Training Opportunities for Managers in Home Health, Hospice, and Community-Based Care Settings.

OBJECTIVE: The aim of this study was to identify areas for developing management skills-focused continuing education for managers working in home health, hospice, and community-based settings. BACKGROUND: Healthcare managers play a vital role in organizations, yet they have a range of management training. METHODS: Researchers conducted a cross-sectional survey of managers at a large Visiting Nurse Association. Descriptive and bivariate analyses were performed to examine confidence in management skills by respondent characteristic. Factor and cluster analyses were used to examine differences by role. RESULTS: For all 33 management tasks, managers with 6+ years of experience reported greater confidence than managers with 0 to 5 years of experience. Tasks with the lowest confidence were budgeting, interpreting annual reports, strategic planning, measuring organizational performance, and project planning. Managers were clustered into 5 "profiles." CONCLUSION: Management training is not 1-size-fits-all. Healthcare organizations should consider investing in training specific to the identified low-confidence areas and manager roles to better support and develop a robust management workforce.

Recommendations From a Systematic Review of Leadership Development to Support a New Nursing Practice Model.

OBJECTIVE: To develop a new nursing practice model for use within the US military, researchers aimed to create evidence-based recommendations for nursing leadership development based on current literature. BACKGROUND: The role of nursing leadership has many implications, including better nurse and patient outcomes. Therefore, an actionable compilation of recommendations informing how to develop effective nurse leaders could be helpful for current and aspiring nurse leaders. METHODS: Researchers conducted a systematic literature review of 5 databases searching for relevant articles published from 2001 to 2020. RESULTS: Seventy-eight articles were synthesized to develop a list of 5 broad yet actionable recommendations for leadership development. CONCLUSIONS: Leadership development is essential for current and future nurse leaders. The recommendations identified from this review can assist in developing leaders. Leaders can use these recommendations to guide leadership training initiatives, engage in self-development, or begin succession planning.

Clinical Leader Series: A Virtual Mental Well-being Initiative for Nurse Leaders During the COVID-19 Pandemic and Beyond.

OBJECTIVE: A virtual mental well-being initiative was developed for nurse leaders to provide education about mental health and to teach self-care skills. BACKGROUND: Because of substantial demand placed on nurse leaders during the COVID-19 pandemic, organizations must address stress and burnout by providing a continuum of care to include education, support, and intervention. METHODS: All levels of nurse leaders at a multicampus healthcare system were invited to attend. Data were collected on coping, empowerment, burnout, and quality of life. Participant responses to discussion prompts were compiled and reviewed. RESULTS: Although the independent parallel comparison did not show significant improvements, scores on the coping, empowerment, burnout, and quality-of-life measures were maintained. Discussion prompts yielded valuable insights into nurse leader experiences and session effectiveness. CONCLUSIONS: This type of education, as well as psychological support, will continue to be needed after the pandemic due to burnout, moral injury, and primary or secondary trauma. Findings are applicable to future crisis situations.

Effects of a learning programme for nurse managers to connect their experience: A quasi-experimental study.

AIM: The present study aimed to examine the effects of a learning programme for nurse managers on connecting learning with their own experiences and fostering competence. BACKGROUND: In Japan, second-level programmes for certified nurse administrators represent the main opportunity for formal training for nurse managers. However, it is difficult for nurse managers to transfer second-level programme learning to their workplace. METHODS: This quasi-experimental study used a two-group pretest-posttest design with purposive sampling and non-random assignment of 29 consenting Japanese nurse managers who were participating in a second-level programme through a prefectural nursing association. The programme provided reflection papers and feedback from a researcher, as well as reflective group sessions. The outcome measure was the Japanese First-Line Nurse Managers Competence Inventory (JNMCI) score. RESULTS: The intervention group showed significant improvement in JNMCI scores after participating in the programme. A significant difference in JNMCI scores was also observed between the intervention and comparison groups. CONCLUSION: This learning programme led to improved competency among nurse managers. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse manager development programmes should include reflection papers and feedback, as well as reflective group sessions, to improve competency among nurse managers.

A mixed-methods systematic review of interventions to improve leadership competencies of managers supervising nurses.

AIM: This study aimed to synthesize evidence on interventions to improve leadership competencies of managers supervising nurses. BACKGROUND: In recent years, numerous interventions have been developed to improve the leadership competencies of managers supervising nurses. However, researchers and nursing leaders are unclear about what aspects of interventions are effective for developing which competencies. METHODS: We conducted a mixed-methods systematic review following the Joanna Briggs Institute (JBI) approach for evidence synthesis. The Medline (Ovid), CINAHL, Embase, Scopus, Nursing and Allied Health Database were reviewed. Data extraction, quality appraisal and narrative synthesis were conducted in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS: A total of 69 studies (35 quantitative, 22 mixed methods, 12 qualitative) evaluating 68 interventions were included. Studies showed that interventions used modal activities such as lectures, group work and mentoring that generally had positive effects on improving leadership competencies such as supporting, developing and recognizing nurses. Opportunities to interact with peers increased managers' engagement in the interventions; however, many barriers existed for managers to use the competencies in practice including understaffing, insufficient time and lack of support from supervisors and staff. CONCLUSIONS: Leadership interventions were shown to have beneficial effects on developing different competencies. Managers predominately felt positive about participating in leadership interventions; however, they expressed many difficulties applying what they learned in practice. IMPLICATIONS FOR NURSING MANAGEMENT: Leadership interventions should include multimodal activities that give managers opportunities for interaction. When considering interventions for developing the leadership of managers, it is imperative to consider the practice environments for managers to be successful in applying the competencies they learned in practice.

Factors facilitating or inhibiting the capacity for effective leadership among front-line nurse managers: A scoping review.

AIMS: The purpose of this scoping review is to map and synthesize research studies addressing the factors that impact leadership behaviours of front-line nurse managers. BACKGROUND: Leadership is a fundamental component of the role of front-line nurse managers. Ineffective leadership is associated with costly outcomes; thus, organizations seek effective strategies to facilitate consistent demonstration of leadership behaviours. EVALUATION: Using a scoping review methodology, findings from 26 empirical studies were mapped to identify barriers and facilitators of leadership among front-line nurse managers. Major categories included personal and environmental factors with subthemes of personal characteristics, competencies and social support. KEY ISSUES: Available evidence captures the influence of personal characteristics, education, competency and formal social support on leadership capacity. The role of informal social support was not captured. CONCLUSIONS: Multiple personal and environmental factors influence the capacity for leadership behaviours among front-line nurse managers. Strategies such as leadership development programmes, mentorship and peer support programmes, and work environments that support relational and structural support may increase leadership capacity for front-line nurse managers. IMPLICATIONS FOR NURSING MANAGEMENT: Senior nurse leaders can use the results of this review to guide implementation of evidence-based strategies to recruit and retain front-line nurse managers.

Data-Based Self-awareness as the Foundation for Effective Leadership.

The AONL Nurse Executive Fellowship supports nurses who are new to an executive role in developing critical executive competencies. Participants engage in an in-depth specialized assessment process to help them understand themselves and the impact on their leadership. Learnings from the 1st 2 cohorts of fellowship participants provide insight into challenges faced by new executives and how self-awareness can improve performance to address those challenges.

Nurses Taking the Lead: A Look Back to Move Forward.

In recognition of the Year of the Nurse and Midwife, the 2020 annual conference of the Association for Leadership Science in Nursing (ALSN) celebrated A Look Back to Move Forward in recognition of the 50th anniversary of ALSN. The ALSN began as the Council of Graduate Education for Administrative Nursing (CGEAN) in 1970. Today, ALSN maintains the goals of shaping graduate education and research to inform nursing leadership practice.

Impact of Evidence-Based Charge Nurse Education on Charge Nurse Skills and Nurse-Specific Metrics.

OBJECTIVE: This research study was designed to analyze the impact of an evidence-based charge nurse (CN) education program on novice and experienced CNs' self-confidence and satisfaction with the role, skill competencies, and nursing metrics. BACKGROUND: Charge nurses are critical to effective daily unit operations. However, executive nursing leadership found that unit performance varied by CN despite experience. METHODS: University faculty partnering with nurse leaders developed an evidence-based CN education program including a series of classes, coaching in skills and role responsibilities by nurse leaders, and evaluation of skills competencies before and after the CN education program. RESULTS: The CN program was associated with significant positive changes in CN performance, nurse-specific metrics, hospital-acquired events, and patient satisfaction. CONCLUSIONS: Interventions targeting frontline leaders positively impact CN performance.

Using a Mentorship Approach to Address the Underrepresentation of Ethnic Minorities in Senior Nursing Leadership.

Healthcare organizations must be intentional and purposeful in creating diversity programs. A nursing leader mentorship program for racial and ethnic minority nurse managers was introduced at a large academic medical center to meet this need. The program design was based on the successful Leadership Institute for Black Nurses, first conducted at a university school of nursing. The participants in the 4-month program were 16 nurse managers from 2 city hospitals and their mentors.

Succession planning in nursing education.

BACKGROUND: Succession planning in nursing is a new concept with limited evidence found in nursing education. PURPOSE: The purpose of this study was to provide a comprehensive summary of the descriptions of succession planning, as self-reported by administrators over an academic nursing division. METHODS: A qualitative descriptive methodology was utilized to obtain descriptions of succession planning from participants having personal experience with succession planning. FINDINGS: The categories discovered in the data included strategies for succession planning implementation, advantages of succession planning, and obstacles to succession planning. DISCUSSION: Succession planning can provide growth plans, leadership development, and mentoring programs allowing for positive relationships that cultivate, inspire, and assist faculty to develop the necessary skills to be successful in a leadership role. Succession planning requires adequate financial and human resources to develop potential leaders to meet the future needs of an organization, and ultimately, nursing education.

Leadership development of nursing professionals: Education and influences of self-efficacy.

BACKGROUND: According to Bandura's theory, understanding the relationship of traits and leader self-efficacy in the various roles of nursing can aid in leader development and the growth of the profession. PURPOSE: The purpose of this study was to explore the perceptions of leader self-efficacy of academic nursing professionals to determine if traits and participation in certain activities was predictive of leader self-efficacy. METHOD: A validated survey tool, the Leader Efficacy Questionnaire (LEQ) was administered to nursing professionals using snowball sampling from publicly available email addresses. FINDINGS: Statistical significance was found between the academic degrees and the 4 scores of the LEQ. Overall, the participants reported moderate to high leader self-efficacy with an LEQ overall score (LSME) of 70 or greater. DISCUSSION: The dynamic challenges of health care require an understanding of nursing professionals' leader self-efficacy in light of their academic preparation and activities to grow the profession.

Integration of Advance Care Planning Into Clinical Practice: A Quality Improvement Project for Leaders.

OBJECTIVE: This quality improvement initiative sought to develop a proactive integrated system approach to advance care planning (ACP) through leadership and colleague engagement. BACKGROUND: Nurse leaders have the capacity to influence the professional competencies of care teams in ACP. Nurse leaders were educated on the importance of ACP, national quality metrics, resources for staff education, and ways to integrate ACP into workflows based on a population management model. METHODS: The project design is a prospective, mixed method design. RESULTS: Nurse leader participants demonstrated a significant increase in knowledge of the importance of ACP and evidence-based models to increase staff engagement and competency. CONCLUSIONS: Study supports nurse leader interventions, promoted engagement of proactive ACP to honor patient choice, and aligns with the mission and vision of one of the largest national Catholic healthcare organizations of being a trusted partner for life.

Developing Leadership Competencies in Midlevel Nurse Leaders: An Innovative Approach.

A pediatric teaching hospital developed a comprehensive leadership training program for midlevel nurse leaders with varying levels of management knowledge and experience. Content was based on American Organization for Nursing Leadership nurse manager competencies and data from a comprehensive needs assessment. Learners identified differentiating between leadership and management, influencing behavior, managing change, and communication as areas of increased confidence. This program is applicable to any hospital with multiple midlevel nurse leaders new to the role.

The Effectiveness of Charge Nurse Training on Leadership Style and Resiliency.

OBJECTIVE: The study objective was to investigate a charge nurse pilot training program as an effective, evidence-based training modality to improve leadership style and resiliency. BACKGROUND: Leadership is inherent and necessary in the charge nurse role. Little published research about charge nurse leadership training programs exists. METHODS: A pre-post design, with intervention and comparison groups, was conducted at an integrated healthcare system. A random sample of charge nurses was selected to pilot a standardized charge nurse leadership training program including in-person learning to foster leadership skills and nurture resiliency. RESULTS: The sample included 19 control participants and 22 intervention participants. Significant improvement was noted in transformational, transactional, leadership outcomes, and resiliency from preintervention to postintervention for the all subjects. Of the 22 intervention participants, the training elicited higher satisfaction with leadership behavior, followed by effectiveness and their ability to motivate. Charge nurses who attended training had higher resiliency scores pre-post intervention. CONCLUSION: The charge nurse pilot training was an effective program that led to improved leadership style and resiliency.

Living up to the job: Confessions of a Brigadier General on the lived experiences of becoming a leader in the Air Force Nurse Corps.

Today, nurse leadership positions are more and more common. However, there have been many exemplary Nurse Leaders in the past whose contributions and sacrifices enabled nursing to transform to the leadership position it is today but have not been documented. It is important to recover and record this history so that future generations of nurses can learn from past examples in a way they cannot learn with current nursing education alone. This article examines the development of the professional nurse through the lens of the service of Brigadier General Sue Ellen Turner. The oral history method guided the exploration of memories and experiences. The recurring characteristics of discernment, reflection, and ability to break barriers/build relationships contributed most to the general's success in restructuring organizational systems to optimize leadership opportunities for nurses. The conclusion discusses the lasting impact and future implications of Turner's work on the profession of nursing.

A hermeneutic-phenomenological study of paediatric intensive care unit nurses' professional identity following hospital redesign: Lessons learned for managers.

AIM: To provide insights for health care managers by exploring paediatric intensive care unit nurses' lived experience of professional identity in the context of organisational change. BACKGROUND: While professional identity improves retention of nurses and provision of quality care, outcomes of importance for managers, organisational change perturbs this identity. METHOD: The study used a hermeneutic-phenomenological design. Data were collected via individual interviews, photographs, participant observation and document review. A purposive sampling strategy was used to recruit paediatric intensive care unit nurses (n = 15) in a large Canadian paediatric hospital. RESULTS: Nurses' critical care identity eroded in this organisation due to the interplay between hospital redesign and new eligibility criteria for patient admissions. CONCLUSION: Interactions between multiple projects and the unit context, as well as nursing professional identity, need to be considered early on during project planning. This study fills an important gap in research concerning the management challenges brought about by the intersection of multiple changes. IMPLICATIONS FOR NURSING MANAGEMENT: The results from this study bring to light three important lessons for nurse managers: 1) the specific unit context should be evaluated before a project is initiated; 2) the physical environment needs to be considered when determining staffing requirements; and 3) identity transitions need to be managed.

Graduate Leadership Education for Nurse Leaders-Needed Now More Than Ever.

The American Association of Colleges of Nursing recently reinforced that as nurses seek to expand their expertise in healthcare delivery they should seek graduate education. Today's healthcare systems are growing in complexity and require greater knowledge to "revolutionize healthcare." This column presents the case to support graduate leadership education for nurse managers followed by recommendations for practice.

Capitalizing on an Existing Shared Governance Structure in Developing Leadership Succession Planning.

This evidence-based project in a large academic medical center presents the integration of a succession-planning framework into existing shared leadership councils to fill open formal leadership positions. The framework included assessment, planning, and outcome evaluation of 3 strategic interventions: 1) leadership development, 2) experiential learning, and 3) mentoring. Benefits included improved self-perception as a leader, improved leadership competency, increased talent bench strength, and 32 internal promotions of frontline staff to formal leadership positions within 1 year.

Examining the Beliefs of Skilled Nursing Facility Directors of Nursing Regarding BSN Completion and the Impact of Nurse Leader Education on Patient Outcomes.

Research suggests that acute care patients cared for by baccalaureate-educated nurses have better outcomes. Directors of nursing (DONs) in skilled nursing facilities (SNFs) have lower rates of baccalaureate attainment than acute care nurses for unclear reasons. To understand the interest in advancing education, researchers surveyed SNF DONs in Connecticut to examine their beliefs about academic advancement and the impact of DON education on resident outcomes. Nearly 70% of participants with diplomas and associate degrees lacked interest in degree advancement and did not believe a baccalaureate degree is necessary for DONs or that DON level of education impacts resident outcomes. Alternatives to degree completion may include interventions to provide SNF DONs with skills for improving resident outcomes.