The purpose of this study was to describe and identify the leadership style that prevails in health care institutions, in order to establish the influence of multilevelleadershipon the effeciveness of hospitals in KwaZulu-Natal. Hunt's extended multilevel leadership Model was used as a conceptual framework. Six institutions were selected by random sampling, categorised into three sizes i.e. large institutions with number of beds above 400, midddle sized between 200-400 and smaller institutions with a bed state below 200. Three categories of leaders were as top, middle and operational leadership. The 8 leaders included the chief medical superintendent, the hospital secretary, the chief nurse manager, two area nurse managers and the three operational nurse managers in each of the six institutions. A total of 48 MLQ instruments designed by Bass and Avolio (1989) focused on leadership style was used to identify transformational, transactional and nonleadership styles. 121 Questionnaires were distributed to staff and community to measure hospital effectiveness. Interviews were carried out on patients and visitors to establish patients' satisfaction. The effectiveness of health care services was described by goal attainment, level of support and system's achievement. The instruments to measure goal attainment and level of support were designed by the researcher. The 6 institutions were measured for system's achievement by using the instrument designed by Beattie, Rispel and Cabral (1995). The criteria used to assess infrastructure, access to the institution, management of personnel, management of resources, patient satisfaction, community outreach programmes and the process of care, was based on the criteria developed by Beattie, Rispel, and Cabral (1995). A correlation was done to establish the relationship between leadership style and hospital effectiveness. Findings; the area manager exhibited the leadership style that is predominantly Transformational, the other four categories identified in the study, revealed a leadership style that was predominently Transactional. Of the six institutions two revealed a transfomational leadership style and three revealed a transactional leadership style. One institution reflected a Laissez-Faire leadership style. The overall leadership style was transactional. On comparing the three effectiveness criteria goal attainment was identified as the most effective area of achievement followed by system's achievement and the least being level of support. A MANOVA multivarate analysis of variance revealed that the relationship between leadership style and goal attainment was not significant. The relationship between leadership style and level of support was significant. On further analysis using the Shetre test, it was found that the level of support was significantly related to transformational leadership. The relationship between leadership style and stystem's achievement was not established, because the sample size of six institutions was too small. The overall relationships between leadership style and hospital effectiveness was significant at p-< 0.01 level. Recommendations; included that all all categoties of leadership at institutions are to increase their diagnostic level of awareness of their leadership styles. Rigorous education and training on leadership and support were essential. A further recommendation was that the methodology used in this study to measure hospital effectiveness be used more widely as a management tool. A common instrument used to evaluate acceptable standards of health care assessment should be used to ensure comparison between and within institutions in KwaZulu- Natal There was a need for further research to establish the influence of leadership style on hospital effectiveness in order to ensure quality care by health care providers and to increase professional efficiency and effectiveness in the hospitals of KwaZulu-Natal. / Thesis (Ph.D.)-University of Natal, Durban. 1998.

It has been reported for over the last decade that the quality of nursing care provided towards patients has decreased tremendously. The literature shows the impact of poor quality nursing to patients and assumes the influence of nurses’ perceptions of quality nursing care on its delivery. However, studies about such perceptions are still few in Rwanda. Aim: The purpose of this study was to explore the perceptions of quality nursing care among nurses working in two district hospitals in Rwanda. Methodology: A non-experimental exploratory descriptive design which was quantitative in nature was used. A self-report questionnaire comprised items related to socio-demographic characteristics of participants, perceptions of quality nursing care, nurses’ role in continuous quality improvement and factors affecting the delivery of quality nursing care. The sample was obtained through a purposive non-probability sampling of the nurses (n=150) who were available during data collection from 16 to 28 October 2011, with a return rate of 110 (73%) of completed questionnaires. Results: The findings from demographic data indicated that many of nurses were young, with 48.2% falling into the 20 to 30 year old bracket and the majority of the participants (83.3%) were enrolled nurses. Many of the participants were new to the nursing profession, with 47.2% falling into the 6 months-5 years working experience bracket. This study suggests that nurses had an appropriate perception of quality nursing care, as evidenced by the mean score of 4.183 (SD: .5741), related to nurses’ understanding of quality nursing care with mean score of 4.137 (SD: .5763) for the perceptions of the delivery of quality nursing care. The role played by nurses in continuous quality improvement was evident, but it was constrained by the factors related their nursing practice environment, including: shortage of nurses, lack of time, heavier workloads, and few opportunities for advancement. Conclusion: In summary, this study provided insights into nurses’ perceptions of quality nursing care, and their current ongoing endeavours to provide quality improvement in spite of challenges in their workforce environment. This study has described the challenges which interfere with the delivery of quality nursing care that need to be addressed so that patients may benefit from evidence-based care. / Thesis (M.N.)-University of KwaZulu-Natal, Durban, 2011.

Rapid and chaotic changes in health care have created a need for a new type of nursing leadership. Many leadership theories have been studied and adopted by nursing. However, historical approaches to leadership will not help nurses thrive in the current health care arena.The purpose of this study was to describe a case example of nursing leadership using a topical life history of one exceptional nurse leader. The topical life history describes two representative periods in an exemplary nurse leader's life to fully describe an insider's perspective of leadership. This definition, which includes the participant's interactions with her self, others, and her environment during two significant periods during her life, will be used as the initial case for the future collection of multiple case examples in an effort to develop a definition of nursing leadership.Nursing leadership was defined, based on the interpretation of interview transcripts, as: Hard work, vision, communication, coaching/facilitating, strong values, proactivity, and charisma. Findings support various leadership theories and identified two core categories previously poorly defined in nursing leadership literature: Hard work and street smarts. Implications for nursing research, education, and practice have been identified. Recommendations for use of this study as a case example to stimulate classroom discussion have been made. Additional recommendations for further research in the areas of hard work and street smarts have also been made. / School of Nursing

America's health care industry is in a state of crisis. Nursing administrators are in the position to facilitate change in institutions. One aspect of nursing which has remained constant is high turnover rates. The high turnover rates have been linked to job dissatisfaction. One method of reducing turnover is to provide greater job satisfaction to staff nurses. Job satisfaction has been connected with management style (Lucas, 1991; Price & Mueller, 1981; Volk & Lucas, 1991).This study described the impact of head nurse management style on staff nurse job satisfaction. Likert's (1967) System 4 management theory was utilized as the framework in the study. All staff nurses and head nurses from three Central Indiana hospitals were given the opportunity to participate in the study. Participants completed two questionnaires, one from Price and Mueller's (1981) work on turnover to determine job satisfaction and one from Likert and Likert's (1976) work to determine management style.Data analysis was conducted to describe any variations between staff nurse experience of head nurse management style and staff nurse job satisfaction. Differences between head nurse and staff nurse description of management style were also examined. There were no identified risks as participation was voluntary and did not affect the employment status of any individual.Results of the study demonstrated agreement with previous research findings. When management style is closer to participative (system 4), greater job satisfaction is expressed. Recommendations are to provide management training and training in communication and self-awareness for head nurses, and to form unit based committees designed to achieve greater staff input in decisions affecting the unit functioning.Benefits of the study include identification of the management style which leads to improved staff nurse job satisfaction. Equipping nurse administrators with information regarding desirable management style to employ for staff nurses to experience greater job satisfaction, and training present managers in that management style are also possible benefits from the study. / School of Nursing

The purpose of this study was to determine if shared governance systems result in an increased perception of autonomy for staff nurses. The population for this study included all registered nurses providing inpatient care at two mid-sized community hospitals in the Midwest, who were not identified as supervisors, managers or executives. The convenience sample was obtained from those completing and returning a distributed survey. The sample was 146 staff nurses from each organization. Only responses from nurses with more than one year experience at the current facility were included in the study. , One hospital had a shared governance system in place. The other hospital had a traditional organizational system.The theoretical framework for the study was the Neuman Systems Model (1989). Staff nurse autonomy was measured by the Nursing Activity Scale (Schutzenhofer, 1987). Management characteristics were measured by the Profile of Organizational Characteristics (Liken, 1978). Also administered was a brief demographic data questionnaire (Schutzenhofer & Musser, 1994).Each hospital provided the researcher with access to participant mailboxes of those registered nurses providing inpatient care and not in management or executive roles Surveys were placed in each mailbox, and drop boxes were made available in unit classrooms in one hospital, and in nursing administration in the other hospital. A reminder notice was placed in each participant mailbox one week after initial survey distribution. Drop boxes were retrieved by the researcher one week following the reminder notice distribution. Study participants were informed about the study by cover letter and invited to participate. Participation was strictly voluntary. Data was available only to the investigator and only group data were reported without reference to individual participants. Participant responses were completely anonymous. Questionnaires were printed on two different colors of paper in order to distinguish between hospitals. No code numbers or other identifying marks were placed on any of the questionnaires. The study provided information on which to base management decisions regarding nursing governance arrangements. / School of Nursing

Diss. (sammanfattning) Stockholm : Karol inst., 2004. / Härtill 5 uppsatser.

Thesis (M.H.A.)--University of Michigan, 1968.

Thesis (M.H.A.)--University of Michigan, 1968.

Thesis (Ph. D.)--University of Virginia, 1999. / Includes bibliographical references (p. 230-254). Also available online through Digital Dissertations.

THESIS (D.N.P. (Doctor of Nursing Practice))--School of Nursing, University of San Francisco, 2010. / Bibliography: leaves 59-73.