The purpose of this study was to understand and measure the
multivariate nature of the contemporary nursing care environment.
Forty-six patient care units in six hospitals and three long-term care facilities
were included in the population. These units represent employment of 55
nurse managers and 1142 registered nurses. The Leadership Practices
Inventory was administered to all staff nurses and three randomly selected
subordinates for each completed the LPI Observer version. The return rate
for managers was 91 percent and 70 percent of staff nurses returned the LPIObserver for their manager. Other instruments included the Work
Environment Scale (Moos & Insel, 1994), and objective measures of
resources, staff expertise, staff stability, teamwork, workload, and patient
outcomes (e.g., hospital acquired pneumonia or urinary tract infection,
mortality, medication errors and patient falls).
"The relationship depicted in the final model indicates that strong leadership
is consistent with low turnover and increased stability of staff. The magnitude
of the effect is moderate. The nurses suggested that inspiring, encouraging,
and modeling behaviors were all important in a leader, and all were significant as appropriate measures of the construct Leadership. Nurses also
talked of the value of a leader who was perceived as an advocate, one who
would challenge the status quo, and this scale of the LPI did indeed measure
leadership as perceived by these nurses" (pp. 45-46).
"The variables in the measurement model for leadership support the
behaviors identified by staff nurses as important in a leader. The focus on
encouraging, modeling, challenging, and inspiring behaviors suggests that
interpersonal influence skills are more important than traditional managerial
skills" (p. 46). Strong leadership was related to higher levels of staff expertise
and stability, as well.
"This research," according to the author, "suggests that a focus on developing
strong leaders can reduce the staff instability and cycle of turnover that often
accompany increased demand. Strong leaders can contribute by developing
staff expertise and stability" (p. 46).