The effect of nursing leadership on hospital nurses' professional practice behaviors.
OBJECTIVE
To understand the effect of unit-level nursing leadership on the relationship of structural empowerment and nursing self-efficacy to professional nursing practice behaviors.


BACKGROUND
Nursing leadership at both organizational and unit levels is a major influence on professional nursing practice. The interaction between environmental factors, such as structural empowerment and unit-based nursing leadership, and self-efficacy for nursing practice may determine whether a nurse's practice behaviors are either professional or more task-focused.


METHODS
A nonexperimental, comparative survey design was used. Instruments included the Conditions for Work Effectiveness-II, Caring Efficacy Scale, Manager's Activities Scale, and Nurse Activity Scale. Multigroup path analysis demonstrated the effects of strong and weak nursing leadership on variables of interest.


RESULTS
Nursing leadership contributed to the effects of empowerment and self-efficacy on practice behaviors. Strong nursing leadership also contributed to an additional relationship between empowerment and self-efficacy. Nursing leadership helped to explain 46% of the variance in nursing practice behaviors overall.


CONCLUSIONS
Nurses may be able to practice more professionally when they perceive strong nursing leadership. By providing more access to structural empowerment factors for staff, strong unit-level nursing leadership may also influence nurses' self-efficacy, which in turn leads to more professional practice behaviors.
Manojlovich
Milisa
M
School of Nursing, University of Michigan, Ann Arbor, MI 48109, USA. mmanojlo@umich.edu
D000328:Adult; D000368:Aged; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007857:Leadership; D008297:Male; D008824:Michigan; D008875:Middle Aged; D009741:Nursing Staff, Hospital / Q000458:organization & administration* / Q000523:psychology; D011209:Power, Psychological; D011364:Professional Practice; D012044:Regression Analysis; D020377:Self Efficacy