The relationship between nursing leadership and patient outcomes: a systematic review update

Authors

  • Carol A. Wong PhD, RN,

    Associate Professor, Ontario Ministry of Health and Long-Term Care Nursing Early Career Research Award Recipient, Corresponding author
    • Arthur Labatt Family School of Nursing, Faculty of Health Sciences, Health Sciences Addition (HSA), The University of Western Ontario, London, Ontario, Canada
    Search for more papers by this author
  • Greta G. Cummings PhD, RN, FCAHS,

    Professor
    1. Faculty of Nursing, Edmonton Clinic Health Academy, University of Alberta, Edmonton, Alberta, Canada
    Search for more papers by this author
  • Lisa Ducharme BScN, RN, MN

    Practice Consultant
    1. Nursing Professional Scholarly Practice, London Health Sciences Centre (LHSC), London, Ontario, Canada
    Search for more papers by this author

Correspondence

Carol A. Wong

Arthur Labatt Family School of Nursing

Faculty of Health Sciences

Room H27, Health Sciences Addition (HSA)

The University of Western Ontario

1151 Richmond Street

London

Ontario N6A 5C1

Canada

E-mail: cwong2@uwo.ca

Abstract

Aim

Our aim was to describe the findings of a systematic review of studies that examine the relationship between nursing leadership practices and patient outcomes.

Background

As healthcare faces an economic downturn, stressful work environments, upcoming retirements of leaders and projected workforce shortages, implementing strategies to ensure effective leadership and optimal patient outcomes are paramount. However, a gap still exists in what is known about the association between nursing leadership and patient outcomes.

Methods

Published English-only research articles that examined leadership practices of nurses in formal leadership positions and patient outcomes were selected from eight online bibliographic databases. Quality assessments, data extraction and analysis were completed on all included studies.

Results

A total of 20 studies satisfied our inclusion criteria and were retained. Current evidence suggests relationships between positive relational leadership styles and higher patient satisfaction and lower patient mortality, medication errors, restraint use and hospital-acquired infections.

Conclusions

The findings document evidence of a positive relationship between relational leadership and a variety of patient outcomes, although future testing of leadership models that examine the mechanisms of influence on outcomes is warranted.

Implications for nursing management

Efforts by organisations and individuals to develop transformational and relational leadership reinforces organisational strategies to improve patient outcomes.

Ancillary