Date of Award

2012-05-01

Degree Name

PhD Nursing

Dissertation Committee

Linda Urden, DNSc, RN, CNS, NE-BC, FAAN, Chair; Cynthia Connelly, PhD, RN, FAAN; Ann Mayo, DNSc, RN, FAAN

Keywords

leadership, magnet hospitals, non-magnet hospitals, nurse managers, nursing, patient outcomes

Abstract

In 2004 the Institute Of Medicine called for healthcare leaders to embrace and adopt transformational leadership practices to promote quality of care and favorable patient outcomes. Nurse managers are accountable for 24-hour operations of their departments and influence patient outcomes. The purpose of this research was to examine the relationships among nurse manager transformational leadership practices, patient outcomes and hospital types (Magnet, On The Journey, and Non-Magnet). A correlational study examined relationships between self-reported transformational leadership practices of nurse managers and patient outcomes by hospital types. The study was conducted using a purposive sample of Association of California Nurse Leader membership database. In addition nurse managers at one San Diego based hospital participated in the study after IRB approval was received. The measurement tools utilized for this study include the Leadership Practices Inventory (LPI) and an investigator designed demographic questionnaire. A One-Way ANOVA showed no statistically significant differences in transformational leadership practices of nurse managers among hospital types and patient outcomes. Levene's test confirmed that there were no differences in the mean variances between hospital types. Pearson's correlation was conducted and showed a positive correlation between the LPI sub-scale Encourage Others to Act (EOA) and patient falls that was moderate and statistically significant, r(22)=.421, p<.05; and a positive correlation between the LPI sub-scale Inspire a Shared Vision (ISV), and hospital acquired pressure ulcers was moderate and statistically significant, r(22)=.406, p<.05. A multiple linear regression analysis was conducted to explore to what extent the LPI total scores predicted patient fall rates and HAPU. Nurse manager experience and LPI scores did not account for a significant amount of variance in HAPU rates, F=.666, p=.678, R2=.190. Nurse manager experience and LPI scores did not account for a significant amount of variance in patient falls, F=2.446, p=.069, R2=.463. Further research should explore transformational leadership practices of nurse managers assessed by the staff that report directly to the manager. Nurse managers should eliminate barriers to support the delivery of quality patient care utilizing transactional and transformational leadership practices. A larger sample size is needed to further explore impact of leadership practices and patient outcomes.

Document Type

Dissertation: Open Access

Department

Nursing

Included in

Nursing Commons

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