Factors influencing nurse manager retention, intent to stay or leave and turnover: A systematic review update.

AIMS: To understand factors influencing nurse manager retention or intention to leave, develop a preliminary theoretical model and identify strategies and interventions for workforce planning. DESIGN: Systematic review update of literature with integrated design of mixed research synthesis. METHODS: We included peer-reviewed articles examining factors influencing retention or intention to leave for front-line, middle or patient care nurse managers. Authors independently screened articles for inclusion and assessed included articles for quality. We adhered to a convergent synthesis approach. DATA SOURCES: Nine databases included MEDLINE, EMBASE, PsychINFO, CINAHL Plus with Full Text, ERIC, Health Source Nursing/Academic Edition, Scopus, ProQuest Dissertations and Theses and LILACS in January 2023. RESULTS: Thirty-five studies published between 1990 and 2022, 22 quantitative and 13 qualitative or mixed methods, were included. 155 factors influencing nurse manager retention, intention to stay, or turnover were reported. Job satisfaction was most frequently examined (n = 7), followed by factors such as empowerment (n = 3), decision-making (n = 3) and resilience (n = 2). We developed a preliminary theoretical model demonstrating staff relations and leadership, organizational and job characteristics, socio-demographics, personal characteristics, well-being and nurse manager relationship with work influence managers' intention to stay or to leave. CONCLUSIONS: Nurse managers who were empowered, satisfied with their work, received constructive feedback and found meaning in their roles showed greater intent to stay. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Nurse administrators can ensure managers are provided with authority to make decisions that promote autonomy. Work cultures that allow for regular meaningful constructive feedback from staff and leaders may contribute to nurse managers feeling valued. IMPACT: Understanding factors that influence job retention or intention to leave may help nurse managers and their supervisors identify areas for strategy and intervention design to ensure sustainability of this workforce. REPORTING METHOD: PRISMA 2020 Guidelines. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Contextually appropriate nurse staffing models: a realist review protocol.

INTRODUCTION: Decisions about nurse staffing models are a concern for health systems globally due to workforce retention and well-being challenges. Nurse staffing models range from all Registered Nurse workforce to a mix of differentially educated nurses and aides (regulated and unregulated), such as Licensed Practical or Vocational Nurses and Health Care Aides. Systematic reviews have examined relationships between specific nurse staffing models and client, staff and health system outcomes (eg, mortality, adverse events, retention, healthcare costs), with inconclusive or contradictory results. No evidence has been synthesised and consolidated on how, why and under what contexts certain staffing models produce different outcomes. We aim to describe how we will (1) conduct a realist review to determine how nurse staffing models produce different client, staff and health system outcomes, in which contexts and through what mechanisms and (2) coproduce recommendations with decision-makers to guide future research and implementation of nurse staffing models. METHODS AND ANALYSIS: Using an integrated knowledge translation approach with researchers and decision-makers as partners, we are conducting a three-phase realist review. In this protocol, we report on the final two phases of this realist review. We will use Citation tracking, tracing Lead authors, identifying Unpublished materials, Google Scholar searching, Theory tracking, ancestry searching for Early examples, and follow-up of Related projects (CLUSTER) searching, specifically designed for realist searches as the review progresses. We will search empirical evidence to test identified programme theories and engage stakeholders to contextualise findings, finalise programme theories document our search processes as per established realist review methods. ETHICS AND DISSEMINATION: Ethical approval for this study was provided by the Health Research Ethics Board of the University of Alberta (Study ID Pro00100425). We will disseminate the findings through peer-reviewed publications, national and international conference presentations, regional briefing sessions, webinars and lay summary.

Nursing home managers' quality of work life and health outcomes: a pre-pandemic profile over time.

AIM: To examine trends in quality of work life and health outcomes of managers in nursing homes in Western Canada pre-pandemic. METHODS: A repeated cross-sectional descriptive study using data collected in 2014-2015, 2017 and 2019-2020, in the Translating Research in Elder Care Programme. Self-reported measures of demographics, physical/mental health and quality of work life (eg, job satisfaction, burnout, work engagement) were administered and completed by nursing home managers. We used two-way analysis of variance to compare scores across times, controlling for clustering effects at the nursing home level. RESULTS: Samples for data collection times 1, 2, 3, respectively, were 168, 193 and 199. Most nursing home managers were nurses by profession (80.63-81.82%). Job satisfaction scores were high across time (mean=4.42-4.48). The physical (mean=51.53-52.27) and mental (mean=51.66-52.13) status scores were stable over time. Workplace engagement (vigour, dedication and absorption) scores were high and stable over time in all three dimensions. CONCLUSIONS: Nursing home managers were highly satisfied, had high levels of physical and mental health, and generally reported that their work was meaningful over time pre-COVID-19 pandemic. We provided a comparison for future research assessing the impacts of the pandemic on quality of work life and health outcomes.

Authentic leadership, organizational culture and the effects of hospital quality management practices on quality of care and patient satisfaction.

AIM: To examine the influence of hospital culture and authentic leadership on the effects of quality improvement practices on patient satisfaction. BACKGROUND: Nurses in formal leadership roles shape and are shaped by organizational culture to achieve high performance standards to influence quality of care. DESIGN: Using structural equation modelling, we tested a model on quality improvement practices across three participant groups that differed based on authentic leadership and hospital culture. METHODS: We used survey data from a cross-sectional study conducted in 2015 measuring nurse. Managers' perceptions of authentic leadership, implementation of quality improvement, and organizational culture in Canadian hospitals. RESULTS: 226 nurse managers participated. Our model estimations fit for the high-relational group and mixed group. Our model explained 50.7% and 39.5% variance in our outcome variable of patient satisfaction for the high-relational group and mixed group, respectively. Our model failed to fit the low-relational group. CONCLUSION: Authentic leadership and developmental/group hospital cultures improve quality management practices, quality of care and patient satisfaction. In organizations with low authentic leadership and hierarchical/rational cultures, strategies should target increasing authentic leadership and shifting to developmental cultures. Organizations with high authentic leadership and/or developmental/group cultures should target employee engagement, autonomy and teamwork. IMPACT: We examined how different combinations of authentic leadership and hospital culture influence the effects of quality management practices on quality improvement and patient satisfaction. Findings demonstrate that having both high authentic leadership and developmental or group hospital cultures are essential for quality improvement practices to enhance the quality of care and patient satisfaction. These organizations would benefit the most from systemic programs aimed at standardizing quality management practices as they have the culture and leadership to support these practices. For hospitals with hierarchical/rational cultures and/or low authentic leadership, enhancing hospital culture and leadership through leadership training and accreditation programs is critically needed. PATIENT OR PUBLIC CONTRIBUTION: The College and Association of Registered Nurses of Alberta contributed to this study by facilitating data collection and supporting the conduct of the study through messaging to its members.

Nurse Educators' Experiences With a Faculty Navigator Program: A Mixed-Methods Study.

BACKGROUND: There is a gap in studies examining formal mentorship programs designed for ongoing faculty support. METHOD: A mixed-methods explanatory research design was used to examine nurse educators' experiences of a navigation-based mentoring program in a baccalaureate nursing program in Western Canada. Descriptive statistics were used to examine the means of three subsets of the Capabilities of Nurse Educators (CONE) questionnaire. Interviews were conducted, and data were analyzed using qualitative descriptive methods. RESULTS: The findings highlight the positive effects the faculty navigator program had on faculty's confidence and development as educators. The most significant finding was the in-time relational support that faculty navigators provided to prevent new faculty from feeling alone in their new role. CONCLUSION: The faculty navigator program is effective for its setting. This program could be expanded to facilitate stronger learner-centered approaches to teaching in various settings with faculty of varying expertise. [J Nurs Educ. 2022;61(10):587-590.].

An Integrative Review of Mentoring Novice Faculty to Teach.

BACKGROUND: Novice nursing faculty require support and guidance as they transition from clinical practice to teaching in an academic faculty. Mentoring is an important part of faculty development during the transitional experience. Currently, the learning needs of novice nursing faculty and the effects of formal mentorship programs are not well understood. METHOD: An integrative literature review was conducted from five electronic databases. The articles included in the review described primary research studies focused on formal mentorship programs that supported novice faculty in developing their teaching expertise and identified their learning needs. RESULTS: The review yielded eight studies that explored different aspects of the mentoring experience. Socialization to Academia and Navigating Mentorship were two key themes developed from the data. CONCLUSION: Included studies described mentoring programs and a clear need for some type of formalized orientation and mentorship process or program to enhance novice nursing faculty transition to the academic setting and role. [J Nurs Educ. 2021;60(4):203-208.].

Determinants of nurse manager job satisfaction: A systematic review.

BACKGROUND: Front-line nurse managers provide direct oversight of healthcare delivery to ensure organizational expectations are implemented to achieve optimal patient and staff outcomes. Ensuring the job satisfaction of front-line nurse managers is key to retaining these individuals in their roles. Understanding factors influencing job satisfaction of nurse managers can support the development and implementation of strategies to enhance job satisfaction and sustain retention. OBJECTIVES: We aimed to systematically review the empirical literature measuring determinants of job satisfaction among nurse managers. DESIGN: We conducted a systematic review using 11 electronic databases. DATA SOURCES: Electronic databases included ABI Inform, Academic Search Premier, CINAHL, EMBASE, ERIC, Health Source Nursing, Medline, ProQuest Dissertations and Theses, PsychINFO, and LILACS. REVIEW METHODS: We included research articles that examined the determinants of job satisfaction for front-line nurse managers. Two research team members independently reviewed and determined inclusion of each study. Each study was appraised independently for quality by two team members. Data extraction was completed for included studies. Content analysis was used to categorize factors associated with job satisfaction of nurse managers. RESULTS: A total of 5608 articles were screened for inclusion or exclusion. Thirty-eight studies were included. One hundred and one factors influencing nurse manager job satisfaction were reported in the included studies. Factors were grouped into three main categories: job characteristics, organizational characteristics, and personal characteristics. Most factors were examined in single studies or their relationship with job satisfaction was equivocal. However, across these categories, findings included significant positive relationships between autonomy, power, social support among team members and job satisfaction of front-line nurse managers. A significant negative relationship between job stress and nurse manager job satisfaction was indicated in the findings. CONCLUSIONS: Promoting autonomy, power to make decisions for change, social support, team cohesion, and strategies to reduce job stress may improve job satisfaction of front-line nurse managers. Innovative solutions such as co-management and targeted administrative and electronic resources warrant further investigation. Promoting prosocial group behaviours, team building, coaching and the implementation of wellness programs may improve social support, team cohesion, and wellbeing. Examining factors of nurse managers job satisfaction beyond the acute care setting could provide further insights into the role that the practice environment plays in nurse manager job satisfaction. TWEETABLE ABSTRACT: Promoting autonomy, power to effect decisions for change, social support, team cohesion, and strategies to reduce job stress are important drivers of job satisfaction of front-line managers.

The essentials of nursing leadership: A systematic review of factors and educational interventions influencing nursing leadership.

BACKGROUND: Nursing leadership plays a vital role in shaping outcomes for healthcare organizations, personnel and patients. With much of the leadership workforce set to retire in the near future, identifying factors that positively contribute to the development of leadership in nurses is of utmost importance. OBJECTIVES: To identify determining factors of nursing leadership, and the effectiveness of interventions to enhance leadership in nurses. DESIGN: We conducted a systematic review, including a total of nine electronic databases. DATA SOURCES: Databases included: Medline, Academic Search Premier, Embase, PsychInfo, Sociological Abstracts, ABI, CINAHL, ERIC, and Cochrane. REVIEW METHODS: Studies were included if they quantitatively examined factors contributing to nursing leadership or educational interventions implemented with the intention of developing leadership practices in nurses. Two research team members independently reviewed each article to determine inclusion. All included studies underwent quality assessment, data extraction and content analysis. RESULTS: 49,502 titles/abstracts were screened resulting in 100 included manuscripts reporting on 93 studies (n=44 correlational studies and n=49 intervention studies). One hundred and five factors examined in correlational studies were categorized into 5 groups experience and education, individuals' traits and characteristics, relationship with work, role in the practice setting, and organizational context. Correlational studies revealed mixed results with some studies finding positive correlations and other non-significant relationships with leadership. Participation in leadership interventions had a positive impact on the development of a variety of leadership styles in 44 of 49 intervention studies, with relational leadership styles being the most common target of interventions. CONCLUSIONS: The findings of this review make it clear that targeted educational interventions are an effective method of leadership development in nurses. However, due to equivocal results reported in many included studies and heterogeneity of leadership measurement tools, few conclusions can be drawn regarding which specific nurse characteristics and organizational factors most effectively contribute to the development of nursing leadership. Contextual and confounding factors that may mediate the relationships between nursing characteristics, development of leadership and enhancement of leadership development programs also require further examination. Targeted development of nursing leadership will help ensure that nurses of the future are well equipped to tackle the challenges of a burdened health-care system.

Theoretical Approaches to Studying Incivility in Nursing Education.

Incivility is a concerning occurrence in nursing education. Examining the concept of incivility is critical to the development of strategies used to prevent and mitigate experiences in nursing education. The purpose of this paper is to examine this concept through theoretical lenses of oppressed group behaviour, attribution theory, and conceptual models of empowerment. A critical social theory perspective is outlined as an additional theoretical approach to studying incivility in nursing education. Examination through various theoretical lenses may help to describe, explain, and predict incivility in nursing education. Theoretical considerations of this concept are limited but may hold the key to comprehensive understanding and advancement of knowledge. The ultimate goal of theoretical and knowledge development of incivility in nursing education is the creation and maintenance of civil educational environments.