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The Influence of Nursing Leadership on Patient Outcomes

Updated on April 1, 2014

The Influence of Nursing Leadership on Patient Outcomes

Nurse Leaders have the opportunity to see what works and what does not work in terms of patient care. Bedside nurses are well positioned to improve patient care and safety processes on hospital units by discovering, correcting, and reporting the underlying causes of faulty care processes. Proper training and resources can transform clinical nurses into leaders with the ability to guide hospitals to improved processes ultimately resulting in improved patient outcomes. Many studies have linked nursing leadership to improved patient outcomes, but none are as complete and cover as many areas as “The Link Between Leadership and Safety Outcomes in Hospitals” (Squires, Tourangeau, Laschinger, & Doran, 2010). The quality of the nursing work environment directly affects patient safety outcomes, it is important to address both nursing outcomes and patient outcomes in order for an organization to properly assess their processes.

Research by Squires, Tourangeau, Laschinger and Doran (2010) documents the relationship between nurse leadership, nurse outcomes and patient outcomes. The study is based around the influence of interactional and resonant leadership on nurse and patient outcomes. The key factors found to enhance patient outcomes were strong resonant leadership and a high staff perception of fairness. A resonant leader is emotionally in tune with themselves and the people they work with, creating a climate of optimism that inspires commitment. Interactional justice involves the perception of fairness and is related to positive work behaviors, commitment to the organization, trust, satisfaction and performance. Perceptions of justice and resonant leadership styles enhance the quality of the work environment and safety climate. Another thing thought to influence interactional justice, patient and employee satisfaction is span of control. Span of control is the number of direct employees that reports to a nurse manager. However, Squires et al. (2010), did not find that the number of people that reported to a manager had a significant effect on these measures. Safety climate reflects the employee perceptions of the organizations safety policies, procedures and practices and influences their behavior and attitudes. A visible and engaged leader can influence the safety climate. It is linked reduction in medication errors and barriers to error reporting. The final analysis, displays that the healthy work environment created through strong leadership reduces nurse injury and burnout and patient outcomes readmission rates and mortality and lower length of stay. When nurses are empowered with opportunities of autonomy, accountability and job control they demonstrate higher job satisfaction, commitment, and lower absenteeism. Strong leadership can impact nurse and patient outcomes through development of a quality nursing work environment and positive safety climate.

“The Link Between Leadership and Safety Outcomes in Hospitals” (Squires et al., 2010) shows how nurse leaders can influence nurse and patient safety outcomes. It is a domino effect process in which proper use of resonant leadership style and interactional justice creates an improved nurse leader-nurse relationship then leading to a high quality and safe nursing environment. This high quality and safe nursing environment shows improved nurse and patient safety outcomes. This research gives organizations a broad knowledge of quality outcomes and the proven way to improve them. It is also gives clinical leaders the importance of how their profession impacts quality outcomes.


To make significant progress on patient safety issues, organizations need to invest in developing leadership skills of nurse leaders, considerable changes will begin once this is accomplished including improved nurse satisfaction and patient quality outcomes which result in improved financial outlook of the organization.

Through an open discussion which stimulates ideas and encourages participation. Remember that each group members opinion is valuable. The group should exhibit an environment of acceptance where no opinion judged or criticized. This increases feedback, leadership and self confidence to those who participate.


Squires, M., Tourangeau, A., Laschinger, H., & Doran, D. (2010). The link between leadership and safety outcomes in hospitals. Journal Of Nursing Management, 18(8), 914-925.


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