Does nursing leadership affect the quality of care in the community setting?

Abstract

Mechanisms to monitor patient safety, a key aspect of the policy agenda for quality care and other technical aspects of care are important for nurse leaders to develop with frontline community nurses.

Being a nurse leader in bedside nursing in hospital and community care contexts in Norway and Sweden

“…It was notable that the highest rate of beds was reported in Swedish community care, where also the lowest rate of RNs was found. These findings are interesting in the light of the many reports where staffing, skill-mix and quality of care are stressed as interdependent variables, with a high rate of RNs as an important quality indicator [40,41] .…”

Challenges in municipality healthcare services—The nurse leaders' perspective

“…These changes are based on the market‐oriented principles inspired by ideas of New Public Management (Christensen, ). This has resulted in different expectations of the role, skills and knowledge of leadership and management highlighting the most important challenges that leaders are facing in the nursing community (Duffield et al, ; Haycock‐Stuart & Kean, ; Holm & Severinsson, ). In Norway, the Coordination Reform was implemented in 2012 (Ministry of Health and Care Services, White Paper, 47), 2008–2009) and many nursing tasks have been transferred from the specialist health services to the municipal health care (Gautun & Syse, ).…”

The nexus of nursing leadership and a culture of safer patient care

“…Nurse leaders who set clear guidelines, share their vision and lead by example have greater employee engagement associated with increased performance from bedside nurses, which is important for safe and innovative practice (Brady Germain & Cummings, ). Senior nurse leaders may use recognition of good practice to motivate and empower bedside nurses to improve quality of care across the board (Haycock‐Stuart & Kean, ). Leadership engagement at the unit level has significant positive effects on the reporting of errors and adverse events as leaders who engage their staff create an open communication environment where there is no fear of repercussions for reporting errors (Castel et al., ).…”

“…Alternatively, the WR can potentially provide a barrier to safety if competing goals are not recognised and mixed messages are sent. WalkRounds may expose a disparity in perceptions between bedside nurses and hospital or organisational leaders’ opinions of the most critical issues to be considered regarding safety practices for positive patient outcomes and those perceptions of hospital or organisational leaders (Haycock‐Stuart & Kean, ; Rotteau et al., ; Sexton et al., ). Hospital leaders may well steer conversations to issues of concern in their remit while missing or ignoring vital issues at the bedside.…”

“…Bedside nurses have been reported as believing that the quality of patient care is dependent on the individual nurse delivering the care, whereas nurse leaders believe leadership impacts the quality of care by driving the quality agenda through policy development and leadership from the executive perspective (Haycock‐Stuart & Kean, ).…”