Annotated bibliography - Nursing and Leadership styles
The health care climate today is extremely challenging even for skilled nurses with strong, different styles of leadership as they relate to health care and nursing. Looking at ways in which different leadership styles have a positive or negative influence on a variety of factors, can assist nurse leaders in moving forward toward organizational goals. The purpose of this annotated bibliography is to read three peer reviewed scholarly articles on nursing leadership, and critically analyze each article in the areas of comprehension, application, analysis, and evaluation as it related to this course.
McCay, R., Lyles, A. A., & Larkey, L. (2018). Nurse leadership style, nurse satisfaction, and patient satisfaction: A systemic review. Journal of Nursing Care Quality, 33(4), 361-367. https://doi.org/10.1097/NCQ.0000000000000317
The article by McCay, Lyles, & Larkey (2018) was a literature search that was decreased to the use of 14 cross sectional articles on using the three outcomes headings of: staff outcomes, organizational outcomes, and patient outcomes. The articles were from different organizational settings and on different continents. The constant theme of the articles showed that positive leadership styles that were in the relational model realm yield positive outcomes with nurses. The articles all seemed to lack specifics regarding patient satisfaction.
In the course materials I have read and listened to so far, it is evident to me that leadership styles that are more democratic in nature, and include all stake holders are the ones that seem to work the best. When your stake holders all have a say in the process, they are bound to want an organization to have a positive outcome. Northouse (2018) brings up many universal positive leadership traits, and through out several chapters related to how they positively influence followers.
The article notes some common strengths and weakness of the articles reviewed. “The most common weakness noted in th 14 studies were related to sampling and design” (McCay et al. 2018, p. 364). Many of the article had samplings of convenience and probability sampling, this could account for some bias in the literature. Many 0f the articles reviewed, ten in total had a strength of using a theoretical framework to guide their sudy. “Using the GRADE (Grading of Recommendation) system for reviewing evidence” (McCay et al. 2018, p. 364). Using a consistent framework across articles makes them more credible in their research. The analysis found that leaders that used positive styles had better nurse satisfaction. My personal analysis of this literature review is that I agree it is a necessary key objective to utilize positive leadership styles to gain satisfaction among nurses, and patients.
It is important to review leadership styles and what their impact is on nurse and patient satisfaction in order to meet the continuous, and often tumultuous landscape of health care in today’s world. Through examining how different style, personalities, traits, and tasks influence nursing factors we can better reach our goals in our organizations.
Moon, S. E., Van Dam, P. J., & Kitos, A. (2019). Measuring transformational leadership in establishing nursing care excellence. Healthcare (4), 1-11. https://dio.org/10.3390/healthcare7040132
This article looked at nurse managers who self-reported a transformational leadership style, and how it impacted the ability to establish excellent nursing care. The research took place in Australia, and looked at how nurse managers who utilized this specific leadership style were able to influence magnet recognition within hospitals. Transformational leadership styles showed higher nurse job satisfaction, higher nurse retention, and better patient outcomes to name a few areas.
Nurse leaders that lead by example and allow their followers to have a say in the goals of the organization have been shown to have more positive outcomes with staff. The lecture models, and readings from the course thus far have shown supporting evidence, and examples that leaders with transformational styles have more positive outcomes then dictator or hands-off leadership styles. Northouse (2018) gives many examples of transformational leaders who have overcome adversity, using positive personality traits and characteristics that have influenced many lives and gone on to conquer great things.
Magnet recognition is a status that shows that excellent nursing care has been achieved at an institution. It tells patients who may come to your institution that there is a high level of patient care. In this study seventy-eight nurse managers were chosen as the final group, and they voluntarily answered a survey to measure leadership styles. The Multifactor Leadership Questionnaire Form 6S (MLQ-6S) was used for the survey. “Significant association was found between nurse managers education and differences in the intellectual stimulation scores, which overall increased with a higher qualification” (Moon, et al. 2019, p.11). One of the major weakness the study identified was that just because nurse managers identified themselves has having high intellectual levels, and transformational leadership styles, there was no way to prove their actions met their personal identifications. The study makes the conclusion that leaders who are transformational, and work in an environment where nursing excellence is upheld have better staff and patient outcomes.
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From a subjective standpoint, I can see a self-reported survey having many limitations. Even using a researched, and accepted questionnaire there are limitations to self-reporting from leaders. Sometimes people think they act in a certain way, but their feelings about how they carry out their leadership skills may not be shared by their staff.
Magnet status has become a goal for health care institutions who want to show patients that they are committed to nursing excellence. “The impact of transformational leadership is recognized by the American Nurses Credentialing Center (ANCC) through the Magnet Recognition Program” (Moon, et al. 2019, p. 1). I feel it will continue to be importance for nursing to continue to investigate the types of leadership styles that further positive nursing outcomes for the future.
Sfantou, D. F., Laliotis, A., Patelarou, A. E., Sifaki-Pistolla, D., Matalliotakis, M., & Patelarou, E. (2017). Imporatnce of leadership style towards quality of care measures in healthcare settings: A systemic review. Healthcare, 5(73). https://doi.org/10.3390/healthcare5040073
This review summarized a total of eighteen different studies on leadership style and how those styles related to quality of care measures in a variety of different healthcare settings.
The article makes the conclusion that democratic or transformational leadership styles have more positive outcomes of quality of care measures. Transactional leadership styles tend to have negative or weak outcomes for healthcare settings. Many of the past two weeks course material have pointed toward these findings. In Northouse (2018), some of histories most influential leaders had strong transformational leadership styles.
As in Moon, et al., 2019, this analysis of the literature from major date bases found the most commonly used tool was the Multifactor Leadership Questionnaire, MLQ. Safantou, et al. (2019) found that the main quality of care measures that had positive outcomes with a transformational or similar type leadership style were improvement of direct healthcare services, and a more positive organizational culture. In contrast, a leadership style such as transactional, or even laissez-faire, had a negative effect on patient outcomes, and organizational culture.
From my personal standpoint, I was not surprised by the findings of the literate review. The major question that the review asked was: “Which is the relationship between styles of leadership in healthcare settings and quality of care?” (Safantou, et al. 2019, p.2). Having worked on patient outcomes committees at the hospital for falls, restrains, and sepsis in Intensive Care Unit, I have seen first hand how leadership styles can influence both nursing job satisfaction, and quality patient outcomes.
I see the value of this review being the importance to groom young nurses, and seasoned nurses’ leaders alike to learn and embody the traits of positive leaders. The implication to continue to research and review leadership style in the literature and the direct correlation to nursing, patient, and organizational outcomes is important for the future of nursing.
To summarize Huber (2018), healthcare is rapidly changing, and the relationship between leadership skills for nurses and the future of healthcare are intimately connected. As we continue to study leadership, and the impact different styles have on nursing, we can continue to improve the healthcare settings in which we work. I feel it is important to note that leadership is not a linear line with an end, it is a back and forth continuum. As our complex healthcare system continues to grow, and change, so will our need to continue this important work of studying leadership and how it relates to our nursing practice.
- Huber, D. L. (2018). Leadership and management nursing care management. (6th ed.). Elsevier.
- McCay, R., Lyles, A. A., & Larkey, L. (2018). Nurse leadership style, nurse satisfaction, and patient satisfaction: A systemic review. Journal of Nursing Care Quality, 33(4), 361-367. https://doi.org/10.1097/NCQ.0000000000000317
- Moon, S. E., Van Dam, P. J., & Kitos, A. (2019). Measuring transformational leadership in establishing nursing care excellence. Healthcare (4), 1-11. https://dio.org/10.3390/healthcare7040132
- Northhouse, P. G. (2018). Introduction to leadership. Concepts and practice. (4th ed.). Sage Publications, Inc.
- Sfantou, D. F., Laliotis, A., Patelarou, A. E., Sifaki-Pistolla, D., Matalliotakis, M., & Patelarou, E. (2017). Imporatnce of leadership style towards quality of care measures in healthcare settings: A systemic review. Healthcare, 5(73). https://doi.org/10.3390/healthcare5040073
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