Factors influencing advanced practitioners' ability to enact leadership: a case study within Irish healthcare

Authors

  • Agnes Higgins PhD, BNS, RPN, RGN,

    Professor of Mental Health Nursing,Head, Corresponding author
    1. School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
    • Correspondence

      Agnes Higgins

      Head of School of Nursing and Midwifery/Professor of Mental Health

      School of Nursing and Midwifery

      Trinity College Dublin

      24 D'Olier Street

      Dublin

      Ireland

      E-mail: ahiggins@tcd.ie

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  • Cecily Begley RM, MSc, PhD, FTCD,

    Professor of Midwifery and Nursing
    1. School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
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  • Joan Lalor PhD, MSc, PGDip Stats, RGN/RCN, RM,

    Associate professor
    1. School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
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  • Imelda Coyne PhD, MA, BSc, Dip N, RSCN, RGN RNT,

    Professor of Children's Nursing
    1. School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
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  • Kathy Murphy PhD, RGN, BA, MSc, Dip N, RNT,

    Professor of Nursing
    1. School of Nursing and Midwifery, National University of Ireland, Galway, Ireland
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  • Naomi Elliott PhD, BNS, RGN

    Assistant Professor
    1. School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
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Abstract

Aim

To report the factors that influence clinical specialists' and advanced nurse practitioners' ability to enact their clinical and professional leadership roles; findings from the SCAPE study.

Background

The importance of leadership for specialist and advanced practitioners is highlighted in the international literature and is considered an important factor in the provision of improved patient outcomes. Despite many studies identifying the barriers in developing and integrating new specialist/advanced practice roles into health services, little is known about the factors that influence the leadership dimension of their role.

Method

A case study design involving 23 clinical specialist/advanced practitioners working in Ireland and multidisciplinary team members working with them, was used. Data were collected using interview, observation and documentary analysis.

Results

Four mediating factors influence the specialist/advanced practitioner's ability to perform a leadership role, namely the presence of a framework for the professional development of the role; opportunities to act as leaders; mechanisms for sustaining leadership; and personal attributes of practitioners.

Conclusion and implications for nursing management

Nursing/midwifery leaders and managers at all levels have a key role in supporting leadership potential, through countering the negative impact of professional isolation, expanding opportunities for specialist/advanced practitioners to influence policy and network with wider professional groups.

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