Core competencies of healthcare professionals in Oman: Research and evidence-based practice needs attention

AIM

The aim of the study was to examine (1) the perceptions on core competencies of healthcare professionals working at clinical settings in Oman and (2) which demographic characteristics explain the overall core competency.

DESIGN

A cross-sectional design.

METHODS

Healthcare Professional Core Competency Instrument, consisting of 11 sub-scales with 81 items, was distributed to healthcare professionals (n = 1,543; 826 nurses and 717 physicians) who worked at primary, secondary and tertiary healthcare institutions. Descriptive statistics, t-test, ANOVA and linear regression were used for data analysis.

RESULTS

Altogether 1,078 healthcare professionals (628 nurses and 450 physicians) responded representing 70% overall response rate. Healthcare professionals perceived their overall core competence as excellent, safety being the highest, and research and evidence-based practice was the lowest. The multiple linear regression analysis revealed that ethnicity, gender and years of working experience were the characters that explained the overall core competence, where expatriate senior professionals reported higher competency levels compared with counterparts.

The effect of Problem-Based Learning on Care Management skills: A quasi-experimental study

OBJECTIVE

to assess the preliminary effect of Problem-Based Learning on Care Management skills.

METHOD

a quasi-experimental pre- and post-test conducted with students attending the Bachelor's Degree in Nursing offered by an educational institution. The sample was comprised by 29 (Experimental Group) and 74 (Control Group) students. The Experimental Group solved four scenarios under the Problem-Based Learning method with the 7 steps proposed by McMaster University, in a Care Management program in distance mode. The self-reporting instrument assessed the pre- and post-test Care Management skills in both groups. Mean values were obtained and descriptive and inferential statistics were performed (Student's t, paired t, linear regression).

RESULTS

the Experimental Group obtained higher scores in analytical, action-related and global skills than the Control Group (p<0.05). No differences were recorded in interpersonal skills or in use of the information. The Control presented no significant differences before and after usual teaching, whereas differences were in fact reported in the Experimental Group (p<0.05).

CONCLUSION

despite the fact that there is little evidence on the development of Nursing Care Management skills, the current study shows that Problem-Based Learning is an effective and significant method in remote education.

Exploration of knowledge, attitudes, and perceived benefits towards nurse managers' participation in the health policy-making process: a qualitative thematic analysis study

Background

Participation of nurse managers in policy-making could help policy-makers to propose relevant and effective policies and support other policy actors involved with these processes.

Objective

This study aimed at exploring the attitudes and perceived benefits of nurse managers' participation in the health policy-making process.

Methods

In this descriptive qualitative research, semi-structured interviews were conducted with 16 nurse managers, government officials, and faculty members. Recruitment was based on purposive sampling from different regions across Iran. A thematic analysis was performed in MAXQDA (version 2012).

Results

After analysis of the qualitative data, four themes and 13 sub-themes emerged. The themes were feelings about nurse managers' participation, advantages of nurse managers' participation, problems due to the non-participation of nurse managers, and recommendations for improvement of the policy-making process.

Conclusion

The outcomes provided new insights into the perceived benefits of and attitudes towards nurse managers' participation in health policy making in the Iranian setting. It is crucial to strengthen the capacity for nurse managers' participation in health policy making to develop effective healthcare policies.

Primary healthcare managers' perceptions of management competencies at different management levels in digital health services: secondary analysis

PURPOSE

The purpose of this study is to describe primary health-care managers' perceptions of management competencies at different management levels in digital health services using the management competency assessment program as a framework.

DESIGN/METHODOLOGY/APPROACH

A secondary analysis study involving 21 semi-structured individual interviews was conducted among Finnish primary health-care managers at different management levels (frontline, middle and senior). The deductive framework method was used to analyze the data.

FINDINGS

Similarities and differences were found in management competencies between different levels of management. Competencies related to the use of digitalization were highlighted by managers at all management levels. Managers at all management levels were involved in developing digital solutions and supporting employees in using digital solutions in their work. Frontline and middle managers emphasized more issues related to day-to-day management and communication with employees, whereas senior managers highlighted the management of large entities.

RESEARCH LIMITATIONS/IMPLICATIONS

In the secondary analysis, data were used for purposes other than originally intended. Therefore, the data are subject to limitations of the methodology applied and should be transferred to other contexts with caution.

PRACTICAL IMPLICATIONS

Identifying the management competencies needed to manage digital health services is important to target managers' training according to needs in the future.

SOCIAL IMPLICATIONS

The results could be used to develop the management of digital health services, as well as improve digital health services and their deployment.

ORIGINALITY/VALUE

Previous literature mostly examined managers' informatics competencies and paid little attention to other management competencies. This study discusses more broadly the management competencies that digital health services require from managers at different levels of management.

A competency model for nurse executives

BACKGROUND

Nurses capable of adequately developing their competencies in the management field are essential for the sustainability of health-care organizations. Such competencies should be included in a model of specific competencies.

AIM

The aim of this research is to propose a competency model for nurse executives.

METHODS

The Delphi method was applied to reach a consensus on the required competencies, and Principal Component Analysis (PCA) was applied to determine the construct validity and reduce the data set's dimensionality. Consensus was defined based on at least 80% of the experts agreeing with the proposed competencies. For each competency, the development levels were beginner, advanced beginner, competent, highly competent and expert.

RESULTS

From among the 51 competencies that were identified to define a model for nurse executives, decision-making, leadership and communication stood out. The PCA indicated the structural validity of the proposed model by saturation of the principal components (Cronbach's α > 0.631).

CONCLUSION

Nurses wishing to develop their professional careers as nurse executives must first develop the competencies shown in the proposed model. Nurse executives should follow the educational programmes specified in this study, to adapt their knowledge to this role's requirements.

Nurse leaders' experiences of professional responsibility towards developing nursing competence in general wards: A qualitative study

AIM

To explore nurse leaders' experiences of professional responsibility to facilitate nursing competence in general wards.

BACKGROUND

Nurse leaders are responsible for maintaining high levels of competence among nurses to improve patient safety.

METHODS

Qualitative analysis was conducted between February and April 2019 using semi-structured interview data from 12 nurse leaders in surgical and medical wards at three Norwegian hospitals.

RESULTS

Four main themes were identified: struggle to achieve nursing staff competence; focus on operational and budgetary requirements rather than professional development; demands to organize sick leaves and holiday periods; and challenges in facilitating professional development.

CONCLUSION

Nurse leaders felt that their responsibilities were overwhelming and challenging. They witnessed more support for current administrative tasks than for the implementation of professional development. Additionally, unclear work instructions from the employer provided few opportunities to facilitate professional development. Hospital management failed to ensure quality of care and patient safety in general wards by not supporting the strengthening of nurses' professional competence and preventing turnover.

IMPLICATIONS FOR NURSING MANAGEMENT

Management may integrate formal work instructions that clarify nurse leaders' responsibilities as professional developers, allowing nurse leaders to meet their obligation of maintaining adequate professional competence among nursing staff in general wards.

Leadership competencies of first-line nurse managers: a quantitative study

PURPOSE

This paper aims to examine the leadership competencies of first-line nurse managers (FLNMs) at the unit level in the eastern region of Ghana.

DESIGN/METHODOLOGY/APPROACH

The paper is a quantitative cross-section design.

FINDINGS

Nurse managers exhibited a moderate level of knowledge and ability to apply leadership competencies. Gender, rank, qualification, professional experience, management experience and management training jointly predicted the leadership competencies of FLNMs [(R² = 0.158, p = 0.016]. However, only management training was a significant predictor in the model.

PRACTICAL IMPLICATIONS

Inappropriate leadership competencies have severe consequences for patients and staff outcomes. This situation necessitates a call for a well-structured program for the appointment of FLNMs based on competencies.

ORIGINALITY/VALUE

This study is the first in Ghana which we are aware of that examined the leadership competencies at the unit level that identifies predictors of leadership competencies.

The effectiveness of the Ethics Quarter intervention on the ethical activity profile of nurse managers: A randomized controlled trial

AIM

To test the effectiveness of a new ethics educational e-learning intervention, Ethics Quarter, in supporting nurse managers' ethical activity profile.

BACKGROUND

Health care organisations need evidence-based ethics interventions to support nurse managers' ethical activity profile.

METHODS

A parallel-group, individually randomized controlled trial was conducted in 2020. Finnish nurse managers nationwide [members of the Union of Health and Social Care Professionals in Finland (Tehy) trade union] were randomly allocated to intervention (n = 169) or control group (n = 172). The intervention group participated in the Ethics Quarter comprising twelve 15-min evidence-based educational 'quarters' spread over 6 weeks. The control group had standard organisational ethics structures. The primary and secondary outcomes were ethical activity profile and ethics knowledge, respectively. The Consolidated Standards of Reporting Trials (CONSORT) statement for study design and reporting was adopted.

RESULTS

Ethical activity profile showed statistically significant differences in mean changes between the groups from baseline to 10 weeks: all five dimensions were statistically significantly higher in the intervention group compared with the control group (p = <.0001).

CONCLUSION

The Ethics Quarter was effective in increasing nurse managers' ethical activity profile.

IMPLICATIONS FOR NURSING MANAGEMENT

Applying this ethics educational e-learning intervention would benefit nursing management education and health care organisations.

TRIAL REGISTRATION

clinicaltrials.gov: NCT04234503.

Competency Model for the Middle Nurse Manager (MCGE-Logistic Level)

Healthcare systems are immersed in transformative processes, influenced by economic changes, together with social and health instability. The middle nurse manager plays a fundamental role, since he or she is responsible for translating the strategic vision, values and objectives of the organization. The objective of this study was to propose the model of competencies to be developed by the middle nurse manager in the Spanish healthcare system. Our methodology consisted in the application of the Delphi method in order to reach an agreement on the necessary competencies, and principal component analysis (PCA) was used to determine the construct validity, reducing the dimensionality of the set of data. Fifty-one competencies were identified for the definition of the model, highlighting decision-making, leadership and communication. The PCA pointed out the structural validity of the proposed model through the saturation of the main components (α Cronbach > 0.631). The results show the model of competencies which the middle nurse manager in the Spanish healthcare system must develop. Middle nurse managers may use these as criteria to plan their professional strategies in the context of management. This model of competencies can be applied to establishing selection processes or training programs for the role of middle nurse manager.

Nurse manager communication and outcomes for nursing: An integrative review

AIM

To evaluate literature on the importance of good communication between managers and nurses, and its influence on nurses and patient care.

BACKGROUND

In the nursing scenario, concepts such as engagement and job satisfaction are tied to manager communication and influence the care provided (Kunie et al., 2017). It is crucial to recognize the importance of manager communication on the nurses and patient care. The evaluation was guided by this question: in the review of post-2014 quantitative studies, is there evidence that nurse managers with high communication competence have better patient/staff outcomes than those with lower competencies?

EVALUATION

We evaluated current research through an evidence review on the day-to-day influence of nurse manager communication. We conducted our search using common health databases. Since the American Organization for Nurse Leadership developed nurse manager competencies in 2014, we only included articles published after that year. Further inclusion criteria included primary, quantitative and peer-reviewed research.

KEY ISSUES

Thirty articles remained after the application of inclusion/exclusion criteria with five themes emerging: patient safety and quality, job satisfaction, leadership styles, innovative practice and general management skills.

CONCLUSION

Research associates positive patient and staff outcomes with a leader who exhibits communication competences.

IMPLICATIONS FOR NURSING MANAGEMENT

Assessment of current competence levels in communication in nurse managers is needed. Education for improving communication skills is also needed.

Morality traits for an ideal nurse manager: A multicentre cross-sectional study

AIMS

To investigate which morality traits are more important for nurses to determine positive opinions of their nurse manager.

BACKGROUND

People selected morality more often than sociability and competence when forming a positive opinion towards an ideal or a newcomer manager.

METHODS

A multicentre, cross-sectional study was carried out by administering two questionnaires to 775 nurses on the influence of morality, sociability and competence traits on their impression formation processes.

RESULTS

Regarding nurses' perceptions about the morality, sociability and competence traits of an ideal nurse manager, the total score for morality was 20.0; for sociability, it was 14.2; and for competence, it was 19.6. For nurses' opinions about a new nurse manager, the total score of the morality section was 16.2, which was very similar to the total score of the competence section (mean = 16.1).

CONCLUSION

Morality positively influences nurses' initial impression of an ideal manager, and though it seems to be a necessary condition, it is not sufficient by itself to support the nursing staff's perception towards a new manager.

IMPLICATIONS FOR NURSING MANAGEMENT

Our findings could be useful in better understanding the role of morality in social perceptions and behavioural consequences of staff nurses towards their nurse manager.

Developing a self-checklist of staff development behavior for associate nurse unit managers using the Delphi method

The most significant influence on nurses' professional growth is through work under direct guidance in clinical settings. Associate nurse unit managers perform direct patient care with the staff, as well as assist management work of nurse unit managers. They can be excellent role models for the staff. We examined their behaviors that help promote staff development, aimed to identify effective behaviors, and created a self-checklist to evaluate them. We created 53 items to assess staff development behaviors, which were evaluated via a Delphi survey with 252 experts and a questionnaire survey with 124 associate nurse unit managers in Japan to evaluate whether the created item was appropriate. The results of the Delphi survey showed an agreement rate of over 90%, and associate nurse unit managers showed an acceptance rate of 82.6-99.2% for 40 of 53 items. Consequently, we created 40-item self-checklist of staff development behaviors for associate nurse unit managers with adequate validity. This checklist would be helpful for them to promote staff development while working in clinical settings and would contribute to enhancing the quality of nursing.

Managerial Strategies for Long-Term Care Organization Professionals: COVID-19 Pandemic Impacts

This paper aims to analyze the strategies that healthcare professionals have adopted during the coronavirus pandemic (COVID-19) in long-term care organizations in Rio de Janeiro city, Brazil, by investigating their competencies—mainly managerial ones. To reach its goals, this paper performs empirical research and theoretical research. For the empirical research, the plans of professionals during COVID-19 pandemic in long-term care organizations are observed, and a questionnaire is applied to analyze observed data integrity. The data are analyzed through the Python and IBM SPSS Statistic programming languages, and descriptive analyses use descriptive statistic proportions, rates, minimum, maximum, mean, median, standard deviation, and coefficient of variation (CV). A non-parametric approach performs repeated measure comparisons using Wilcoxon’s test, while the McNemmar test is used to repeat the categorical variables. Statistical significance is assumed at the 5% level. For the theoretical research, a literature review is developed using scientific databases. The results show that for the searched period, the number of deaths and the number of people infected by COVID-19 in these organizations are low when compared to general statistics of Rio de Janeiro city. This paper concludes that these strategical adoptions have brought significant benefits to long-term care organizations, and it might motivate researchers to develop future studies related to long-term care organizations, helping to fill the literature gap on the subject.

Leadership and Management Competencies for Hospital Managers: A Systematic Review and Best-Fit Framework Synthesis

OBJECTIVE

Competent managers are vital to the productivity and service quality of healthcare organizations and the sustainability of the healthcare system. To improve their management competence, understanding of management competency requirements is important. The purpose of this study was to synthesize the evidence related to the leadership and management competencies in healthcare organizations through the best-fit method.

METHODS

A systematic review of literature published between 2000 and 2020 was performed to identify studies focusing on confirming and/or identifying the competency requirements of hospital managers. The best-fit framework synthesis method was used to map the identified competencies and associated behavioral items against the validated management competency assessment program (MCAP) management competency framework.

RESULTS

Twelve studies were identified for inclusion in the review. The mapping of the identified competencies and behavioral items generated a competency model for hospital managers that can apply for different healthcare context. The new competency model includes the following seven core leadership and management competencies: evidence-informed decision-making, operations, administration and resource management, knowledge of healthcare environment and the organization, interpersonal, communication qualities and relationship management, leading people and organisation, enabling and managing change, and professionalism.

CONCLUSION

This review and the mapping of the competencies identified in previous studies against the validated MCAP framework has resulted in the recommendation for an extended leadership and management competency framework for health service managers. It provides guidance for the formulation of training and development directions for the health service management workforce in a different healthcare context.

Nurse Manager Core Competencies: A Proposal in the Spanish Health System

Nurses who are capable of developing their competencies appropriately in the field of management are considered fundamental to the sustainability and improvement of health outcomes. These core competencies are the critical competencies to be developed in specific areas. There are different core competencies for nurse managers, but none in the Spanish health system. The objective of this research is to identify the core competencies needed for nurse managers in the Spanish health system. The research was carried out using the Delphi method to reach a consensus on the core competencies and a Principal Component Analysis (PCA) to determine construct validity, reducing the dimensionality of a dataset by finding the causes of variability in the set and organizing them by importance. A panel of 50 experts in management and healthcare engaged in a four-round Delphi study with Likert scored surveys. We identified eight core competencies from an initial list of 51: decision making, relationship management, communication skills, listening, Leadership, conflict management, ethical principles, collaboration and team management skills. PCA indicated the structural validity of the core competencies by saturation into three components (α Cronbach >0.613): communication, leadership and decision making. The research shows that eight competencies must be developed by the nursing managers in the Spanish health system. Nurse managers can use these core competencies as criteria to develop and plan their professional career. These core competencies can serve as a guideline for the design of nurse managers’ development programs in Spain.

Factors influencing motivation of nurse leaders in a private hospital group in Gauteng, South Africa: A quantitative study

BACKGROUND

Nurse leadership is about aligning employees to a vision. This happens with buy-in, motivation and communication. When conducive environments are created by organisations, the motivation of nurse leaders will be enhanced, which will have a positive outcome on the organisation. Highly motivated nurse leaders accomplish more and are more productive. Nurse leadership is an essential source of support, mentorship and role modelling. These attributes tend to be more evident when nurse leaders are motivated.

OBJECTIVES

The objective of this study was to determine the factors that influence the motivation of nurse leaders.

METHOD

A quantitative, descriptive design and stratified sampling was used. Participants comprised unit managers (n = 49) from five hospitals in a private hospital group in South Africa. A self-administered questionnaire, namely, the Multidimensional Work Motivation Scale, was used to collect the data. Data were analysed using the IBM SPSS 22.0 program.

RESULTS

The results indicated that the nurse leaders in this study were intrinsically motivated. Their motivation was influenced by support, relatedness, autonomy and competence. No relationships were found between motivation and age, years in a management position, gender, qualifications and staff-reporting structure.

CONCLUSION

By implication, to understand what motivates nurse leaders and to keep them motivated, recommendations were proposed to nursing and human resources management. It is expected that the implementation of the recommendations will have a positive influence on patient outcomes, organisational success and the motivation and satisfaction of nurse leaders.

The Role of the Nurse Unit Manager Function on Nursing Work Performance: A Systematic Review

Introduction: The role of Nurse Unit Manager is to improve the nurses’ performance in the context of their professional services. This role consists of planning, organizing, actuating and controlling. The aim of this systematic review was to determine the influence of the nurse unit manager’s management functions related to the nurses’ performance.Methods: The literature search was conducted in the PubMed, Scopus, ProQuest, Science Direct and SAGE databases with the keywords ‘head nurses’, ‘management function’ and ‘nurse performance’. The articles were reviewed using the inclusion criteria, which was that the title and abstract was in accordance with the desired topic, that the article aimed to analyze the influence of the nurse unit manager’s management functions related to the nurses’ performance and that it was explained in English. The exclusion criteria were that the title, abstract and purpose of the article was not in accordance with the topic of focus. The search identified 15 relevant journals from the 276.303 articles published between 2014 and 2019.Results: The results indicate a significant relationship exists between the role of the nurse unit manager and nursing work performance.Conclusion: To improve the management function of the nurse unit manager, it is necessary to conduct training for the nurse unit manager to allow them to better understand the functions and role of the nurse unit manager.

Perceived importance and performance of clinical leadership in practice: A cross-sectional study of nurses and midwives of all grades

AIM

To explore the differences in perceived importance and actual performance of clinical leadership for all grades of nurses and midwives engaged in clinical practice.

BACKGROUND

Clinical leadership is central to the provision of person-centred care. However, little is known about how nurses and midwives perceive this in practice.

METHODS

Data were collected on a sample of nurses and midwives in the Republic of Ireland, using a cross-sectional study design (n = 324). The clinical leadership needs analysis instrument was used to measure perceived importance and performance of clinical leadership in practice. Grades of nurses/midwives included; staff, manager, advanced practitioner and senior manager.

RESULTS

Senior managers were more likely to report significantly higher scores than staff grades for perceived importance of Technology & Care Initiatives (p < .01) and Financial & Service Management (p = .02). Performance of Staff & Care Delivery was significantly higher for senior managers than staff grades [F(5,309) = 6.06 p < .01].

CONCLUSION

There was a mismatch between the perceived importance and actual performance of clinical leadership in practice between different grades of staff.

IMPLICATIONS FOR NURSING MANAGEMENT

Leadership training for all grades and mentoring of staff grades can promote the building of confidence and empower staff in leading clinical practice.

Realizing appreciative management from the viewpoint of first-line managers in social and health care

BACKGROUND

First-line managers are links between an organizations' administration and the workforce. They transmit information from higher managers to workers and vice versa. Their management skills and especially their interaction with staff are a key point in successful management.

AIM

To describe how first-line managers realized appreciative management in their everyday management practice in health and social care.

METHOD

A quantitative descriptive study was conducted by means of an electronic survey among social and healthcare managers in Finland.

RESULTS

Based on the self-evaluations of the managers, appreciative management is well realized. The most recognition was given to equality and the least to appreciative know-how. Connections were seen between appreciative management and gender, education, education level and managers with higher education, and those with fewer work units below them tended to have a better realization of appreciative management.

CONCLUSION

The education level of first-line nurse managers is meaningful when realizing appreciative management in social and healthcare settings.

IMPLICATIONS FOR NURSING MANAGEMENT

More advanced education levels of first-line managers help to promote appreciative management in social and health care, together with the amount of work units (meaning outpatient and inpatient wards). A first-line manager is responsible for the needs of their workforce and needs to be critically assessed so that they might have more time for managing in an appreciative way. Appreciative management should be given increased focus when educating nurse managers.

International Nursing: Nurse Managers' Leadership and Management Competencies Assessed by Nursing Personnel in a Finnish Hospital

The aim of this research was to describe nurse managers' leadership and management competencies (NMLMC) from the perspective of nursing personnel. Nurse managers are responsible for the management of the largest professional group in social and health care. The assessment of NMLMC is needed because of their powerful influence on organizational effectiveness. An electronic survey was conducted among the nursing personnel (n = 166) of 1 Finnish hospital in spring 2016. Nursing personnel assessed their manager using a NMLMC scale consisting of general and special competences. The data were statistically analyzed. Leadership and management competencies were assessed as being quite good by the nursing personnel. The best-assessed area of general competence was professional competence and credibility and the weakest was service initiation and innovation. The best-assessed area of special competence was substance knowledge and the weakest was research and development. The nursing personnel's assessment of their nurse manger's competencies was associated with the personnel's education level, working experience, and with their knowledge of the manager's education. Conclusion was made that nursing personnel highly value professional competence as part of nursing leadership and management. To achieve more appreciation, nurse managers have to demonstrate their education and competence. They must also work in more open and versatile ways with their nursing personnel.