“Navigation to prioritizing the patient” – first-line nurse managers’ experiences of participating in a quality improvement collaborative

Sjølie, Berit Mosseng; Hartviksen, Trude Anita; Bondas, Terese

doi:10.1186/s12913-020-4918-z

Cited by 14 publications

(14 citation statements)

References 27 publications

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“…Multiple studies have identified a positive link between the relational leadership style and nurses' job satisfaction [3,6,40], while other research has linked this leadership approach with patient satisfaction [2,3,41]. In addition, it is challenging for nurse managers to lead quality improvement in the complex everday environment of a health care organization [42]. Recent studies have shown that leadership, managerial support and nurse-manager trust reduce medication errors and increase both patient safety culture and the quality of care [5,6,43].…”

Section: Introductionmentioning

confidence: 99%

Relationships between nurse managers’ work activities, nurses’ job satisfaction, patient satisfaction, and medication errors at the unit level: a correlational study

Nurmeksela

Mikkonen

Kinnunen

et al. 2021

BMC Health Serv Res

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Background Nurse managers play a critical role in enhancing nursing and patient outcomes. The work of nurse managers, who can be described as middle-managers at health care organizations, is complex and changes on a daily basis. Only a few studies have clarified how nurse managers divide their time across various work activities. This study aimed to describe the relationships between nurse managers’ work activities, nurses’ job satisfaction, patient satisfaction, and medication errors at the hospital unit level. Methods A cross-sectional and correlational study design was used. The data were collected from nurse managers (n = 29), nursing staff (n = 306), and patients (n = 651) from 28 units across three Finnish acute care hospitals between April and November 2017. In addition, data concerning medication errors (n = 468) over one calendar year (2017) were acquired from the hospitals’ incident reporting register. Analysis of covariance (ANCOVA) was used to estimate relationships between data from subareas of Nurse Managers’ Work Content Questionnaire, Kuopio University Hospital Job Satisfaction Scale, and Revised Humane Caring Scale, along with medication error reports. A significance level of 95% was applied when estimating the covariances between variables. Unstandardized regression coefficients (B) were used to explain the relationships between variables. Results Multiple relationships between nurse managers’ work activities, nurses’ job satisfaction, patient satisfaction, and medication errors were identified. Nurse managers’ work activities had both positive and negative relationships on the other studied variables. The Requiring factors of work (p < .001) subarea of nurses’ job satisfaction, total patient satisfaction (p < .001), and medication errors (p < .001) were identified as the variables most significantly affected by other factors. Conclusions The findings suggest that nurse managers should focus on improving nursing practices by managing and organizing nurses’ work in a way that makes their employees feel supported, motivated and secure. Furthermore, nurse managers should adopt a leadership style that emphasizes safe and patient-centered care. The results also suggest that the administration of today’s health care organizations should actively evaluate nurse managers’ share of work activities to ensure that their daily work is in line with the organizational goals.

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Section: Introductionmentioning

confidence: 99%

Relationships between nurse managers’ work activities, nurses’ job satisfaction, patient satisfaction, and medication errors at the unit level: a correlational study

Nurmeksela

Mikkonen

Kinnunen

et al. 2021

BMC Health Serv Res

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“…The literature highlights the important role of leaders in improving collaboration (Lemetti et al, 2015). According to Sjølie et al (2020), first-line nursing managers are essential for improving the quality of care; they are able to change work practices, which leads to better outcomes for patients. However, in our context, the assistance units are physically far from the management ones (Guzmán-Fernández, 2011).…”

Section: Discussionmentioning

confidence: 99%

Primary healthcare midwives’ experiences of caring for parents who have suffered an involuntary pregnancy loss: a phenomenological hermeneutic study

et al. 2021

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“…These daily adaptations and resource restrictions affected the way that managers prioritise the ordinary operations of services and integrate quality and safety improvement activities. A recent qualitative study of front-line nurse managers found that both a lack of time for quality improvement work and a lack of time generally when several problems needed to be solved led to hasty solutions and not permanent improvement work in nursing homes and homecare services (Sjølie et al, 2020). Our study co-designed an intervention that was contextually sensitive to the challenges facing managers in their daily work, their risk picture and also in terms of where they were performing well (Paper I).…”

Section: Multiple Challenges In Quality and Safety Workmentioning

confidence: 99%

“…Boundary objects can also promote knowledge sharing and transfer within groups and facilitate learning (Kanwal et al 2019). In healthcare settings, boundary objects are often used to improve interprofessional collaboration (Engstrøm et al, 2005;Keshet et al, 2013;Sjølie et al, 2020;Wiig et al, 2014b).…”

Section: The Leadership Guide As a Boundary Object For Managers In Qu...mentioning

confidence: 99%

Exploring the role of managers in quality and safety work in nursing homes and homecare services; A multiple case study

Johannessen¹

2022

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Introduction: Working on quality and safety in nursing home and homecare services is difficult. Ever-increasing demands from an ageing population and political pressure to keep patients at home are among the challenges facing nursing homes and homecare. There is less knowledge of patient safety risks and adverse events in primary care than in specialised healthcare. Aim: This thesis explores the role of managers in quality and safety work in nursing homes and homecare services. Moreover, the thesis designs, implements, and evaluates a leadership intervention in nursing homes and homecare services to support managers’ quality and safety work. Methods: This study was designed as a two-phase longitudinal multiple case study consisting of design and pilot testing; and implementation and evaluation of the SAFE LEAD intervention. The intervention is based on a leadership guide and includes several workshops and learning activities facilitated by researchers. In phase 1, the intervention was designed with researchers, co-researchers and managers from two nursing homes and one homecare service. The pilot test of the leadership intervention was conducted in one nursing home and one homecare service. Data collection consisted of focus group interviews and observation of managers. Phase 2 started by exploring quality and safety challenges as perceived by managers and employees in two nursing homes and two homecare services prior to participation in the leadership intervention. The study then continued with a longitudinal study of the implementation and evaluation of the leadership intervention and its influence on managers quality and safety work. Data collection in phase 2 included focus group interviews, observations, workshops and site visits with managers and employees. Data analyses in phases 1 and 2 included deductive content analysis and interweaving of observation and interview data. Results: The results describe all activities from development to evaluation of a leadership intervention and its influence on managers’ quality and safety improvement work in nursing homes and homecare services. Paper I detailed the involvement of stakeholders and demonstrated how a participatory approach was important for adaptations of a leadership guide to nursing home and homecare contexts. An intervention that managers could use in their work practice was developed and pilot tested in one nursing home and one homecare service. A key finding in Paper I is the role of context and the need to tailor intervention material (web and booklet) to the context and to the needs, time constraints, language, and interests of managers. Paper II explored managers’ and employees’ perceptions of quality and safety challenges in two nursing homes and two homecare services before the intervention took place. Managers and employees found that quality and safety challenges depended on several factors and implied multiple trade-offs. Managers struggled with external change processes, budget cuts that affected common understanding of and commitment to quality and safety improvement at managerial and staff levels. Paper III showed that the intervention workshops and leadership guide contributed to a common understanding and commitment to quality and safety in the management teams. The leadership intervention influenced managers’ work practice in different ways depending on capacity and needs in the organisations. The leadership guide and the workshops created a social and reflexive arena for quality and safety work in which managers could focus on these topics. Moreover, it provided the managers with a tool for clearer sense of quality and safety work in different settings. Managers found it important that someone established a structure and took responsibility for scheduling and organising quality meetings. However, management continuity and the establishment of structures were crucial for the intervention to be adopted. Conclusion: The longitudinal insight in this thesis broadens the understanding of contextual impact on quality and safety work in nursing homes and homecare services and showed the comprehensive work with translating knowledge into practice. The thesis demonstrates the importance of participatory approach and involvement of stakeholders when designing a leadership intervention. Managers and employees perceived interrelated quality and safety challenges and found context work to be time consuming to make quality and safety improvement common efforts in the organisations. The leadership intervention created a place for reflection for managers and brought a more structured process and commitment to organisational quality and safety work.

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“Navigation to prioritizing the patient” – first-line nurse managers’ experiences of participating in a quality improvement collaborative

Cited by 14 publications

References 27 publications

Relationships between nurse managers’ work activities, nurses’ job satisfaction, patient satisfaction, and medication errors at the unit level: a correlational study

Relationships between nurse managers’ work activities, nurses’ job satisfaction, patient satisfaction, and medication errors at the unit level: a correlational study

Primary healthcare midwives’ experiences of caring for parents who have suffered an involuntary pregnancy loss: a phenomenological hermeneutic study

Exploring the role of managers in quality and safety work in nursing homes and homecare services; A multiple case study

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