in nursing is crucial for strengthening the quality of the holistic, competent care. A study by Wong (2015), stated that effective leadership quality improves the patient outcome along while exercising cost-effective care practice.
Another study by Reichenpfader, Carlfjord, and Nilsen (2015), stated that leadership quality is crucial for evidence-based practice since it recognized as the modifier of implementation success. According to Regan, Laschinger, and Wong (2016), structural empowerment and accurate leadership are modify the experience of nurse’s interpersonal collaborative practice. Scully (2015), stated that leadership theories and the presence of nurse leaders in healthcare sectors are crucial for providing café since it aid in recognizing inherited values and attributes for securing positive futures for the professions.
Therefore, study accumulated by the above authors suggested that the Leadership in nursing practices improves the quality of the care and strengthen the interpersonal skills (Huber, 2017). This paper will illustrate identified leadership theory and issues observed in health care with the help of four peer-reviewed journals, discuss, the relevance of finding for developing leadership in nursing and lastly state recommendation for these articles in following paragraphs.
Discussion:
Quality of the care vital element for high productivity levels within the healthcare organizations and the achievement of the quality of the care depend on the updated professional knowledge and skills within the health services, which in turn improve health outcomes. Nurses are the primary stakeholders that help the healthcare setting for providing quality care to the patient. In today’s changing and demanding healthcare environment nurse, leaders is one of the greatest challenges faced by nursing professions.
A study by Scully (2015), suggested that nursing leadership are recognized as a vehicle to improve health policies and nursing practices within the healthcare setting. Many accumulated evidence failed to address the external factors that influence nursing leadership. In the paper, the author identified that transformational leadership gained the popularity for being the center of practices in nursing situations where nurse leaders are challenged to master situations in an ever-changing environment; indeed many leading researchers advocate this approach.
On the other hand, transactional leadership involves both leaders and followers receiving something for their effort (Makaroff et al., 2014). However, the author suggested the transactional leadership depends on the development of culture, which allows the proactive supportive environment. The nurse leaders possess the quality of vision, energy, self-discipline, and flexibility (Blair & Jansen, 2015). The main issue is that often nurses failed to address the inherent values of nursing while providing care to the patient, which further decrease the quality of care (Laschinger et al., 2014). Therefore, the development of leadership is crucial for resolving this issue and secures a future for the nursing profession.
The author, Reichenpfader, Carlfjord, and Nilsen (2015) stated that most of the accumulate evidence highlighted the importance of leadership in the evidence-based practice of nursing. However, the leadership varies depending on the domain they are working in. the author suggested that most of the evidence accumulated from the literature indicate the essentiality of transformational leadership with distinguishable training skills for future leaders in nursing (Kearney-Nunnery, 2015). The study suggested that in order to gain leadership quality, the proper knowledge of current research and training is required. Therefore, patients do not receive accurate treatment, which in turn decreases the quality of care.
In the paper, Regan, Laschinger, and Wong (2016), stated that authentic leadership and the structural environment is crucial for interpersonal collaborative practice. The authentic leadership theory suggested that when leaders are ethical and true to their values and strengths then they will provide positive organizational culture (Lima et al., 2016). Nurses following this leadership are more open to the sharing information has and make decisions, which furthermore, enhance interpersonal collaborative practice (Porter-O’Grady & Malloch, 2015). However, the only barriers of this are that lower level of professional anatomy and higher-level individual cultural values for authentic leadership, which decreases professional values (Backman et al., 2017).
According to Wong (2015), after testing a range of leadership, the transformational leadership proved to be associated with greater patient outcome and cost-effective patient treatment and therefore, the nurses having transformational leadership quality able achieve positive leadership outcome.
Research findings of the literature:
Scully (2015), suggested that the in order to nurse leader the development of positive leadership is crucial enhancing the quality of the care and strengthening the nursing skills. Nurses’ leaders possess a vision, self-discipline, energy and drive and flexibility with the ability to work as team interns forming situations. Therefore, in order to be efficient nursing leaders, these skills need to acquire by every nursing professionals.
The study outlined that the identification of leadership quality is complex work and therefore it should be avoided to fostering people who are not well suited for to leadership is important to eliminate which will improve the quality of health care (Beardwood & Kainer, 2015). The study pointed out the organization failed to develop positive leaders and therefore, fostering appropriate environments should be given to every professional for leadership development.
Reichenpfader, Carlfjord, and Nilsen (2015), accumulated evidence on the development of leadership in nursing and evidence practices. The study indicates a gap between the theory of leadership and implements in evidence-based practices. The prime reason behind it is the underdeveloped concept of leadership for evidence-based practice in nursing professions. Therefore, in order to develop leadership quality in the nursing for implementing evidence-based practices in the clinical field, proper decision making and sound knowledge about current researches require which further can support others to develop the skills.
Regan, Laschinger, and Wong (2016) showed that nurses may perceive higher interpersonal collaboration when nurse leaders show behavior consists of authentic leadership. the study reported that new graduate nurses perception of collaboration is related to their concept of the relationship with other team members. Therefore, the development of authentic leadership provides a nurses confidence to participate in interpersonal collaboration by enhancing the relationship between team members.
Wong (2015), found a significant relationships between relationships and task-oriented leadership, transformational leadership, and patient satisfaction. The study also suggested that each style of leadership is crucial for increasing patient outcome. Due to higher economic pressure and lack of sound skills about competent care decreases the quality of care and increase the professional burnout within patient. Therefore, acquiring leadership skills such as communication, decision-making, and intelligence increases patient satisfaction and clinical performance (Auerbach et al., 2015). It will also reduce the healthcare expenditure, professional burn out of nurses and prevalence of chronic disease. Furthermore, it will also increase the decision-making skills, which will maximize the patient satisfaction.
Limitation and recommendation:
Scully (2015), the main limitation of the study is that no primary research has been taken into consideration for obtaining the accurate data. Therefore, researchers need to conduct some primary research for obtaining the effect of positive leadership. Moreover, the study did not describe the elimination process of negative research.
Reichenpfader, Carlfjord, and Nilsen (2015), the researchers did not conduct comprehensive literature research and therefore might miss the unpublished primary research. Researchers did not conduct the assessment and study selection independently and did not define the outcome of evidence-based research. Therefore, it can be recommended to conduct comprehensive research for the accuracy of the study and proper assessment need to be done for detained study. The outcome of evidence-based practice needs to be defined.
Regan, Laschinger, and Wong (2016), the limitation of the study is that the sample size is poor, most research is mailed survey and low response rate to the survey. Therefore, researchers need to conduct a concrete survey for obtaining accurate data for the research and sample size should be adequate to give an accurate result.
Wong (2015), the limitation of the study is that the researchers did not consider primary research for connecting aspects of leadership theory with patient outcome. The majority of the evidence was based on secondary search collected from databases. The primary research should be conducted for obtaining a more detailed connection between patient outcome and leadership. it is also recommended to obtain professional point view for patient outcome.
Conclusion:
Thus, it can be concluded that acquiring leadership skills improve the patient care and patient outcome in the healthcare setting. From the data obtained from the four-reviewed journal it was found out that transformational leadership gained the popularity in most cases but few journals suggested the authentic leadership is effective nursing. The first suggested the importance of positive leadership in nursing.
The second journal highlighted the importance of leadership for nursing in evidence-based practices. The third journal highlighted the influence of authentic leadership in collaborative practice in nursing. The fourth journal highlighted the association between patient outcome and leadership. The peer-reviewed journals have certain limitations, which can be modified through recommendation.
References
Auerbach, D. I., Martsolf, G. R., Pearson, M. L., Taylor, E. A., Zaydman, M., Muchow, A. N., … & Lee, Y. (2015). The DNP by 2015: A study of the institutional, political, and professional issues that facilitate or impede establishing a post-baccalaureate doctor of nursing practice program. Rand health quarterly, 5(1).
Backman, A., Sjögren, K., Lindkvist, M., Lövheim, H., & Edvardsson, D. (2017). Characteristics of highly rated leadership in nursing homes using item response theory. Journal of advanced nursing, 73(12), 2903-2913.
Balsanelli, A. P. (2017). Leadership in nursing: Challenges and possibilities. Acta Paulista de Enfermagem, 30(1), 3-4.
Beardwood, B. A., & Kainer, J. M. (2015). Exploring risk in professional nursing practice: an analysis of work refusal and professional risk. Nursing inquiry, 22(1), 50-63.
Blair, K. A., & Jansen, M. P. (Eds.). (2015). Advanced practice nursing: Core concepts for professional role development. Springer Publishing Company.
Huber, D. (2017). Leadership and Nursing Care Management-E-Book. Elsevier Health Sciences.
Kearney-Nunnery, R. (2015). Advancing Your Career Concepts in Professional Nursing. FA Davis.
Laschinger, H. K. S., Nosko, A., Wilk, P., & Finegan, J. (2014). Effects of unit empowerment and perceived support for professional nursing practice on unit effectiveness and individual nurse well-being: A time-lagged study. International journal of nursing studies, 51(12), 1615-1623.
Lima, S., Newall, F., Jordan, H. L., Hamilton, B., & Kinney, S. (2016). Development of competence in the first year of graduate nursing practice: a longitudinal study. Journal of advanced nursing, 72(4), 878-888.
Makaroff, K. S., Storch, J., Pauly, B., & Newton, L. (2014). Searching for ethical leadership in nursing. Nursing ethics, 21(6), 642-658.
Porter-O’Grady, T., & Malloch, K. (2015). Leadership in nursing practice. Jones & Bartlett Publishers.
Regan, S., Laschinger, H. K., & Wong, C. A. (2016). The influence of empowerment, authentic leadership, and professional practice environments on nurses’ perceived interprofessional collaboration. Journal of nursing management, 24(1), E54-E61.
Reichenpfader, U., Carlfjord, S., & Nilsen, P. (2015). Leadership in evidence-based practice: a systematic review. Leadership in Health Services, 28(4), 298-316.
Scully, N. J. (2015). Leadership in nursing: The importance of recognising inherent values and attributes to secure a positive future for the profession. Collegian, 22(4), 439-444.
Wong, C. A. (2015). Connecting nursing leadership and patient outcomes: state of the science. Journal of Nursing Management, 23(3), 275-278.
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