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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.
Abstract
Purpose
This study aims to appraise and synthesize evidence examining the effects of toxic leadership on the nursing workforce and patient safety outcomes.
Design/methodology/approach
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.
Findings
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.
Practical implications
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.
Originality/value
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.
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Maureen Nokuthula Sibiya, Thembelihle Sylvia Patience Ngxongo and Somavathy Yvonne Beepat
The purpose of this paper is to explore the influence of peer mentoring on critical care nursing students’ learning outcomes in critical care units.
Abstract
Purpose
The purpose of this paper is to explore the influence of peer mentoring on critical care nursing students’ learning outcomes in critical care units.
Design/methodology/approach
A qualitative exploratory research design was used to conduct the study. Ten critical care nursing students were recruited from critical care units in the five private and two public hospitals. Descriptions of their experiences were gained through individual face-to-face interviews.
Findings
The study reinforces peer mentoring as a vital strategy in helping the critical care nursing students to attain their learning outcomes. However, peer mentoring was not consistent in all hospitals and there were no structured support systems to ensure that peer mentoring was formalized. Making peer mentoring a vital component in the registered nurses core competencies would enable efficiency and guarantee the viability of peer mentoring.
Research limitations/implications
Mentors for the critical care nursing students were not included in the study.
Practical implications
The study identified a need for incorporating a formalized mentorship programme into the core competencies of all qualified critical care nurses, the unit mentor to familiarise themselves with the prescribed learning objectives of the critical care nursing student and an allocation of supernumerary time for the critical care nursing student and mentors to allow for formal mentoring responsibilities to take place.
Originality/value
The study reinforces peer mentoring as a vital strategy in helping the critical care nursing students to attain their learning outcomes and conscietises registered nurses of their responsibility as mentors.
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Muhammad Shakil Ahmad, Massimiliano Barattucci, Thurasamy Ramayah, Tiziana Ramaci and Narmeen Khalid
Referring to the theory of organizational empowerment, the purpose of this study is to examine the relationship of organizational support and perceived environment on quality of…
Abstract
Purpose
Referring to the theory of organizational empowerment, the purpose of this study is to examine the relationship of organizational support and perceived environment on quality of care and job satisfaction, with organizational commitment as a mediator for the first variable.
Design/methodology/approach
This study employed a cross-sectional research design and data was collected from seven private and public sector hospitals in Pakistan, involving 352 nurses on a voluntary basis through a self-administered survey.
Findings
The results showed that organizational commitment mediates the relationship between organizational support and job satisfaction with the quality of care. Moreover, the perceived environment has an impact on job satisfaction and quality of care.
Originality/value
Healthcare service quality seems strictly dependent on the perceived quality of care and job satisfaction among healthcare workers. Theoretical and practical implications for policymakers and HR management are discussed.
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Nick Zonneveld, Carina Pittens and Mirella Minkman
The purpose of this paper is to synthesize the existing evidence on leadership that best matches nursing home care, with a focus on behaviors, effects and influencing factors.
Abstract
Purpose
The purpose of this paper is to synthesize the existing evidence on leadership that best matches nursing home care, with a focus on behaviors, effects and influencing factors.
Design/methodology/approach
A narrative review was performed in three steps: the establishment of scope, systematic search in five databases and assessment and analysis of the literature identified.
Findings
A total of 44 articles were included in the review. The results of the study imply that a stronger focus on leadership behaviors related to the specific context rather than leadership styles could be of added value in nursing home care.
Research limitations/implications
Only articles applicable to nursing home care were included. The definition of “nursing home care” may differ between countries. This study only focused on the academic literature. Future research should focus on strategies and methods for the translation of leadership into behavior in practice.
Practical implications
A broader and more conceptual perspective on leadership in nursing homes – in which leadership is seen as an attribute of all employees and enacted in multiple layers of the organization – could support leadership practice.
Originality/value
Leadership is considered an important element in the delivery of good quality nursing home care. This study provides insight into leadership behaviors and influencing contextual factors specifically in nursing homes.
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This ethnographic revisit of a general hospital aims to critically explore and describe the mechanisms of corporate culture change and how institutional excellence is facilitated…
Abstract
Purpose
This ethnographic revisit of a general hospital aims to critically explore and describe the mechanisms of corporate culture change and how institutional excellence is facilitated and constrained by everyday management practices between 1996/1997 and 2014/2015.
Design/methodology/approach
A five-month field study of day-to-day life in the hospital's nursing division was conducted by means of an ethnographic revisit, using participant-observation, semi-structured interviews, free conversations and documentary material.
Findings
Using labour process analysis with ethnographic data from a general hospital, the corporate culture is represented as faceted, complex and sophisticated, lending little support to the managerial claims that if corporate objectives are realised, they are achieved through some combination of shared values, beliefs and managerial practices. The findings tend to support the critical view in labour process writing that modern managerial initiatives lead to tightened corporate control, advanced employee subjection and extensive effort intensification. The findings demonstrate the way in which the nursing employees enthusiastically embrace many aspects of the managerial message and yet, at the same time, still remain suspicious and distance themselves from it through misbehaviour and adaptation, and, in some cases, use the rhetoric against management for their own ends.
Practical implications
What are the implications for clinical and managerial practitioners? The recommendations are to (1) develop managerial practitioners who are capable of managing change combined with the professional autonomy of clinical practitioners, (2) take care to practise what you preach in clinical and managerial reality, as commitment, consent, compliance and difference of opinion are signs of a healthy corporate culture and (3) consider the implications between social structures and human actions with different work behaviours on different levels involved.
Originality/value
This ethnographic revisit considers data from a labour process analysis of corporate culture change in a general hospital and revisits the ways in which contradictory expectations and pressures are experienced by nursing employees and management practitioners spread 17 years apart.
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This systematic review aims to examine integrating innovative work behavior through transformational leadership in the Saudi healthcare sector. A thorough literature research was…
Abstract
Purpose
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.
Design/methodology/approach
A total of 50 papers reporting research on innovative work behavior, healthcare organizational performance and transformational leadership were included in the review.
Findings
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.
Practical implications
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.
Originality/value
In an innovative workplace, workers may pitch fresh ideas to their management. Hence, employees see their employer as more transformational.
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Malin Rosell Magerøy and Siri Wiig
The purpose of this study is to increase knowledge and understanding of the relationship between full-time-culture and the outcome for quality and safety of care.
Abstract
Purpose
The purpose of this study is to increase knowledge and understanding of the relationship between full-time-culture and the outcome for quality and safety of care.
Design/methodology/approach
The paper is a literature review with a qualitatively oriented thematic analysis concerning quality or safety outcomes for patients, or patients and staff when introducing a full-time culture.
Findings
Identified factors that could have a positive or negative impact on quality and patient safety when introducing full-time culture were length of shift, fatigue/burnout, autonomy/empowerment and system/structure. Working shifts over 12 h or more than 40 h a week is associated with increased adverse events and errors, lower quality patient care, less attention to safety concerns and more care left undone. Long shifts give healthcare personnel more flexibility and better quality-time off, but there is also an association between long shifts and fatigue or burnout. Having a choice and flexibility around shift patterns is a predictor of increased wellbeing and health.
Originality/value
A major challenge across healthcare services is having enough qualified personnel to handle the increasing number of patients. One of the measures to get enough qualified personnel for the expected tasks is to increase the number of full-time employees and move towards a full-time culture. It is argued that full-time culture will have a positive effect on work environment, efficiency and quality due to a better allocation of work tasks, predictable work schedule, reduced sick leave, and continuity in treatment and care. There is limited research on how the introduction of full-time culture will affect the quality and safety for patients and staff, and few studies have been focusing on the relationship between longer shift, work schedule, and quality and safety of care.
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Joanna Barbara Baluszek, Kolbjørn Kallesten Brønnick and Siri Wiig
The purpose of this rapid review was to present current evidence on relations between resilience and self-efficacy among healthcare practitioners in the context of COVID-19…
Abstract
Purpose
The purpose of this rapid review was to present current evidence on relations between resilience and self-efficacy among healthcare practitioners in the context of COVID-19 pandemic.
Design/methodology/approach
Literature searches were conducted in February/2022 in the online database MEDLINE EBSCO and not date/time limited. Eligibility criteria were as follows: population – healthcare practitioners, interest – relations between resilience and self-efficacy and context – COVID-19.
Findings
Six eligible studies from Italy, China, United Kingdom, India, Pakistan and Spain, published between 2020 and 2021 were included in the review. All studies used quantitative methods. The relations between resilience and self-efficacy were identified in contexts of resilience programs, measuring mental health of frontline nurses, measuring nurses' and nursing students' perception of psychological preparedness for pandemic management, perception of COVID-19 severity and mediating roles of self-efficacy and resilience between stress and both physical and mental quality of life. Findings indicated limited research on this topic and a need for more research.
Practical implications
Broader understanding of the relations between resilience and self-efficacy may help healthcare organizations' leaders/managers aiming to support resilience of their employers under challenging circumstances such as future pandemic.
Originality/value
The latest COVID-19 pandemic presented the opportunity to research relations between resilience and self-efficacy and enrich existed research in a new and extraordinary context.
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Naif Alzahrani, Russell Jones, Amir Rizwan and Mohamed E. Abdel-Latif
The purpose of this paper is to perform and report a systematic review of published research on patient safety attitudes of health staff employed in hospital emergency departments…
Abstract
Purpose
The purpose of this paper is to perform and report a systematic review of published research on patient safety attitudes of health staff employed in hospital emergency departments (EDs).
Design/methodology/approach
An electronic search was conducted of PsychINFO, ProQuest, MEDLINE, EMBASE, PubMed and CINAHL databases. The review included all studies that focussed on the safety attitudes of professional hospital staff employed in EDs.
Findings
Overall, the review revealed that the safety attitudes of ED health staff are generally low, especially on teamwork and management support and among nurses when compared to doctors. Conversely, two intervention studies showed the effectiveness of team building interventions on improving the safety attitudes of health staff employed in EDs.
Research limitations/implications
Six studies met the inclusion criteria, however, most of the studies demonstrated low to moderate methodological quality.
Originality/value
Teamwork, communication and management support are central to positive safety attitudes. Teamwork training can improve safety attitudes. Given that EDs are the “front-line” of hospital care and patients within EDs are especially vulnerable to medical errors, future research should focus on the safety attitudes of medical staff employed in EDs and its relationship to medical errors.
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