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The relationship between nursing leadership and patient outcomes: a systematic review update
Abstract
AIM: Our aim was to describe the findings of a systematic review of studies that examine the relationship between nursing leadership practices and patient outcomes. BACKGROUND: As healthcare faces an economic downturn, stressful work environments, upcoming retirements of leaders and projected workforce shortages, implementing strategies to ensure effective leadership and optimal patient outcomes are paramount. However, a gap still exists in what is known about the association between nursing leadership and patient outcomes. METHODS: Published English-only research articles that examined leadership practices of nurses in formal leadership positions and patient outcomes were selected from eight online bibliographic databases. Quality assessments, data extraction and analysis were completed on all included studies. RESULTS: A total of 20 studies satisfied our inclusion criteria and were retained. Current evidence suggests relationships between positive relational leadership styles and higher patient satisfaction and lower patient mortality, medication errors, restraint use and hospital-acquired infections. CONCLUSIONS: The findings document evidence of a positive relationship between relational leadership and a variety of patient outcomes, although future testing of leadership models that examine the mechanisms of influence on outcomes is warranted. IMPLICATIONS FOR NURSING MANAGEMENT: Efforts by organisations and individuals to develop transformational and relational leadership reinforces organisational strategies to improve patient outcomes.
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Evaluating the quality of medical care
DONABEDIAN, A. (2005) · The Milbank Quarterly · doi:10.1111/j.1468-0009.2005.00397.x · Cited by 6,102 · cited 6×
“Originally described as a framework for conceptualising the dimensions of health care practice, Donabedian (1966) postulated that each of these core dimensions was a necessary condition for the one that followed.”
BackgroundMethodInfluentialHospital Nurse Staffing and Patient Mortality, Nurse Burnout, and Job Dissatisfaction
Aiken, L. H. (2002) · JAMA · doi:10.1001/jama.288.16.1987 · Cited by 5,226
Effects of Hospital Care Environment on Patient Mortality and Nurse Outcomes
Aiken, L. H., Clarke, S. P., Sloane, D. M., Lake, E. T., & Cheney, T. (2008) · JONA: The Journal of Nursing Administration · doi:10.1097/01.nna.0000312773.42352.d7 · Cited by 860
Vogus, T. J., & Sutcliffe, K. M. (2007) · Medical Care · doi:10.1097/mlr.0b013e318053674f · Cited by 259
Research works printed but not linked: 102
- Aiken, 2000, Measuring organizational traits of hospitals: The Revised Nursing Work Index, Nursing Research, 49, 146, 10.1097/00006199-200005000-00006 · DOI · Paper page
- Aiken, 1997, Studying outcomes of organizational change in health services, Medical Care, 35, NS6
- Alexander, 1985, The fit between technology and structure as a predictor of performance on nursing units, Academy of Management Journal, 28, 844, 10.2307/256240 · DOI · Paper page
- Anderson, 1997, Proceedings 1997 Academy of Management Annual Meeting
- *Anderson, 2003, Nursing homes as complex adaptive systems, Nursing Research, 52, 12, 10.1097/00006199-200301000-00003 · DOI · Paper page
- Avolio, 2007, Promoting more integrative strategies for leadership theory-building, American Psychologist, 62, 25, 10.1037/0003-066X.62.1.25 · DOI · Paper page
- Avolio, 2004, Unlocking the mask: a look at the process by which authentic leaders impact follower attitudes and behaviours, Leadership Quarterly, 15, 801, 10.1016/j.leaqua.2004.09.003 · DOI · Paper page
- Bass, 1985, Leadership and Performance Beyond Expectations
- Bass, 1994, Improving Organizational Effectiveness Through Transformational Leadership
- Bass, 1995, Multifactor Leadership Questionnaire (MLQ): Sampler Set Manual
- Bass, 2000, Multifactor Leadership Questionnaire
- Bass, 1990, Bass and Stogdill's Handbook of Leadership: Theory, Research and Applications
- Blegen, 2011, Nurse staffing effects on patient outcomes: safety-net and non-safety-net hospitals, Medical Care, 49, 406, 10.1097/MLR.0b013e318202e129 · DOI · Paper page
- Bono, 2004, Personality and transformational and transactional leadership: a meta-analysis, Journal of Applied Psychology, 89, 901, 10.1037/0021-9010.89.5.901 · DOI · Paper page
- Bonoma, 1978, Executive Survival Manual
- Boyatzis, 2005, Resonant Leadership
- *Boyle, 2004, Nursing unit characteristics and patient outcomes, Nursing Economics, 22, 111
- Brady-Germain, 2010, The influence of nursing leadership on nurse performance: a systematic literature review, Journal of Nursing Management, 18, 425, 10.1111/j.1365-2834.2010.01100.x · DOI · Paper page
- *Capuano, 2005, Use of a validated model to evaluate the impact of the work environment on outcomes at a magnet hospital, Health Care Management Review, 30, 229, 10.1097/00004010-200507000-00007 · DOI
- *Castle, 2011, Top management leadership style and quality of care in nursing homes, Gerontologist, 51, 630, 10.1093/geront/gnr064 · DOI
- Cho, 2001, Nurse staffing and adverse patient outcomes: a systems approach, Nursing Outlook, 49, 78, 10.1067/mno.2001.114381 · DOI
- Cho, 2003, The effects of nurse staffing on adverse events, morbidity, mortality, and medical costs, Nursing Research, 52, 71Y79, 10.1097/00006199-200303000-00003 · DOI · Paper page
- Clarke, 2011, Nursing Outcomes: The State of the Science, 487
- Cowden, 2011, Leadership practices and staff nurses' intent to stay: a systematic review, Journal of Nursing Management, 19, 461, 10.1111/j.1365-2834.2011.01209.x · DOI · Paper page
- Cummings, 2004, Investing relational energy: the hallmark of resonant leadership, Canadian Journal of Nursing Leadership, 17, 76, 10.12927/cjnl.2004.17019 · DOI
- Cummings, 2003, The effects of hospital restructuring that included layoffs on individual nurses who remained employed: a systematic review, International Journal of Sociology & Social Policy, 8, 8, 10.1108/01443330310790633 · DOI
- Cummings, 2010a, Leadership styles and outcome patterns for the nursing workforce and work environment: a systematic review, International Journal of Nursing Studies, 47, 363, 10.1016/j.ijnurstu.2009.08.006 · DOI · Paper page
- *Cummings, 2010b, The contribution of hospital nursing leadership styles to 30-day patient mortality, Nursing Research, 59, 331, 10.1097/NNR.0b013e3181ed74d5 · DOI
- Doran, 2011, Nursing-Sensitive Outcomes, 1
- *Doran, 2004, Impact of the Manager's Span of Control on Leadership and Performance
- Dunham, 2000, Nurse executive transformational leadership found in participative organizations, Journal of Nursing Administration, 30, 241, 10.1097/00005110-200005000-00005 · DOI
- Estabrooks, 2003, Individual determinants of research utilization: a systematic review, Journal of Advanced Nursing, 43, 506, 10.1046/j.1365-2648.2003.02748.x · DOI · Paper page
- Estabrooks, 2005, The impact of hospital nursing characteristics on 30-day mortality, Nursing Research, 54, 74, 10.1097/00006199-200503000-00002 · DOI · Paper page
- Fine, 2009, Leading lean: a Canadian healthcare leader's guide, Healthcare Quarterly, 12, 32, 10.12927/hcq.2013.20877 · DOI
- Flynn, 2005, Organizational attributes valued by hospital, home care, and district nurses in the United States and New Zealand, Journal of Nursing Scholarship, 37, 67, 10.1111/j.1547-5069.2005.00005.x · DOI
- *Flynn, 2010, Effects of nursing practice environments on quality outcomes in nursing homes, Journal of the American Geriatrics Society, 58, 2401, 10.1111/j.1532-5415.2010.03162.x · DOI
- *Gardner, 2007, The relationships between nurses' perceptions of the hemodialysis unit work environment and nurse turnover, patient satisfaction, and hospitalizations, Nephrology Nursing Journal, 34, 271
- Gilmartin, 2007, Chapter 8: Leadership research in healthcare, The Academy of Management Annals, 1, 387, 10.5465/078559813 · doi:10.5465/078559813
- Ginsburg, 2005, An educational intervention to enhance nurse leaders' perceptions of patient safety culture, Health Services Research, 40, 997, 10.1111/j.1475-6773.2005.00401.x · DOI
- Goleman, 2002, The New Leaders: Transforming the Art of Leadership into the Science of Results
- Graen, 1995, Relationship-based approach to leadership: development of leader-member exchange (LMX) theory of leadership over 25 years: applying a multi-level multi-domain perspective, Leadership Quarterly, 6, 219, 10.1016/1048-9843(95)90036-5 · DOI · Paper page
- Hage, 1969, Routine technology, social structure, and organization goals, Administrative Science Quarterly, 14, 366, 10.2307/2391132 · DOI · Paper page
- *Hansen, 2011, Perceptions of hospital safety climate and incidence of readmission, Health Services Research, 46, 596, 10.1111/j.1475-6773.2010.01204.x · DOI
- *Havig, 2011, Leadership, staffing and quality of care in nursing homes, BMC Health Services Research, 11, 10.1186/1472-6963-11-327 · DOI
- *Houser, 2003, A model for evaluating the context of nursing care delivery, Journal of Nursing Administration, 33, 39, 10.1097/00005110-200301000-00008 · DOI
- Huston, 2008, Preparing nurse leaders for 2010, Journal of Nursing Management, 16, 905, 10.1111/j.1365-2834.2008.00942.x · DOI · Paper page
- Kane, 2007, The association of registered nurse staffing levels and patient outcomes: systematic review and meta-analysis, Medical Care, 45, 1195, 10.1097/MLR.0b013e3181468ca3 · DOI · Paper page
- Karasek, 1998, The Job Content Questionnaire (JCQ): an instrument for internationally comparative assessments of psychosocial job characteristics, Journal of Occupational Health Psychology, 3, 322, 10.1037/1076-8998.3.4.322 · DOI · Paper page
- Kirkevold, 2006, The quality of care in Norwegian nursing homes, Scandinavian Journal of Caring Sciences, 20, 177, 10.1111/j.1471-6712.2006.00396.x · DOI
- Kouzes, 1988, The Leadership Challenge: How to Get Extraordinary Things Done in Organizations
- Kouzes, 1995, The Leadership Challenge: How to Get Extraordinary Things Done in Organizations
- Kovner, 1998, Nurse staffing levels and adverse events following surgery in U.S. hospitals, Image: Journal of Nursing Scholarship, 30, 315
- *Kroposki, 2006, Correlation among client satisfaction, nursing perception of outcomes, and organizational variables, Home Healthcare Nurse, 24, 87, 10.1097/00004045-200602000-00006 · doi:10.1097/00004045-200602000-00006
- Lake, 2002, Development of the practice environment scale of the Nursing Work Index, Research in Nursing and Health, 25, 176, 10.1002/nur.10032 · DOI · Paper page
- Lake, 2006, Variations in nursing practice environments: relation to staffing and hospital characteristics, Nursing Research, 55, 1, 10.1097/00006199-200601000-00001 · DOI · Paper page
- Larrabee, 1995, Predictors of patient-perceived quality, Scandinavian Journal of Caring Sciences, 9, 153, 10.1111/j.1471-6712.1995.tb00406.x · DOI
- *Larrabee, 2004, Predictors of patient satisfaction with inpatient hospital nursing care, Research in Nursing and Health, 27, 254, 10.1002/nur.20021 · DOI · Paper page
- Laschinger, 2007, The impact of leader-member exchange quality, empowerment, and core self-evaluation on nurse manager's job satisfaction, The Journal of Nursing Administration, 37, 221, 10.1097/01.NNA.0000269746.63007.08 · DOI · Paper page
- Lee, 2008, Examining the relationship between director leadership practices and manager worklife and burnout, Journal of Leadership Studies, 2, 47, 10.1002/jls.20061 · DOI
- Lowe, 2005, Raising the bar for people practices: helping all health organizations become ‘preferred employers’, Healthcare Quarterly, 8, 60, 10.12927/hcq..16940 · doi:10.12927/hcq..16940
- MacPhee, 2010, Transforming work place relationships through shared decision making, Journal of Nursing Management, 18, 1016, 10.1111/j.1365-2834.2010.01122.x · DOI
- Mark, 1996, A theoretical model for nursing systems outcomes research, Nursing Administration Quarterly, 20, 12, 10.1097/00006216-199602040-00004 · DOI
- Mark, 2004, The role of theory in improving patient safety and quality health care, Nursing Outlook, 52, 11, 10.1016/j.outlook.2003.10.010 · doi:10.1016/j.outlook.2003.10.010
- McClelland, 1987, Human Motivation
- McCutcheon, 2009, Understanding nurse manager stress and work complexity: factors that make a difference, Nursing Leadership, 22, 48, 10.12927/cjnl.2009.21154 · DOI
- McGillis, 2003, Nurse staffing models as predictors of patient outcomes, Medical Care, 41, 1096, 10.1097/01.MLR.0000084180.07121.2B · DOI
- McGillis-Hall, 2007, Nurses' perceptions of hospital work environment, Journal of Nursing Management, 15, 264, 10.1111/j.1365-2834.2007.00676.x · DOI
- *McNeese-Smith, 1999, The relationship between managerial motivation, leadership, nurse outcomes and patient satisfaction, Journal of Organizational Behavior, 20, 243, 10.1002/(SICI)1099-1379(199903)20:2<243::AID-JOB888>3.0.CO;2-2 · doi:10.1002/(sici)1099-1379(199903)20:2<243::aid-job888>3.0.co;2-2
- Meterko, 1990, Patient judgments of hospital quality: report of a pilot study, Medical Care, 28, S1, 10.1097/00005650-199009001-00003 · doi:10.1097/00005650-199009001-00003
- Mitchell, 1997, Adverse outcomes and variations in organization of care delivery, Medical Care, 35, NS19, 10.1097/00005650-199711001-00003 · DOI · Paper page
- Needleman, 2002, Nurse-staffing levels and the quality of care in hospitals, New England Journal of Medicine, 346, 1715, 10.1056/NEJMsa012247 · DOI · Paper page
- Northouse, 2001, Leadership: Theory and Practice
- Page, 2004, Keeping Patients Safe Transforming the Work Environment of Nurses
- *Paquet, 2013, Psychosocial work environment and prediction of quality of care indicators in one Canadian health center, Worldviews on Evidence-Based Nursing, 10, 82, 10.1111/j.1741-6787.2012.00250.x · DOI
- Peterson, 2012, The relationship between authentic leadership and follower job performance: the mediating role of follower positivity in extreme contexts, The Leadership Quarterly, 23, 502, 10.1016/j.leaqua.2011.12.004 · DOI
- Polit, 2011, Nursing Research: Generating and Assessing Evidence for Nursing Practice
- *Pollack, 2003, Association of outcomes with organizational characteristics of neonatal intensive care units, Critical Care Medicine, 31, 1620, 10.1097/01.CCM.0000063302.76602.86 · DOI
- *Raup, 2008, The impact of ED nurse manager leadership style on staff nurse turnover and patient satisfaction in academic health center hospitals, Journal of Emergency Nursing, 34, 403, 10.1016/j.jen.2007.08.020 · DOI
- Roberts, 1974, Measuring organizational communication, Journal of Applied Psychology, 59, 321, 10.1037/h0036660 · DOI · Paper page
- Rubin, 1990, Patient judgments of hospital quality questionnaire, Medical Care, 28, 22, 10.1097/00005650-199009001-00007 · doi:10.1097/00005650-199009001-00007
- Sexton, 2000, Error, stress, and teamwork in medicine and aviation: cross sectional surveys, British Medical Journal, 320, 745, 10.1136/bmj.320.7237.745 · DOI · Paper page
- Sheridan, 1992, Ineffective staff, ineffective supervision, or ineffective administration? Why some nursing homes fail to provide adequate care, The Gerontologist, 32, 334, 10.1093/geront/32.3.334 · DOI
- Shortell, 2000, Health Care Management: Organization Design and Behavior
- Shortell, 1991, Organizational assessment in intensive care units (ICUs): construct development, reliability, and validity of the ICU nurse-physician questionnaire, Medical Care, 29, 709, 10.1097/00005650-199108000-00004 · DOI · Paper page
- Singer, 2009, Relationship of safety climate and safety performance in hospitals, Health Services Research, 44, 399, 10.1111/j.1475-6773.2008.00918.x · DOI · Paper page
- Stahl, 1986, Power Motivation
- *Taylor, 2012, Do nurse and patient injuries share common antecedents? An analysis of associations with safety climate and working conditions, BMJ Quality and Safety, 21, 101, 10.1136/bmjqs-2011-000082 · DOI
- Thomas-Hawkins, 2003, Staff nurses' perceptions of the work environment in freestanding hemodialysis facilities, Nephrology Nursing Journal, 30, 169
- Thompson, 2011, A relational leadership perspective on unit-level safety climate, Journal of Nursing Administration, 41, 479, 10.1097/NNA.0b013e3182346e31 · DOI
- Tourangeau, 2005, A theoretical model of the determinants of mortality, Advances in Nursing Science, 28, 58Y69, 10.1097/00012272-200501000-00007 · DOI
- Tourangeau, 2002, Nursing-related determinants of 30-day mortality for hospitalized patients, Canadian Journal of Nursing Research, 33, 71
- *Tourangeau, 2007, Impact of hospital nursing care on 30-day mortality for acute medical patients, Journal of Advanced Nursing, 57, 32, 10.1111/j.1365-2648.2006.04084.x · DOI · Paper page
- Tregunno, 2009, On the ball - leadership for patient safety and learning in critical care, Journal of Nursing Administration, 39, 334, 10.1097/NNA.0b013e3181ae9653 · DOI
- Vogus, 2007a, The Safety Organizing Scale: development and validation of a behavioral measure of safety culture in hospital nursing units, Medical Care, 45, 46, 10.1097/01.mlr.0000244635.61178.7a · DOI · Paper page
- Weick, 2001, Managing the Unexpected: Assuring High Performance in an Age of Complexity
- Westra, 1995, Development of the home care client satisfaction instrument, Public Health Nursing, 12, 393, 10.1111/j.1525-1446.1995.tb00168.x · doi:10.1111/j.1525-1446.1995.tb00168.x
- Wong, 2007, The relationship between nursing leadership and patient outcomes: a systematic review, Journal of Nursing Management, 15, 508, 10.1111/j.1365-2834.2007.00723.x · DOI · Paper page
- Wong, 2009, Authentic leadership: a new theory for nursing or back to basics?, Journal of Health Organization and Management, 23, 522, 10.1108/14777260910984014 · DOI
- Wong, 2010, Decisional involvement of senior nurse leaders in Canadian acute care hospitals, Journal of Nursing Management, 18, 122, 10.1111/j.1365-2834.2010.01053.x · doi:10.1111/j.1365-2834.2010.01053.x
- Xin, 2003, Supervisor-subordinate conflict and perceptions of leadership behaviour: a field study, The Leadership Quarterly, 14, 25, 10.1016/S1048-9843(02)00185-6 · DOI
- Young-Ritchie, 2009, The effects of emotionally intelligent leadership behaviour on emergency staff nurses' workplace empowerment and organizational commitment, Nursing Leadership, 22, 70, 10.12927/cjnl.2009.20614 · DOI
- Yukl, 2006, Leadership in Organizations
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Metadata
- Authors
- Wong, C. A., Cummings, G. G., & Ducharme, L.
- Venue
- Journal of Nursing Management
- Publisher
- Hindawi Limited
- Published
- 2013-07
- Volume
- 21
- Issue
- 5
- Pages
- 709-724
- ISSN
- 0966-0429 (ISSN-L)
- OpenAlex
- W2148111600
- Cited by
- 846
- References
- 4
- FWCI
- 9.91
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- doi.wiley.com/10.1002/tdm_license_1.1 (tdm)
- onlinelibrary.wiley.com/termsAndConditions#vor (vor, 17 d)
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