Nurse leadership important for patient care

By ahhb
Wednesday, 01 April, 2015

Australian Hospital and Healthcare Bulletin welcomes the Australian College of Nursing as its newest regular contributor. Chief Executive Officer, Adj Professor Debra Thoms, will provide informative updates on issues facing the nursing profession, starting with this edition’s topic of leadership.

Effective leadership is a key influence in managing these factors and in developing the innovation and change that is necessary for both a sustainable and economically viable health care system. Research supports the unique role nurse leaders have in promoting patient safety, because they lead and manage a workforce which has the highest level of contact and most diverse range of interactions with patients (Riley, 2009).
Research indicates the clinical work environment strongly influences nursing turnover, staff satisfaction and, of most importance to all health care professionals, patient outcomes. In addition to research, one of the most high-profile findings in recent years are those of the final report of the Mid Staffordshire NHS Foundation Trust Public Inquiry, which clearly linked a lack of clinical and professional leadership for nurses to low staff morale, bullying and poor quality of care (Francis, 2010). One of the report’s key recommendations was that the management and leadership of nursing staff in the Mid-Staffordshire trust should be reviewed, to ensure that nursing teams have leaders who lead by example, support high performance and foster a culture of high-quality care.
The UK King’s Fund has also recognised the key role of nurse leaders and championed their role in driving the quality agenda. The King’s Fund, From Ward to Board, report defined the ‘added value’ of defined the ‘added value’ of nurse leaders at all levels, which stems from the breadth of nurses’ roles. It highlights that nurse leaders can be involved in many aspects of clinical governance, from conducting clinical audits to staff management. They are accountable for nursing staff (one of the largest staff groups in hospitals) and the quality of nursing care. Nurse leaders bring an understanding of the nurses’ role and a focus on standards of care to leadership positions (King’s Fund, 2009 1).
The Putting Quality First in the Boardroom report outlined the importance of nurse leadership beyond the clinical environment. It found that nurse executives can assist health care managers to understand and interpret data about quality of care and strengthen engagement between front-line clinicians and boards. Nurse executives are also well placed to effectively communicate the patient experience to senior management and assist the board to develop quality improvement initiatives (King’s Fund, 2009 2).
The Australian College of Nursing (ACN) recognises the Government has a legitimate concern with putting publicly funded health care on a more sustainable footing long term. ACN knows that nurse leaders have the skill and acumen to contribute to this economic discussion. In many organisations, nursing services are the largest cost centre. Nurse leaders are required to make sound fiscal decisions without compromising quality of care or undermining staff satisfaction (Swearingen, 2009). Within a health system that is facing increasing financial challenges in meeting the demand for health care, the role of effective nurse leaders is, and will continue to be, critical in achieving positive financial and clinical outcomes.
It is important to mention here the vital role that effective and interconnected multi- disciplinary relationships can have within the health care landscape. While nurses have key roles in delivering high-quality patient care and securing positive patient outcomes, their ability to provide best-practice care is influenced by the environment in which they work; including their interactions with other health care professionals. Leadership in the 21st century needs to engage all the health disciplines and utilise their expertise and insight to achieve optimum outcomes for those we care for.
ACN’s goal is to ensure nurses are well-represented across all levels of health care and to build the nursing profession’s capacity to lead and influence; nurses want to be part of this engagement.
To achieve this level of engagement across all facets of health care, in 2014 ACN revealed its new strategic direction as the national organisation advancing nursing leadership, for the purpose of enhancing the health care of all Australians. This leadership focus includes the development of a range of leadership supports, programs and opportunities for nurses in Australia at all stages of their career, and with varying aspirations. ACN’s new direction aims to make explicit the positive contribution of nurse leadership to the delivery of health care in Australia.
Nurse leaders must be recognised as a valuable resource, able to make significant contributions to the positive transformation of the health system. There is an opportunity to draw on nurse leaders from around Australia; to gather their intelligence, unique expertise and motivation, to build a stronger health care system, ensuring it is wholly effective, efficient and responsive to the needs of all.

“Research indicates the clinical work environment strongly influences nursing turnover, staff satisfaction and, of most importance to all health care professionals, patient outcomes.”

“Within a health system that is facing increasing financial challenges in meeting the demand for health care, the role of effective nurse leaders is, and will continue to be, critical in achieving positive financial and clinical outcomes.”

Francis, R (2010), Independent Inquiry into care provided by Mid Staffordshire NHS Foundation Trust January 2005 – March 2009, vol. 1, <>, accessed 17/02/2015.
King’s Fund (20091), From Ward to Board: Identifying good practice in the business of caring, < February-2009.pdf>, accessed 17/02/2015.
King’s Fund (20092), Putting Quality First in the Boardroom: Improving the Business of Caring, < Sue-Machell-Pippa-Gough-David-Naylor-Vijaya-Nath-Katy-Steward-Sally-Williams-Kings-Fund- April-2010.pdf>, accessed 17/02/2015.
Riley W 2009, ‘High reliability and implications for nursing leaders’, Journal of Nursing Management vol. 17, no. 2, pp. 238-246.
Swearingen, S 2009, ‘Retention reflects leadership style’, Nursing Management, vol. 34, no. 8, pp. 18-19.
Adjunct Professor Debra ThomsAdjunct Professor Debra Thoms
RN, RM, BA, MNA, Adv Dip Arts, Grad Cert Bioethics, MAICD, GIA(Cert), FACHSM (Hon), FACN (DLF)
Adjunct Professor Debra Thoms is the Chief Executive Officer of the ACN.
Her career in nursing, health management and nursing leadership spans over thirty years.
Debra is inspired by the impact of connectivity that nursing brings, which she believes is critical to the practice of nursing. For even in the highly technical and scientific environments nurses work in, she has seen first-hand how the relationships created with patients through face-to-face engagement and communication are vital to the provision of excellent care.
Her other areas of interest include the important role that nursing plays in the health of our society, and the vital role culture and leadership play in organisations.
ACN is the national professional organisation for all nurse leaders: nurses with an interest in leadership, nurses aspiring to leadership roles and nurses in leadership roles across the Australian health system. The leadership capabilities of all nurses play a critical role in the delivery of health services to the Australian community.
ACN is an advocate for the nursing profession, advancing the skills and expertise of nurses to provide leadership in their contribution to the policy, practice and delivery of health care. ACN encourages and supports nurses to develop and grow to become nurse leaders who are able to contribute by providing professional, economic and
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