Comprehensive Report on Clinical Leadership in Nursing Practice

This report provides a comprehensive overview of clinical leadership in nursing, emphasizing its importance in delivering quality patient care and fostering professional development. It explores various domains of clinical leadership, including personal qualities, teamwork, service management, direction setting, and service improvement. The report also delves into the roles of clinical leaders in budgetary allocation, curriculum evaluation, and advocacy for nurses' rights. The literature review highlights the significance of nurse leaders in ensuring effective, safe, and high-quality services, as well as their role in advocating for nurses' well-being. The project plan outlines the goal of understanding clinical leadership roles, expectations, objectives, and key outcomes, along with resources and evaluation methods. The report concludes by underscoring the critical role of clinical leadership in shaping the nursing profession and ensuring optimal patient outcomes.

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Running Head: CLINICAL LEADERSHIP
Clinical leadership in nursing
Author’s name:
Submission date:

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Contents
Introduction.................................................................................................................................................2
Project aim..................................................................................................................................................3
Background..................................................................................................................................................4
Domains of clinical leadership in nursing....................................................................................................5
Ability to demonstrate personal qualities...............................................................................................5
Working with others................................................................................................................................6
Managing services...................................................................................................................................6
Setting direction......................................................................................................................................6
Improving services...................................................................................................................................7
Literature review.........................................................................................................................................7
Introduction to the literature review.......................................................................................................7
Body of the literature review...................................................................................................................9
Conclusion of the literature review.......................................................................................................10
Project plan...............................................................................................................................................11
Goal of the project.................................................................................................................................11
Expectations of the project....................................................................................................................12
Body of the project................................................................................................................................12
Objectives and evidence of achievement..............................................................................................14
Objectives of the achievement..............................................................................................................14
Evidence of achievement.......................................................................................................................15
The key outcome used to determine the success of the project...........................................................15
Resources used to implement the project.............................................................................................16
Project evaluation plan..............................................................................................................................16
Project conclusion.....................................................................................................................................16
References.................................................................................................................................................19

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Introduction
Clinical leaders are leaders or managers within the health care setting. It is a situation
whereby some members of the health care profession offer to guide other members of the
profession (Swanwick & Mickimm 2017). Clinical leaders are required to have an additional
leadership and management training in addition to their nursing training. Most of the qualified
registered nurses have done a leadership and management unit which helps them step in as
leaders in-case the need arises. Nurses who occupy bigger leadership position in the nursing
profession have specialized in leadership and management in nursing at the masters or doctorate
level.
Clinical leadership is an important aspect of the nursing profession because it helps
the nurse provide quality patient care. Clinical leadership ensures that services provided by
nurses are often evaluated and changes are made according to the most effective strategies which
will achieve optimal patient care. Clinical leaders also determine and allocate finances to the
health care facility. They are given the authority to write the clinical budget because they are
well versed with the clinical area (Ham, Baird & Gregory et al,,, 2015).
Leadership in the clinical area, not only benefits the client but, it also benefits the
profession by ensuring continuous development within the profession. Continuous development

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is made possible through on job trainings, seminars and school breaks for nurses with the
intention of broadening their scope of knowledge and specialization.
Clinical leaders in nursing have the mandate of evaluating and making changes to the
nursing curriculum; they also fight for professional recognition and appropriate pay. Clinical
leaders should be disciplined, courageous, humane, intelligent, and trustworthy. These five traits
should be balanced for leadership to be effective too much of a trait may result in faulty
leadership for instance too much discipline may result in cruelty which will result in poor work
performance. A balance in the five trait results in effective performance.
Clinical leadership in nursing is associated with all other management functions such
as controlling, staffing, directing, controlling, planning and organizing (Swanwick & Mickimm,
2017). In clinical nursing there are different roles; there is the charge nurse, nurse manager and
service director.
Project aim
The aim of this project is to understand the roles of clinical leadership in nursing,
to understand the different leadership roles in clinical leadership nursing and the functions of
clinical leadership in nursing (Pegram, Grainger & Sigsworth, 2014). It is important for the
student to understand the roles or functions of a clinical leader in nursing context, because some
may go into leadership after completing nursing school. The role of the clinical leader is ensuring
the provision of quality services through adequate budgetary allocation which ensures that clients
get comprehensive and quality care at the health care facility (Huber 2017).

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Background
Leadership is a vital element in any group of professionals. Leadership is
responsible for the group’s progress and success (John, 2017). Clinical leadership in nursing is
no exception, nursing leaders are responsible for the progress of the nursing profession and the
success of nursing services and quality of the nursing services offered to clients (Kozier, 2008).
Beneficiaries of clinical leadership in nursing are both the clients and the nurses
themselves. The clients benefit in terms of the services offered and the nurses benefit from
having a stable leadership function that has the nurse’s best interest in mind. Most of the leaders
in nursing are elected by fellow nurses. It is a requirement for everyone vying for a leadership
role in any of the nursing service to be nurse in any field of nursing for them to be eligible for
such a role.
The aim of nurse leaders is to ensure that they uphold the profession through competency
exhibited during their leadership regime and they should ensure that the nursing profession is
treated with the dignity and respect it deserves. Nurse leaders should be creative and innovative
through researching and investigating better ways f offering nursing services to the public
(Ennis, Happel & Reid-Searl 2015).
Effective leadership is important in nursing so as to ensure effective, safe and high
quality services are provided to clients in all the nursing fields (Morton, Hudak & Galla, 2013).
Leadership is dynamic to all groups; therefore it is not confined in a certain group of
professionals. The aim of nursing services is to ensure that all clients receive safe and high
quality care and this is made possible by effective and efficient leadership (Northhouse, 2018).

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Nurses are the patients advocate and for them to offer quality services they need leaders who are
competent and leaders who understand the importance of a nurse in an organization.
In health care nurse leaders work in collaboration with leaders from other
departments to ensure that the goals and objective of the facility are meet on time and above all
they work in collaboration to ensure that the client receives high quality, safe and humane care
without discrimination and stigmatization associated with certain conditions (Cherry & Jacobs,
2016).
It is the duty of leaders in nursing to ensure that clients get the best service and that
their rights are respected and protected when receiving health care in a hospital, a nursing home,
a maternity or any other form clinical set up even in a dentist clinic. Clinical leaders in nursing
ensue that nurse uphold humanity and empathy when dealing with clients and they are
responsible for disciplinary actions and conflict management when need arises (Peltzer, Ford &
Shen et al,,, 2015).
Domains of clinical leadership in nursing
The main aim of nursing is delivery of services. Delivery of services is the main
constant in all fields of nursing. To effectively offer nursing services a leader must be competent
in the following domains; that are the ability to demonstrate personal qualities effectively, ability
to work with others, ability to manage services, ability to improve services and the ability to set
direction. These elements are requisites for nursing leaders. The leaders form the mainstay of the
services offered (Webb, Mitchell & Nyatanga et al,,,2018). Good leadership results in excellent
service provision, whereas bogus leadership results to poor service provision.

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Ability to demonstrate personal qualities
This domain is further subdivide into four parts; integrity, self-management,
continual personal development, and self-awareness. For a leader to function effectively they
must be aware of their strengths and weaknesses, they should be able to manage themselves time
wise and goal wise dealing with the priorities first (Wong, 2015). Leaders should be open
minded and have room for continuous personal development, over the course of leadership,
leaders will meet with many people who have different ideas. Leaders should be able to select
and assimilate the beneficial ideas and leave out the non-beneficial ideas. Leaders should be able
to act with integrity and without biasness (Storey, Holti & Hartley et al,,, 2018).
Working with others
A leader should be able to work leaders from other department. A hospital requires
other departments for it to be fully functional; therefore nurses and their leaders should be able to
work harmoniously with leaders from other departments for the hospital to meet its objectives
and goals. A good leader should have good interpersonal skills and good communication skills to
be able to work with others (Joseph & Huber, 2015).
Managing services
A leader should be able to manage the nursing services effectively and efficiently.
A leader should ensure that all services are provided in the right way and by the right person. In
nursing there are different fields of nursing, it is the duty of the leader to identify the number of
nurses available and their field of specialization, this helps the leader to allocate duties according
to the different areas of specialty, thus enhancing the quality of nursing services provided (Scully
2015). A clinical nurse leader should ensure that the available resources are well planned for and

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well utilized. The leader should also access the performance of the team and evaluate it for
changes if need arises (Veronessi, Kirkpatrick & Altanblar, 2015).
Setting direction
A clinical nurse leader is given the duty of setting the teams direction. Clinically
the position of the team leader is given to the person with the most experience and the top most
education level. This role is entrusted to such a person because they have the most knowledge
about nursing services and management. The leader uses evidenced based knowledge to make
changes in the provision of nursing services and evaluates the impact of the change implemented
and the efficacy of the nursing services provided. A nurse leader makes decision regarding the
profession and evaluates the need for change. They should use their unique managerial
knowledge to ensure that the clients get the best form of nursing services and the nurse is paid
well for the services offered (Daly, Speedy & Jackson, 2015).
The leaders set direction for the profession and quality of services offered. An
effective and efficient leadership results in good outcome, both in the services provided and the
wages provided, poor leadership results in a poor outcome both in the quality of services
provided and the wages given to the nurse (Moorley & Chin, 2016).
Improving services
This is the mainstay domain of the nurse leader. The leader has the ability to improve
services because of the referent power that comes with the leadership position. A leader has the
authority to make changes where necessary; therefore it is the duty of a nurse leader to critically
evaluate the services offered for effectiveness and efficiency and make the necessary changes

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that ensure that clients receive quality services (John, 2017). A leaders should facilitate
transformation and encourage innovation and improvement of services offered.
Literature review
Introduction to the literature review
Nurses require leaders to guide and manage them. Nursing just like other departments
needs leadership; therefore a leader is selected by fellow colleagues or the state that is given the
authority to make decisions and changes affecting the nursing profession and provision of
services to clients (Ramazani & Jergeas, 2015) A nurse leader advocates for quality provision of
services to client and they uphold the profession through fighting for the rights of nurses to good
working environment and sustainable wages equivalent to the time and skills offered to clients.
The nurse is trained on providing compassionate care to the client and providing a
listening ear to the clients concerns. Patients are more comfortable around nurses because nurse
spend most of their time taking care of them and they have a unique bond; therefore the client is
likely to disclose more information to the nurse because of the rapport created (Mannix, Wilkes
& Daly, 2015).
Nurse leader play a very important role in ensuring that nurses provide the best
form of care. Clinical nurse leaders are responsible for ensuring that nursing services are
evaluated for effectiveness and efficiency (Fischer, 2016). The evaluation process should
determine the need for changes in the nursing curriculum at school or during provision of
services.

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Nurse leaders are divided into leaders of nursing unions, leaders of the nursing
regulatory bodies and leaders of nursing services within a hospital set up (Grossman & Valiga,
2016). Leaders in the nursing regulatory bodies are responsible for creating and making changes
in the nursing curriculum. Leaders of the nursing unions are responsible for advocating nurse’s
grievances to the government and relevant bodies for changes in their working conditions and
wages. Leaders within the hospital; set up are responsible for the nursing services provided at a
health care facility (Liang, Tang & Wang et al,,,2016).
The charge nurse reports to the director of nursing services who reports to the
chief nursing officer who reports to the medical director or the chief executive officer of the
facility. This is the chain of command used in a hospital setting and in conflict management
(Dubois, Hanlan and Koch et al,,, 2015).
Literature review
Clinical nurse leader was developed in the United States with the aim of preparing
highly trained nurses in the improvement of quality and safe provision of services to the clients.
Clinical nurse leaders are registered nurse with an additional training on leadership and
management who oversees patient care, implement evidence-based solutions to challenges faced
by nurses at their work place and during training (Bender, 2016). The clinical nurse leader has a
duty to assess the client’s health risk when receiving services and the nurse’s health risk when
offering services. They should develop quality improvement strategies and facilitate team
communication between the nursing team and other departments working in the healthcare
facility.

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This role was developed and certified by the American Association of the college of
Nursing in July 2007, after the first certification examination was done in May 2007. Currently
there are over 2500 nurse who are trained and are working as clinical nurse leaders in various
regions (Zanchetta, Edwards & Salomi et al,,, 2016).
The need for clinical nurse leaders arose after a study was conducted and the findings
were 44000-98000 people die due to medical errors; therefore the need for highly skilled nurses
whose main aim was assessing patient’s health risk and advocating for quality patient care
increased. This lead to the joint participation of the American Association of college of Nursing
and American organization of Nurse Executives, who developed and revised a curriculum for
clinical nurse leaders, thus curriculum was later adopted by other nursing schools in other
regions of the world (Grossman & Valiga, 2016). According to literature quality of is determined
by managerial decisions made at the lower levels of management. This implies that decisions
made by clinical leaders directly influence the quality of care provided at the health care facility
(Doherty, 2013).
Nurse leaders are trained on leadership and management on top of the basic
training for a nurse. This helps them when making financial decisions especially in the budget
allocation (Patterson & Krouse, 2015).
Conclusion of the literature review
Leaders make the most important part of the nursing profession. They are tasked with
the duty to manage the profession and set the direction for the profession. They determine the
outcome of the nursing profession and strategies for service delivery (Hubner, Shaw and Thye et
al,,, 2016).

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Nursing is a profession that involve dealing with people at their most vulnerable and
delicate moments in life. The type of leaders leading nurses determine the type of services
provided. Nurse leaders ensure that all nursing services are available, availability is ensured
through budgetary allocation and if not, they invent and come up with innovative strategies that
will help their clients (Storey, Holti & Hartley, 2015). These strategies are evaluated for
effectiveness and efficiency and they are then documented for continued and future use if they
are safe for the client in terms of effective service delivery and efficiency in service delivery
(Hafteinsdottir, Hamer & Francke et al ,,, 2016).
Leaders in the nursing profession have to be willing to learn and continue their
education. For instance some nursing procedures a decade ago are now outdated, like
documenting is now solely done by computers. Technology has come to help by reducing the
workload for example the time used for documenting or manually looking for patient files has
now been reduced to seconds by computers, it is easier to access information on patients files
today compared to 4 decades ago (Westrup, 2017). It is the duty of the leaders to ensure that all
nurses accustom to using computers and they are all computer literate. Leaders play a key role in
ensuring that nurses and other health care professionals have the ability to utilize technology,
because technology is known to enhance efficacy of the services provided. All of these factors
determine how nurses provide their services, and it is the duty of the leaders to research, analyze
and understand these factors and their interaction with the profession (Lin, Maclennan & Hunt et
al,,, 2015).

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Project plan
This project will involve nurse leaders in the clinical perspective. It will involve the
charge nurse, the director of nursing services in the institution, the chief nursing officer and the
medical director. These cadres are directly involved with running the nursing profession and the
delivery of nursing services.
Goal of the project
The goal of the project is to ensure:
Safety of nurse in their workplace, by analyzing their working environment, and
revising their wages
Quality services are offered to clients
Maintain the professions integrity.
Encourage continued learning within the profession.
Expectations of the project
It is expected that after the implementation of this project, there will be enhanced
communication between the department of nursing services and other departments within the
health care facility.
Enough research and data analysis on provision of nursing services will be conducted
and evaluated for efficiency and effectiveness.
It is expected that the leaders will be able to identify and meet the needs of the nurses and
the patients.

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Body of the project
This project is aimed at improving leadership which will in turn improve the nursing
services offered at all the health care facilities. The leaders are the main component of this
project whereby they will be taught on the importance of the nursing profession and their roles as
nursing leaders (Park, 2015).
The goals are centered on clients, nurses and nurse leaders because of their daily
interactions in the hospital set up.
The main task is to be carried out by the nurse in charge who will be reporting to the
director of nursing services within the facility. The nurse leader will organize lessons for the staff
nurses and they will entail the importance of technology, the importance of communication, the
importance of enough wages for the nurses, the importance of proper equipment use and the
importance of upholding the professional dignity through offering safe and quality nursing
services to clients (Brown, Edwards & Seaton et al ,,, 2017).
The project will take place in 10 working days. 5 official working days will be used to
evaluate, analyze and collecting feedback from the staff nurses and interviewing clients and
nurse to assess the level of satisfaction of the nursing services they get. After the interviews the
topics will be taught in 5 working days and the nurse leaders will coordinate the project, and they
will be reporting to the chief nursing officer.
Studies conducted show that leaders should be able to demonstrate good personal
qualities. They should be able to work with others, leaders should be able to engage with others
during the decision making process, because leaders have the obligation of setting direction of
the teams they lead (Backman, Ahnlund & Sjogren et al,,,2018).

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Communication and dialogue make the main elements of leadership. Dialogue between
the leader and their team members enables the nurse leader make decision regarding the
profession, these decision are communicated to their supervisors who then implement the
strategies discussed.
Nurse leaders are known to engage fellow nurses when making decisions regarding the
nursing profession and its development. Nurse leaders encourage positive professional
development through on job training and workshops organized to ensure that nurses are trained
on the latest updates concerning nursing procedures and provision of quality services.
Objectives and evidence of achievement
Objectives of the achievement
The objectives of the project are:
To evaluate other departments role in quality service delivery. Educating the nurses on
the importance of communication with fellow nurses and with other departments within the
health care facility. The importance of communication will be accessed by use of questionnaires.
Leaders ensure that there is coordination between departments, which lead to provision of safe
and quality services.
To understand the role of budgetary setting in the delivery of services at health care
centers or clinics. In clinical setting finances play an important role in determining how the
operations will be conducted. Budgetary determination and allocation is done by the clinical

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leaders, who have the capability of determining and analyzing the amount of money the facility
needs to run. Needs and services offered at the facility must be analyzed and evaluated in order
to determine their budgetary allocation.
The clinical area is allocated the most amount of money by the Government during the
budgetary allocation. It is the duty of the leaders to determine how this money will be utilized in
an economical and sensible way. Money allocated to health care facility usually comes from
insurance funds and taxes collected from the people. These funds are collected and distributed in
all health care facilities with the aim of ensuring that every person has access to safe and quality
services.
Clinical Leaders can best provide budget in health care settings as they are more
associated with it. According to the National Health Service it is the duty of the leaders to ensure
that health services are comprehensive and universal at the point of delivery (Ham, Baird &
Gregory et al,,,2017).
To identify the role of public administration in determining of budget is critical
factor for Clinical Leaders. Public administration is responsible for allocating funds and
reviewing the budget for clinical leaders. This objective will be assessed through evaluation of
funds utilization within the clinical area. Clinical leaders play a pivotal role in determining the
financial budget at their work place because they spend most of their time at the clinical area;
therefore it is easy to come up with a budget and adhere to it (Pegram, Grainger & Sigsworth et
al,,,2014).

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Evidence of achievement
Evidence of achievement will be analyzed after 6 months whereby the leaders
will evaluate the effectiveness of the project through evaluation of services provided and
utilization of funds. Evaluation will be conducted through use of interviews and questionnaire.
They will be administered to clients and nurses. The data collected will be tabulated by the
director of nursing services and the chief nursing officer who will report the findings to the
medical director.
The key outcome used to determine the success of
the project
The factors determining the success of the project will be the successful
achievement of the objectives. Proper use of funds indicates an achievement of one of the
objective. Proper coordination and communication between the departments is an indication of
the successful implementation of the project.
Resources used to implement the project
Implementing the project will involve the government and the regulatory bodies.
The government plays the role of making and implementing policies which allow
implementation of the project. The regulatory bodies ensure that these policies are adhered to
and the monitor the evaluation of the project.
Project evaluation plan
The plan will be evaluated 6 months after the implementation of the project to assess its
effectiveness and efficiency. This evaluation will help analyze the need for additional changes
and modification of the strategies used. The plan will include use of questionnaires and face to

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face interviews with the clients to assess satisfaction of services offered and interviews with the
department directors. Questionnaires will be used to analyze the effectiveness of communication
across the departments, client satisfaction and staff satisfaction on the services offered and wages
offered.
Communication is the key to successful project implementation and evaluation. The
questionnaires will be used to analyze the importance of technology and profession integrity.
Project conclusion
Leadership is vital for the smooth running of operations in any facility or
organization. In a facility all department need leadership the nursing department included. Nurse
leaders are nurses who have taken extra training in leadership and management. This helps them
fulfill their role as leaders because they have the training needed to lead other nurses. Nurse
leaders are selected by fellow nurses mostly through elections. The nurses entrust their well-
being and service delivery to their leaders. Nurse leaders ensure that clients receive quality care
and the working environment for nurses is safe and their wages are fair. The leaders are used for
conflict management between nurses and between the nursing department and other departments.
Leading is a vital part for professional development, because leaders will come up
with strategies and innovative ideas which not only uphold the integrity of the nursing profession
but ensure safe and quality services are provided to the clients. Nurse leaders also evaluate the
nursing profession, the nursing curriculum, the provision of nursing services, and the strategies
used in the provision of services. They are also advocate for technology, because currently
technology is a vital part of human existence. Leaders evaluate the need for change, how the
change is perceived and the effectiveness of change within the nursing profession.

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The purpose of nurse leaders is controlling all the nursing services provided at the
health care facility, directing the nursing services provided at a facility, organizing the nursing
services provided, planning for the nursing services offered at a health care facility and staffing
of nurses at the health care facility (Daly, Jackson & Mannix et al,,, 2014). These leaders come
up with the budget for the services provided and implement the budget with the aim of providing
comprehensive, universal, safe and quality services (Sigsworth, Pegram & Grainger 2014).
Nurse leaders research and collect data on service provision and service satisfaction
and they come up with strategies to mitigate the challenges faced by nurses at their workplaces
and the challenges faced by clients during acquisition of services at a healthcare facility.
The role of a nurse is to ensure that a client receives the best form of care at the health
facility. The nurse is the patient advocate, teacher and educator. They will listen to their concerns
and they will come up with strategies to ensure that the clients receive the best form of care. It is
the duty of the leaders to make sure that nurses act according to their professional code of
conduct and they maintain professional integrity by observing ethical boundaries.

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