An integrative review of leadership competencies and attributes in advanced nursing practice

Abstract

AimTo establish what leadership competencies are expected of master level‐educated nurses like the Advanced Practice Nurses and the Clinical Nurse Leaders as described in the international literature.BackgroundDevelopments in health care ask for well‐trained nurse leaders. Advanced Practice Nurses and Clinical Nurse Leaders are ideally positioned to lead healthcare reform in nursing. Nurses should be adequately equipped for this role based on internationally defined leadership competencies. Therefore, identifying leadership competencies and related attributes internationally is needed.DesignIntegrative review.MethodsEmbase, Medline and CINAHL databases were searched (January 2005–December 2018). Also, websites of international professional nursing organizations were searched for frameworks on leadership competencies. Study and framework selection, identification of competencies, quality appraisal of included studies and analysis of data were independently conducted by two researchers.ResultsFifteen studies and seven competency frameworks were included. Synthesis of 150 identified competencies led to a set of 30 core competencies in the clinical, professional, health systems. and health policy leadership domains. Most competencies fitted in one single domain the health policy domain contained the least competencies.ConclusionsThis synthesis of 30 core competencies within four leadership domains can be used for further development of evidence‐based curricula on leadership. Next steps include further refining of competencies, addressing gaps, and the linking of knowledge, skills, and attributes.ImpactThese findings contribute to leadership development for Advanced Practice Nurses and Clinical Nurse Leaders while aiming at improved health service delivery and guiding of health policies and reforms.

Nurse leaders’ perceptions and experiences of leading evidence: A qualitative enquiry

“…Nurse leaders' education is a demanding task. According to the integrative review of Heinen, van Oostveen, Peters, Vermeulen, and Huis (), leadership in nursing is based on 30 core competencies. Enhancing EBP is only one aspect in the core competencies of clinical leadership.…”

“…Leaders also need the support of committed facilitators or change agents who support the EBP of their units (Hanharan et al, ; Warren et al, ). Evidence‐based interventions to support shared learning and to create infrastructures that promote EBP are also required (Heinen et al, ; Välimäki et al, ; XX et al, 2017). The implementation of EBP in decision‐making that concerns work with patients is a key challenge (Häggman‐Laitila, Mattila, & Melender, ; Heinen et al, ).…”

“…Evidence‐based interventions to support shared learning and to create infrastructures that promote EBP are also required (Heinen et al, ; Välimäki et al, ; XX et al, 2017). The implementation of EBP in decision‐making that concerns work with patients is a key challenge (Häggman‐Laitila, Mattila, & Melender, ; Heinen et al, ). It requires strengthening the competence of the entire staff and their commitment to EBP.…”

“…A cultural and practical transformation of this magnitude will need many changes, happening simultaneously and at every organisational level, to make it happen. (Bianchi et al, ; Heinen et al, ).…”

“…This absence of EBP from strategic plans allows the leaders and their professional nurses to fill the vacuum by acting according to their various personal views. The systematic implementation of EBP and its introduction at every level of an organisation (Heinen et al, ) also requires leaders' long‐term commitment. Indeed, the persistent failure to lead on EBP at the strategic level should be further explored in order to understand why this should be the case.…”