Evaluation of nurse leadership practices : the importance of inspiring a shared vision

Background: Many countries have identified a lack of leadership skills among nurse leaders. To develop these skills, Basel University Hospital in Switzerland adapted and implemented the RCN Clinical Leadership Programme (CLP). Aim To evaluate the impact of the CLP on the development of leadership competencies of nurse leaders. A specific focus was on the development of a vision and its effect on practice development (PO). Methods: The study was a mixed-methods design with a sequential explanatory approach. In a one-group pre-test-post-test quasi-experimental design, a convenience sample of 14 ward leaders was assessed three times using the Leadership Practices Inventory (LPI). Individual interviews (n=6) and focus groups (n=4) were then undertaken with a selection of ward leaders and their teams. Descriptive, inferential and content analysis techniques were employed as appropriate. Results 420 LPI-Observer-, and 42 LPI-Self-assessment questionnaires were distributed and the response rate was 406 (96%) and 42 (100%) respectively. Nurse leaders demonstrated significant improvement in two subscales: 'inspiring a shared vision' (self p=0.011; observer p= 0.015) and 'challenging the process' (self p= 0.004; observer p= 0.047). Interviews also evidenced growth and development of the leaders which enabled them to build trust and interact in a more facilitative way with their teams. Leaders described the development of a vision as a creative, joyful, timeconsuming and nonlinear process. They applied different approaches and experienced enabling and hindering factors. Having a vision helped leaders and teams to become inspired and committed to a shared goal. Moreover, the vision was a strong driving force for PO and thus established a culture that favoured quality and safety improvement. Conclusion: This study demonstrated improvement in leadership practices of nurse leaders following the CLP. Moreover, it identified factors that are crucial to vision development, which should be considered when planning educational programmes