title: Nurses' perspectives on how operational leaders influence function-focused care for hospitalised older people.
abstract: OBJECTIVE
  To explore nurses' perspectives on how leaders influence function-focused care, defined as care that preserves and restores older people's functional abilities.
  
  
  BACKGROUND
  Hospitalised older people are at risk of functional decline. Although leaders have the potential to influence function-focused care, few studies have explored nurses' perspectives on how leaders influence function-focused care.
  
  
  METHODS
  Thirteen focus groups were held with 57 acute care nurses. Semi-structured questions prompted discussion on nurses' perspectives, needs and strategies to meet their needs. Data were thematically analysed.
  
  
  RESULTS
  Three themes were identified: (1) the emphasis in hospitals is on moving older people quickly through the system, not supporting their functioning; (2) leaders are generally seen as too disconnected from practice to design system efficiency initiatives that support older people's functioning and nurses' provisioning of function-focused care; and (3) leadership strategies to better support nurses in providing function-focused care to older people in the context of system efficiency.
  
  
  CONCLUSIONS
  Leaders should connect with practice to devise age-sensitive efficiency initiatives that support function-focused care. Nurses need support from leaders in four areas to provide function-focused care to older people in the current hospital context.
  
  
  CONCLUSIONS
  The findings provide direction on how leaders can facilitate function-focused care in the current health-care environment emphasising system efficiency.
authors.affiliation: School of Nursing, York University, Toronto, Ontario, Canada. maryfox@yorku.ca.
authors.forename: Mary T
authors.initials: MT
authors.lastname: Fox
authors.affiliation: York University Centre for Aging Research and Education, Toronto, Ontario, Canada.
authors.forename: Jeffrey I
authors.initials: JI
authors.lastname: Butler
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D017144:Focus Groups; D005851:Geriatric Nursing / Q000592:standards*; D006801:Humans; D007857:Leadership; D008875:Middle Aged; D009718:Nurse Administrators / Q000592:standards*; D009726:Nurses / Q000523:psychology*; D010465:Perception; D036301:Qualitative Research; D000078329:Workforce
keywords: acute care; function-focused care; health-care system efficiency; older people; operational leaders