Clinical Leadership in Nursing: Evidence-Based Practice Report

This report critically analyzes four research papers on clinical leadership in nursing, exploring the significance of effective leadership in improving the quality of care within healthcare settings. The report examines studies by Démeh and Rosengren (2015), Stanley (2014), Mannix, Wilkes, and Daly (2013), and Martin et al. (2012), focusing on leadership styles such as transformational, affiliative, and visionary leadership, as well as transactional and situational leadership. The analysis highlights the importance of positive work environments, effective communication, and the reduction of job stress and workload in nursing. The report also discusses the limitations of each study and suggests recommendations for future research, emphasizing the need for comprehensive leadership models that address the challenges faced by nursing professionals. The findings underscore the role of clinical leadership in fostering patient satisfaction and improving overall healthcare outcomes.

Running head: CLINICAL LEADERSHIP IN NURSING
Evidence Based Practice
Name of the Student
Name of University
Author’s note

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Introduction
The workplace under the healthcare settings experiences a number of challenges. These
challenges are mainly guided by the increase in the expectations of the service users, more focus
over the patient centred care, reduction in the cost of care, reducing unwanted hospital admission
and increase in the level of patient satisfaction (Stanley & Stanley, 2018). These challenges are
mainly pronounced under hospital or the nursing home settings and are mostly experienced by
the nursing professionals who spent majority of the time in ward, serving for the patients. Thus,
proper management of the challenges experienced by the nursing professionals require optimal
application of clinical leadership (Stanley & Stanley, 2018). The following paper aims to
examine the importance of clinical leadership in nursing professionals for increasing the overall
quality of care. In doing so, the paper will critically analyse 4 research papers published online
which are based on the central theme of clinical leadership in nursing. This assignment will
analyse the study conducted by Démeh and Rosengren (2015), Stanley (2014), Mannix, Wilkes
and Daly (2013), Martin et al. (2012). The critical analysis will be based on leadership styles
highlighted in the paper along with a focus on the limitations. At the end the paper will highlight
possible recommendations for the further research in clinical leadership as stated by the authors
of the four papers and how clinical leadership styles can be effectively implemented.

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Critical analysis of the papers
Démeh, W., & Rosengren, K. (2015). The visualisation of clinical leadership in the content of
nursing education—a qualitative study of nursing students' experiences. Nurse education
today, 35(7), 888-893.
Démeh and Rosengren (2015) conducted a qualitative descriptive style study under the
healthcare settings of Jordan with an aim to describe the experiences of the nursing students in
the domain of clinical leadership during the final year of the undergraduate course. The data was
collected in a written narrative format from 20 nursing students. The analysis of the content
highlighted that clinical leadership model is a valuable tool for bridging the gap between practice
and theory in the nursing education. Effective clinical leadership model helps in smooth
transition of a nursing student to a qualified yet competent registered nurse who is capable to
executing the duties under tight work pressure. The main limitation of the article is low sample
size. Sample size below 100 restricts the generalizability of the data leading to the generation of
biased results (Parahoo, 2014). From the overview of the paper, it can be gauged that the main
leadership model highlighted is affiliative leadership. Affiliative leadership is helpful in the
establishment of harmony and augment morale. This help to increase the interaction among the
members (Pundt & Herrmann, 2015). This friendly leadership styles motivates the aspiring
nurses to get accustomed with the work culture of the nursing professional through overcoming
the hurdle of job stress. This approach is relevant in nursing profession as friendly leadership
styles executed by the nursing mentor help the newly recruited nurse to get accustomed with the
clinical proceedings. It also helps to manage job stress and workload (Chávez & Yoder, 2015).
However, Démeh and Rosengren (2015) recommended proper focus over the views of the
associated stakeholder will help to design the pillars of clinical leadership in a succinate manner.

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Stanley, D. (2014). Clinical leadership characteristics confirmed. Journal of Research in
Nursing, 19(2), 118-128.
Stanley (2014) conducted comparative study in order to compare and contrast results of
two studies undertaken by the same researcher in order to study the important characteristics of
clinical leadership in nursing. The two studies which were compared used almost identical
questionnaire but the only different is the data of conduction of the two studies is 6 years apart.
The main focus group of the study is the healthcare professionals. The findings of the study
showed that though the difference is 6 years, the under clinical leadership in nursing leaders are
followed as the role models and they are known for their values, clinical competency,
communication skills inspiring confidence and integrity. The findings are relevant in nursing
profession as because it upholds the concept of visionary leadership. Visionary leadership theory
is somewhat identical to transformational leadership. The only difference is the leaders mainly
look up to the prospect in the future. In order to make the future smooth, the leader inspires, train
and motivates the team mates. This help to increase the level of positive energy and an optimistic
attitude of visionary leader help the members to stay focused and hopeful (Van Knippenberg &
Stam, 2014). According to Hall et al. (2016), a positive attitude in the work environment is
effective in nursing professions as it helps the nurses to stay focused, overcoming the job stress
and thereby helping to reduce the chances of medication errors. One of the limitations of the
study conducted by Stanley (2014) is, it selected comparison of two studies conducted by same
author and thus might include observational bias (Parahoo, 2014).

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Mannix, J., Wilkes, L., & Daly, J. (2013). Attributes of clinical leadership in contemporary
nursing: an integrative review. Contemporary Nurse, 45(1), 10-21.
Mannix, Wilkes and Daly (2013) also conducted a study with an aim similar to Stanley
(2014). However, the research approach used by Mannix, Wilkes and Daly (2013) was
systematic review. The authors selected 10 research papers in their review in order to understand
the important attributes defining the contemporary clinical leadership in nursing. The review
highlighted that both practical and technical skills are important for effective clinical leadership
in nursing. Apart from these skills, effective communications also holds importance in nursing
leadership. It helps in the establishment of friendly relationship and this creates positive work
environment. The review mainly highlighted the concept of clinical leadership in nursing as a
positive leadership approach which helps to increase confidence and reduces stress. This
approach of clinical leadership highlighted in the review is relevant in nursing research because
it coincides with the transformational leadership theory. Transformational leadership style in
nursing deals with the encouragement of the employees to deliver their best at work through
motivating them with awards and recognition (Avolio & Yammarino, 2013). Dumdum, Lowe
and Avolio (2013) stated that an effective transformational leaders help the nursing professionals
to work in a positive environment and this helps the nursing professionals to overcome their
professional stress. Though the importance of effective leadership in nursing is highlighted under
the light of transformational leadership theory by Mannix, Wilkes and Daly (2013), the authors
further recommended more research over the topic so that it becomes easier for the nursing
professionals to quickly adopt this leadership approach. However, the study has one limitation, it
reviewed only 10 articles, this might decrease the generalizability of the research.

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Martin, J. S., McCormack, B., Fitzsimons, D., & Spirig, R. (2012). Evaluation of a clinical
leadership programme for nurse leaders. Journal of Nursing Management, 20(1), 72-80.
The aim of the study conducted by Martin et al. (2012) was to evaluate the impact of
clinical leadership program in establishing the competencies of leadership skills among the
nursing leaders. The study approach was missed method analysis of quantitative data which were
extracted from 420 participants with the use of 42-self assessment questionnaire. The overall
study is based on the set up of health care domain of Switzerland. This can be considered as one
of the limitations of the study is prevented from get more generalised data which can be applied
across different healthcare sectors. This mixed method study mainly highlighted the
transformational leadership model just like the study of Mannix, Wilkes and Daly (2013). Martin
et al. (2012) highlighted that transformational leadership is crucial for delivering care for the
nursing professionals working in the healthcare organisation. The analysis of the survey results
highlighted that transformational leaders are inspiring and their inspiring vision help in the
generation of positive work environment which promotes highest level of clinical interaction.
Here comes the relevancy with the nursing leadership. According to O'hagan et al. (2014),
effective clinical interaction both with the patients and with the healthcare providers helps to
facilitate clinical interventions. Effective communication among the members of the same team
helps in the upliftment of the idea of multidisciplinary team which will help to increase the
overall outcome of the patients. In relation to transformation leadership, Dumdum, Lowe and
Avolio (2013) stated that transformational leadership might hamper the discipline such that
transactional leadership is important thus the nursing leadership styles must change as per
situation giving hint towards the situational leadership. Effective transactional or situational
leaderships also helps in reporting of the mistakes and thus helping to train the nursing

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professionals accordingly. While in the training process, transformational leadership needs to be
followed (Dumdum, Lowe & Avolio, 2013).
Conclusion
Thus analysis of the four literary articles highlighted three main aspect of nursing
leadership styles and this include transformational leadership, affiliative leadership and
visionary. The critical analysis also highlighted transactional and situational leadership styles in
order to maintain strict discipline within the ward. All the articles highlighted one common
concept in the clinical leadership in nursing and this is effective leadership in the nursing
professional helps in the promotion of positive work environment which helps to motivate the
nursing professionals. Thus positive motivation helps to overcome the job stress, high workload
and burn out and thereby helping to delivery best quality care. Moreover, analysis of the articles
in clinical leadership in nursing also highlighted that effective nursing leaderships is important in
order to reduce the chances of medications ward which mainly results from increase in work
load. Thus of environment is positive, then the nursing professionals can work with motivation
while effectively communication with the other professionals of the multidisciplinary team this
further helps to improve the overall health outcome of the patients.

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References
Avolio, B. J., & Yammarino, F. J. (Eds.). (2013). Introduction to, and overview of,
transformational and charismatic leadership. In Transformational and Charismatic
Leadership: The Road Ahead 10th Anniversary Edition (pp. xxvii-xxxiii). Emerald Group
Publishing Limited.
Chávez, E. C., & Yoder, L. H. (2015, April). Staff nurse clinical leadership: A concept analysis.
In Nursing forum (Vol. 50, No. 2, pp. 90-100).
Démeh, W., & Rosengren, K. (2015). The visualisation of clinical leadership in the content of
nursing education—a qualitative study of nursing students' experiences. Nurse education
today, 35(7), 888-893.
Dumdum, U. R., Lowe, K. B., & Avolio, B. J. (2013). A meta-analysis of transformational and
transactional leadership correlates of effectiveness and satisfaction: An update and
extension. In Transformational and Charismatic Leadership: The Road Ahead 10th
Anniversary Edition (pp. 39-70). Emerald Group Publishing Limited.
Hall, L. H., Johnson, J., Watt, I., Tsipa, A., & O’Connor, D. B. (2016). Healthcare staff
wellbeing, burnout, and patient safety: a systematic review. PloS one, 11(7), e0159015.
Mannix, J., Wilkes, L., & Daly, J. (2013). Attributes of clinical leadership in contemporary
nursing: an integrative review. Contemporary Nurse, 45(1), 10-21.
Martin, J. S., McCormack, B., Fitzsimons, D., & Spirig, R. (2012). Evaluation of a clinical
leadership programme for nurse leaders. Journal of Nursing Management, 20(1), 72-80.

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O'hagan, S., Manias, E., Elder, C., Pill, J., Woodward‐Kron, R., McNamara, T., ... & McColl, G.
(2014). What counts as effective communication in nursing? Evidence from nurse
educators' and clinicians' feedback on nurse interactions with simulated patients. Journal
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Parahoo, K. (2014). Nursing research: principles, process and issues. Macmillan International
Higher Education.
Pundt, A., & Herrmann, F. (2015). Affiliative and aggressive humour in leadership and their
relationship to leader–member exchange. Journal of Occupational and Organizational
Psychology, 88(1), 108-125.
Stanley, D. (2014). Clinical leadership characteristics confirmed. Journal of Research in
Nursing, 19(2), 118-128.
Stanley, D., & Stanley, K. (2018). Clinical leadership and nursing explored: A literature
search. Journal of clinical nursing, 27(9-10), 1730-1743.
Van Knippenberg, D., & Stam, D. (2014). Visionary leadership. The Oxford handbook of
leadership and organizations, 241-259.