Management skills for directors of nursing

Psychometric properties and development of the competency inventory for Taiwanese nurse managers across all levels

AIMS

To describe the development and psychometric testing of the competency inventory for nurse managers across all levels in Taiwan.

BACKGROUND

The competency-based approach to develop nursing leadership and management competencies for the health care context is still insufficiently explored in terms of professional development in nursing administration.

METHODS

This study used mixed methods, including qualitative study for generating the preliminary inventory and a cross-sectional survey of 573 nurse managers for psychometric properties of the inventory.

RESULTS

Exploratory factor analysis revealed four domains with 23 items that explained 58.21% of the overall variance. The overall Cronbach's alpha coefficient was 0.93. Confirmatory factor analysis showed a well-fitting goodness-of-fit statistics. The construct validity was adequate, with an average variance extracted of 0.68 and composite reliability of 0.90.

CONCLUSIONS

Across different levels, nurse managers have 23 essential competencies. The competency inventory demonstrates adequate psychometric properties with good construct validity and internal consistency, thereby reliable and valid for guiding the competency development of nurse managers.

IMPLICATIONS FOR NURSING MANAGEMENT

The essential competencies of the inventory serve as a criterion-referenced measurement for competence proficiency in professional development of nursing administration and contribute to performance improvement of nurse managers in practice.

Working community as the basis of the quality of care

Nursing takes place in a working community and the working community influences the quality of nursing. The purpose of this study was to find out the effects of nurses' individual characteristics, working conditions, and the ward sisters' management skills on working climate and team spirit. Thirty-seven wards of two Finnish hospitals took part in the study, and 717 nurses answered the questionnaire. Statistical analyses indicate that the ward sister's management skill is the best predictor of the climate and team spirit of the wards as perceived by nurses. The nurses' age, education, and working experience have no direct effect on the working community. Nurses who work by the day, who have plenty of further education and permanent employment, are most likely to be dissatisfied with the climate. According to the results, it is important that the ward sister provides sufficient opportunities for professional development, especially for those who are highly motivated to advance their careers. The ward sister can influence the ward's team spirit also by furthering operational preconditions of the ward.

Reflecting professional values in the philosophy of nursing

If nurses are to remain central in restructuring efforts, their professional values must be at the core. Nurse administrators play a key role in promulgating values. The authors examined philosophy of nursing documents to identify professional values and found them to be lacking. They discuss their findings and their implications for nurse executives.