Leadership Styles and Nurses’ Job Satisfaction. Results of a Systematic Review

Healthcare organisations are social systems in which human resources are the most important factor. Leadership plays a key role, affecting outcomes for professionals, patients and work environment. The aim of this research was to identify and analyse the knowledge present to date concerning the correlation between leadership styles and nurses’ job satisfaction. A systematic review was carried out on PubMed, CINAHL and Embase using the following inclusion criteria: impact of different leadership styles on nurses’ job satisfaction; secondary care; nursing setting; full-text available; English or Italian language. From 11,813 initial titles, 12 studies were selected. Of these, 88% showed a significant correlation between leadership style and nurses’ job satisfaction. Transformational style had the highest number of positive correlations followed by authentic, resonant and servant styles. Passive-avoidant and laissez-faire styles, instead, showed a negative correlation with job satisfaction in all cases. Only the transactional style showed both positive and negative correlation. In this challenging environment, leaders need to promote technical and professional competencies, but also act to improve staff satisfaction and morale. It is necessary to identify and fill the gaps in leadership knowledge as a future objective to positively affect health professionals’ job satisfaction and therefore healthcare quality indicators.

Hospital accreditation impact on healthcare quality dimensions: a systematic review

Purpose To systematically review the impact of hospital accreditation on healthcare quality indicators, as classified into seven healthcare quality dimensions. Data source We searched eight databases in June 2020: EBSCO, PubMed, Web of Science, Emerald, ProQuest, Science Direct, Scopus and Virtual Health Library. Search terms were conceptualized into three groups: hospitals, accreditation and terms relating to healthcare quality. The eligibility criteria included academic articles that applied quantitative methods to examine the impact of hospital accreditation on healthcare quality indicators. Study selection We applied the PICO framework to select the articles according to the following criteria: Population—all types of hospitals; Intervention—hospital accreditation; Comparison—quantitative method applied to compare accredited vs. nonaccredited hospitals, or hospitals before vs. after accreditation; Outcomes—regarding the seven healthcare quality dimensions. After a critical appraisal of the 943 citations initially retrieved, 36 studies were included in this review. Results of data synthesis Overall results suggest that accreditation may have a positive impact on efficiency, safety, effectiveness, timeliness and patient-centeredness. In turn, only one study analyzes the impact on access, and no study has investigated the impact on equity dimension yet. Conclusion Mainly due to the methodological shortcomings, the positive impact of accreditation on healthcare dimensions should be interpreted with caution. This study provides an up-to-date overview of the main themes examined in the literature, highlighting critical knowledge-gaps and methodological flaws. The findings may provide value to healthcare stakeholders in terms of improving their ability to assess the relevance of accreditation processes.

Development of a longlist of healthcare quality indicators for physical activity of patients during hospital stay: a modified RAND Delphi study

ObjectiveTo develop a longlist of healthcare quality indicators for the care of hospitalised adults of all ages with (or at risk of) low physical activity during the hospital stay.DesignA modified RAND/UCLA Appropriateness Method Delphi study.Setting and participantsParticipants were physical therapists, nurses and managers working in Dutch university medical centres.MethodsThe current study consisted of three phases. Phase I was a systematic literature search for quality indicators and relevant domains. Phase II was a survey among healthcare professionals to collect additional data. Phase III consisted of three consensus rounds. In round 1, experts rated the relevance of the potential indicators online (Delphi). The second round was a face-to-face expert panel meeting managed by an experienced moderator. Acceptability, feasibility and validity of the quality indicators were discussed by the panel members. In round 3, the panel members rated the relevance of the potential indicators that were still under discussion.ResultsThe search retrieved 1556 studies of which 53 studies were assessed full text. Data from 17 studies were included in a first draft longlist of indicators. Eighteen nurses and one physical therapist responded to the survey and added data for a second draft of the longlist. Experts constructed the final longlist of 23 indicators in three consensus rounds. Seven domains were identified: ‘Policy’, ‘Attitude and education’, ‘Equipment and support’, ‘Evaluation’, ‘Information’, ‘Patient-tailored physical activity plan’ and ‘Outcome measure’.Conclusion and implicationsThe healthcare quality indicators developed in this study could help to grade, monitor and improve healthcare for hospitalised adults of all ages with (or at risk of) low physical activity during the hospital stay. Future research will focus on the psychometric quality of the indicators and selection of key performance indicators.

Classification of Patient Complaints and Developing Patient Complaints Indicators

Based on actual patient complaints, we have assessed the suitability of measurable elementary criteria for the selected patient complaint indicator aggregate. These indicators enable, as evidenced by the study, the monitoring and reporting of recorded patient rights violations. The data acquired from processed patient rights violations were obtained through a quantitative study via an electronic complaint form, which constitutes an integral part of the prototype interactive software solution. This solution was used for submitting and monitoring of patients’ complaints on violation of their rights. Based on the data acquired from anonymised cases (71 complaints) and study findings, it was established that the recorded requests for the processing of patient rights violations occur as a result of: (1) inadequate attitude of healthcare professionals (n = 38.03%), (2) inadequate actions by healthcare professionals (n = 57.75%), and (3) later consequences of violations (n = 4.22%). The proposed set of patient complaint indicators can lead to a significant contribution to national patient rights protection policies, to improvement of healthcare quality indicators, and to implementation of measures for better healthcare quality.

RN4Cast Study in Portugal: Nurses and care left undone

Background: Over the past decades, nursing in Portugal has evolved greatly both academically and professionally and this evolution brought along growing concerns about the quality of the healthcare provided. Due to lack of time or poor organization of the workload, nurses are often faced with the need to choose between what must be done and what will have to be postponed or even not be done at all.Objective: To investigate the care activities that are most frequently left undone or are postponed by nurses working in medical and surgical inpatient units in Portugal.Methods: A descriptive, cross-sectional, quantitative study that follows the RN4CAST (Nurse Forecasting in Europe) methodology was carried out from October 2013 to April 2014. A total of 31 hospitals and a random sample of adult medical-surgical units were involved. The data were collected using a socio-demographic questionnaire and a nursing questionnaire that included the identification of the nursing activities of surveillance and direct patient care that were necessary but postponed or not performed by nurses in their most recent shift.Results: A total of 2,235 nurses participated. Almost all participants had a nursing bachelor degree (98.2%). The most frequently left undone or postponed care items were “Educating patients and family” (50.2%) and “Comfort/talk with patients” (50.1%); the least frequently left undone items were “Treatments and procedures” (3.9%) and “Pain management” (5.6%). Nurses in the North and Center regions of the country were the ones who reported less care left undone due to lack of time. Nurses under the age of 40 were those who reported a highest number of activities left undone.Conclusions: Nurses make selective choices about the care activities that are crucial for the patient. Some activities that may not have an immediate impact on the health of the patients are sidelined, although they may have an impact on other important healthcare quality indicators.