Nurse performance: A path model of clinical leadership, creative team climate and structural empowerment

Abstract

Aims and Objectives This study aimed to: (a) identify and examine the influence of clinical leadership, creative team climate (CTC) and structural empowerment (SE) on the nurse performance (NP) of clinical nurses in hospitals in Turkey, and (b) establish a model designed to verify the fit and effect of these factors. Background Nurse performance is a significant indicator of work efficiency, patient care quality and patient safety. Existing studies explaining the mechanisms that lead to higher nurse performance have been limited. Design This descriptive, cross‐sectional study used relation prediction modelling and adhered to STROBE guidelines. Methods This study used an online survey to collect data from volunteered 664 clinical nurses working in hospitals in Turkey. The data were analysed using SPSS version 26.0 and the AMOS 24.0 program. Path analysis was used to verify/test the hypothetical model, and the fit was evaluated by χ2/df, GFI, AGFI, NFI, CFI, IFI, RFI, TLI, RMR and RMSEA. Results The fit index of the modified path model was χ2/df = 3.730, GFI = 0.904, AGFI = 0.892, NFI = 0.907, CFI = 0.923, IFI = 0.923, RFI = 0.906, TLI = 0.912, RMR = 0.078 and RMSEA = 0.064. Through creative team climate and structural empowerment, clinical leadership had the greatest standardised direct (β = .35) and indirect (β = .17) effects on clinical nurse performance, the final outcome variable. Creative team climate (β = .23) and structural empowerment (β = .19) also had a significant standardised direct effect on nurse performance. Clinical leadership, creative team climate and structural empowerment explained 39% of the total variance of nurse performance. Conclusions This study shows that clinical nurse performance in hospitals was significantly influenced by clinical leadership, creative team climate and structural empowerment. The results suggest that intervention programmes considering these factors could be implemented to enhance nurse performance. Relevance to Clinical Practice Improved nurse performance requires strong clinical leadership, creative team climate and structural empowerment. Therefore, healthcare organisations may implement initiatives to enhance nurse performance by taking these factors into account.

Impact of Structural Employee Empowerment on Hospital Ratings: Mediating Role of Social Climate and First-Line Managers’ Resilience

“…42 Studies affirm the substantial influence of structural empowerment, clinical leadership, and a creative team climate on hospital performance. 45 Access to empowering structures not only positively affects FLMs' performance but also benefits patients, contributing to overall facility ratings. 43,46 An empowering environment can provide the best care and a healthy, engaged staff.…”

The association between team cohesion and performance: A network analysis of nurses

“…Team cohesion is defined as the tendency of a team to unite and remain united in the pursuit of its goals (Tekleab et al, 2009), which motivates team members to be more willing to unite and cooperate with other members to jointly complete team tasks (Majeed et al, 2023). For nurses who spend a great deal of time working together, effective cooperation and collaboration are critical to providing the best feasible care to patients and achieving optimal productivity (Anselmann et al, 2023; Karatepe & Turkmen, 2023). This suggests that team cohesion, as an important force leading to effective teamwork, may play an integral role in enhancing team performance, which has been supported by previous studies (Majeed et al, 2023; Wang et al, 2022).…”

“…The nursing team is an important sector in the healthcare system and its level of team performance has been an important issue (Anselmann & Mulder, 2020; Seok & Lee, 2021). Poor nursing team performance not only affects the development of the whole team, but also leads to adverse care events, reduces the quality of nursing services, and poses a serious threat to patient safety (Han et al, 2023; Karatepe & Turkmen, 2023). Team performance can be influenced by many factors, of which team cohesion—one of the most common team states studied—is a strong protective factor (Chiu et al, 2023; Majeed et al, 2023).…”