• Background Links between teamwork and outcomes have been established in a number of fields. Investigations into this link in healthcare have yielded equivocal results. • Objective To examine the relationship between the level of self-identified teamwork in the intensive care unit and patients’ outcomes. • Method A total of 394 staff members of 17 intensive care units completed the Group Development Questionnaire and a demographic survey. The questionnaire is a reliable and valid measure of team development and effectiveness. Each unit’s predicted and actual mortality rates for the month in which data were collected were obtained. Pearson product moment correlations and analyses of variance were used to analyze the data. • Results Staff members of units with mortality rates that were lower than predicted perceived their teams as functioning at higher stages of group development. They perceived their team members as less dependent and more trusting than did staff members of units with mortality rates that were higher than predicted. Staff members of high-performing units also perceived their teams as more structured and organized than did staff members of lower-performing units. • Conclusions The results of this study and others establish a link between teamwork and patients’ outcomes in intensive care units. The evidence is sufficient to warrant the implementation of strategies designed to improve the level of teamwork and collaboration among staff members in intensive care units.

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Aim & Objective Explore leadership self‐perception of clinical nurses at the bedside and their perception of leadership on patient care and outcomes. Background According to Institute of Medicine Future of Nursing Report, nurses are called to exhibit leadership at every level. Published research on nursing leadership is primarily focused on formal leaders. Research examining leadership at the clinical nurse level has either tested application of a particular leadership model or studied nurses who have been identified as informal clinical leaders. We took an inductive approach without any prior knowledge if participating clinical nurses viewed themselves as leaders. Design Descriptive qualitative method was used. Methods Four focus groups were conducted with a total of 20 clinical nurses from 2 hospitals within an integrated health system using a convenience sampling method until saturation was reached. The Consolidated criteria for Reporting Qualitative research (COREQ) was used to report findings. Results All participants identified qualities they admired in leaders. Fifty percent did not initially view themselves as leaders until they realised that they often demonstrated those same leadership qualities in providing nursing care to patients and families. Participants struggled to make a connection between their leadership at the bedside and patient outcomes. Conclusions Clinical nurses assume a formal title is required to be a leader. Findings from this study imply that leadership attributes required at point of care are embedded in the nursing practice and look similar to servant leadership. Relevance to clinical practice Leadership is in the nature of nursing practice, and more work is required to increase awareness that every nurse is a leader. Further efforts need to be pursued to help clinical nurses become self‐aware they are leaders in order to impact patient outcomes and transform health care from bottom‐up and inside‐out.

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The clinical nurse specialist is in a unique position to identify and study clinical problems in need of answers, but lack of time and resources may discourage nurses from conducting research. However, some research methods can be used by the clinical nurse specialist that are not time-intensive or cost prohibitive. The purpose of this article is to explain the utility of survey methodology for answering a number of nursing research questions. The article covers survey content, reliability and validity issues, sample size considerations, and methods of survey delivery.