Leadership Best Practice Guidelines: Every Nurse a Leader

Purdy, Nancy

Tuesday, 23 July 2013: 11:05 AM

Nancy Purdy, RN, PhD
Daphne Cockwell School of Nursing, Ryerson University, Toronto, ON, Canada
Pamela M. Pogue, RN, MSc, ACNP, CCN, (C)
Mississauga, ON, Canada
Althea Stewart-Pyne, RN, MHSc
International Affairs and Best Practice Guidelines Programs, Registered Nurses' Association of Ontario, Toronto, ON, Canada
Wendy Gifford, RN, PhD
Research Department, Saint Elizabeth, Markham, ON, Canada
Nancy Lefebre, RN, BScN, MScN
Saint Elizabeth Health Care, Markham, ON, Canada
Allison W. Patrick, RN, PhD
College of Nurses of Ontario, Toronto, ON, Canada

Learning Objective 1: Discuss the evidence and framework for leadership practices that support healthy work environments and quality outcomes for patients, nurses, organizations and the healthcare system.

Learning Objective 2: Demonstrate application of the leadership best practice guideline (BPG) at the level of the organization, front line manager and point-of-care nurse.

Purpose: There has been a significant body of international research published in the last seven years examining nursing leadership. Under the auspices of the Registered Nurses Association of Ontario (Canada), a panel of experts conducted a systematic review of the literature to update the current best practice guideline (BPG) “Developing and Sustaining Nursing Leadership” and to identify new evidence and trends in nursing leadership.

Methods: The literature search was conducted using Medline, CINAHL, Embase, PsychInfo and Cochrane databases. Research publications of studies using qualitative and quantitative designs including systematic reviews, meta-analyses and meta-syntheses published between 2005 and 2011 were included. Theses and dissertations, grey literature, non-research publications and non-English materials were excluded from the review. A total of 1003 abstracts were obtained and screened for inclusion/exclusion by a master’s-prepared Research Assistant. From this search, 292 articles were retrieved and data was extracted from 51 full-text articles.

Results: Based on the findings, there remains an evidence base to support transformational leadership practices for leaders in formal roles such as first line managers and senior-level administrators, but there was also an emerging body of knowledge to describe leadership for nurses at the point-of-care. While many of the leadership behaviours remain consistent across roles, the goals vary.

Conclusion: Developing nursing leadership at all levels of the health care system is becoming increasingly important as complexity increases and resources become more constrained. The revised conceptual model for Developing and Sustaining Nursing Leadership, with associated competencies and behaviours, is an evidence-based tool to assist individuals and organizations in leadership development strategies. Continued research is needed to measure the impact of point-of-care leadership behaviours on nurse-led quality improvement and other initiatives to improve patient care.

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