Resources

Laschinger & Leiter (2006)
— 8,597 acute care nurses in Ontario and Alberta

higher nurse participation in hospital affairs

lower nurse-reported adverse events

Clarke (2007)
— 11,512 nurses in 188 hospitals in Pennsylvania

higher nurse participation in hospital affairs

lower needle or sharps injuries

Gregory et al. (2010)
— 548 acute care nurses in Canada

higher control/empowerment and input into decision-making

higher nurse perceptions of quality of care, standards of care, and safety issues

Hanrahan, Aiken, et al. (2010)
— 353 direct inpatient care psychiatric nurses in 67 hospitals in Pennsylvania

higher nurse participation in hospital affairs

lower emotional exhaustion

Flynn et al. (2012)
— 686 RNs in 82 medical-surgical units in 14 hospitals in New Jersey

higher nurse participation in hospital affairs

higher error interception practices, which linked to lower medication errors

Friese & Himes-Ferris (2013)
– 242 outpatient oncology nurses in a large southeastern state

higher nurse participation in practice affairs

higher intent to stay

Leineweber, Chungkham, et al. (2014)
— 8,948 medical/surgical RNs in 53 hospitals in Sweden

higher nurse participation in hospital affairs

lower work-family conflict

Nowrouzi et al. (2015)
— 506 registered practical nurses in Ontario, Canada

higher involvement in decision making

higher intent to stay in current position for next 5 years

Papastavrou et al. (2015)
— 1,163 RNs and LPNs in 91 wards in 34 hospitals in Cyprus, Finland, Greece, Portugal, Sweden, Turkey, and the state of Kansas

higher control over practice

higher nurse perceptions of individualized care successfully provided to patients in latest shift

Zaheer et al. (2015)
— 2,495 nurses (81%), physicians (13%), and pharmacists (6%) in 13 hospitals in Ontario, Canada

higher levels of participative leadership

stronger frontline staff perceptions of patient safety climate (senior and supervisory leadership support for patient safety)

Kutney-Lee et al. (2016)
— 20,674 RNs in 425 hospitals in California, New Jersey, Pennsylvania, and Florida

higher engagement in shared governance

lower nurse reports of

• high burnout
• high job dissatisfaction
• intent to leave
• poor quality of care and patient safety

higher patient reports of

• experience of care
• hospital rating
• willingness to recommend hospital

Cox Sullivan et al. (2017)
— 10 nurses at a Veterans Health Administration facility

higher engagement in shared governance at unit level

increased nurse empowerment, self-management, engagement, and satisfaction

Underwood et al. (2017)
— 11 US healthcare SCNEs from the American Nurses Credentialing Center's repository of Magnet®-designated facilities

system-level shared governance

higher empowerment in nurses

Orchard et al. (2017)
— dual role of nurse leaders as both managers and advocates for nurses to demonstrate their disciplinary knowledge and practice.

promotion of a culture of interprofessional decision-making

increased capacity to influence integration of interprofessional collaborative practice with other health professionals within their leadership areas

Chisengantambu-Winters et al. (2019)
— nurse unit managers, after-hours coordinators and directors of nursing working in rural and regional health institutions in South Australia

interprofessional decision making processes

increased awareness of the governance system

Kaddourah et al. (2020)
—186 registered nurses in a hospital in Saudi Arabia

 nurses involved in shared governance

increased professional development

Bagot et al. (2020)
—169 nurses and 134 non-nurses

interprofessional decision-making process to select new technology

improved rates in:

• clinical support and patient care
• perception of “ease of use” (technical, clinical aspects)
• facilitating conditions (setting, education, confidence)
• social influence (working relationships)

Sawatzky & Enns (2012)
— 261 RNs in adult emergency departments in Manitoba, Canada

higher perceptions of nursing management

• ·higher engagement, which in turn related to lower intent to leave current position

Van Bogaert et al. (2013)
— 1,201 RNs in 116 units in 8 hospitals in Belgium

higher perceptions of nurse management at the unit level

• higher nurse-assessed quality of care
• higher nurse job satisfaction, intent to stay in the hospital, and intent to stay in nursing

Leineweber, Westerlund, et al. (2014)
— 8,620 RNs in 53 hospitals in Sweden

better leadership and support for RNs

reduced risk of

• emotional exhaustion
• depersonalization of patients

Roche et al. (2015)
— 1,673 nurses in 62 wards in 11 hospitals in 3 states in Australia

higher perceptions of nurse unit manager leadership skills

lower intent to leave within 12 months

Spano-Szekely et al. (2016)

better access to the nurse manager

• better collaboration between the nurse manager and the direct care nurses,
• more effective NM leadership
• improved RN performance and patient outcomes

Roche et al. (2016)
— 3 Australian states between 2004 and 2013

positive practice environment perception, higher retention

• improved organizational restructuring
• decreased turnover of nurse executives

Duffield et al (2019)

higher involvement of direct care nurses in cost management discussions

• increased clinical and management skills
• improved patient-centered ness
• cost-effective care

Moeta et al (2019)
— 11 nurse unit managers

better role orientation for NM

• improved professional development
• enhanced role competence as a leader
• better conflict management competency

Keutchafo et al. (2019)
— 10-unit managers in two district hospitals in Cameroon

role orientation for NM and leadership development

• enhanced role competence as a leader

Frasier (2019)
— 16 NMs who participated in the leadership development program.

leadership development

• managers perceived greater self-awareness,
• and direct reports perceived positive change in managers' use of authentic leadership behaviors.

Rosen et al. (2010)
— 4,581 VA hospital workers in 29 hospitals

higher overall emphasis on safety

lower rates of

• decubitus ulcer
• iatrogenic pneumothorax

Chang & Mark (2011)
— 4,954 medical-surgical RNs in 286 units in 146 US hospitals

stronger learning climate (communication and thinking about errors)

lower medication errors

Houser et al. (2012)
— 420 nurses in 54 units in 9 hospitals in Colorado

higher RN involvement in planning for staffing

higher unit-level indicators of patient satisfaction with nursing care

Tvedt et al. (2012)
— 3,618 nurses in surgical and medical wards in 35 hospitals in Norway

higher patient safety management

nurse-reported:

• higher quality of nursing care
• higher patient safety ratings
• higher ratings of patients' self-care ability
• lower frequency of adverse events

Steyrer et al. (2013)
— 549 nurses, 185 physicians, and ICU 378 patients in 57 hospitals in Austria, Germany, and Switzerland

more positive safety climate (management commitment to patient safety, organizational learning, communication and cooperation, and attitude toward safety management)

lower rates of medical errors

Zaheer et al. (2015)
— 2,495 nurses (81%), physicians (13%), and pharmacists (6%) in 13 hospitals in Ontario, Canada

higher ease for reporting events

stronger frontline staff perceptions of patient safety climate (senior and supervisory leadership support for patient safety)

Richter et al. (2016)

— 237,409 clinical staff in 1,046 hospitals

higher perceptions of management support for safety

higher perceptions of successful handoffs

Quillivan et al. (2016)
—169 (47.2%) nurses at a specialized pediatric hospital

positive practice environment and higher perception of safety

• reduced punitive response to error
• encouraged supportive coworker, supervisor, and institutional interactions may
• reduced severity of second victim experiences

Trahan & Bishop (2016)
—112 neurology nurses in the United States

better organization safeguards nurses from verbal or physical abuse directed at nurses from patients and families

• improved administrative approach to address abuse of nurses by patients and families
• reduced the use of avoidance as a way of dealing with this abuse.

Bambi et al. (2017)
—7 original papers were included in this review

organizational promotion of a culture free from 1) incivility, 2) bullying, 3) and workplace violence among the healthcare provider team, including nurse-to-nurse, include methods to track and address trends

the implementation of zero tolerance policies and passive dissemination of information about these phenomena showed to be clearly ineffective

M Clark et al. (2018)
—393 nursing faculty and practice-based nurses in the United States

organizational commitment to safe working environment

improved trust among coworkers, colleagues, or work group help improve self-awareness, give, and receive constructive feedback form the basis for continuing strengths and addressing areas for improvement

In-Young Jeong & Ji-Soo Kim (2018)
—214 nurses with over one year of experience of working in an emergency department.

higher organizational safeguards to protect nurses from abuse

• increase useful information to guide nurse’s management of violence experiences
• increase report violent experiences to the administrative department more opportunities to communicate feelings

Shi-Hong Zhao et al. (2018)
—1,024 nurses from 26 cities in China (February-May 2016)

Increased awareness of verbal or physical abuse directed at nurses from patients and families

• improved well-being
• better control and mitigation of the adverse effects of workplace violence

Xin Zhang et al. (2019)
—267 RNs who were involved in direct patient care and medical errors within the previous year in China

higher perception of positive practice environment and safety

reduced second victim-related distress

Saville et al. (2019)

higher involvement of direct care nurses in staffing plans

Improved skill mix, nursing work other than direct patient care, quantifying risks, and benefits of staffing below or above a target level, and validating staffing methods in a range of hospitals

Wen Qi Mok 1 et al. (2020)
—1,163 nurses from an acute public hospital in Singapore

strong organizational support to a positive practice environment and higher perception of safety

• increased awareness of the reduced trauma and improved reconciliation process in the aftermath of an unanticipated error

Howard et al. (2020)
—mixed-methods design to improve dialogue and interpersonal engagement and to create behavioral change - Workplace Civility Index (WCI)

organizational promotion of a culture free from 1) incivility, 2) bullying, 3) and workplace violence among the healthcare provider team, including nurse-to-nurse, include methods to track and address trends

educational activities raise awareness of these issues and can improve the ability to reduce the frequency and overall impact of incivility

Gittell et al. (2000)
— 338 care providers (nurses and physicians) from 9 hospitals, 878 orthopedic patients

higher mutual respect, shared goals, and frequency of communication (dimensions of “relational coordination”)

• lower length of stay
• higher quality of care
• higher postoperative freedom from pain
• higher postoperative functioning

Brooks et al. (2009)
— 1,578 patients in 12 Midwest acute care hospitals

intervention of evidence-based pain management practices

lower total cost per inpatient stay, cost per day, and length of stay

Gregory et al. (2010)
— 548 acute care nurses in Canada

higher satisfaction with managerial and interdisciplinary relations

higher nurse perceptions of quality of care, standards of care, and safety issues

Hickey et al. (2013)
— 3,413 pediatric critical nurses with 26,158 congenital heart disease patients in 38 children’s hospitals

participation in national quality metric benchmarking

lower odds of in-hospital mortality

Melnyk et al. (2014)
— 80 EBP mentors across the United States

more educational opportunities provided by the organization for direct care nurses regarding application of evidence-based practice

higher quality, reliability, and consistency of healthcare as well as reduce costs

Lee Khuan et al. (2017)
—20 registered nurses from general wards in a Malaysian public hospital

organizational promotion of a culture of person-and-family centered care.

• increased patient involvement in care
• nursing practices congruent with patient-centered care

Melnyk et al. (2018)
—2344 nurses from 19 hospitals or healthcare systems

more educational opportunities provided by the organization for direct care nurses regarding application of evidence-based practice

improved competency in EBP ensure the highest quality of care and best population health outcomes

Asmirajanti et al. (2018)
 —literature published from 2000 to 2015

organizational promotion of interprofessional collaboration to meet wide quality initiatives

• reduced the average length of stay for patients
• increase cost effectiveness, and,
• improved quality of service

Berit Misund Dahl (2018)
—23 public health nurses from urban and rural districts in two counties in Norway

organizational approach to improving population health

increased population-based interventions

Malfait et al. (2019)
—799 patients and 165 nurses

organizational promotion of a culture of person-and-family centered care

put patient participation on the agenda and negative effects are absent

Saunders et al. (2019)
—the Delphi panel was conducted in late 2017 among 14 Finnish nurse clinicians, educators, and leaders with a special interest in EBP

more educational opportunities provided by the organization for direct care nurses regarding application of evidence-based practice

international quality standardize path for nurses to aspire to and attain on EBP and provide guidance for nurses in integrating best evidence into their daily practice, facilitating broad-based, consistent implementation of EBP worldwide

Myers(2020)

organizational approach to improving population health

Nurses need to actively embrace strategies to improve population health outcomes and reduce health and other disparities.

Lasater et al. (2020)
— 24 nursing leaders from academic (n = 15), practice (n = 4) and regulatory (n = 5) sectors.

organizational approach to improving population health

• encourage rebalancing nurse education towards population health,
• recognize social determinants of health.
• understand the impact of policy and politics on health.
• motivate to encourage behavior change

Tourangeau & Cranley (2006)
— 6,856 RNs and 1,325 RPNs in Ontario, Canada

higher satisfaction with praise and recognition

higher intention to remain employed in current hospital

Duffield et al. (2010)
— 1,559 nurses in 91 wards in 21 public hospitals in 2 Australian states

• higher availability of flexible or modified work schedules
• higher praise and recognition for a job well done

higher job satisfaction

Estryn-Behar et al. (2010)
— 866 nurses in Belgium, Germany, Finland, France, Italy, the Netherlands, Poland, and Slovakia

work schedule difficulties

exited organization in past year

Carter & Tourangeau (2012)
— 17,707 RNs and midwives at 140 acute and 20 specialist hospitals in England

better ability to achieve good work-life balance

lower intention to leave

Leineweber et al. (2016)
— 23,076 RNs Belgium, England, Finland, Germany, Greece, Ireland, the Netherlands, Norway, Poland, Spain, Sweden, and Switzerland

higher satisfaction with scheduling flexibility

less likely to

• leave hospital
• leave nursing profession

Nantsupawat et al. (2016)
—1351 nurses working in 43 inpatient units in five university hospitals across Thailand

better integration of employee well-being and resilience into strategic planning

• better work environments
• less job dissatisfaction, intention to leave, and burnout

Brennan (2017)              

better integration of employee well-being and resilience into strategic planning

• high-quality patient care
• higher resilience
• professionally development

Labrague et al. (2017)
—166 nurses

better integration of employee well-being and resilience into strategic planning

perceived organizational politics predicted nurses' stress and burnout levels, turnover intention and job satisfaction

Kelly et al. (2017)
—726 intensive care unit nurses in 14 hospitals with an established meaningful recognition program and 410 nurses in 10 hospitals without such a program.

meaningful recognition

• decreased burnout
• increased job satisfaction and job enjoyment
• decreased secondary traumatic stress,
• and increased compassion satisfaction

Kelly et al. (2017)
—105 nurses in 3 intensive care units at an academic medical center

meaningful recognition

• decreased burnout

Jakimowicz  et al. (2017)
—a self-reported cross-sectional survey using an established tool collected data from critical care nurses of two adult Australian intensive care units

implemented organizational strategies to address compassion fatigue

• high compassion satisfaction
• moderate/low fatigue

Alharbi et al. (2019)
—10 articles related to the compassion fatigue in critical care situations.

implemented organizational strategies to address compassion fatigue

provision of education to nurses to assist with the development of coping strategies to avoid compassion fatigue

Salmond et al. (2019)
—23 papers, representing studies conducted in 7 countries and 821 total nurse participants

implemented organizational strategies to address compassion fatigue

• increased awareness, better prevention mechanisms
• improved personal and organizational coping strategies and adaptive responses to keep nurses balanced, renewed and able to continue compassionate connection and caring

Moloney et al. (2020)
—integrative review of literature published between 2005-2019

better integration of employee well-being and resilience into strategic planning

promotes the development of management approaches that enable their nurses to thrive

Salvant et al. (2020)
—46 RN/support staff (RN/SS group) and 10 nurse leaders (leaders group) from a Level 1 trauma center.

meaningful recognition

promotes age recognitions (preference for monetary rewards stems from the younger generations' focus on work-life balance)

Boyle et al. (2016)
— 5,144 patient care units in 857 hospitals

higher unit-level rates of specialty certification

better quality on a composite index of pressure ulcer and fall rates

Rondeau et al. (2009)
— 680 CNOs and others responsible for nursing function at 232 hospitals and 473 long-term care facilities in Canada

higher intensity of staff training and development across 10 broad areas (e.g., workplace safety, clinical skills, quality improvement, and team effectiveness)

lower turnover (percentage of RNs that voluntarily left the organization in the past year)

Carter & Tourangeau (2012)
— 17,707 RNs and midwives at 140 acute and 20 specialist hospitals in England

more perceived developmental opportunities

lower intention to leave

Boltz et al. (2013)
— 44 medical and medical-surgical units serving older adults in 25 hospitals

higher percent unit RNs certified in any specialty

lower fall rates

Covell & Sidani (2013)
— 91 units in 6 hospitals in Ontario and Quebec

higher unit-level proportion of RNs with specialty certification

• lower rates of hospital- acquired infection
• lower vacancy rates (less unfilled positions)
• lower recruitment rates (less need to hire nurses)

Trinchero et al. (2013)
— 827 nurses in 6 public and private hospitals in Italy

higher satisfaction with training and development provided by the hospital

higher employee engagement

Unruh & Zhang, 2014a
— 533 newly licensed RNs in Florida

higher perceptions of having a good orientation

• lower turnover (nurse reports of leaving a job within 1.5-2.5 years of graduating)

Unruh & Zhang, 2014b
— 414 newly licensed RNs in Florida

more positive orientation experience

higher job satisfaction

Rush et al. (2015)
— 245 new graduate nurses in acute care settings in British Columbia

participation in formal new graduate transition program

higher scores on transition experience (workplace integration)

Spector et al. (2015)
— 486 new graduate nurses in 51 hospitals in Illinois, North Carolina, and Ohio

participation in established (vs. limited) onboarding/transition program

nurse self-reports of:

• fewer patient care errors
• fewer negative safety practices employed
• higher competency levels
• lower work stress
• better job satisfaction organization reports of:
• higher retention rates

Vander Elst et al. (2016)
— 633 nurses from a large home healthcare organization in Belgium

more opportunities provided in the job situation to learn and to develop

• higher work engagement
• lower burnout

Warshawsky et al. (2016)
— 348 nurse managers working in 9 healthcare systems

organizational support for ongoing development of nursing leaders (culture of generativity)

• higher job satisfaction
• lower intent to leave

Phillips et al. (2018)
—a cost-benefit analysis of a formal succession-planning program from one hospital

organizational succession planning for a nursing leadership role

effectively reduces replacement costs and time to transition into the new role

Cziraki et al. (2018)
—727 registered nurses across Canada

organizational succession planning for a nursing leadership role

leadership self-efficacy increases motivation and intention to pursue a leadership careers

Gomes Nogueira et al. (2019)
—36 nurses from a public university hospital

organizational succession planning for a nursing leadership role

Promotes the diagnosis of the leadership profile in the institution that favor the development of succession planning

Tucker (2020)
—evidence-based model was developed to provide academic nurse leaders with a guide for succession planning

organizational succession planning for a nursing leadership role

a formal succession plan gives purposeful direction in identifying and developing emerging leaders and is especially useful for individuals who are new to a major leadership role