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Aim. To establish current evidence on the relationship between transformational nursing leadership and turnover intention. Background. The persistent nursing shortage in healthcare has led to heightened demands for addressing both current needs and the healthcare requirements of a growing population. Recognizing the pivotal role of nursing leadership in fostering retention, this review highlights the influence of positive leadership on nursing staff. Evaluation. An integrative review, guided by Whittemore and Knafl's (2005) framework, was conducted using articles sourced from four online databases deducing to an inclusion of sixteen quantitative articles, one systematic review, and one integrative review published between 1992 and 2022. Key Issues. The study reveals conflicting evidence regarding the sole impact of transformational leadership on the nursing staff's intention to remain. However, it highlights transformational leadership's ability to enhance job satisfaction and organizational commitment contributes significantly to retention. Conclusion. Using transformational leadership can effectively bolster nursing staff retention along with promoting other favorable workplace outcomes. Implications for Nursing Management. This review underscores the importance of enhancing leadership skills within nursing management. This involves not only fostering transformational leadership but also cultivating positive work‐related outcomes to optimize nursing staff retention. [ABSTRACT FROM AUTHOR]

Aims: To investigate the relationships between transformational leadership, psychological empowerment and innovative behaviour among nurses in China. Background: The innovative behaviour of nurses is important to adapt to the changing medical environment. However, there is currently a limited understanding of the relationship between nurses' innovative behaviour and transformational leadership and psychological empowerment during the pandemic. Methods: Convenience sampling was used to conduct an investigation involving 1317 nurses from 10 hospitals in China from January 2022 to April 2022. Data analysis was performed using correlation analysis, univariate analysis and multiple regression analysis. The STROBE checklist was followed when writing this manuscript. Results: High transformational leadership and high psychological empowerment were associated with high innovative behaviour. The results of the multiple linear regression analysis showed that physical condition, whether or not you have attended academic conferences or whether or not you have participated in fund research projects, transformational leadership and psychological empowerment were the main factors on nurses' innovative behaviour, together explaining 64.5% of the total variance. Conclusion: Promotion of transformational leadership and psychological empowerment is vital for nurses to promote innovation, thereby meeting the urgent demand for innovative nurses and the rapid development of nursing disciplines. Implications for Nursing Management: This study highlights the importance of transformational leadership in developing nurses' innovative behaviours. Understanding the role of psychological empowerment can help nurse managers formulate relevant intervention strategies and cultivate nurses' innovative behaviour. [ABSTRACT FROM AUTHOR]

Aims: To explore whether perceived overqualification increases the risk of burnout and whether transformational leadership negatively moderates this relationship. Background: Perceived overqualification might contribute to burnout and lead to poor experience of transformational leadership, and transformational leadership might be associated with burnout. However, these relationships have not yet been confirmed. Methods: A multicentre cross‐sectional study. A total of 321 nurses from intensive care units were recruited from six tertiary hospitals. Scale of Perceived OverQualification, Transformational Leadership Questionnaire and emotional exhaustion subscale of the Maslach Burnout Inventory—General Survey were employed to collect the data. Hierarchical multiple regression and bootstrap resampling were applied to analyse the data. Results: Burnout was positively associated with perceived overqualification and negatively associated with transformational leadership (each p < 0.05). Transformational leadership significantly mediated the relationship between perceived overqualification and burnout (b = −0.6389, 95% confidence interval: −0.8706, −0.4072). Conclusion: Our findings indicated that perceived overqualification and transformational leadership directly or indirectly affect burnout among nurses from intensive care units. Implications for Nursing Managers: Personal and organizational‐oriented interventions utilizing nurses' overall qualifications and implementing transformational leadership should be employed by nurse managers to alleviate burnout and promote the work performance of nurses from intensive care units. [ABSTRACT FROM AUTHOR]

Leadership behavior has been emphasized as one of the most important influencing factors in the innovation process. Leaders can encourage subordinates to innovate by creating the right environment, promoting knowledge integration, and setting specific goals. However, different leadership styles make different decisions and behaviors in the innovation process, and the final innovation effect is also different. Today, in the context of China, most business leaders still adopt "paternalistic" or "authoritarian" leadership behaviors, but more and more entrepreneurs and scholars are aware of the importance of this leadership style in enhancing employee creativity. Authoritarian leaders are more likely to exercise more control and supervision over team members, limit the autonomy of team members, and reduce work initiative and creativity. Although the positive effect of transformational leadership on employee creativity has been recognized by some scholars, in the real work environment, this leadership style rarely appears, especially in the context of China. This study first constructs a theoretical model of how transformational leaders in colleges and universities affect educational management innovation through the atmosphere of school organizational innovation, based on the deep learning theory and other related research results, and then puts forward research hypotheses on this basis. Secondly, a measurement scale was designed according to the existing research results, and the scale was revised through the pretest to form the formal questionnaire of this study. This research uses cluster sampling and random sampling to conduct a questionnaire survey on 1022 college teachers and uses the SPSS20.0 and AMOS21.0 to conduct an empirical analysis on the survey data. Each measurement scale was tested by exploratory factor analysis and confirmatory factor analysis. The experimental results show that the transformational leadership style of college principals has a positive impact on teachers' teaching innovation. There is a positive correlation between the influence of charisma and teachers' teaching management, and there is a positive correlation between intellectual stimulation and teachers' teaching management. [ABSTRACT FROM AUTHOR]

Aim: To explore the experiences of a nursing team who implemented an international nurse‐led clinical trial in practice and understand the facilitators to their involvement. Background: The role and responsibilities of the clinical nurse are advancing to encompass research activity to help inform evidence‐based practice. However, several personal and organisational challenges can inhibit nurses' capacity to implement and undertake research within clinical practice. Methods: Three focus groups were conducted with members of a nursing team (N = 18). Thematic analysis was employed, and themes were identified and agreed upon by the research team. Results: Five themes were identified: 'Previous experience of and attitudes to participation in clinical research', 'Decision‐making regarding participation in the clinical trial', 'Facilitators of participation in the clinical trial', 'Challenges of research in nursing practice' and 'Future orientation towards research'. Conclusion: Through their experiences of implementing a nurse‐led clinical trial within practice, nurses recognized a number of facilitators and challenges to their participation. The perceived relevance of the clinical trial to the nurses' practice, potential to improve patient care and appreciation of the nurse leader's expertise and understanding of their context were key motivators. Reciprocal trust with the nurse leader who was encouraging, motivating, supportive and accessible resulted in the engagement and commitment of the nursing team. Implications for Nursing Management: This paper offers a perspective that can inform senior nursing management teams when implementing and conducting evidence‐based research amongst nursing teams and in doing so meet the needs of developing research capacity amongst clinical nurses. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this research was to explore nurses' mentorship, mentors' basic psychological needs satisfaction and transformational leadership. Moreover, this study evaluated the moderating role of a protégé's mindfulness. Background: Previous research had only focused on the benefits that protégés reaped from the mentoring relationship, neglected the mentor's benefits. Method: We conducted an analysis of a cross‐sectional sample comprising 366 frontline nurses in China. Descriptive, correlation and regression analyses were conducted using SPSS 22.0. Mediating, moderating and conditional process analyses were conducted using Process Macro 3.3. Results: Mentorship is associated with mentors' transformational leadership through the satisfaction of their basic psychological needs (β =.13, 95% confidence interval [CI]: [0.05, 0.23]). The indirect association of mentorship and transformational leadership is stronger for protégés with low mindfulness levels (β = −.05, 95% CI: [−0.08, −0.02]). Conclusion: The establishment of healthy associations between mentors and protégés facilitates the fulfilment of the mentors' basic psychological needs, enhancing the former's transformational leadership, especially for protégés with low mindfulness levels. Implications for Nursing Management: Mentors should provide more meaningful knowledge about the organisation and protégés' career path, obtain information to help tailor the advice and put more energy into building trust‐based relationships with protégés. [ABSTRACT FROM AUTHOR]

The demand to comprehend leadership across the world is becoming necessary and more urgent since the inevitable trend of globalization. In today's global arena, on the one hand, China has maintained its remarkable economic performance and Chinese culture will have a more powerful influence in the foreseeable future; on the other hand, due to the policy of reform and opening and the economy market, western management theories and practices have flowed into the Chinese market and influencing Chinese companies. Thus Chinese leadership needs to develop more compatible with western leadership, thereby Chinese MNEs become more adaptive and competitive in the current global business environment. Against this background, this paper focuses on Confucian leadership, the most important Chinese leadership shaped by traditional Confucianism for more than 3000 years, and attempts to explore the compatibility of Confucian leadership and transformational leadership. After a thorough case study of Haier Group and its CEO Zhang, Ruimin, the research found that the great success of Haier is due largely to Zhang's Confucian-transformational leadership, which combines both the wisdom of traditional Chinese Confucianism and the essence of western transformational leadership theory. Therefore, it is demonstrated that Confucian leadership plays a vital role in shaping the management style and performance of Chinese companies, and there can be a high level of compatibility between Confucian leadership and transformational leadership. [ABSTRACT FROM AUTHOR]

Aim: To examine whether supportive supervisor (transformational leadership) and coworker (autonomy‐supportive) behaviours predict occupational commitment and turnover intention over time through autonomous motivation. Background: Nurse turnover is a serious issue in several countries, straining the efficiency of the healthcare system and compromising both the quality and accessibility of healthcare. Method: Longitudinal data were collected over 12 months from 387 French–Canadian registered nurses. Structural equation modeling was used to test the hypothesized model. Results: The relationships between predictors at Time 1 (supervisor and coworker behaviours) and occupational commitment and turnover intention at Time 2 are mediated by autonomous motivation at Time 1. Conclusion: In times of global scarcity, the present findings provide insights into how the healthcare work environment acts on nurses' occupational turnover and commitment. Implications for Nursing Management: Healthcare organizations are advised to foster supportive work environments and promote autonomous motivation to sustain the nursing workforce. [ABSTRACT FROM AUTHOR]

This paper aims to systematically analyze the reasons for the differences in the relationship between transformational leadership (TL) and project success and apply meta-analysis to summarize which dimensions of TL are the main driving forces for project success. Adopting the meta-analysis approach, we investigated 31 independent studies (N = 6475) and studied the theoretical moderators of this relationship from the perspectives of mediating variables, cultural background, and document type to test whether the moderating effects can explain the inconsistent research results. The results reveal that TL positively affects project success and leadership charm is the primary driver of TL. Also, the existence of a mediating mechanism has a more significant impact on the success of the leading project. Meanwhile, compared with project construction under the Western cultural background, countries with Eastern culture are more inclined to use a people-oriented philosophy for project management to promote project success. This research provides an empirical perspective to help project leaders select management talents, regulate leaders' words and deeds, and cultivate technical and soft leadership skills. Besides, this paper proposes a unique and nuanced view of the relationship between TL and project success, enhancing people's understanding of the TL's role in influencing project success. [ABSTRACT FROM AUTHOR]

Aim: This study aims to explore the relationship between work environment, job characteristics and person‐centred care for people with dementia in nursing homes. Background: Person‐centred care approaches have become a dominant indicator for good quality of care in nursing homes. Little is known about the relationship between work environment, job characteristics and person‐centred care in nursing homes. Method(s): Cross‐sectional data from the LAD study were used. Direct care staff (n = 552) of nursing homes (n = 49) filled an online questionnaire about work environment characteristics and person‐centred care. To examine relationships, multilevel linear regression analyses were conducted. Results: Associations were found between a higher transformational leadership style, less social support from a leader, a higher unity in philosophy of care, higher levels of work satisfaction, more development opportunities, better experienced teamwork and staff‐reported person‐centred care. Conclusion(s): In a complex nursing home environment, person‐centred care is influenced by organisational and work characteristics, shared values and interpersonal relationships. Implications for Nursing: Leaders may consider facilitating collaboration and creating unity between care staff, clients and family members in order to provide person‐centred care. Therefore, a transformational leadership style, educational programmes and coaching for leaders are recommended. [ABSTRACT FROM AUTHOR]

Aim: To understand the situational profiles of clinical nurse managers' transformational leadership practices in Saudi hospitals. Background: Clinical nurse managers' effective leadership may enable registered nurses to provide safe patient care. Methods: This included 29 clinical nurse managers and 318 registered nurses from three Saudi hospitals. Data were collected using the leadership practice inventory‐self and the leadership practice inventory‐observer. Results: A significant difference between self‐ and observer‐assessed transformational leadership practices of clinical nurse managers was found. There was also a significant difference in transformational leadership practice between Saudi and non‐Saudi clinical nurse managers. Ward experience of clinical nurse managers was statistically positively associated with higher ratings of "enabling others to act". Length of clinical nurse managers' experience was associated with "enabling others to act" and "encouraging the heart" practices. Conclusion: Clinical nurse managers rated their transformational leadership performance higher than that reported by registered nurses. Further, non‐Saudi clinical nurse managers working in Saudi hospitals overestimated the extent of their transformational leadership practices. Implications for Nursing Management: Clinical nurse managers should gather feedback about their leadership performance regularly and implement required changes. Hospital administrations should provide additional support to clinical nurse managers through effective leadership programmes, enculturation and team‐building strategies, to create a shared vision regarding the execution of optimal leadership. [ABSTRACT FROM AUTHOR]

Aims: To investigate the association between the five components of nurse managers' transformational leadership and each process of organisational learning in a hospital ward. Background: Elucidating the components of nurse managers' transformational leadership that promote organisational learning is needed. Methods: In 2018, 591 self‐report questionnaires from two hospitals in Japan were analysed, using the measurement scale for Organizational Learning Subprocesses and Multifactor Leadership Questionnaire. Hierarchical linear modelling was conducted using the wards' mean scores of five components of transformational leadership and five subprocesses of organisational learning. Results: None of the transformational leadership components were significantly associated with information acquisition, but all five were significantly positively associated with information distribution and information integration. Only some of the five components showed a significant association with information interpretation and organisational memory. Conclusion: Transformational leadership may be effective to promote the four organisational learning processes other than information acquisition. Implications for Nursing Management: A nurse manager should exercise leadership other than transformational leadership, or use other strategies to promote information acquisition. However, particular behaviours of transformational leadership, such as intellectually stimulating behaviours and personal considerations, could be effective in promoting the understanding of information among the members and establishing new routines. [ABSTRACT FROM AUTHOR]

Health care social workers' attitudes towards evidence‐based practice (EBP) are an indispensable precursor of implementing EBP. Using a subset including 405 health care social workers from the first nationally representative survey of social workers in China, this study empirically assesses how transformational leadership (TFL) promotes health care social workers' attitudes towards EBP. The results show that organisational learning capacity (OLC) and professional competence (PC) fully mediate the positive relationship between TFL and EBP attitudes. Furthermore, TFL, OLC and PC explain 56% of the variance in health care social workers' attitudes towards EBP. This result supports the perspective that both organisational factors and individual factors may facilitate social workers' positive attitudes towards EBP, but organisational factors are more important. Therefore, to adopt, use and sustain EBP in health care social work, learning and innovation in the organisation should be increased. Furthermore, it is important to help social workers improve their PC. [ABSTRACT FROM AUTHOR]

Aim: The aim was to determine whether there are relationships among transformational leadership, safe team climate, knowledge sharing and reflection, and team performance in nursing and social work teams. Background: Based on organisational learning theory, we hypothesized that transformational leadership could create a safe team climate that fosters knowledge sharing and reflection in teams and thus influences the performance of teams. Methods: We conducted a cross‐sectional study using questionnaires and validated scales to measure transformational leadership, safe team climate, knowledge sharing and reflection, and performance. The sample consisted of 32 teams (N = 32 teams, n = 183 team members). Results: We conducted structural equation modelling. The results indicate that reflection positively relates with team performance, transformational leadership has a direct positive relationship with safe team climate, and safe team climate has positive relationships with knowledge sharing and reflection. Conclusion: Our findings regarding transformational leadership's positive influence on teams in nursing and social work fill an important gap in the literature. The study's limitations are the use of self‐reports and a small sample size. Implications for nursing management: Our results indicate that transformational leadership can foster a safe climate in work teams and hereby team learning and performance. [ABSTRACT FROM AUTHOR]

Aim: To explore the impact mechanism of transformational leadership and clan culture on the willingness to stay of nursing staff in the aged care industry. Background: Previous researchers had paid much attention to the leadership and culture, yet it was unclear how the transformational leadership and clan culture influence the willingness to stay of nursing staff, especially those in the aged care industry. Methods: A questionnaire was conducted in an aged care agency in Anhui Province, with a total of 217 valid questionnaires collected for empirical analysis. Results: (a) Transformational leadership indirectly affects willingness to stay by affecting organisational commitment and job satisfaction. (b) Clan culture also affects the willingness to stay by affecting their organisational commitment and job satisfaction. (c) Professional identity also has a significant positive impact on the willingness to stay. Conclusions: The findings of the study emphasize the importance of transformational leadership and clan culture in enhancing the willingness to stay of nursing staff in the aged care industry, and clarify the specific impact mechanism. Implications for Nursing Management: Nurse leaders in the aged care agencies should improve transformational leadership, and strive to build clan culture to help retain nursing staff better. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to describe innovativeness among nurses and examine the impact of transformational leadership and demographic and occupational variables on individual innovativeness in nurses. Background: Staff nurses must be innovative in order to solve problems occurring in health care environments and implement evidence‐based practice. Methods: This descriptive, correlational cross‐sectional study comprised 300 nurses working in two hospitals in Turkey. The data were collected with a demographic and occupational questionnaire, the Individual Innovativeness Scale and the Transformational Leadership Scale. Data were analysed using descriptive statistics, Pearson's correlation and backward regression. Results: Most nurses were categorized as "early majority" (45.3%) or "early adopter" (39.3%) for innovativeness. Education level, position, high self‐perceptions of leadership skills and/or perceiving transformational leadership as a high‐performance expectation were associated with high levels of individual innovativeness. Conclusion: Almost half of the nurses were early adopters who can be role models to other nurses in the diffusion of innovation. Having higher education levels, positions, leadership skills and expectations from management affected nurses' individual innovation more positively. Implications for Nursing Management: It can be helpful for nurse managers to understand the adopter categories and affective variables of innovativeness for the diffusion of innovative practices and evidence‐based standards at hospitals. [ABSTRACT FROM AUTHOR]

Aim: This study examined the influence of toxic and transformational leadership practices on nurses' job satisfaction, psychological distress, absenteeism and intent to leave the organisation or the nursing profession. Background: Transformational leadership is attributed to favourable nurse consequences; however, the nursing literature is silent regarding the causal association between toxic leadership and nurses' job outcomes. Methods: This is a cross‐sectional study involving 770 registered nurses from 15 hospitals in Central Philippines. Data were collected using seven self‐report scales during the months of December 2019 to February 2020. Results: The composite scores for the transformational leadership scale and toxic leadership scale were 4.22 and 1.59, respectively. Toxic leadership predicted job satisfaction, absenteeism, psychological distress and intention to leave the profession. Transformational leadership predicted job satisfaction and intent to leave the profession. Conclusion: Results suggest that nurses working with a transformational leader report higher job contentment and lower intent to leave the nursing profession. Nurses who work for a manager exhibiting toxic leadership behaviours demonstrated lower job contentment, higher stress levels, frequent absenteeism and higher intent to leave the nursing profession. Implication for Nursing Management: Nurse retention strategies should include measures to foster transformational leadership and derail toxic leadership practices in nurse managers through evidence‐based education, training and professional development. [ABSTRACT FROM AUTHOR]

Aim: This study investigated whether generation Y nurses (1981–1995) adopt a different attitude about work than generation X caregivers (1966–1980) and baby boomers (1956–1965). Background: Employees' positive attitude to work engagement is a competitive factor for clinics. In age‐diverse team structures, possible different attitudes can lead to conflicts. Methods: As part of a quantitative, descriptive, cross‐sectional study with the survey instrument AVEM‐44, health and nursing staff, as well as nursing directors and ward administrators, were interviewed. Results: A total of N = 992 individuals (n = 312 nursing directors, n = 259 ward administrators and n = 421 nurses) were included in the study. Nurses and executives viewed generation Y as being less willing to give oneself out and as attaching less importance to work than generation X and the baby boomers. On the other hand, professional ambition was more important to generation Y than the older generations. Conclusions: Transformational leadership behaviour represents an approach to guide employees of different generations individually and to harmonize different attitudes. Implications for Nurse Management: To lead employees transformationally, it is necessary to know generation‐specific differences concerning attitudes towards work. [ABSTRACT FROM AUTHOR]

Aim: To characterize registered nurses' (RNs') perceptions of nurse leaders' transformational leadership (TL) qualities in Finnish university hospitals and identify predictors of positive and negative evaluations. Background: Transformational leadership can improve health care but requires development. Information on TL is typically derived from survey results, which are vulnerable to confounders. Method: Cross‐sectional survey. Registered nurses' perceptions of nurse leaders were measured with the TL scale. Kohonen's self‐organizing map was used to cluster the data based on RNs' opinions and questionnaire items. Logistic regression explained background characteristics' effects on cluster formation. Results: A total of 1,970 RNs participated and evaluated their nurse leaders' TL qualities as moderate. Giving feedback and rewarding clustered separately from other TL qualities. Females and permanent workers evaluated nurse managers more negatively but nurse directors positively. Positive perceptions of nurse managers' TL predicted better TL among nurse directors. Vice nurse managers gave the most positive evaluations. A total of 197 RNs had no opinions about nurse directors' TL. Conclusions: Registered nurses evaluated nurse managers' TL qualities as moderate and were unfamiliar with nurse directors. Background characteristics affecting evaluations differed between leader types. Implications for Nursing Management: Giving feedback and rewarding should be more closely associated with other TL qualities. Transformational leadership requires transformational approaches from both nurse managers and directors. [ABSTRACT FROM AUTHOR]

Transformational leadership (TL) is a highly discussed approach in the literature for many professions. Likewise, the TL approach continues to be explored in a myriad of nursing contexts to demonstrate its advantages for practice and client health. The tension between custody and care is particular to correctional nursing practice, such as the correctional priorities of safety and security that often override caring‐focused nursing practice. Presented herein, is information relating to correctional nursing leadership as found in the minimal, available literature; and hypothetical examples of how correctional nursing leaders can use TL are provided. Measuring the influence of TL on practice and offender health can assist in determining if this approach is an appropriate "fit" for the correctional nursing context. The dearth of literature regarding correctional nursing leadership must be addressed to advance this subspecialty of nursing and promote offender health. The intent is not to argue that TL is the only applicable leadership approach for this subspecialty of nursing. Rather, introductory insight is offered regarding the suitability of TL in correctional nursing practice. [ABSTRACT FROM AUTHOR]

Aims: This pilot study evaluated an Association Development and Professional Transformation (ADAPT) model for nursing leadership development and assessed satisfaction with the ADAPT workshop. Background: Nurses often lack self‐confidence and self‐efficacy in leadership roles. There is a need for nurses to take leadership opportunities that serve to advance the nursing profession. Methods: A quasi‐experimental pre‐test post‐test design was used. The sampling method selected professional nursing association (PNA) members. Novice participants completed a pre‐assessment and post‐assessment Leadership Practice Inventory‐Self (LPI‐S) survey and attended the ADAPT workshop. Experienced nurse leaders participated as mentors. Both groups completed a satisfaction survey after the workshop. Results: Awareness of nursing leadership behaviours increased. Total mean scores for each subscale on the LPI‐S increased but this was not statistically significant. All participants reported satisfaction with the ADAPT workshop. Conclusions: This study offers evidence that the ADAPT model influences leadership behaviours. The ADAPT workshop provided a method to gain a leadership perspective and to encourage nurses to fulfil a leadership role within professional nursing associations. Implications for Nursing Management: Organisations and professional nursing associations that support the leadership potential of nurses must invest in providing leadership development opportunities. [ABSTRACT FROM AUTHOR]

Aim: This study investigated transformational leadership from the perspectives of primary care nurse practitioners. Background: The growing workforce of nurse practitioners in the United States could play a critical role in meeting the increasing demand for primary care. Little is known about how leadership within primary care practices could promote nurse‐practitioner care. Transformational leadership is a widely recognized leadership style that affects clinician practice and outcomes. Method: A cross‐sectional survey design was used to collect data from nurse practitioners in New York state in 2012. The online survey containing measures of nurse practitioners and leadership relationships was completed by 278 nurse practitioners. Results: The four factors of transformational leadership—idealized influence, inspirational motivation, intellectual stimulation, and individual consideration—were recognized by nurse practitioners. Almost half of nurse practitioners reported that leadership did not share information equally between nurse practitioners and physicians (idealized influence), and 45.9% reported that nurse practitioners were not represented on important organisational committees (intellectual stimulation). Conclusion: Transformational leadership can be applied to promote nurse practitioner practice in primary care. Future research should explore how transformational leadership affects nurse practitioner care and outcomes. Implications for Nursing Management: Leaders in primary care practices should consider applying transformational leadership principles to promote nurse practitioner practice. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to determine whether elements of transformational leadership are present in nursing managers’ actions following adverse events. Background: Transformational leadership exerts a positive influence on organisational culture and patient safety. Method: Eleven nursing managers were interviewed individually using a semi‐structured format. Data were analysed using inductive content analysis. Results: Four themes emerged relating to nursing managers’ actions following adverse events: patient‐centredness as a principle for common action, courage to reform operational models to prevent future adverse events, nursing staff's encouragement of open and blame‐free discussion, and challenge to recognize adverse events. Conclusion: Nursing managers must understand their responsibilities and the importance of making it clear to staff that patient‐centredness should be evident in all health care actions. Nursing managers must also recognize the need to ensure that staff treat patients’ interests as the top priority. Implications for Nursing Management: If an adverse event occurs, the situation should be discussed with the nursing staff and any unique aspects of the event must be accounted for. Nursing managers must have the skill to motivate and empower staff to find new ways to work, to prevent adverse events and to promote patient safety. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study was to examine the role of staff nurse emotional intelligence between transformational leadership and nurse intent to stay. Background: Nurse intent to stay and transformational leadership are widely recognized as vital components of nurse retention. Staff nurse emotional intelligence that has been confirmed improvable has been recently recognized in the nursing literature as correlated with retention. Yet, the nature of the relationships among these three variables is not known. Methods: Cross‐sectional data for 535 Chinese nurses were analysed using Structural Equation Modelling. Results: Transformational leadership and staff nurse emotional intelligence were significant predictors of nurse intent to stay, accounting for 34.3% of the variance in nurse intent to stay. Staff nurse emotional intelligence partially mediates the relationship between transformational leadership and nurse intent to stay. Conclusion: The findings of the study emphasized the importance of transformational leadership in enhancing nurse emotional intelligence and to provide a deeper understanding of the mediating role of emotional intelligence in the relationship between nurse manager's transformational leadership and nurse's intent to stay. Implications for Nursing Management: Nurse leaders should develop training programmes to improve nursing manager transformational leadership and staff nurse emotional intelligence in the workplace. [ABSTRACT FROM AUTHOR]

Aim To validate a framework of factors that influence the relationship of transformational leadership and safety climate, and to enable testing of safety chain factors by generating hypotheses regarding their mediating and moderating effects. Background Understanding the patient safety chain and mechanisms by which leaders affect a strong climate of safety is essential to transformational leadership practice, education, and research. Methods A systematic review of leadership and safety literature was used to develop an organising framework of factors proposed to influence the climate of safety. A panel of 25 international experts in leadership and safety engaged a three-round modified Delphi study with Likert-scored surveys. Results Eighty per cent of participating experts from six countries were retained to the final survey round. Consensus (>66% agreement) was achieved on 40 factors believed to influence safety climate in the acute care setting. Conclusions Consensus regarding specific factors that play important roles in an organisation's climate of safety can be reached. Generally, the demonstration of leadership commitment to safety is key to cultivating a culture of patient safety. Implications for Nursing Management Transformational nurse leaders should consider and employ all three categories of factors in daily leadership activities and decision-making to drive a strong climate of patient safety. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to examine the relationships among education, leadership experience, emotional intelligence and transformational leadership of nurse managers. Background Nursing leadership research provides limited evidence of predictors of transformational leadership style in nurse managers. Methods A predictive correlational design was used with a sample of nurse managers ( n = 148) working in varied health care settings. Data were collected using the Genos Emotional Intelligence Inventory, the Multi-factor Leadership Questionnaire and a demographic questionnaire. Simple linear and multiple regression analyses were used to examine relationships. Results A statistically significant relationship was found between emotional intelligence and transformational leadership ( r = 0.59, P < 0.001) explaining 34% variance in transformational leadership. Conclusions Nurse managers should be well informed of the predictors of transformational leadership in order to pursue continuing education and development opportunities related to those predictors. Implications for nursing management The results of this study emphasise the need for emotional intelligence continuing education, leadership development and leader assessment programmes. [ABSTRACT FROM AUTHOR]

Aims This paper discusses the application of transformational leadership to the teaching and learning of safe medication management. Background The prevalence of adverse drug events ( ADEs) and medication-related hospitalisations (one hundred thousand each year in the USA) are of concern. Evaluation This discussion is based on a narrative literature review and scrutiny of international nursing research to synthesise pedagogical strategies for the application of transformational leadership to teaching medication safety. Key issues The four elements relating transformational leadership to medication safety education are: 'Idealised influence' or role modelling, both actual and exemplary, 'Inspirational motivation' providing students with commitment to medication safety, 'Intellectual stimulation' encouraging students to value improvement and change, and 'Individualised consideration' of individual students' educational goals, practice development and patient outcomes. The model lends itself to experiential learning and a case-study approach to teaching, offering an opportunity to reduce nursing's theory-practice gap. Conclusion Transformational leadership for medication safety education is characterised by a focus on the role of nurse educators and mentors in the development of students' abilities, creation of a supportive culture, and enhancement of students' creativity, motivation and ethical behaviour. This will prepare nursing graduates with the competencies necessary to be diligent about medication safety and the prevention of errors. Implications for nursing management Teaching medication safety through transformational leadership requires the close collaboration of educators, managers and policy makers. Investigation of strategies to reduced medication errors and consequent patient harm should include exploration of the application of transformational leadership to education and its impact on the number and severity of medication errors. [ABSTRACT FROM AUTHOR]

Aim To determine if nurse managers' leadership style is related to Japanese staff nurses' affective commitment to their hospital. Background In Western countries, nurse managers' transformational leadership style has been found to increase staff nurses' affective commitment to their hospital. However, there are few studies examining this relationship in the context of acute care hospitals in Japan. Methods Staff nurses completed measures of their nurse managers' perceived leadership style and factors related to their own affective commitment. The association between affective commitment and perception of leadership style was assessed with multiple logistic regression. Results Of 736 questionnaires distributed, 579 (78.9%) were returned, and data from 396 (53.8%) fully completed questionnaires were analysed. The intellectual stimulation aspect of transformational leadership positively increased staff nurses' affective commitment (odds ratio: 2.23). Nurse managers' transactional and laissez-faire leadership styles were not related to affective commitment among staff nurses. Conclusions The intellectual stimulation aspect of transformational leadership may increase the retention of staff nurses through enhanced affective commitment. Implications for nursing management To increase staff nurses' affective commitment to their hospital, we suggest that hospital administrators equip nurse managers with intellectual stimulation skills. [ABSTRACT FROM AUTHOR]

Aim This study explored the influences of transformational leadership on nurse innovation behaviour and the mediating role of organisational climate. Background Recently, global nursing experts have been aggressively encouraging nurses to pursue innovation in nursing in order to improve nursing outcomes. Nursing innovation, in turn, is affected by nursing leadership. Method We employed a questionnaire survey to collect data, and selected a sample of nurses from hospitals in Taiwan. A total of 439 valid surveys were obtained. Hierarchical multiple regression model analysis was conducted to test the study hypothesis. Result The mean values of agreement of nurse innovation behaviour and transformational leadership were 3.40 and 3.78, respectively. Patient safety climate and innovation climate were found to have full mediating effects on the relationship between transformational leadership and innovation behaviour. Conclusion Organisational climate has a significant impact on innovation behaviour. Transformational leadership has indirect effects on innovation behaviour via the mediation of patient safety climate and innovation climate. Implications for nursing management Hospitals should enhance transformational leadership by designing leadership training programmes and establishing transformational culture. In addition, nursing managers should foster nursing innovation through improvements in organisational climate. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to explore and understand the leadership experiences of modern matrons. Background Modern matrons were re-introduced to the National Health Service in 2002, and effective leadership has been identified as being essential for the role to be successful. However, there is minimal evidence of how modern matrons experience effective leadership. Methods The study used a descriptive generic qualitative methodology; one-to-one semi-structured interviews were conducted with nine matrons. This was subjected to an inductive thematic analysis. Results Three themes were found to influence modern matron's leadership experiences: leadership behaviours, negative influences and leadership investment. They did not follow one leadership style but adapted this to their situation. Various factors appeared to restrict their leadership effectiveness. Conclusions The findings suggest that exposure to a range of leadership styles should be included in preparation and CPD for the modern matron role and a more consistent job description and job purpose should be developed. Implications for nursing management Leadership styles such as transformational leadership alone do not meet the complex demands of nursing leaders, and therefore there is a requirement for greater flexibility in leadership development for all health care professionals. [ABSTRACT FROM AUTHOR]

This paper describes the changes in transformational leadership and quality outcomes that occurred between 2008 and 2011 in a Finnish university hospital that is aiming to meet the Magnet standards. Measurements were conducted in 2008-2009 and subsequently in 2010-2011 by surveying nursing staff and patients. Nursing staff were surveyed using web-based surveys to collect data on transformational leadership (n1 = 499, n2 = 498) and patient safety culture (n1 = 234, n2 = 512) and using both postal and web-based surveys to gather information on job satisfaction (n1 = 1176, n2 = 779). Questionnaires were used to collect data on care satisfaction from patients (n1 = 678, n2 = 867). Transformational leadership was measured using the 54-item TLS, job satisfaction with the 37-item KUHJSS, patient safety culture with the 42-item HSPSC, and patient satisfaction using the 42-item RHCS questionnaire. Transformational leadership, which was the weakest area, was at the same level between the two measurement occasions. Job satisfaction scores increased between 2008 and 2010, although they were generally excellent in 2008. The scores for nonpunitive responses to errors and events reported were also higher in the 2010-2011 surveys. The highest empirical outcome scores related to patient satisfaction. The project and the development initiatives undertaken since 2008 seem to have had positive effects on empirical quality outcomes. [ABSTRACT FROM AUTHOR]

Aim The overall aim of this study was to examine nurses' and patients' perceptions of the Magnet model components of transformational leadership and empirical quality outcomes in four Finnish hospitals and to determine if the evidence for transformational leadership and empirical quality outcomes is the same or different in the four hospitals. Background This report presents baseline measurements for a longitudinal study of the adaptation of the Magnet model in Finnish hospitals. Methods Web-based surveys and mailed questionnaires were used in 2008-2009 to collect data from patients ( n = 2566) about their satisfaction with care, and from nursing staff about transformational leadership ( n = 1151), job satisfaction ( n = 2707) and patient safety culture ( n = 925) in the selected hospitals. Results Awareness of the work of nursing leaders was low. Nurses reported a high level of job satisfaction. Patient safety culture varied considerably between the four hospitals. Patients believed they generally received excellent quality care. Conclusions Leadership systems are in transition at the hospitals. Patient safety culture is a complex phenomenon that may be unfamiliar to respondents. The results of the study provide a baseline description to guide the journey toward development of Magnet standards. Implications for nursing management Finnish nursing leaders, especially nursing directors, should increase their visibility by working more closely with their staff. They should also pay attention to giving direct feedback about work generally and patient safety issues in particular. [ABSTRACT FROM AUTHOR]

Aim The aim was to determine whether nursing leaders met the criteria for transformational and/or transactional leadership. Background Many changes have occurred in South Africa and are reflected in the health-care systems. As a result, it has become crucial to source leaders who are able to manage the change process effectively so as to ensure the success and survival of our health-care organizations. Methods The 45-item Multifactor Leadership Questionnaire (Rater) was completed by 41 respondents out of a population of 121. A proportional stratified simple random sampling technique was used to select the raters of seven leaders. Results Most nursing leaders role-modelled the culture of the organisation but did not stimulate their followers intellectually and did not demonstrate innovative motivation or individual consideration. Consequently, their followers may exhibit a lack of commitment to collective goals, with detrimental effects on the health-care organisation as a whole. Conclusions and implications for nursing managers Nursing leaders should be trained to become transformational leaders so as to encourage their followers to become innovative and motivated to render high quality nursing care. [ABSTRACT FROM AUTHOR]

munir f., nielsen k., garde a.h., albertsen k. & carneiro i.g. (2012) Journal of Nursing Management 20, 512-521 Mediating the effects of work-life conflict between transformational leadership and health-care workers' job satisfaction and psychological wellbeing Aim To explore the mediating effects of work-life conflict between transformational leadership and job satisfaction and psychological wellbeing. Background The importance of work-life balance for job satisfaction and wellbeing among health-care employees is well-recognized. Evidence shows that transformational leadership style is linked to psychological wellbeing. It is possible that transformational leadership is also associated with employees' perceptions of work-life conflict, thereby influencing their job satisfaction and wellbeing. Methods A longitudinal design was used where staff working within Danish elderly care completed a questionnaire at baseline and 18-month follow-up ( N = 188). Results Regression analyses showed that transformational leadership style was directly associated with perceptions of work-life conflict, job satisfaction and psychological wellbeing. Work-life conflict mediated between transformational leadership and wellbeing, but not job satisfaction. Conclusion The findings suggest transformational leadership style may improve perceptions of work-life balance and employee wellbeing. Implications for nursing management Managers should adopt transformational leadership styles to reduce work-life conflict and enhance the wellbeing of their staff. [ABSTRACT FROM AUTHOR]

davis j. & adams j. (2012) Journal of Nursing Management 20, 354-360 The 'Releasing Time to Care - the Productive Ward' programme: participants' perspectives Aim The aim of this study was to explore the perceptions of nursing staff concerning the implementation of the 'Releasing Time to Care - the Productive Ward' programme in a specialist cardiothoracic hospital. Background The 'Releasing Time to Care - the Productive Ward' programme uses the 'lean' philosophy originally developed in the Japanese motor industry to improve the efficiency of hospital wards. Its aim is to increase the proportion of time that nurses are able to spend in direct patient care. Method This study used a descriptive qualitative method with a sample size of four nurses and two health-care support workers. Thematic analysis of the interview transcripts was undertaken using the procedure developed by Burnard. Results Thematic content analysis identified five major themes: starting to implement the programme, anxiety and defensiveness, the importance of leadership and communication, challenges, and learning and personal development. Conclusion Overall, the programme had a positive impact on both the wards studied. Challenges that were identified included the need to sustain momentum once the initial enthusiasm had waned. Implications for Nursing Management This study highlighted the importance of key transformational leadership skills at ward manager level, such as the ability to inspire nurses to approach old problems in new ways, in the implementation of the 'Releasing Time to Care - the Productive Ward' programme. [ABSTRACT FROM AUTHOR]

(2011) Journal of Nursing Management, 487-497 Mental health nurses are agents of change, and their leadership, management role and characteristics exist at many levels in health care. Previous research presents a picture of mental health nurses as subordinate and passive recipients of the leader's influence and regard leadership and management as distinct from the nurses' practical work. The aim was to provide a synthesis of the studies conducted and to discuss the relationship between nursing leadership and nursing management in the context of mental health nursing. A literature search was conducted using EBSCO-host, Academic Search Premier, Science Direct, CINAHL and PubMed for the period January 1995-July 2010. Leadership and management in the context of mental health nursing are human activities that imply entering into mutual relationships. Mental health nurses' leadership, management and transformational leadership are positively related in terms of effectiveness and nurses' skills. It is important to consider mental health nurses' management as a form of leadership similar to or as a natural consequence of transformational leadership (TL) and that ethical concerns must be constantly prioritized throughout every level of the organization. [ABSTRACT FROM AUTHOR]

bamford-wade a. & moss c. (2010) Journal of Nursing Management 18, 815-821 Transformational leadership and shared governance: an action study Aims The present study demonstrates the practical relevance of the concepts of transformational leadership as a Director of Nursing working with structure (shared governance) and active processes, informed by action research, to achieve the incremental breakthroughs associated with culture change in nursing. Background Responding to the context of a decade of health reforms in a New Zealand tertiary hospital, the leadership challenge, as a Director of Nursing, was to find ways of transforming the nursing workforce. How could nursing evolve from a relatively disempowered position within the organization (impact of the reforms) and reshape to achieve effectiveness within the new organizational culture? Methods Interwoven with transformational leadership are action processes progressively moving forward through cycles of reconnaissance, planning, implementation and evaluation. The principles of shared governance 'partnership', 'equity', 'accountability' and 'ownership' underpin and work synchronically with the active processes in advancing the effectiveness of nursing. It is leadership for and in action. This study is descriptive and exploratory overall, and more specifically it uses reflective practice and self-reporting as methods. Results The outcomes of transformational leadership are evident in a confident, competent and committed nursing workforce which embraces continuous learning and expresses a professional respect for each other. Conclusions The practical inter-weaving of the concepts of transformational leadership, shared governance and action processes provide a framework for sustainable change processes both at a unit and organizational level. Implications for nursing management It is the interplay between the three concepts that generates a process of creative innovation, questioning and challenging existing structures to try and reach a new level of excellence through the participation and valuing of nurses and nursing practice. [ABSTRACT FROM AUTHOR]

malloy t. & penprase b. (2010) Journal of Nursing Management  18, 715-725 Nursing leadership style and psychosocial work environment Aim This study examines the relationship between leadership style and the psychosocial work environment of registered nurses. Background Research consistently supports the positive relationship between transformational leadership style and job satisfaction. There is less evidence, which identifies the relationship between leadership style and psychosocial work environment. Method The Multifactor Leadership Questionnaire 5× was used to identify the leadership style. The Copenhagen Psychosocial Questionnaire was used to measure psychosocial work environment dimensions. Statistical analysis included Pearson's r correlation between leadership style and psychosocial work environment andanova to analyse group means. Results There is a significant correlation between leadership style and 22 out of the 37 dimensions of the psychosocial work environment. This correlation was significant ranging from r = 0.88, P < 0.01 to r = 0.18, P < 0.05. Nurses divided into groups based on transformational leadership scores of the immediate supervisor report significant differences in their psychosocial work environment. Conclusion This study supports the significant correlation between leadership style and psychosocial work environment for registered nurses. Implications for nursing management The results of this study suggest that there would be an improvement in the nursing psychosocial work environment by implementation of transformational and contingent reward leadership behaviours. [ABSTRACT FROM AUTHOR]

solman a. (2010) Journal of Nursing Management 18, 472–476 Director of nursing and midwifery leadership: informed through the lens of critical social science Aims Highlight the use of critical social science theories, practice development principles and a situational leadership framework within transformational leadership to inform Directors of Nursing and Midwifery (DoNM) practices as leaders. Background Healthcare is constantly changing, unpredictable, strives for quality service and cost containment, which can result in stress and crisis for healthcare workers. DoNM leadership is critical to supporting and leading staff through these complex times within healthcare. Key issues Understanding theories, frameworks and their application to real-world practice can assist in supporting individuals and teams to navigate through the changing healthcare environment. Conclusion Blending critical social science theories with practice development principles and the situational leadership framework can assist the DoNM to enact transformational leadership to support the development of individuals and teams to meet the complex healthcare needs of patients within the clinical setting. Implications for nurse management This article contributes through the practical application of critical social science theories, practice development principles and situational leadership framework within transformational leadership as an approach for enacting DoNM leadership. To further understand and develop in the role of the contemporary DoNM in leadership, these directors are encouraged to publish their work. [ABSTRACT FROM AUTHOR]

grant b.,colello s.,riehle m. &dende d. (2010) Journal of Nursing Management 18, 326–331 An evaluation of the nursing practice environment and successful change management using the new generation Magnet Model Aim To discuss the new Magnet Model as it relates to the successful implementation of a practice change. Background There is growing international interest in the Magnet Recognition Programme. The latest generation of the Magnet Model has been designed not only as a road map for organizations seeking to achieve Magnet recognition but also as a framework for nursing practice and research in the future. Evaluation The Magnet Model was used to identify success factors related to a practice change and to evaluate the nursing practice environment. Key issues Even when proposed changes to practice are evidence based and thoughtfully considered, the nurses’ work environment must be supportive and empowering in order to yield successful and sustainable implementation of new practice. Conclusion Success factors for implementation of a practice change can be illuminated by aligning environmental characteristics to the components of the new Magnet Model. Implications for nursing management The Magnet Model provides an exceptional framework for building an agile and dynamic work force. Thoughtful consideration of the components and inter-relationships represented in the new model can help to both predict and ensure organizational vitality. [ABSTRACT FROM AUTHOR]