ROSS TL Presentation Vancouver 9 5 13sohnnurse.com/wp-content/uploads/pdf/352 Ross... ·...

9/7/2013

1

Erin J. Ross DNP, MS, ANP-BC, CORLN

� SOHN Nursing Practice and Research Committee

� Sigma Theta Tau International: Alpha Mu Chapter

� Background

� Problem & Research Question

� Review of Literature

� Method

� Results

� Limitations

� Summary and Conclusions

� Questions

� The nursing profession is the largest segment of the nation’s health care workforce with more than 3 million members

� Identifies a need for resilient and proficient nursing leadership

� Nursing associations provide leadership development through mentoring and best practice opportunities for members

� Lack of research

� What are the transformational leadership practices of nurse leaders in professional nursing associations?

� Is a leadership style that inspires and empowers followers to achieve extraordinary outcomes while transcending individual self interests, aligning objectives and goals of the followers, the leader, groups and the organization (Bass & Avolio, 1993)

9/7/2013

2

� Transformational leadership (TL) practices were first described by James Burns (1978) in his theory of leadership

� TL was extended in the work of Bass (1985), who defined how transformational leadership could be measured and how it influences follower enthusiasm and performance

� Influenced by Bass and Avolio’s (1993) transformational model of leadership, Kouzes and Posner (1987) developed their model of exemplary leadership

� Inspiring Inspiring Inspiring Inspiring a shared a shared a shared a shared visionvisionvisionvision: : : : Envisioning the future by imagining exciting and ennobling possibilities; enlisting others in common vision by appealing to shared aspirations.

� Challenging Challenging Challenging Challenging the the the the processprocessprocessprocess: : : : Searching for opportunities by seeking new ways to change, grow, and improve, experimenting and taking risks, generating small wins and learning from mistakes.

� Enabling Enabling Enabling Enabling others to others to others to others to actactactact: : : : Fostering collaboration by promoting cooperative goals and building trust, strengthening others by sharing power and discretion along the way.

� Modeling Modeling Modeling Modeling the waythe waythe waythe way: : : : Finding voice and clarifying personal values by setting an example and aligning actions with the shared values of the team.

� Encouraging Encouraging Encouraging Encouraging the the the the heartheartheartheart: : : : Recognizing individual contributions, showing appreciation for excellence, celebrating victories by creating a spirit of community.

� Transformational Leadership (TL) has been studied extensively over the last several decades withinwithinwithinwithin (Xirasagar, Samuels, & Stoskopf, 2005; Larrabee, Janne, Ostrow, Witbrow, Hobbs, & Burant, 2003; Spinelli, 2006, Failla, & Stichler, 2008; Weberg, 2008; Corrigan, Diwan, Campion, & Rashid, 2003) and outsideoutsideoutsideoutside of health care environment (Bass B., M., & Riggio R., E. 2006, Bass, 2008).

� Leadership has been studied among nursing leaders (Weberg, 2010, Failla, K. R., & Stichler, J. F. (2008), Larrabee, Janney, Ostrow, Witbrow, Hobbs, & Burant, (2003), Bass (1985), Tuna, M., Ghazzawi, Tuna, A., & Çatir (2011),Wong & Cummings (2007)

� Dunham-Taylor (2000) found that as the nurse executive's transformational leadership score increased, the hospital organization was more participative

� Chiok Foong Loke, Leach (2001) and McGuire & Kennerly (2006) recognized significant relationships between TL practices and organizational commitment

� Wylie and Gallagher (2009) explored self-reported transformational leadership behavior profiles; seniority and prior leadership training were positively related to TL

� Failla and Stichler (2008) found a significant relationship between nurse manager transformational leadership style and job satisfaction

� Porter-O’Grady (2009) compared 71 Magnet chief nursing officers (CNOs) and 90 non-Magnet CNOs

� Results showed no significant differences between Magnet CNOs and non-Magnet CNOs using the Leadership Practices Inventory (LPI) self-report tool

9/7/2013

3

� Clavelle, Drenkard, Tullai-McGuiness and Fitzpatrick (2012) provided new evidence that the top two TL practices of Magnet CNOs: Enabling others to act and Modeling the way

� As CNOs gain experience and education, they exhibit more transformational leadership characteristics

� CNOs 60 years or older scored significantly higher than younger CNOs

� White and Olsen (2004) reported the reasons given by member nurses for joining their organization were: to increase knowledge (22%), professional benefits (21%), networking (21%), and to earn continuing education units (CEUs) (17%), social interaction and mentoring opportunities accounted for 9.3% and 7.9% of the benefits, respectively

� Deleskey (2003) reported the variables that most strongly influenced joining a particular professional nursing association were: self-improvement, education, new ideas, programs, professionalism, validation of ideas, improvement of the profession, personal work improvement, and maintenance of professional standards

� National descriptive study

� What are the transformational leadership practices of nurse leaders in professional nursing associations?

� The Leadership Practices Inventory Self (LPI-self) and a demographic questionnaire

� Approved by the Case Western Reserve University Institutional Review Board

� Recruitment of nurse leaders via internet (n= 448) email invitation via Survey Monkey

� Sample: English speaking RNs who were President, VP, PP, or BOD of a PNA

� Informed consent

� Email reminders

� Minimum of 50 surveys returned (n=134)

� SPSS software utilized

� Leaderships Practices Inventory (LPI) Self

� 30 behavioral-based statements (1-10 Likert scale)

� Cronbach's alpha 0.70-0.84 (high internal consistency)

� My survey:0.70-0.88

� Test/retest reliability of 0.93—0.95

� Demographic survey

� LPI subscales: means and standard deviations

� To identify relationships between means of the LPI-S and amount of leadership training acquired, Pearson’s correlations were calculated

� To determine differences between office held and LPI-S, analysis of variance tests were conducted

� Comparison of Means of Previous Studies using LPI in Nursing

9/7/2013

4

� n=134 (30% return rate)

� Female: 84.4%

� Age: mean of 54.6 years old (30-78)

� Race: 95.5% White

� States: 38 of 50 represented

� Education: Masters 54.5% (DNP 15.7%)

� Certification: 73.1%

� Work status: Full-time (80.6%)

� Office held: BOD 29.9% (Pres. 26.1%)

� YRS in leadership: 6-10 yrs. (24.6%)

� # of members: 1001-5000 (35.1%)

� YRS in a PNA: >25 yrs. (25.4%),6-10yrs. (24.6%)

� AMT of leadership training: moderate amount (32.8%), a little/a lot (21.6%), none at all (9.7%)

� Over 50 different nursing specialties

� The top two transformational leadership practices of nurse leaders in a professional nursing association were Enabling others to act and Encouraging the heart

Challenge the

Process

Enable Others to

Act

Encourage the

Heart

Model the Way Inspire A Shared

Vision

N 134 134 134 134 134

Mean 8.1704 8.7724 8.6119 8.5037 8.2164

SD 1.09843 .66212 .89480 .92186 1.21017

Minimum 3.67 6.33 6.00 4.50 3.33

Maximum 10.0 10.0 10.0 10.0 10.0

� Respondent’s with more leadership training reported higher transformational leadership practices

� modeling the way (r =.296, p < .001), inspiring a shared vision (r =.320, p < .001), challenging the process (r = .240, p < .05), enabling others to act (r = .193, p < .05), encouraging the heart (r = .212, p <.05)

� There were no significant differences in five LPI subscales based on the office held

� challenge the process (F = 1.433, p = .227), enable others to act (F = .579, p = .678), encourage the heart (F = 1.021, p = .400), inspire a shared vision (F = 1.170, p = .328) modeling the way (F = 1.162, p = .331)

� Porter-O’Grady (2009) compared Magnet CNOs and non-Magnet CNOs: no statistically significant differences

� Clavelle et al.’s (2012): the top two TL practices of CNOs in Magnet organizations were enabling others to act and modeling the way

Model the Way Inspire a Shared

Vision

Challenge the

Process

Enable Others to

Act

Encourage the

Heart

Ross et al M 8.50

SD .921

M 8.21

SD 1.21

M 8.17

SD 1.10

M 8.77

SD .662

M 8.61

SD .895

Clavelle et al M 8.39

SD .872

M 8.22

SD 1.05

M 8.16

SD .909

M 8.70

SD .674

M 8.17

SD 1.10

Porter-O’Grady M 8.81

SD .67

M 8.51

SD .92

M 8.50

SD .85

M 9.17

SD .57

M 8.61

SD .95

9/7/2013

5

� The study is limited by being the first to study TL in nursing leaders of PNAs

� The closet nursing comparison group was the leadership practices of Magnet and non-Magnet CNOs

� The LPI was administered as self-assessment and was not combined with an observational 360-degree data collection process (members in the PNA)

� Sample size and response rate

� There was a difficulty obtaining emails of nursing leaders

� Potential limitations of the transformational model, it is possible that the claim made by advocates regarding the extent of transformational leadership in nursing is exaggerated (Hutchinson & Jackson, 2013).

� A larger sample, repeat the study

� Identify other leadership attributes with other types of instruments in leadership

� Expand on the finding that the more leadership training one had the more TL practices were reported

� Leadership development r/t improved outcomes

� Lack of research investigating TL and nurse leaders of PNAs on nursing and outcomes

� Are nurse leaders in PNAs really as transformational

� Further investigation with research into leadership development and improved outcomes is warranted

� Future opportunity exists with the variable of the current office held and researching each office independently looking at outcomes

� It would be interesting to further research the finding of low scoring means of challenge the process (why so low)

� Understanding why leaders rate this quality so low and changing this perception is important to complying with the recommendations of the IOM Report on the Future of Nursing

� Professional nursing associations have the opportunity to provide a culture that promotes and values leadership

� Transformational leadership is a model that provides an approach to foster organizational and personal change

� TL practices can be learned by those seeking to strengthen their abilities and maybe as easily adaptable to other settings such as professional nursing associations

� Professional nursing association’s nurse leaders must identify priorities for accomplishing the IOM’s report on the Future of Nursing recommendations and take responsibility for executing those recommendations

� PNAs and nurse leaders should make available leadership development and mentoring programs throughout their associations

9/7/2013

6

Transformational Leadership Practices of Nurse Leaders in Professional Nursing Associations

� Abraham, P. A. (2011). Developing nurse leaders: A program enhancing staff nurse leadership skills and professionalism. Nursing Administration Quarterly, 35 (4), 306-312.

�

� ANCC: Magnet Recognition Program® Model. Retrieved March 4, 2013from

� http://www.nursecredentialing.org/Magnet/ProgramOverview/New-Magnet-Model

�

� Alotaibi, M. (2007). Factors affecting nurses’ decisions to join their professional association.

� International Nursing Review, 54(2), 160-165.�

� Bass B. (1999). On the taming of charisma: A reply to Janice Beyer. Leadership Quarterly, 10, � 541-553.

�

� Bass, B., & Avolio, B. (1993). Transformational leadership and organizational culture. Public � Administration Quarterly, 17(1), 112-121.�

� Bass, B. M. (1985), Leadership and performance. New York, NY: Free Press.�

� Bass, B. M., Jung, D. I., Avolio, B. J., & Berson, Y. (2003). Predicting unit performance by

� assessing transformational and transactional leadership. Journal of Applied Psychology, 88(2), 207-218.

� Bass, B. M., Jung, D. I., Avolio, B. J., & Berson, Y. (2003). Predicting unit performance by

� assessing transformational and transactional leadership. Journal of Applied Psychology, 88(2), 207-218.

�

� Bass, B., M., & Riggio R.,E. (2006).Transformational Leadership, 2nd ed. Mahwah, NJ: � Lawrence Erlbaum Associates.

�

� Bass, B., M. (2008).The Bass Handbook of Leadership. Theory, Research and Managerial � Applications, 4th ed. NewYork, NY: Free Press.�

� Booth, D. (1999). Arkansas Louisiana Nurses Association workplace advocacy/membership

� survey. Pelican News, 55, 31-33.�

� Burns, J. (1978). Leadership. New York, NY: Harper and Row.�

� Chiok Foong Loke, J. (2001). Leadership behaviours: Effects on job satisfaction, productivity

� and organizational commitment. Journal of Nursing Management, 9(4), 191-204.�

� Clavelle, J. T., Drenkard, K., Tullai-McGuinness, S., & Fitzpatrick, J. J. (2012).

� Transformational leadership practices of chief nursing officers in Magnet® Organizations. Journal of Nursing Administration, 42(4), 195-201.

� Corrigan, P. W., Diwan, S., Campion, J., & Rashid, F. (2003). Transformational leadership and

� the mental health team. Administration and Policy in Mental Health, 30(2), 97-108.�

� Cullen K. (1999). Recruitment, retention, and restructuring report. Strong leaders strengthen

� retention. Nursing Management, 30, 27-28.�

� Cummings, G. G., MacGregor, T., Davey, M., Lee, H., Wong, C.A., & Lo, E. (2010). Leadership

� styles and outcome patterns for the nursing workforce and work environment: a systematic review. International Journal of Nursing Studies, 47, 363-385.

�

� Cummings G.G., Midodzi, W.K., Wong C.,A., & Estabrooks, C.,A. (2010)The contribution of

� hospital nursing leadership styles to 30-day patient mortality. Nursing Research, 59(5):331-339.

�

� Deleskey, K., (2003). Factors affecting nurses’ decisions to join and maintain membership in

� professional associations. Journal of Perianesthesia Nursing, 18 (1), 8-17.�

� Dunham-Taylor, J. (2000). Nurse executive transformational leadership found in participative

� organizations. Journal of Nursing Administration, 30(5), 241-250.�

� Failla, K. R., & Stichler, J. F. (2008). Manager and staff perceptions of the manager's leadership

� style. JONA: The Journal of Nursing Administration, 38(11), 480-487.

� Firestone, D. T. (2010). A study of leadership behaviors among chairpersons in allied health

� programs. Journal of Allied Health, 39(1), 34-42.�

� Gabel, S. (2012). Transformational leadership in medical practice: capturing and influencing

� principles-driven work. Journal of Ambulatory Care Management, 35(4):304-10.�

� Hassmiller,S.B., & Reinhard, S.,(2011). The Institute of Medicine Report on the Future of

� Nursing: A legacy for nursing leadership. Nurse Leader, 9(6), 30-32.�

� Helms, M. M. (Ed.). (2006). Leadership theories and studies. In Encyclopedia of management

� (Vol. 1). Retrieved Nov, 5, 2012 from http://www.enotes.com/leadership-theories-studies-reference

�

� Heuston, M., M. & Wolf G.A., (2011). Transformational leadership skills of successful nurse

� managers. Journal of Nursing Administration, 41(6), 248-257.�

� Hutchinson, M. & Jackson D. (2013). Transformational leadership in nursing: towards a more

� critical interpretation. Nursing Inquiry ;20(1):11-22.

� Institute of Medicine. (2010). The future of nursing: Leading change, advancing health.� Retrieved from http://www.iom.edu/Reports/2010/The-Future-of-Nursing-Leading-Change-Advancing-Health.

�

� Kleinman, C. (2004). Leadership: A key strategy in staff nurse retention. Journal of Continuing � Education in Nursing, 35, 128-132.�

� Kouzes, J. M., & Posner B. Z. (1987). The leadership challenge: How to get extraordinary� things done in organizations. San Francisco: Jossey-Bass.�

� Kouzes, J. M., & Posner, B. Z. (1988). Development and validation of the leadership practices � inventory. Educational and Psychological Measures;48(2):483-496.�

� Kouzes, J. M., & Posner, B. Z. (2008). The leadership challenge (4th ed.). San Francisco, CA: � Jossey-Bass.

�

� Lamb-Merchanick, D., & Block, D. E., (1984). Professional membership recruitment: A

� marketing approach. Nursing Economics, 2, 398-402.�

� Larrabee, J. H., Janney, M. A., Ostrow, C. L., Witbrow, M. L., Hobbs, G. R., & Burant, C.

� (2003). Predicting registered nurse job satisfaction and intent to leave. Journal of Nursing Administration, 33(5), 271-283.

�

� Leach L., (2005). Nurse executive transformational leadership and organizational commitment.

� Journal of Nursing Administration, 35(5), 228-237.

9/7/2013

7

� Matthews, J., (2012). Role of professional organizations in advocating for the nursing profession.

� OJIN: The Online Journal of Issues in Nursing Vol. 17, No. 1, Manuscript 3.�

� Mastal, M.F., Joshi, M., Schulke, K., (2007) Nursing leadership: championing quality and patient

� safety in the boardroom. Nursing Economics,25(6):323-330.�

� McGuire, E., & Kennerly, S. (2006). Nurse managers as transformational and transactional

� leaders. Nursing Economics, 24(4), 179-185.�

� Medley, F., & Larochelle, D. (1995). Transformational leadership and job satisfaction. Nursing � Management, 26(9), 64JJ.�

� Porter-O’Grady, T. (2009). Creating a context for excellence and innovation: Comparing chief

� nurse executive leadership practices in Magnet and non-Magnet hospitals. Nursing Administration Quarterly, 33(3), 198-204.

�

� Porter-O’Grady, T. (2011). Leadership at all levels. Nursing Management. May;42(5):32-7.�

� Porter-O’Grady T., & Malloch, K. (2007). Quantum leadership: A textbook of new leadership� (2nd ed.) Sudbury, MA: Jones & Bartlett.

� Posner, B. Z. (2010, September). Leadership practices inventory (LPI) data analysis. Retrieved

� October 5, 2012, from http://media.wiley.com/assets/2260/07/LPIDataAnalysisSept2010.pdf

�

� Posner, B. Z., & Kouzes, J. M. (1988). Development and validation of the leadership practices

� inventory. Educational and Psychological Measurement, 48(2):483-496. �

� Rapp, L.A., & Collins, P. A. (1999). Reasons why nurses do or do not join their professional

� organizations: A research study done in New Hampshire. Nursing News, 49(5) 1, 8.�

� Sherman, R., Pross, E., (2010) Growing future nurse leaders to build and sustain healthy work

� environments at the unit level. Online Journal of Issues in Nursing, 15(1).

�

� Spinelli, R. J. (2006). The applicability of Bass’s model of transformational, transactional, and

� laissez-faire leadership in the hospital administrative environment. Hospital Topics: Research and Perspectives on Healthcare, 84(2), 11-18.

�

� Stein, A. M., (2001). Learning and change among leaders of a professional nursing association.

� Holistic Nursing Practice, 16(1), 5-15.�

� The Leadership Challenge: Retrieved March 10, 2013 from

� http://www.leadershipchallenge.com/professionals-section-lpi.aspx

�

� Tuna, M., Ghazzawi, I., Tuna, A., & Çatir, O. (2011). Transformational leadership and

� organizational commitment: The case of Turkey's hospitality industry. SAM Advanced Management Journal, 76(3), 10-25.

�

� Van Achterberg, T., Holleman, G., M, Grypdonck, M., Eliens, A., & Van Vliet, M. (2006).

� Promoting evidence-based practice: The roles and activities of professional nurses' associations. Journal of Advanced Nursing, 53(5), 605-612.

�

� Ward, K. (2002). A vision for tomorrow: Transformational nursing leaders. Nursing Outlook, � 50(3), 121-126.�

� Weberg, D. (2010). Transformational leadership and staff retention. An Evidence Review with � Implications for Healthcare Systems, 34(3), 246–258.�

� White, M. J., & Olson, R. S. (2004). Factors affecting membership in specialty nursing

� organizations. Rehabilitation Nursing, 29(4), 131-137.�

� Wylie, D.A., & Gallagher, H,L,.(2009). Transformational leadership behaviors in allied health

� professions. Journal of Allied Health, 38(2):65-73.

�

� Wolf, G., Triolo, P., & Ponte, P. R. (2008). Magnet recognition program: The next generation.

� Journal of Nursing Administration, 38(4), 200-204.�

�

� Wong, C., & Cummings, G., (2007). The relationship between nursing leadership and patient

� outcomes: a systematic review. Journal of Nurse Management, 15, 508-521.

�

� Xirasagar, S., Samuels, M. E., & Stoskopf, C. H. (2005). Physician leadership styles and

� effectiveness: An empirical study. Medical Care Research and Review, 62(6), 720-740.