The development of leadership outcome-indicators evaluating the contribution of clinical specialists and advanced practitioners to health care: a secondary analysis
Article first published online: 30 SEP 2013
© 2013 John Wiley & Sons Ltd
Journal of Advanced Nursing
Volume 70, Issue 5, pages 1078–1093, May 2014
How to Cite
2014) The development of leadership outcome-indicators evaluating the contribution of clinical specialists and advanced practitioners to health care: a secondary analysis. Journal of Advanced Nursing 70(5), 1078–1093. doi: 10.1111/jan.12262, , & (
- Issue published online: 2 APR 2014
- Article first published online: 30 SEP 2013
- Manuscript Accepted: 24 AUG 2013
- National Council for the Professional Development of Nursing and Midwifery
- advanced nurse/midwife practitioner;
- case study data set;
- clinical nurse/midwife specialist;
- leadership outcomes;
- outcome-indicator development;
- secondary analysis
To report a secondary analysis of data collected from the case study phase of a national study of advanced practitioners and to develop leadership outcome-indicators appropriate for advanced practitioners.
In many countries, advanced practitioners in nursing and midwifery have responsibility as leaders for health care development, but without having leadership outcome measures available they are unable to demonstrate the results of their activities. In Ireland, a sequential mixed method research study was used to develop a validated tool for the evaluation of clinical specialists and advanced practitioners. Despite strong evidence of leadership activities, few leadership-specific outcomes were generated from the primary analysis.
Secondary analysis of a multiple case study data set.
Data set comprised 23 case studies of advanced practitioner/clinical specialists from 13 sites across each region in Ireland from all divisions of the Nursing Board Register. Data were collected 2008–2010. Data sources included non-participant observation (n = 92 hours) of advanced practitioners in practice, interviews with clinicians (n = 21), patients (n = 20) and directors of nursing/midwifery (n = 13) and documents. Analysis focused on leadership outcome-indicator development in line with the National Health Service's Good Indicators Guide.
The four categories of leadership outcomes for advanced practitioner developed were as follows: (i) capacity and capability building of multidisciplinary team; (ii) measure of esteem; (iii) new initiatives for clinical practice and healthcare delivery; and (iv) clinical practice based on evidence.
The proposed set of leadership outcome-indicators derived from a secondary analysis captures the complexity of leadership in practice. They add to existing clinical outcomes measuring advanced practice.