9/7/2013. SOHN Nursing Practice and Research Committee Sigma Theta Tau International: Alpha Mu Chapter. Erin J. Ross DNP, MS, ANP-BC, CORLN

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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) 1

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 a shared vision: Envisioning the future by imagining exciting and ennobling possibilities; enlisting others in common vision by appealing to shared aspirations. Challenging the process: Searching for opportunities by seeking new ways to change, grow, and improve, experimenting and taking risks, generating small wins and learning from mistakes. Enabling others to act: Fostering collaboration by promoting cooperative goals and building trust, strengthening others by sharing power and discretion along the way. Modeling the way: Finding voice and clarifying personal values by setting an example and aligning actions with the shared values of the team. Encouraging the heart: 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 within (Xirasagar, Samuels, & Stoskopf, 2005; Larrabee, Janne, Ostrow, Witbrow, Hobbs, & Burant, 2003; Spinelli, 2006, Failla, & Stichler, 2008; Weberg, 2008; Corrigan, Diwan, Campion, & Rashid, 2003) and outside 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 selfreported 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 2

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 (LPIself) and a demographic questionnaire Approved by the Case Western Reserve University Institutional Review Board Recruitment of nurse leaders via internet (n= 448) invitation via Survey Monkey Sample: English speaking RNs who were President, VP, PP, or BOD of a PNA Informed consent 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 (high internal consistency) My survey: Test/retest reliability of 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 3

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: (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 N Mean SD Minimum Maximum Inspire A Shared Vision 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 M 8.50 M 8.21 Ross et al SD.921 SD 1.21 Challenge the Process M 8.17 SD 1.10 Enable Others to Act M 8.77 SD.662 Encourage the Heart M 8.61 SD.895 Clavelle et al M 8.39 M 8.22 M 8.16 M 8.70 M 8.17 SD.872 Porter-O Grady M 8.81 SD 1.05 M 8.51 SD.909 M 8.50 SD.674 M 9.17 SD 1.10 M 8.61 SD.67 SD.92 SD.85 SD.57 SD.95 4

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 s 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 5

6 Abraham, P. A. (2011). Developing nurse leaders: A program enhancing staff nurse leadership skills and professionalism. Nursing Administration Quarterly, 35 (4), Transformational Leadership Practices of Nurse Leaders in Professional Nursing Associations ANCC: Magnet Recognition Program Model. Retrieved March 4, 2013from Alotaibi, M. (2007). Factors affecting nurses decisions to join their professional association. International Nursing Review, 54(2), Bass B. (1999). On the taming of charisma: A reply to Janice Beyer. Leadership Quarterly, 10, Bass, B., & Avolio, B. (1993). Transformational leadership and organizational culture. Public Administration Quarterly, 17(1), 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), 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), Bass, B., M., & Riggio R.,E. (2006).Transformational Leadership, 2 nd 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, 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), 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), 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), Cullen K. (1999). Recruitment, retention, and restructuring report. Strong leaders strengthen retention. Nursing Management, 30, 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, 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): Deleskey, K., (2003). Factors affecting nurses decisions to join and maintain membership in professional associations. Journal of Perianesthesia Nursing, 18 (1), Dunham-Taylor, J. (2000). Nurse executive transformational leadership found in participative organizations. Journal of Nursing Administration, 30(5), 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), Firestone, D. T. (2010). A study of leadership behaviors among chairpersons in allied health programs. Journal of Allied Health, 39(1), Gabel, S. (2012). Transformational leadership in medical practice: capturing and influencing principles-driven work. Journal of Ambulatory Care Management, 35(4): 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), Helms, M. M. (Ed.). (2006). Leadership theories and studies. In Encyclopedia of management (Vol. 1). Retrieved Nov, 5, 2012 from Heuston, M., M. & Wolf G.A., (2011). Transformational leadership skills of successful nurse managers. Journal of Nursing Administration, 41(6), Hutchinson, M. & Jackson D. (2013). Transformational leadership in nursing: towards a more critical interpretation. Nursing Inquiry ;20(1): Institute of Medicine. (2010). The future of nursing: Leading change, advancing health. Retrieved from Advancing-Health. Kleinman, C. (2004). Leadership: A key strategy in staff nurse retention. Journal of Continuing Education in Nursing, 35, 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): Kouzes, J. M., & Posner, B. Z. (2008). The leadership challenge (4 th ed.). San Francisco, CA: Jossey-Bass. Lamb-Merchanick, D., & Block, D. E., (1984). Professional membership recruitment: A marketing approach. Nursing Economics, 2, 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), Leach L., (2005). Nurse executive transformational leadership and organizational commitment. Journal of Nursing Administration, 35(5),

7 9/7/2013 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): McGuire, E., & Kennerly, S. (2006). Nurse managers as transformational and transactional leaders. Nursing Economics, 24(4), Posner, B. Z. (2010, September). Leadership practices inventory (LPI) data analysis. Retrieved October 5, 2012, from Posner, B. Z., & Kouzes, J. M. (1988). Development and validation of the leadership practices inventory. Educational and Psychological Measurement, 48(2): 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. 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), 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. 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), Stein, A. M., (2001). Learning and change among leaders of a professional nursing association. Holistic Nursing Practice, 16(1), The Leadership Challenge: Retrieved March 10, 2013 from 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), 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), Wong, C., & Cummings, G., (2007). The relationship between nursing leadership and patient outcomes: a systematic review. Journal of Nurse Management, 15, Xirasagar, S., Samuels, M. E., & Stoskopf, C. H. (2005). Physician leadership styles and effectiveness: An empirical study. Medical Care Research and Review, 62(6), Ward, K. (2002). A vision for tomorrow: Transformational nursing leaders. Nursing Outlook, 50(3), Weberg, D. (2010). Transformational leadership and staff retention. An Evidence Review with Implications for Healthcare Systems, 34(3), White, M. J., & Olson, R. S. (2004). Factors affecting membership in specialty nursing organizations. Rehabilitation Nursing, 29(4), Wylie, D.A., & Gallagher, H,L,.(2009). Transformational leadership behaviors in allied health professions. Journal of Allied Health, 38(2): Wolf, G., Triolo, P., & Ponte, P. R. (2008). Magnet recognition program: The next generation. Journal of Nursing Administration, 38(4),