The influence of empowerment, authentic leadership, and professional practice environments on nurses’ perceived interprofessional collaboration

Regan, Sandra; Laschinger, Heather K. Spence; Wong, Carol

doi:10.1111/jonm.12288

Cited by 133 publications

(127 citation statements)

References 40 publications

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“…In one study conducted with nurses in hospitals, researchers found that nurses' autonomy did not undermine teamwork between nurses and physicians, but rather, improved it. 27 Leadership can play a vital role in promoting teamwork 28,29 by engaging members into collaborative efforts and changing the organizational structures to better meet patients' and providers' needs. 22,30,31 Despite the attention in recent years on primary care teams, we lack empirical evidence about how to promote teamwork.…”

Section: Introductionmentioning

confidence: 99%

Nurse Practitioner Autonomy and Relationships with Leadership Affect Teamwork in Primary Care Practices: a Cross-Sectional Survey

Poghosyan

Liu

2016

J GEN INTERN MED

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BACKGROUND:The Nurse Practitioner (NP) workforce represents a substantial supply of primary care providers able to contribute to meeting a growing demand for care. However, controversy exists regarding the expanding role of NPs in primary care in terms of challenging the teamwork between NPs and physicians. To date, no empirical evidence exists regarding how to promote teamwork in primary care between NPs and physicians. OBJECTIVE: We investigated whether NP autonomy within primary care practices and the relationships they have with leadership affect teamwork between NPs and physicians. DESIGN: Using a cross-sectional survey design, data was collected from 163 p ri mary care practices in Massachusetts. PARTICIPANTS: Three hundred and fourteen primary care NPs completed and returned the mail survey yielding a response rate of 40 %. MAIN MEASURES: The Autonomy and Independent Practice (AIP) and NP-Administration Relations (NP-AR) scales were used to measure NP independent practice and the relationships with leadership, respectively. These measures were aggregated to the practice level. Teamwork between NPs and physicians was measured at the individual NP level using the Teamwork (TW) scale. KEY RESULTS: The multilevel linear regression models investigated the influence of practice-level NP autonomy and the relationship between NPs and leadership on teamwork. With every unit increase on the practice-level mean score of AIP centered at the grand mean, the mean TW score increased by 0.271 units (p < 0.0001). With every unit increase of NP-AR centered at the grand mean, the mean TW score increased by 0.375 (p < 0.001). Over one-third (41.3 %) of the variance in teamwork could be explained by the final model. CONCLUSION: The study findings demonstrate that NP autonomy and favorable relationships with leadership improve teamwork. Policy and organizational change should focus on promoting NP autonomy and improving the relationship between NPs and leadership to improve teamwork and consequently improve patient care and outcomes.

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Section: Introductionmentioning

confidence: 99%

Nurse Practitioner Autonomy and Relationships with Leadership Affect Teamwork in Primary Care Practices: a Cross-Sectional Survey

Poghosyan

Liu

2016

J GEN INTERN MED

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“…[69][70][71] The presence of a nurse manager who is visible and communicates effectively, strengthens the organisational structure and protects the work environment reducing the risks associated with burnout. [27,72] A potentially positive influence of the hot-floor model was in relation to nurses being less likely to be redeployed to external wards on a short-term shift-by-shift basis than those in the conventional ICU. Intensive care nurses possess a broad range of skills applicable to complex patients in a majority of clinical specialties, and as such are highly mobile across the hospital.…”

Section: Discussionmentioning

confidence: 99%

Intensive care unit organisation and nurse outcomes: A cross-sectional study of traditional and “hot-floor” structures

Abbenbroek

Duffield

Elliott

2017

JHA

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Aim: To explore the relationship between the practice environment and nurse outcomes in two Intensive Care Unit (ICU) models. Background: Internationally the demand for intensive care is increasing. A large capacity multi-specialty integrated critical care service, the "hot-floor", is emerging as the preferred organisational model. Benefits include resource consolidation and improved utilisation, operational synergies, operational flexibility and demand management. A large clinical workforce with commensurate frontline management, education and support positions are required. The association between these factors, within the ICU hot-floor work environment, and nurse outcomes is not known. Methods: Registered nurses (RNs) working in two ICUs, one a hot-floor model and one traditional ICU, completed a structured questionnaire. Nurse perceptions of work-life and organisational factors, and dimensions of burnout were examined using the Practice Environment Scale-Nursing Work Index (PES-NWI) and Maslach's Burnout Inventory (MBI). Results: Units matched on service level characteristics, training accreditation, patient casemix, operational and clinical care processes. Nurses in had similar demographic characteristics, professional attributes and experience. Workforce structures were also similar though the hot-floor had relatively less dedicated resources for frontline nurse management and clinical education positions. Hot-floor nurses worked more paid overtime and were redeployed less frequently to external wards. Nurse manager leadership and support was less effective, and nurses expressed lower personal accomplishment. Conclusions: Improved demand management achieved through greater operational flexibility is a key driver for the hot-floor model. Planning for enhanced organisational effectiveness requires corresponding improvements in the work environment to optimise nurse retention to ensure organisational sustainability.

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“…It is important that although it is a collaborative environment, individual team members still feel supported and recognized in their professional role (Regan et al, 2016). Working collaboratively requires time to engage with others, so adequate staffing is also important to relieve time constraints for professionals and administrative support can help with documentation and organizational tasks (van Dongen et al, 2016;Orchard et al, 2005;Regan et al, 2016).…”

Section: Fundamentals Of Interprofessional Educational and Collaboratmentioning

confidence: 99%

“…Professionals should be provided time, information, support, and space to engage in collaborative practice and encourage feedback from peers (Orchard, 2010;Regan et al, 2016). It is important that although it is a collaborative environment, individual team members still feel supported and recognized in their professional role (Regan et al, 2016).…”

Section: Fundamentals Of Interprofessional Educational and Collaboratmentioning

confidence: 99%

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Graduate Interprofessional Education and Collaborative Practice Experiences: A Phenomenological Inquiry

Sand¹

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The influence of empowerment, authentic leadership, and professional practice environments on nurses’ perceived interprofessional collaboration

Abstract: Nurse leaders who ensure access to resources such as knowledge of IPC, embody authenticity and build trust among nurses, and support the presence of a professional nursing practice environment can contribute to enhanced IPC.

Cited by 133 publications

References 40 publications

Nurse Practitioner Autonomy and Relationships with Leadership Affect Teamwork in Primary Care Practices: a Cross-Sectional Survey

Nurse Practitioner Autonomy and Relationships with Leadership Affect Teamwork in Primary Care Practices: a Cross-Sectional Survey

Intensive care unit organisation and nurse outcomes: A cross-sectional study of traditional and “hot-floor” structures

Graduate Interprofessional Education and Collaborative Practice Experiences: A Phenomenological Inquiry

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