Nurses Perception of Leadership and Impact of Healthcare Changes

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Table of Contents

Background
Support of Nursing Practice Issue
Method of Study
Results of Study
Outcomes Comparison
References

Background

In their study, Zaheer et al. (2021) set the objective of examining the relationships, both direct and moderated, between nurses’ perceptions of senior leadership, the leadership of the supervisors, teamwork within their practice settings, intentions of turnover, and self-reported measures of patient safety. Gathering evidence on the above-mentioned contextual factors, such as the support of nursing leaders for teamwork, and outcomes such as patient safety, could add to the extended body of research on the importance of context and relationships within teams in influencing the practices of safety and quality.

Liu et al.’s (2020) research aimed to compare the changes in care quality, the outcomes of nurses’ work, non-professional tasks, the environment, and nursing care left unfinished in the context of Guangzhou’s acute care hospitals. In addition, the researchers wanted to identify the connection between the changes in nurses’ environments, non-nursing-related tasks, and nursing care left unfinished with work outcomes and the quality of care provided at healthcare facilities.

Support of Nursing Practice Issue

The current PICO question is “How implementation of burnout management tools within health organization would affect nurse turnover rates compared to existing retention strategies?” Both articles support the identified practice issue related to the effects of burnout management tools on nurses’ rates of turnover. For example, Zaheer et al. (2021) suggested that although some turnover of employees is to be expected, the safe functioning of healthcare institutions is threatened by unfavorable environments that contribute to high rates of turnover. Notably, at healthcare organizations where nurse turnover is high, there is an increased risk for the well-being and safety of patients. Specifically, healthcare-related infections, rehospitalizations, and medical errors are more likely to take place in the context of high rates of nurses’ turnover. In turn, when nurses’ turnover is low, medication errors, patient falls, and other adverse events are less likely to occur.

These findings are supported by Liu et al. (2020), who suggested that healthcare organizations with better environments and processes of healthcare provision have a better quality of healthcare and nurse profession outcomes. Importantly, when the environments for work are overall positive, this means that there will be fewer reports regarding nurse job dissatisfaction, less burnout, lower intentions to leave, but improved quality of care and enhanced patient safety. Nurses’ responsibilities are more likely to be completed when there are fewer non-professional tasks on which providers waste their time and energy. Nurses who are overloaded with functions that are not related to patient care are more likely to be dissatisfied and consider leaving their positions. The interventions in the articles are relevant to the identified PICOT question as they test the impact of improved healthcare environments on the attitudes and effectiveness of personnel.

Method of Study

Zaheer et al. (2021) implemented a mixed-method study, collecting cross-sectional survey data from nurses and non-physician health professionals. Besides, nurses were asked to participate in semi-structured interviews, with the data collected from them also being used for analysis. The quantitative survey data and qualitative data from semi-structured interviews were collected in a single-stage concurrently while their analyses occurred separately. At the discussion stage, the mixing of qualitative and quantitative findings from the data occurred. The data was gathered in the context of the large community hospital in Southern Ontario offering different specialty services ranging from cancer care to mental health care. On the bright side, the method is advantageous for merging the benefits of both qualitative and quantitative characteristics. On the downside, the method is highly complex, and limitations can be found in results interpretation.

Liu et al. (2020) carried out a prospective two-stage study in the context of a healthcare facility located in Guangdong province, China, during a prolonged time period. For instance, in 2014, the research team conducted surveys involving 111 units from 23 facilities, which resulted in data from 1,582 nurses and 1,330 patients (Liu et al., 2020). In 2018, the study was replicated involving 108 units at the same hospitals, resulting in 1,530 nurses and 1,291 patients participating (Liu et al., 2020). The data was used to explore nursing work environments, nurse job outcomes, quality of care, and so on. The benefit of the method used in the study entails the possibility to get exposure to time-specific data to get a more complete picture. However, the follow-up period is long, which means that the researchers could miss some data, especially since it was self-reported by nurses and patients.

Results of Study

From the hierarchical regression analysis, Zaheer et al. (2021) found that nurses’ perceptions of senior leadership, teamwork, and turnover intention were significantly associated with overall patient safety indicators. It was also found that the significant interrelationship between the interactive effect of turnover intention and teamwork influenced the overall safety of patients. It is also important to mention that the findings of qualitative analysis corroborated the results of quantitative surveys while also allowing to broaden the characteristics of the study’s main concepts. However, some statistical relationships were found to be insignificant. Namely, the interviewed nurses perceived the safety-associated responsibilities of frontline supervisors much more broadly in contrast with the narrow conceptualization included in the study.

From the study conducted by Liu et al. (2020), it was found that the nursing work environment in the studied setting had improved between 2014 and 2018, contributing to the reduction of non-professional workloads. Even though the average number of nursing care tasks left unfinished had increased over the years, the improvement in environments contributed to nurses’ increased satisfaction with their jobs and decreased intentions to leave. As a result of improved work environments at facilities, nurses tend to show better outcomes of care and its quality. Fewer cases of nursing care left unfinished were shown to be associated with better quality of patient care, while units, where professionals experienced less burnout and dissatisfaction, were more likely to show the high quality of patient care. The implications of the studies suggest that in order for nurse turnover rates to improve and for professionals to remain in their positions, significant improvements in their environments are needed.

Outcomes Comparison

Drawing from the findings, the anticipated finding of the PICOT question is that burnout management tools implemented within healthcare settings will significantly improve nurses’ turnover and improve retention rates. Such anticipated findings align with the studies by Liu et al. (2020) and Zaheer et al. (2021) as both of them point to the importance of addressing the setting and environment within a healthcare context to facilitate a better quality of care for patients. Nurses who feel that their needs are considered and nurtured are less likely to get burnout and engage in turnover.

References

Liu, X., Liu, J., Liu, K., Baggs, J. G., Wang, J., Zheng, J., … You, L. (2021). Association of changes in nursing work environment, non-professional tasks, and nursing care left undone with nurse job outcomes and quality of care: A panel study. International Journal of Nursing Studies, 115(2021), 103860.

Zaheer, S., Ginsburg, L., Wong, H. J., Thomson, K., Bain, L., & Wuffhart, Z. (2021). Acute care nurses’ perceptions of leadership, teamwork, turnover intention and patient safety – A mixed methods study.BMC Nursing, 20(134), 1-14.

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Nurses Perception of Leadership and Impact of Healthcare Changes

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