SITUATIONAL LEADERSHIP STYLE IN NURSING MANAGEMENT IN CRITICAL CARE UNITS

Main Article Content

Waleed Saad Tulayhan Alshammari
Abdulsalam Salem Mohammad Alshammari
Tariq Kareem Dhaidan AlShammari
Rinad Aedh Abed Alresheedi
Ohud Binyah Thayid Alshammari

Keywords

leadership, style, nursing, critical care units

Abstract

Leadership styles wield a profound influence on the dynamics of critical care units, shaping nursing workforce outcomes and patient care quality. Emphasizing the significance of transformational leadership and situational adaptability, this research explores the multifaceted impact of diverse leadership styles in nursing management. Investigating their effects on job satisfaction, intention to stay, and service provision, the study underscores the relevance of situational leadership in emergencies. As healthcare systems evolve, understanding these leadership dynamics becomes paramount for ensuring high-quality patient care amidst unprecedented challenges such as the COVID-19 pandemic, this study aims to explore the impact of nurse leadership philosophies—specifically transformational, transactional, and laissez-faire—on quality indicators in intensive care units. Through surveys, interviews, and patient data analysis, the research reveals that transformational leadership significantly enhances quality metrics, fostering increased patient satisfaction, reduced mortality rates, and improved cooperation among healthcare workers. The findings underscore the importance of nurse leadership development programs and emphasize the pivotal role of effective nursing leadership in delivering high-quality care, The study employed an integrated review technique, combining quantitative and qualitative findings on situational leadership in nursing management within critical care units. Adhering to Whittemore & Knafl's framework, the research involved problem identification, literature search, data evaluation, analysis, and findings presentation. Following PRISMA guidelines, the search strategy targeted studies published in English between 2000 and 2020, focusing on situational leadership in critical care units. Data collection involved extracting key study details, employing thematic analysis for qualitative data, and meta-analysis for quantitative data. Quality assessment utilized JBI checklists, identifying strengths and limitations, subsequently addressed through sensitivity analysis, In conclusion, situational leadership proves vital for nursing managers in dynamic critical care units, offering flexibility to address staff readiness levels effectively. The findings underscore the compatibility and effectiveness of transformational and situational leadership styles in promoting clinical leadership. Emphasizing collaborative leadership, shared values, and authentic behaviors, the studies highlight their positive impact on staff outcomes and care quality. Continuous training for nurse leaders is crucial for creating positive work environments, ultimately improving patient care and staff well-being.,

Abstract 1964 | PDF Downloads 1110

References

1. Asamani, J., Naab, F., & Ofei, A. (2016). Leadership styles in nursing management: implications for staff outcomes. Journal of Health Sciences, 6(1), 23-36.
https://doi.org/10.17532/jhsci.2016.266
2. Cosentino, C., Luca, E., Sulla, F., Uccelli, S., Sarli, L., & Artioli, G. (2021). Leadership styles' influence on ICU nurses' quality of professional life: a cross‐sectional study. Nursing in Critical Care, 28(2), 193-201. https://doi.org/10.1111/nicc.12738
3. Cummings, G., MacGregor, T., Davey, M., Lee, H., Wong, C., Lo, E., … & Stafford, E. (2010). A systematic review of leadership styles and outcome patterns for the nursing workforce and work environment. International Journal of Nursing Studies, 47(3), 363–385.
https://doi.org/10.1016/j.ijnurstu.2009.08.006
4. Fischer, S. (2016). Transformational leadership in nursing: a concept analysis. Journal of Advanced Nursing, 72(11), 2644–2653. https://doi.org/10.1111/jan.13049
5. Kallas, K. (2014). Profile of an excellent nurse manager. Nursing Administration Quarterly, 38(3), 261–268. https://doi.org/10.1097/naq.0000000000000032
6. Kiwanuka, F., Nanyonga, R., Sak-Dankosky, N., Muwanguzi, P., & Kvist, T. (2020). Nursing leadership styles and their impact on intensive care unit quality measures: an integrative review. Journal of Nursing Management, 29(2), 133-142. https://doi.org/10.1111/jonm.13151
7. Saleem, M. and Faraj, R. (2022). Correlation between emotional intelligence and leadership style among nurse managers. PJMHS, 16(5), 823-826. https://doi.org/10.53350/pjmhs22165823
8. Alčauskienė, A., Vitkienė, A., & Grigaliūnienė, V. (2019). Significance of head nurses – nursing administrators’ leadership styles in health care., 29(6), 179-182. https://doi.org/10.35988/sm-hs.2019.123
9. Asamani, J., Naab, F., & Ofei, A. (2016). Leadership styles in nursing management: implications for staff outcomes. Journal of Health Sciences, 6(1), 23-36.
https://doi.org/10.17532/jhsci.2016.266
10. Casida, J. and Parker, J. (2011). Staff nurse perceptions of nurse manager leadership styles and outcomes. Journal of Nursing Management, 19(4), 478-486.
https://doi.org/10.1111/j.1365-2834.2011.01252.x
11. Cherian, S. and Karkada, S. (2017). A review on leadership in nursing. International Journal of Nursing Research and Practice (Ijnrp), 4(1). https://doi.org/10.15509/ijnrp.2017.4.1.347
12. Cummings, G., MacGregor, T., Davey, M., Lee, H., Wong, C., Lo, E., … & Stafford, E. (2010). A systematic review of leadership styles and outcome patterns for the nursing workforce and work environment. International Journal of Nursing Studies, 47(3), 363–385. https://doi.org/10.1016/j.ijnurstu.2009.08.006
13. Durmuş, S. and Kirca, K. (2020). Leadership styles in nursing..
https://doi.org/10.5772/intechopen.89679
14. Fischer, S. (2016). Transformational leadership in nursing: a concept analysis. Journal of Advanced Nursing, 72(11), 2644–2653. https://doi.org/10.1111/jan.13049
15. Kiwanuka, F., Nanyonga, R., Sak-Dankosky, N., Muwanguzi, P., & Kvist, T. (2020). Nursing leadership styles and their impact on intensive care unit quality measures: an integrative review. Journal of Nursing Management, 29(2), 133-142. https://doi.org/10.1111/jonm.13151
16. Matini, J., Nejad, N., Hanifi, N., & Fallah, R. (2022). The leadership styles of head nurses working in the training hospitals affiliated with Zanjan University of Medical Sciences in 2020. Preventive Care in Nursing and Midwifery Journal, 12(2), 32-38.
https://doi.org/10.52547/pcnm.12.2.32
17. Ngabonzima, A., Asingizwe, D., & Kouveliotis, K. (2020). Influence of nurse and midwife managerial leadership styles on job satisfaction, intention to stay, and services provision in selected hospitals of Rwanda. BMC Nursing, 19(1). https://doi.org/10.1186/s12912-020- 00428-8
18. Vesterinen, S., Suhonen, M., Isola, A., & Paasivaara, L. (2012). Nurse managers’ leadership styles in Finland. Nursing Research and Practice, 2012, 1-8. https://doi.org/10.1155/2012/605379 Vesterinen, S., Suhonen, M., Isola, A., Paasivaara, L., & Laukkala, H. (2013). Nurse managers' perceptions related to their leadership styles, knowledge, and skills in these areas—a viewpoint: the case of health center wards in Finland. Isrn Nursing, 2013, 1-8.
https://doi.org/10.1155/2013/951456
19. Boyle, D. K., Bott, M. J., Hansen, H. E., Woods, C. Q., & Taunton, R. L. (1999). Managers’ leadership and critical care nurses' intent to stay. American Journal of Critical Care, 8(6), 361–371. DOI:10.4037/AJCC1999.8.6.361
20. Bratt, M. M., Broome, M., Kelber, S., & Lostocco, L. (2000). Influence of stress and nursing leadership on job satisfaction of pediatric intensive care unit nurses. American Journal of Critical Care, 9(5), 307–317. doi:10.4037/ajcc2000.9.5.307
21. Braun, J.-P., Mende, H., Bause, H., Bloos, F., Geldner, G., Kastrup, M., … NeQuI (quality network in intensive care medicine). (2010). Quality indicators in intensive care medicine: Why? Use or burden for the intensivist. German Medical Science, 8, Doc22. doi:10.3205/000111
22. Cardiff, S., Sanders, K., Webster, J., Manley, K., (2020). ‘Guiding lights for effective workplace cultures that are also good places to work.’ International Practice Development Journal, Vol 10, Issue 2, Article 2. https://doi.org/10.19043/ipdj.102.002.
23. Chen, L., Huang, L.-H., Xing, M.-Y., Feng, Z.-X., Shao, L.-W., Zhang, M.-Y., & Shao, R.-Y. (2017). Using the Delphi method to develop nursing-sensitive quality indicators for the NICU. Journal of Clinical Nursing, 26(3-4), 502–513. doi:10.1111/jocn.13474
24. Cook, M. J., & Leathard, H. L. (2004). Learning for clinical leadership. Journal of Nursing Management, 12(6), 436–444. doi:10.1111/j.1365-2834.2004.00420.x
25. Cummings, G. G., Tate, K., Lee, S., Wong, C. A., Paananen, T., Micaroni, S. P. M., & Chatterjee,
26. G. E. (2018). A systematic review of leadership styles and outcome patterns for the nursing workforce and work environment. International Journal of Nursing Studies, 85, 19–60. doi:10.1016/j.ijnurstu.2018.04.016
27. De Brun A., Rogers L., O'Shea M., McAuliffe E.(2020), ‘Understanding the impact of a collective leadership intervention on team working and safety culture in healthcare teams: a realist evaluation protocol.’ HRB Open Research. Mar Vol. 26 No. 2, p. 5.
doi: 10.12688/hrbopenres.12860.2.
28. De Brún, A. and McAuliffe, E. (2020), ‘Identifying the context, mechanisms, and outcomes underlying collective leadership in teams: building a realist program theory. ‘BMC Health Services Research, Vol 20, p:261 https://doi.org/10.1186/s12913-020-05129-1
29. Dimick, C. (2010). Quality check: An overview of quality measures and their uses. Journal of AHIMA, 81(9), 34–38. https://library.ahima.org/doc?doi=101998
doi:10.1097/01.NUMA.0000424019.83292.fa
30. Donabedian, A. (1988). The quality of care. How can it be assessed? The Journal of the American Medical Association, 260(12), 1743–1748. doi:10.1001/jama.260.12.1743
31. Duignan, M., Drennan, J., McCarthy, V.J.C. (2020). ‘ Impact of clinical leadership in advanced practice roles on outcomes in health care: A scoping review’ Journal of Nursing Management pp. 1– 10. https://doi.org/10.1111/jonm.13189
32. Dumitrascu, O. M., & Demaerschalk, B. M. (2017). Telestroke. Current Cardiology Reports, 19(9), 85. doi:10.1007/s11886-017-0895-1
33. Endres, S., Weiler, J. (2020), ‘Understanding (non)leadership phenomena in collaborative inter- organizational networks and advancing shared leadership theory: an interpretive grounded theory study.’ Business Research, Vol 13, pp. 275–309. https://doi.org/10.1007/s40685-019-0086-6
34. Eslami, K., Aletayeb, F., Aletayeb, S. M. H., Kouti, L., & Hardani, A. K. (2019). Identifying medication errors in neonatal intensive care units: a two-center study. BMC Pediatrics, 19(1), 365. doi:10.1186/s12887-019-1748-4
35. Hocking L, Newbould, J. Parkinson, S. et al., (2020), ‘An evaluation of the Q Initiative 2016– 2020’. RAND Europe. https://www.rand.org/randeurope/research/projects/evaluating-q initiative-2016-2020.html. (accessed 3.12.2020).
36. Hoffer Gittell, J. (2002). Coordinating mechanisms in care provider groups: relational coordination as a mediator and input uncertainty as a moderator of performance effects. Management Science, 48(11), 1408–1426. doi:10.1287/mnsc.48.11.1408.268
37. Kallas, K. D. (2014). Profile of an excellent nurse manager: identifying and developing health care team leaders. Nursing Administration Quarterly, 38(3), 261–268.
doi:10.1097/NAQ.0000000000000032
38. Lappalainen, M., Härkänen, M., & Kvist, T. (2019). The relationship between nurse manager’s transformational leadership style and medication safety. Scandinavian Journal of Caring Sciences. doi:10.1111/scs.12737
39. Laschinger, H. K. S., Wong, C. A., Cummings, G. G., & Grau, A. L. (2014). Resonant leadership and workplace empowerment: the value of positive organizational cultures in reducing workplace incivility. Nursing Economic, 32(1), 5–15, 44; quiz 16. Doi 10.1016/j.outlook.2017.10.004. Epub 2017 Nov 23. PMID: 29174629.
40. Lee, J., Austin, J. M., Kim, J., Miralles, P. D., Kaafarani, H. M. A., Pronovost, P. J., … Martinez, E. (2019). Developing and testing a chart abstraction tool for ICU quality measurement. American Journal of Medical Quality, 34(4), 324–330. doi:10.1177/1062860618800596
41. Linton, J., & Farrell, M. J. (2009). Nurses’ perceptions of leadership in an adult intensive care unit: a phenomenology study. Intensive & Critical Care Nursing, 25(2), 64–71. doi:10.1016/j.iccn.2008.11.003
42. Manley, K., & Jackson, C.(2020), ‘The Venus model for integrating practitioner‐led workforce transformation and complex change across the health care system.’ Journal of Clinical Evaluation, Vol. 26 No. 2, pp. 622–634.
43. McCay, R., Lyles, A. A., & Larkey, L. (2018). A systematic review of nurse leadership style, nurse satisfaction, and patient satisfaction. Journal of Nursing Care Quality, 33(4), 361–367. doi:10.1097/NCQ.0000000000000317
44. Miller C, Cook J, Gibson J, et al. (2020), ‘Clinical academic research internships for nurses, midwives, and allied health professionals: a qualitative evaluation,’ Nurse Researcher. doi: 10.7748/nr.2020.e1724
45. Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & PRISMA Group. (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Annals of Internal Medicine, 151(4), 264–9, W64. doi:10.7326/0003-4819-151-4- 200908180-00135
46. Moneke, N., & Umeh, O. J. (2013). How leadership behaviors impact critical care nurse job satisfaction. Nursing Management, 44(1), 53–55.
47. Murphy, L. (2005). Transformational leadership: a cascading chain reaction. Journal of Nursing Management, 13(2), 128–136. doi:10.1111/j.1365-2934.2005.00458.x
48. Pharande, P., Lindrea, K. B., Smyth, J., Evans, M., Lui, K., & Bolisetty, S. (2018). Trends in late- onset sepsis in a neonatal intensive care unit following implementation of infection control bundle: A 15-year audit. Journal of Paediatrics and Child Health, 54(12), 1314–1320. doi:10.1111/jpc.14078
49. Pollack, M. M., Koch, M. A., & NIH-District of Columbia Neonatal Network. (2003). Association of outcomes with organizational characteristics of neonatal intensive care units. Critical Care Medicine, 31(6), 1620–1629. doi:10.1097/01.CCM.0000063302.76602.86
50. Rouse, R. A. (2009). Ineffective participation: reactions to absentee and incompetent nurse leadership in an intensive care unit. Journal of Nursing Management, 17(4), 463–473. doi:10.1111/j.1365-2834.2009.00981.x
51. Tønnessen, S., Christiansen, K., Hjaltadóttir, I., Leino-Kilpi, H., Scott, P. A., Suhonen, R., … Halvorsen, K. (2020). Visibility of nursing in policy documents related to health care priorities. Journal of Nursing Management. doi:10.1111/jonm.12977
52. Vogus, T. J., & Sutcliffe, K. M. (2007). The impact of safety organizing, trusted leadership, and care pathways on reported medication errors in hospital nursing units. Medical Care, 45(10), 997–1002. doi:10.1097/MLR.0b013e318053674f
53. Whittemore, R., & Knafl, K. (2005). The integrative review: updated methodology. Journal of Advanced Nursing, 52(5), 546–553. doi:10.1111/j.1365-2648.2005.03621.x
54. Ylitörmänen, T., Turunen, H., & Kvist, T. (2018). Job satisfaction among registered nurses in two Scandinavian acute care hospitals. Journal of Nursing Management, 26(7), 888– 897. doi:10.1111/jonm.12620
55. Ylitörmänen, T., Turunen, H., Mikkonen, S., & Kvist, T. (2019). Good nurse-nurse collaboration implies high job satisfaction: A structural equation modeling approach. Nursing Open, 6(3), 998–1005. doi:10.1002/nop2.279
56. Mohamed, A. S., & Saleh, N. M. A. (2019). Assessing Nursing Manager's Situational Leadership Style and Nurse's Work Readiness Levels.
57. Aliakbari, F., Ghaedamini, M., Deris, F., & Masoudi, R. (2020). Relationship between nurses’ decision-making style and their disaster response competencies. Disaster Medicine and Public Health Preparedness, 16(1), 19-24. https://doi.org/10.1017/dmp.2020.225
58. Cummings, G., MacGregor, T., Davey, M., Lee, H., Wong, C., Lo, E., … & Stafford, E. (2010). A systematic review of leadership styles and outcome patterns for the nursing workforce and work environment. International Journal of Nursing Studies, 47(3), 363-385.
https://doi.org/10.1016/j.ijnurstu.2009.08.006
59. Khairunnisa, P. and Nadjib, M. (2019). Effect of leadership style on service quality and job satisfaction among hospital nurses: a systematic review. https://doi.org/10.26911/the6thicph-fp.04.32
60. Lynch, B., McCance, T., McCormack, B., & Brown, D. (2017). The development of the person‐ centred situational leadership framework: revealing the being of person‐centredness in nursing homes. Journal of Clinical Nursing, 27(1-2), 427-440. https://doi.org/10.1111/jocn.13949
61. Mangion, M. and Scicluna, K. (2022). We are exploring the links between ethical leadership, creativity, and the work environment in hospital wards. ECMLG, 18(1), 262-271. https://doi.org/10.34190/ecmlg.18.1.879
62. Ngabonzima, A., Asingizwe, D., & Kouveliotis, K. (2020). Influence of nurse and midwife managerial leadership styles on job satisfaction, intention to stay, and services provision in selected hospitals of Rwanda. BMC Nursing, 19(1). https://doi.org/10.1186/s12912-020- 00428-8
63. Ofei, A. and Paarima, Y. (2022). Nurse manager's leadership styles and intention to stay among nurses at the unit in Ghana. The International Journal of Health Planning and Management, 37(3), 1663-1679. https://doi.org/10.1002/hpm.3433
64. Sabbah, I., Ibrahim, T., Khamis, R., Bakhour, H., Sabbah, S., Droubi, N., … & Sabbah, H. (2020). The association of leadership styles and nurses well-being: a cross-sectional study in healthcare settings. Pan African Medical Journal, 36. https://doi.org/10.11604/pamj.2020.36.328.19720
65. Sfantou, D., Laliotis, A., Patelarou, A., Sifaki-Pistolla, D., Matalliotakis, M., & Patelarou, E. (2017). A systematic review of the importance of leadership style towards quality of care measures in healthcare settings. Healthcare, 5(4), 73. https://doi.org/10.3390/healthcare5040073
66. Warri, D. (2021). Effects of leadership styles on quality of health services.
https://doi.org/10.21203/rs.3.rs-389590/v1
67. Zhang, G., Zhang, X., Wang, L., Chen, J., Li, H., Sun, L., … & Song, G. (2023). Authentic leadership and nurses’ caring behavior in China: the mediating effect of psychological capital.. https://doi.org/10.21203/rs.3.rs-2788421/v1
68. AL-Dossary, R. (2022). Leadership style, work engagement and organizational commitment among nurses in Saudi Arabian hospitals. Journal of Healthcare Leadership, Volume 14, 71-81. https://doi.org/10.2147/jhl.s365526
69. AL-Dossary, R. (2022). The effects of nursing work environment on patient safety in Saudi Arabian hospitals. Frontiers in Medicine, 9. https://doi.org/10.3389/fmed.2022.872091
70. Aboshaiqah, A. (2016). Strategies to address the nursing shortage in Saudi Arabia. International Nursing Review, 63(3), 499-506. https://doi.org/10.1111/inr.12271
71. Almutairi, A. (2015). Fostering a supportive moral climate for health care providers: toward cultural safety and equity. Nursingplus Open, 1, 1-4. https://doi.org/10.1016/j.npls.2015.02.001
72. Almutairi, H. and Bahari, G. (2021). A multisite survey of managerial competence and organizational commitment among nurses working at public hospitals in Saudi Arabia. Journal of Nursing Management, 30(1), 179-186. https://doi.org/10.1111/jonm.13453
73. Alrwili, A. (2022). Impacts of leadership style on staff job satisfaction in primary health care organizations, primary health care centers in al-jour, saudi arabia as a case study. اﻟﻤﺠﻠﺔ 428-407 ,(1)42 ,ﻟﻺدارة اﻟﻌﺮﺑﯿﺔ. https://doi.org/10.21608/aja.2022.223181
74. Alsadaan, N., Jones, L., Kimpton, A., & DaCosta, C. (2021). Challenges facing the nursing profession in Saudi Arabia: an integrative review. Nursing Reports, 11(2), 395-403. https://doi.org/10.3390/nursrep11020038
75. Alshammari, M., Duff, J., & Guilhermino, M. (2019). Barriers to nurse–patient communication in Saudi Arabia: an integrative review. BMC Nursing, 18(1). https://doi.org/10.1186/s12912- 019-0385-4
76. Alshammari, M., Duff, J., & Guilhermino, M. (2022). A qualitative study of adult patient communication experiences with nurses in cancer care settings. BMC Nursing, 21(1). https://doi.org/10.1186/s12912-022-00981-4
77. Falatah, R. and Salem, O. (2018). Nurse turnover in the Kingdom of Saudi Arabia: an integrative review. Journal of Nursing Management, 26(6), 630-638. https://doi.org/10.1111/jonm.12603
78. Hibbert, D., Al-Sanea, N., & Balens, J. (2012). Perspectives on specialist nursing in Saudi Arabia: a national model for success. Annals of Saudi Medicine, 32(1), 78-85. https://doi.org/10.5144/0256-4947.2012.78
79. Othman, M. and Khrais, H. (2022). The relationship between transformational leadership, job satisfaction, and organizational commitment in Jordanian nurses. Anaesthesia Pain & Intensive Care, 26(3), 304-309. https://doi.org/10.35975/apic.v26i3.1896
80. Asamani, J., Naab, F., & Ofei, A. (2016). Leadership styles in nursing management: implications for staff outcomes. Journal of Health Sciences, 6(1), 23-36.
https://doi.org/10.17532/jhsci.2016.266
81. Johansen, B. (1990). Situational leadership: a review of the research. Human Resource Development Quarterly, 1(1), 73–85. https://doi.org/10.1002/hrdq.3920010109
82. Lavoie‐Tremblay, M., Fernet, C., Lavigne, G., & Austin, S. (2015). Transformational and abusive leadership practices: impacts on novice nurses, quality of care and intention to leave. Journal of Advanced Nursing, 72(3), 582-592. https://doi.org/10.1111/jan.12860
83. Morsiani, G., Bagnasco, A., & Sasso, L. (2016). How staff nurses perceive the impact of nurse managers’ leadership style on job satisfaction: a mixed method study. Journal of Nursing Management, 25(2), 119-128. https://doi.org/10.1111/jonm.12448
84. Zaghini, F., Fiorini, J., Piredda, M., Fida, R., & Sili, A. (2019). The relationship between nurse managers' leadership style and patients' perception of the quality of the care provided by nurses: Cross-sectional survey. International journal of nursing studies, 101, 103446. https://doi.org/10.1016/j.ijnurstu.2019.103446.
85. Batubara, S., Wang, H., & Chen, K. (2021). Nurse Leadership Style and Quality of Care in Clinical Setting: A Systematic Review. Nurse Line Journal.
https://doi.org/10.19184/NLJ.V6I1.19831.
86. Balsanelli, A. P., & Cunha, I. C. (2015). Nursing leadership in intensive care units and its relationship to the work environment. Revista latino-americana de enfermagem, 23(1), 106–113. https://doi.org/10.1590/0104-1169.0150.2531
87. Guo-wen Zhang, Xiao-hong Zhang, Wen-feng Lin, et al. Authentic Leadership and Nurses’ Caring Behavior in China: The Mediating Effect of Psychological Capital, 20 April 2023, PREPRINT (Version 1) available at Research Square [https://doi.org/10.21203/rs.3.rs- 2788421/v1].