Clinical Leadership and Nursing: A Literature Review

This literature review examines the importance of clinical leadership in nursing and its impact on patient safety and quality of care. The review analyzes four primary articles on clinical leadership and nursing, highlighting different leadership issues addressed in the articles.

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Introduction
In several regions of the industrialized world, modern healthcare is faced by labor force
challenges, ever-changing client anticipations, along with demand, growing pressure for access
to care and matters to do with the degree of quality and safety of healthcare. Emerging from
these multifaceted trends is the task of leadership in the clinical environment. The significance of
efficient clinical leadership (CL) is guaranteeing a high-class healthcare organization, which
constantly offers secure and efficient form of care has been emphasized in many studies
(Moscrop, 2012). Clinical leadership has become an important component of the nursing
profession given the challenging and demanding environment that nurses operate in. CL is
described as the course of influencing point-to-care innovation along with development in both
the organizational practices plus person care routines to attain safety and quality of nursing care
results (Bamford, Wong & Laschinger, 2013).
Consequently, clinical leadership among the nurses regards increasing care for safety and
quality through the use of innovation along with the improvement. The puts the prospect for
clinical leadership in the sphere of every direct healthcare provider, particularly the nurses who
are usually at direct contact with patients offering care. There is the obvious call for for CL in
nursing due to several and diverse point-of-care implementation challenges that come up
(Kirwan, Matthews & Scott, 2013). Therefore, many governments and healthcare providers
around the world have continued to promote efforts designed to promote clinical leadership,
especially among the nurses to promote the quality and safety of the patients; hence, improving

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the outcomes of care. The paper will review the literature of four primary articles on clinical
leadership and nursing and examine the different leadership issues addressed in the articles.
Literature Review
Daly et al (2015) argue that the current growing demands for healthcare services and the
increasing costs of healthcare system has placed pressure on healthcare providers to rethink their
leadership needs. The authors claim there is need of transformative leadership to ensure that
these emerging challenges in the healthcare sector are addressed to maximize the safety and
quality of care offered to patients. It is clear that clinicians, especially nurses not only make
frontline decisions, but also need technical know-how to promote the quality of care. The authors
utilize the transformational leadership theory towards promoting care. In addition, the authors
underscore the need for effective leadership to guarantee a high-quality healthcare system, which
constantly offers safe and efficient care (Daly, Jackson, Mannix, Davidson & Hutchinson, 2014).
Thus, nurses will play a leading role in embracing knowledge that will promote clinical
leadership in offering best care to the patients. The authors effectively identify the concern that
CL is not a limited realm of any specific group, but all teams of the healthcare team, including
nurses are seen as prospective leaders. Consequently, the article provides insightful information
regarding clinical leadership and nursing and uses many examples that make the article good for
research. However, the authors should endeavor and examine more leadership theories to support
the subject on clinical leadership (Edmonstone, 2014).
According to Häggström, Holmström & Jong (2017), clinical leadership in the nursing
practice has an important role in promoting the safety, as well as quality of care to the patients.

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The growing challenges among the nurses demands that nurses should be trained on appropriate
knowledge that will impart leadership skills and competence. The authors emphasize the need to
clinical leadership among nurses working in the intensive care unit (ICU) because the
environment is demanding. Thus, the authors similar to other authors emphasize that nurses
should develop leadership skills that will enable them to deal with different situations that they
face on regular basis (Häggström, Holmström & Jong, 2017). The authors employs grounded
theory that better offer better understanding on the need to clinical nurses, especially in ICU to
better develop leadership skills. The theory allows the nurses to reconcile their professional
identity while delivering care to different patients in the clinical environment. The article
provides thoughtful information that makes the article appropriate for research in the field of
clinical leadership. One recommendation of the article is that it should investigate more on the
impact of clinical leadership among other nurses in different units, such as emergency
departments (Ennis, Happell & Reid-Searl, 2015).
According to Lindell and Huber (2015) emphasize the significance of CL in the modern
nursing environment. The authors argue that the realization of the Affordable Care Act (ACA),
promote the responsibilities of nurses from nurses of care coordinator, clinical nurse leader
(CNL), in addition to advanced practice registered nurse (APRN) have come to be front position
nurse. Like other authors, Lindell and Huber stresses the current changing demand for high-
quality and safe care by clients, nurses are needed to develop better leadership skills to handle
these demands. They claim that nurses are need to develop leadership skills that will allow them
to use evidence-based practice (EBP) for problem-solving, as well as product of managing.
Hence, there is the apparent need for CL that will promote the safety of the patient and

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healthcare outcomes. In order to promote clinical leadership among nurses, the authors
underscore the significance of transformational leadership theory that is evidence-based theory
as an approach as a way of working in the complication of nursing care plus the utilization of
interdisciplinary teams (Lindell & Huber, 2015). The authors also used middle-range theory to
provide recommendations for future development of clinical leadership among nurses. They
emphasize that this leadership theory addresses some leadership competencies that will boost the
delivery of care. This is an excellent article that offers comprehensive information on improving
clinical leadership through transformational leadership as a guide towards providing safe and
high-quality care to patients. In addition, the authors used many examples and studies that
support the main arguments (Wong, Cumming & Ducharme, 2013).
Husebø and Olsen (2016) argue that CL has long been acknowledged as vital for
maximizing the safety, excellence along with interpersonal teamwork in demanding, as well as
demanding environments. The authors acknowledge that clinical leadership is vital in promoting
safe and quality care where it is a requirement for nurses to understand the multifaceted structure
of care for the advantage of patients, as well as guaranteeing healthy workplaces. The authors
employ behavioral-based competency models to advance the need to clinical leadership in the
nursing practice towards promoting competency among the leaders. The results of the study
indicated that the top leaders in the nursing profession in healthcare setting should carry to
promote continuous learning and education towards imparting necessary knowledge on nurses
(Husebø & Olsen, 2016). The strength of the study is the utilization of qualitative plus
quantitative techniques of research that allowed the authors to collect the needed data. These
techniques were instrumental in providing reliable and valid information on the need of clinical

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leadership in the healthcare setting for nurses to improve patient care that is safe and of high-
class (Mannix, Wilkes & Daly, 2013). The authors should in the future undertake more research
to determine the effective of clinical leadership among those nurse leaders working in the
emergency departments (EDs) on how the leadership improves the patient outcomes.
Recommendations and Conclusions
Effective clinical leadership is linked to optimal healthcare performance in promoting the
safety in addition to quality of care towards the benefit of the client. Because nurses are in the
frontline in delivering care to patients, should endeavor to cultivate knowledge through
education and continuous learning to promote their knowledge on clinical aspects. Developing
clinical leadership skills in the nursing practice among nurses along with other healthcare
professional is of critical significance in addressing the current issues. Clinical leadership will
specifically boost the efficiencies of nurses and improve the quality of care that will ensure that
patients the best care (Leeson & Millar, 2013).
It is recommended that educators in the field of nursing should develop, train, plus
educate nurses both for the nursing practice in universal and as well for the kinds of works that
they are anticipated to get in the future. The education and training of nurses should be founded
on a blend of particular experience degrees plus supplementary knowhow gaining because CL
needs extra experience and education on the part of the nurse.

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References
Bamford, M., Wong, C.& Laschinger, H. (2013). The influence of authentic leadership and areas
of worklife on work engagement of registered nurses. Journal of Nursing Management.
21(3):529–40.
Daly,J., Jackson, D., Mannix, J., Davidson, P.M. & Hutchinson, M. (2014). The importance of
clinical leadership in the hospital setting. Journal of Healthcare Leadership. 6(1): 75-83.
Edmonstone, J.D. (2014). Whither the elephant?: the continuing development of clinical
leadership in the UK National Health Service. International Journal Health Planning
Management. 29(3):280–291.
Ennis, G., Happell, B., & Reid-Searl, S. K. (2015). Clinical Leadership in Mental Health
Nursing: The Importance of a Calm and Confident Approach. Perspectives in
Psychiatric Care, 51(1), 57–62.
Häggström, M., Holmström, M.R. & Jong, M. (2017). Establishing Patient Safety in Intensive
Care-A Grounded Theory. Open Journal of Nursing. 7(1), 1157-1171.
Husebø, S.E& Olsen, Ø.E. (2016). Impact of clinical leadership in teams’ course on quality,
efficiency, responsiveness and trust in the emergency department: study protocol of a
trailing research study. BMJ Open. 6(1):e011899.
Kirwan, M., Matthews, A. & Scott, P.A. (2013). The Impact of the Work Environment of
Nurses on Patient Safety Outcomes: A Multi-Level Modelling Approach. International
Journal of Nursing Studies, 50(1); 253-263.

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Leeson, D. & Millar,M. (2013). Using the 7 Habits programme to develop effective leadership.
Nursing Management. 20(6):31–37.
Lindell, J.M. & Huber, D.L. (2015). Clinical leadership development and education for nurses:
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Mannix, J., Wilkes, L & Daly, J. (2013). Attributes of clinical leadership in contemporary
nursing: an integrative review. Contemporary Nurse. 45(2):10–21.
Moscrop, A. (2012). Clinical leadership: individual advancement, political authority, and a lack
of direction? British Journal of General Practice. 62(598):e384–e385.
Wong, C.A., Cumming, G.G. & Ducharme, L. (2013). The relationship between nursing
leadership and patient outcomes: a systematic review update. Journal of Nursing
Management. 21(5):709–724.