Academic Master

Nursing

Evidence Based Practice and Applied Nursing Research

Leadership skills are considered as the crucial aspect of any profession. In this article, it has been argued that leadership practices, that are associated with healthcare managers or nurse administrators, can impact the outcomes related to the health sector. Most of the healthcare organizations are adopting and practicing leadership skills for the effectiveness of day to day operations. Leadership practices can positively or negatively affect the outcomes of a health organization. Nurses are in the best position to address several issues related to the patients as nurses are closer to the patients in the hospitals. The purpose of this article is to understand the major leadership traits, in the nursing staff, that can positively influence the outcomes of healthcare providers and especially patients.

Nowadays, not only the board of directors or upper management but also the nursing staff is trained to enhance their leadership skills in the diverse culture and rapidly changing the environment. The major purpose of this research is to contribute to the leadership practices that can influence the outcomes of healthcare organizations as well as develop leadership behavior in the nurses. This study has examined various factors that are associated with the leadership traits present in the nurses. Various factors that contribute to the development of leadership traits in the nurses are also examined in this research paper. Different leadership traits or factors that contribute to the development of leadership behaviors in the nursing staff are identified in the outcomes of this study. For this purpose, ten electronic databases are used by the researchers.

Assessment, extraction of data and data analysis is based on the quantitative research work grabbed from the research papers published in the electronic databases. Surprisingly, different organizations paid less attention to the need of effective leadership for the improvement of quality. A recent survey of 700 hospitals in the United States of America identified that only a few executives of the organizations addressed the need of quality improvement and assessment in the workplace for the patients as well as for the personnel of that particular organization and fewer emphasized the need of training the workers for effective quality and efficient leadership. This condition is changing, as most of the organizations, now a days, place their emphasis on the need of effective leadership and quality measuring practices for the productivity of the organization and safety of the clients in general and patients in specific.

This study contributed to the major influences that can result in leadership behaviors in the nursing staff. Moreover, the research paper has identified four major factors that can influence the course of leadership behaviors in the nurses. Twenty factors were studied out of which eight are categorized in groups.

  • Behaviors of individual leaders
  • Practices of individual leaders
  • Traits and characteristics of individual leaders
  • Influence of context
  • Practice settings
  • Leader participation
  • Educational activities

The factors that are associated with the development of leadership behaviors in the nursing staff comprise of the various activities and practices that have a positive influence on the leadership practices and effectiveness. In this study, behaviors of individual leaders are identified that can be examined to ingrain leadership skills in the nurses of all the levels. It has been argued that leadership behaviors can increase and improve the organizational effectiveness and patient safety along with quality deliverance. Nurses should be trained in a way to exhibit their leadership skills in the hospital to perform their duties effectively and efficiently. Furthermore, practices of the leaders must be examined and utilized by the individual nurses to make one more skillful regarding leadership. Leadership skills also enhance managerial skills and practices as nurses also perform managerial duties in the hospital or healthcare sector.

Different theories and studies show that effective leaders have some common traits that can influence the outcomes of healthcare practices. Decision making in emergency cases is the most crucial aspect of the leadership traits. Indecisiveness in the nurses can lead to many adverse outcomes that can affect the effectiveness of healthcare providers. It is necessary to ingrain leadership skills in the nurses by educational activities and training workshops.

Various types of leadership styles exist which can be used to improve the quality and safety in hospitals and other organizations. Leadership style is adopted by matching it with the goals and objectives of the organization to influence the behavior of the workers and to attain quality effectiveness. A laissez-faire leader has the absence of direct supervision, and he does not have the ability to provide feedback to the upper management. There are some other leadership styles that can be adopted by the nurses for improving work quality and effectively training the employees for shaping their behaviors by the goals set by the organization. Another type of leadership style is participative leadership also known as democratic leadership. Participative leaders are more engaged in the meetings with peers and employees, and they value the opinions and recommendations of the workers. Participative leadership is used when the company needs to make a change in the organization. This challenge is easily accepted by the employees because they are involved in the change process directly, and they are more committed to their work because of participative leadership.

The most effective leadership style for effective quality and safety in healthcare is transformational leadership style. This type of leadership includes communication, communication, and communication. The effectiveness of the communication depends upon the involvement of the employees. And the involvement of employees is only possible when the culture of an organization is safety oriented, and employees are trained to improve quality. It has also been proved with research in the United Kingdom and United States of America that high-quality hospitals and organizations were adopting effective management strategies to improve and enhance quality and workplace safety. These strategies consist of the use of highly structured data to improve healthcare, by determining specific quality oriented goals, communicating those goals at all levels of the organization and effectively monitoring the reliability and efficiency of the performance.

This study indicates that leadership skills can be acquired by effective educational practices centered upon the leadership practices. It is also necessary that leadership competencies must be identified and practiced by the nurses to improve their leadership and decision-making skills. Most of the healthcare organizations are adopting and practicing leadership skills for the effectiveness of day to day operations. Leadership practices can positively or negatively affect the outcomes of a healthcare organization. Nurses are in the best position to address several issues related to the patients as nurses are closer to the patients in the hospitals. This study provides weak evidence for the effectiveness of factors associated with the leadership behaviors and leadership competencies. Leadership is the crucial ingredient in the success and safety, productivity, and effectiveness of any organization which plans to succeed in the changing culture and diverse environment. With the passage of time safety and health sector has improved, there is an emerging acknowledgement of the way in which organizational leadership enhances the safety measures, by not only determining the adverse events and identifying unfavorable situations but also implementing the strategies that prevent the future adversity by proper and charismatic leadership and excellent monitoring and management practices.

Assessment, extraction of data and data analysis is based on the quantitative research work grabbed from the research papers published in the electronic databases. Surprisingly, different organizations paid less attention to the need of effective leadership for the improvement of quality. A recent survey of 700 hospitals in the United States of America identified that only a few executives of the organizations addressed the need of quality improvement and assessment in the workplace for the patients as well as for the personnel of that particular organization and fewer emphasized the need of training the workers for effective quality and efficient leadership.

Different theories and studies show that effective leaders have some common traits that can influence the outcomes of healthcare practices. Decision making in emergency cases is the most crucial aspect of the leadership traits. Indecisiveness in the nurses can lead to many adverse outcomes that can affect the effectiveness of healthcare providers. Various types of leadership styles exist which can be used to improve the quality and safety in hospitals and other organizations. Leadership style is adopted by matching it with the goals and objectives of the organization to influence the behavior of the workers and to attain quality effectiveness.

Article # 2

This research is based on the motivational theories that can influence the behavior motivation and work motivation of the professional nurses in the healthcare sector. This study indicates the application of motivation theories to the working of nurses in the healthcare industry and hospitals. The study indicates various work motivations and motivation traits of nurses that can be related to the environment and culture of the organization. Patient health outcomes can be identified by examining the relation between work motivation and characteristics of the nurses that lead to the optimum motivation in the healthcare setting. Selected theories of motivation are examined to identify traits and characteristics of the nurses that improve the motivational level. Moreover, it has also been suggested that how the work environment and organizational culture affects the motivational levels of the nurses.

Conceptual analysis of the various motivation theories indicates that there is a close relation between the organizational culture and level of motivations in the nurses. Several factors that are associated with the motivational levels of nurses are also identified in this research paper. It is evident that all individuals have some needs that compel them to perform some activities (behavior) to satisfy those needs (satisfaction). It can be comprehended that needs influence the behaviors of the individuals which ultimately result in the satisfaction. In addition to this, needs can be classified as primary or secondary. When the primary needs are satisfied, individuals strive for the secondary needs to acquire satisfaction from the fulfillment of those needs.

Different motivational theories are examined in this research paper to identify various factors that are associated with the levels of motivation in the nurses. According to Maslow’s Hierarchy of Needs theory, needs can be divided into five major groups. The first one is physiological needs that include food, water, sex, etc. when an individual satisfies these needs then he strives to satisfy safety needs that may include freedom from war, violence, etc. the third primary need of the individual is belongingness which he strives to maintain after the fulfillment of the first two needs. The top needs on the hierarchy are self-esteem and self actualization that are fulfilled after the satisfaction achieved from the low-level needs. This theory can be applied to increase the level of motivation in the nurses. Nurses with physical well-being and satisfied low-level needs will be more likely to acquire needs for self-esteem and self actualization. These nurses will be more consistent with the goals of personal growth and achievements.

In this context, it can be argued that hospital management should play its role in enhancing the personal growth of the nurses. The motivational level can be increased with the help of satisfying the low-level needs of the nurses in the healthcare sector. Hospitals can provide nurses with incentives and bonuses to satisfy their needs. Moreover, organizational culture also plays a vital role in the development of motivational behavior in the nurses. Lively and energetic culture and reward-based strategies can improve the motivational level. This increase in the level of motivation of nurses will help to improve the patient safety outcomes in the healthcare sector. Alderfer, in his theory, has categorized needs into three major groups.

  • Growth needs
  • Relatedness needs
  • Existence needs

Alderfer believes that when higher needs are satisfied, they become more intense. For instance, one who has gained power will need more power as in the case of addiction. Alderfer’s theory is similar to Maslow’s Hierarchy of needs theory, but the sex factor is eliminated from the basic needs as it identifies human survival rather than individual’s motivational level. The motivation for the personal growth is increased when an individual identifies and satisfies the primary needs. Hospitals can provide nurses with incentives and bonuses to satisfy their needs. Moreover, organizational culture also plays a vital role in the development of motivational behavior in the nurses.

Levels of motivation are highly associated with the culture and environment of an organization. Management and leaders play their role to enhance the motivational levels in the nurses. Nurse leaders can influence the level of motivation in their nurse members with motivational behaviors and activities. This study indicates the application of motivation theories to the working of nurses in the healthcare industry and hospitals. The study indicates various work motivations and motivation traits of nurses that can be related to the environment and culture of the organization. Patient health outcomes can be identified by examining the relation between work motivation and characteristics of the nurses that lead to the optimum motivation in the healthcare setting. Involvement of the nurses in various practices and strategy developments can lead to an optimum level of motivation in the nurses. This type of improvement can lead to positive outcomes not only for the healthcare organization but also for the patients. Quality and safety can be improved with the application of motivation theories to the behaviors and activities of nurses in the healthcare sector. This study provides weak evidence for the level of motivation regarding diverse culture as these theories were published a long time ago and recent theories are not applied in this study.

Article 3: Quantitative Study

Introduction and Literature Review

The article titled “Reviewing and evaluating the literature” by Benton, D. C., & Cormack, D. F. S. (2000) specifically focuses on the important of literature review and meta-analysis for the nursing department.

In this particular study, the sections of Literature review and introduction are given in a collective manner. This is probably done to ensure that the focus of the study remains on the quantities aspect of the study rather than the qualitative review. The authors utilize the introduction to contextualize the issue in connection to distributed research, stating the clinical significance of health-related quality of life (HRQL) for the patients who are diagnosed with HIV/AIDS. This significantly affects their quality of life. The authors focus on the developments in treatment choices for this condition about the HRQL. Later they also examine the relationship between the incidence of the disease and the HRQL.

Conducting the meta-analysis of some researches having the similar topic, and further considering the self-mind methodologies, manifestation administration, and treatments, the authors presented a much comprehensive overview of the subject.

The initial section also provides a brief introduction to the concept of HRQL and its association with the roles of nursing. They emphasize on some important themes in connection to the concentration of the article that includes treatment, diagnosis, supportive care, social support, and different issues.

Regardless of the fact that the introduction and the review of the literature that contextualizes and introduces this review. Furthermore, it is insufficient to refer to previous research as a method for setting up the qualifications of the review, in a manner of speaking. Other than that, a more extensive scope of research could have been incorporated, so that the research could have been assessed to recognize its quality. Furthermore, it is left for the readers to seek after this matter and decide the quality of the research after that they base the commencement and support for this review. This is one of the major strengths of this article.

Methodology

The section discussing the methodology, however, does not focus on the decision of a quantitative approach. Furthermore, the emphasis of the methodology is somewhat on the instrumentations that were used for the purpose of data analysis. The critical evaluation of this section shows that it is done in a very comprehensive and reliable manner with the careful choice of quantitative approach, selection of data, instrumentations, etc. Furthermore, the Quantitative approach also offers the superior norms of evidence, with largely more prominent ability for duplication and meticulousness. In the case of the healthcare and nursing researches, the quantitative reviews are preferred as they are more reliable and precise.

Therefore, it is one of the strengths of this paper that the authors have specifically discussed their research methods in significant details and depth. It was also important since it conquers one of the restrictions of quantitative research, that of not requesting that the correct questions inspire answers that identify with individual al experience.

Data Collection and Analysis

However, one of the weaknesses of this paper is that the authors have not described the process of data collection in much detail. No evidence has been provided regarding who has supervised, developed the questionnaires and other instrumentations as well. Furthermore, there is also no evidence regarding the nature and type of questionnaire if they were self-reporting or some other type.

The issue of researcher predisposition is important in the fulfillment of data collection instruments, and keeping in mind that questionnaires might be considered a method for maintaining a strategic distance from this, on the off chance that they are remotely controlled, it is not generally conceivable to check they are full, or genuine, or reliable. Having the researcher present, nevertheless, could introduce predisposition, impact, or something to that effect, especially in helpless individuals. As these are helpless grown-ups going to clinics for their endless condition, not exchange how the data was collected from a reliable source and may involve certain ethical consideration.

However, the authors did the measurable analyses using the statistical tool called SPSS, which is a set up factual program, and LISREL, which is not a program this author considers. They depict making illustrative insights for each of the elements under consideration. This was not presented in sufficient details.

The authors, however, do discuss the use of multivariate analysis using distinctive tests, some of which are outstanding. However, there is a need of more straightforwardness could have been proficient by including a clarification of these tests.

Conclusions

The conclusion underpins the results got, regardless of the way that it is not an exhaustive summation of the multifaceted nature of the disclosures. It is obvious from this survey social and diverse factors to have a bona fide impact upon the lived involvement and personal satisfaction of the goal masses. It is in like manner clear that social components may surpass therapeutic components, other than in the course of action of antiretroviral medicines for these patients.

References

Cummings, G., Lee, H., Macgregor, T., Davey, M., Wong, C., Paul, L., & Stafford, E. (2008). Factors contributing to nursing leadership: a systematic review. Journal of Health Services Research & Policy,13(4), 240-248. doi:10.1258/jhsrp.2008.007154

Moody, R. C., & Pesut, D. J. (2006). The motivation to care. Journal of Health Organization and Management,20(1), 15-48. doi:10.1108/14777260610656543

Benton, D. C., & Cormack, D. F. S. (2000). Reviewing and evaluating the literature. The Research Process in Nursing. Oxford: Blackwell Science.

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