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探索变革型和交易型领导风格对护理绩效及患者结局的影响。

Exploring the Impact of Transformational and Transactional Style of Leadership on Nursing Care Performance and Patient Outcomes.

作者信息

Al-Rjoub Saleem, Alsharawneh Anas, Alhawajreh Mohammad J, Othman Elham H

机构信息

Department of Community & Mental Health Nursing, Faculty of Nursing, The Hashemite University, Zarqa, Jordan.

Department of Adult Health Nursing, Faculty of Nursing, The Hashemite University, Zarqa, Jordan.

出版信息

J Healthc Leadersh. 2024 Dec 27;16:557-568. doi: 10.2147/JHL.S496266. eCollection 2024.

Abstract

BACKGROUND

The form of leadership that can positively influence nursing care performance and patient outcomes remains a crucial subject in the healthcare sector.

AIM

This study examines the effect of leadership style at different managerial levels on nursing care performance and patient outcomes.

METHODS

A retrospective cohort study was conducted in a public hospital, focusing on two primary settings: the general ward and the critical care unit. The study sample included 60 nurses and 300 patients. The leadership style is a predictor of this study and was measured using a cross-sectional survey of Jordanian nurses using the Multifactor Leadership Questionnaire (MLQ). Nursing care performance and patient outcomes were measured by surveying patients, observing practice, and reviewing health records. The analysis involved descriptive statistics, chi-square tests, odds ratios, and multivariate regression analysis.

RESULTS

The study found that transformational leadership was predominant in the general ward, while transactional leadership was more common in the critical care unit. Leadership styles significantly influence clinical nursing performance. Nurses under transformational leaders were more likely to follow generic policies like patient surveillance but less consistent with specific care standards. Nurses under transactional leaders were linked to higher adherence to standardized care protocols like fall risk assessment and medication rights. Patient outcomes were similar between units, except for higher readmission rates under transactional leadership.

CONCLUSION

The study's findings underscore the complexities of nurse leadership styles and clinical nursing performance. Nurse manager should adapt their leadership style to the particular setting and a one-size-fits-all approach to leadership may not be effective in healthcare.

摘要

背景

能够对护理绩效和患者结局产生积极影响的领导形式仍是医疗保健领域的一个关键课题。

目的

本研究考察不同管理层面的领导风格对护理绩效和患者结局的影响。

方法

在一家公立医院开展了一项回顾性队列研究,重点关注两个主要场所:普通病房和重症监护病房。研究样本包括60名护士和300名患者。领导风格是本研究的一个预测因素,采用多因素领导问卷(MLQ)对约旦护士进行横断面调查来衡量。通过对患者进行调查、观察实践以及查阅健康记录来衡量护理绩效和患者结局。分析包括描述性统计、卡方检验、优势比和多变量回归分析。

结果

研究发现,变革型领导在普通病房占主导,而交易型领导在重症监护病房更为常见。领导风格对临床护理绩效有显著影响。变革型领导下的护士更有可能遵循诸如患者监测等一般政策,但在具体护理标准方面的一致性较低。交易型领导下的护士与更高程度地遵守诸如跌倒风险评估和用药权利等标准化护理协议相关。各病房之间的患者结局相似,但交易型领导下的再入院率较高。

结论

该研究结果凸显了护士领导风格和临床护理绩效的复杂性。护士长应根据具体环境调整其领导风格,一刀切的领导方式在医疗保健中可能并不有效。

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