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This study aims to appraise and synthesize evidence examining the effects of toxic leadership on the nursing workforce and patient safety outcomes.

This is a systematic review in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. Five electronic databases (SCOPUS, PubMed, Web of Science, CINAHL and Psych INFO) were searched to identify relevant articles. Two independent researchers conducted the data extraction and appraisal. A content analysis was used to identify toxic leadership outcomes.

The initial literature search identified 376 articles, 16 of which were deemed relevant to the final review. Results of the content analysis identified 31 outcomes, which were clustered into five themes: satisfaction with work; relationship with organization; psychological state and well-being; productivity and performance; and patient safety outcomes. Seven mediators between toxic leadership and five outcomes were identified in the included studies.

Organizational strategies to improve outcomes in the nursing workforce should involve measures to build and develop positive leadership and prevent toxic behaviors among nurse managers through theory-driven strategies, human resource management efforts and relevant policy.

The review findings have provided modest evidence suggesting that working under a leader who exhibits toxic behaviors may have adverse consequences in the nursing workforce; however, more research examining if this leadership style influences patient safety and care outcomes is warranted.

Residents in under-resourced/high-Medicaid (85% or higher) nursing homes on average receive care from relatively lower quality providers and have worse health outcomes, which may increase the risk of higher COVID-19 incidence. This study aims to evaluate if having a culture that encourages employee empowerment results in better quality (lower COVID-19 deaths) in times of crisis, such as the current pandemic. The study combined primary survey data from 391 Directors of Nursing (response rate of 37%), with Centers for Medicare and Medicaid Services’ (CMS) Nursing Home COVID-19 Public File, LTCFocus, Area Health Resource File, and Nursing Home Compare. The dependent variable consisted of the number of COVID-19 death as of November 25, 2021. The independent variables consisted of Likert scale for employee empowerment (Cronbach alpha= 0.82). Control variables consisted of organizational factors (e.g., size, location, and ownership), as well as community factors (e.g., poverty, unemployment, and competition). The results indicated that one unit increase in employee empowerment was associated with 6% lower likelihood of having COVID-19 deaths. Nursing homes, particularly those under-resourced, face difficulty improving the quality of care due to financial constraints. However, the results suggest that adopting a culture that fosters employee empowerment may give nursing homes an edge in improving quality outcomes in crises.

This study aims to analyze the structure of publications on transformational leadership in nursing and determine its evolution process through a bibliometric analysis.

It is a descriptive bibliometric study. Data were collected on October 24, 2022, from the Web of Science and analyzed using Excel, VOSviewer, HistCite and Bibliometrix R programs.

A total of 348 studies conducted by 962 authors and published between 1990 and 2021 were included. It was found that 84.5% of these publications were original articles and 97.7% were published in English. The studies are from 82 different journals and were carried out by researchers from 43 countries. The most productive country was the USA (n = 151).

Only one database was used to search for studies. The searches were limited to the nursing category, and only studies published up to 2021 were included. Another important point is that, although there were no language limitations for the field literature search, English keywords were used; thus, the search can be considered semi-limited. It is believed that more comprehensive search strategies may generate different findings.

Two main themes were identified as the studies carried out in the field of transformational leadership in nursing, generally, directly or indirectly addressed the effects of this style of leadership either on nurses’ performance/job satisfaction or on quality care/patient safety; however, a gap was observed in the literature in the area of nursing education. Researchers can be inspired by the results of the present study, by learning about the focus of published research on transformational leadership, which will encourage them to plan new studies to improve nursing education, nursing care, nursing management and working conditions of nurses. Through the results of this study, it is also possible to learn about countries and researchers for possible collaborations in future studies.

Nurses are one the essential health-care providers within society, seeking the employment of authentic leadership approaches to reduce the burnout and stressors established within the emergency departments. Burnout has been vitally documented as a psychological impulse that emerges due to the prevalence of chronic job stressors. Authentic leadership approaches will act as an affirmative organizational resource that could help to minimize burnout in the work environments. Therefore, this study aims to evaluate the role of authentic leadership in stress and burnout among nurses in emergency departments.

This study used a quantitative, cross-sectional design. A package of surveys was distributed to nurses working in emergency departments using standardized questionnaires that measured the study variables. A total of 188 nurses participated in the study. SPSS was used to analyze data.

The study’s results supported the hypotheses and found that authentic leadership significantly and negatively influenced nurses’ job stress R = –0.169, p = 0.0205. Also, the results of this study found that the relationship between authentic leadership and burnout was significant and negative R = –0.245, F (1,186) = 11.8, p = 0.0007.

Nurse leaders can introduce flexible working hours and develop coordination and cooperation among nurses, and management of the hospitals needs to focus on improving the structure and enhancing nurses’ outcomes that could affect patients’ and organizations’ outcomes.

The present study aims to analyze the effect of workplace incivility and coworker deviant behavior on turnover intentions and nurses' job performance.

Data were obtained from 318 nurses using a structured questionnaire. The multistage sampling technique was used to distribute the questionnaire and analysis was performed through structural equation modeling.

The findings show association between workplace incivility and coworker deviant behavior on turnover intentions and nurses' job performance. Further, the findings state that coworker deviant behavior has impact on turnover intentions and nurses' job performance.

Results of the study show critical situation for healthcare sector. Findings show that negative behaviors influence nurses' performance and escalate their intentions to leave this profession. These findings can help authorities to take some actions and use interventions to suppress or control these negative behaviors to improve the nursing performance at workplace.

The nursing literature is devoid of evidence about how workplace incivility and coworker deviant behavior influence employee outcomes.

The purpose of this research paper is to study the effect of transformational leadership (TL) and job crafting (JC) on nurses’ innovative work behaviors (IWB) while accounting for the mediating effect of psychological empowerment (PsyEmp).

To test the developed hypotheses quantitatively, two statistical methods were used: structural equation modeling via partial least squares and bootstrapping estimation. The survey elicited responses from 270 nurses, but after data screening, only 168 were used. Confirmatory factor analysis was used to establish the distinctness of the variables used in this study.

Findings indicate that there are a positive influence of both TL and JC on PsyEmp. Additionally, the findings show a beneficial effect of PsyEmp as a mediator between TL, JC and IWB.

This study adds to the body of knowledge by demonstrating the effects of nurse TL and JC on nurses’ PsyEmp and IWB. In addition to the role of PsyEmp as a partial mediator in the relationship between TL, JC and IWB. The research novelty resides in the fact that none of these links has before been studied in the context of Iraq.

This systematic review aims to examine integrating innovative work behavior through transformational leadership in the Saudi healthcare sector. A thorough literature research was carried out to address this problem.

A total of 50 papers reporting research on innovative work behavior, healthcare organizational performance and transformational leadership were included in the review.

As employees are motivated and developed, their innovative work behaviors are boosted, which improves organizational performance. It can be concluded that innovative work behavior and transformational leadership are correlated. The capacity of a healthcare company to create and execute benefits to the employees may assure service delivery efficiency in employees' performance.

This systematic review will allow contemporary advancements, efficient health status monitoring and reliable solutions that aid optimal, equal and effective treatment in Saudi’s healthcare industry.

In an innovative workplace, workers may pitch fresh ideas to their management. Hence, employees see their employer as more transformational.

Recent advancements in the field of organizational psychology have transformed the employees’ perceptions related to the reactions of the employment relationship. The main aim of the study is to explore the consequences of psychological contracts among the nursing staff and how to provide better patient care and quality service in the health-care system as nurses play a pivotal role in the context of Pakistan. Significantly, this study attempts to bridge the research gap by exploring consequences of psychological contracts. Drawing on the social exchange theory, this study examined the psychological contracts of nurses and their reactions to the perceived violation.

This research adopted a qualitative method and was based on an exploratory approach. Data were collected through in-depth semi-structured interviews from 21 nurses working in public, private and charity hospitals in Karachi, Pakistan. The thematic content analysis is employed for the analysis of data by using NVivo software.

The study identified the relational and transactional elements related to the psychological contract of nurses who predominantly consisted of supervisor support, autonomy, tangible/intangible rewards and trust. The intrinsic motivation which relates to their devotion to work was found as an additional element to balance their psychological contract. This research also establishes that the psychological contract of nurses is being violated in their work settings.

By highlighting the importance of psychological contract breach, the findings demonstrate that health-care institutions should take measures to cope with psychological contract breach issues at the workplace.

This study contributes to the body of knowledge by exploring psychological contract breach. Substantially, there are rare studies conducted on psychological contract breach among nurses in developing country context (Pakistan). However, this study adds to the previous studies related to the psychological contract of nurses in the context of Pakistan by using social exchange theories. Finally, this study enables the management of healthcare to balance the psychological contract issues effectively.

The authors examine how physician staffing, human capital and knowledge spillovers are related to multiple dimensions of hospital operational and financial performance at the organizational level.

The authors use a data set assembled from multiple sources for more than 1,300 US hospitals and employ hierarchical linear regression to test this study’s hypotheses. The authors use multiple quality, efficiency and financial measures of performance for these hospitals.

The authors find that higher levels of staffing, skills and knowledge spillovers associated with physicians were positively associated with multiple dimensions of hospital performance. The authors find linear and nonlinear relationships between experience and performance, with the relationships primarily negative, and nonlinear relationships between spillovers and quality performance.

Hospital managers should consider increasing physician staffing levels if possible. In addition, the overall Final MIPS Score from the Centers for Medicare and Medicaid Services might be included as a factor in determining which physicians practice in a hospital. Finally, if possible, encouraging physicians to practice at multiple hospitals will likely be beneficial to hospital performance.

This study’s findings are original in that they explore how physician-specific staffing and human capital, which have received comparatively little attention in the literature, are related to several different dimensions of hospital-level operational and financial performance. To the best of the authors’ knowledge, this paper is also the first to examine the relationship between the construct of physician knowledge spillovers and hospital-level operational and financial performance.

This paper aims to explore the role of retention strategies and psychological contract (PC) factors in private hospitals.

The current study is an empirical research. The study was conducted by receiving responses from a sample size of 190 respondents who participated in the Doctors and Nurses’ survey.

The study results show the relationship between PC and the retention strategies of employees in hospitals. The research found that employees try to be committed to the hospital due to the image of the hospital and career development opportunities. Creating a sense of commitment among the employees towards their job and organisation, making to feel pride in the job, creating an attitude among the employees, a willingness to advocate the benefits and advantages and satisfaction among the employee towards the job and organisation.

With a population of more than one million employees (Doctors and Nurses) in the Indian health-care sector, the sample needs to be more adequate. However, these limitations present scope for future studies on this topic bearing on the aspiration for generalisation of the findings on the entire population.

The study has strong practical implications in strengthening the relationships by identifying the factors of PC and influencing the retention strategies of health-care professionals in the hospital.

This research explores the changing dynamics of the Indian health-care sector. Health-care professionals may perceive and react differently to the retention strategies and policies of the HR system in the health-care sector and have more expectations of PC fulfilment that enhance their capability to use professional skills and resources in the realisation of their organisational goals.