Implementing Evidence-Based Practices (EBPs) at the point of care (POC) is crucial for optimal patient outcomes. Strong nursing leadership is essential for successful EBP implementation. This systematic review analyzes two leadership measurement tools, the Implementation Leadership Scale (ILS) and iLEAD, to determine their suitability for assessing and guiding point of care leadership in nursing.
PRISMA flow diagram summarizing the systematic review process.
Assessing Point of Care Leadership: The ILS and iLEAD
Effective leadership fosters environments conducive to EBP adoption. This review examines two tools designed to measure implementation leadership (IL): the ILS and the iLEAD. The goal is to determine their applicability in nursing and provide Point Of Care Leadership Tips And Tools For Nurses based on the findings.
The Implementation Leadership Scale (ILS)
The ILS measures leadership from the perspectives of both leaders (self-report) and staff. It comprises 12 items across four subscales:
- Proactive Leadership: Planning and initiating EBP implementation.
- Knowledgeable Leadership: Understanding and communicating EBPs.
- Supportive Leadership: Providing resources and encouragement for EBP adoption.
- Perseverant Leadership: Maintaining focus and overcoming obstacles in EBP implementation.
Several versions of the ILS exist, including adaptations for different cultural contexts (Chinese and Greek translations).
The iLEAD Tool
The iLEAD assesses leadership behaviors based on the Full Range Leadership Model (FRLM). It includes 16 items categorized into active and passive leadership factors. Active leadership further breaks down into:
- Exemplary Behaviors: Modeling commitment to EBPs.
- Individualized Consideration: Supporting individual staff needs in EBP implementation.
- Intellectual Stimulation: Encouraging critical thinking and problem-solving related to EBPs.
- Contingent Reward: Recognizing and rewarding EBP adoption.
Key Findings and Point of Care Leadership Tips for Nurses
This review revealed strengths and weaknesses of both tools. While both demonstrated good psychometric properties in some areas (structural validity, internal consistency), limitations existed in content validity and reporting of item development. Specifically, the processes for item development and content validation lacked detailed reporting, potentially impacting the tools’ overall validity.
Based on the review, the ILS appears more promising for nursing contexts due to:
- Validation in hospital settings with nurse managers and staff.
- Alignment with the Ottawa Model of Implementation Leadership (O-MILe), which incorporates nursing-specific leadership behaviors.
- Availability of translated versions for broader accessibility.
However, both tools require further validation, especially considering the diverse and collaborative nature of nursing leadership at the POC. Future research should explore the tools’ applicability to various nursing leadership roles (e.g., clinical nurse specialists, nurse educators, charge nurses) and shared leadership models.
Point of Care Leadership Tools for Nurses: Recommendations for Future Development
This review highlights the need for robust, context-specific leadership measurement tools in nursing. Future development should prioritize:
- Rigorous Item Development: Utilizing established methods (e.g., qualitative interviews, expert panels) and clearly reporting the processes.
- Comprehensive Content Validation: Involving diverse nursing stakeholders and formally evaluating item relevance, comprehensiveness, and comprehensibility.
- Consideration of Shared Leadership: Developing items that capture the collective and collaborative nature of nursing leadership at the POC.
- Feasibility Testing: Evaluating the practicality of using the tools in real-world nursing settings.
Conclusion: Empowering Nurses Through Point of Care Leadership
Strong leadership is fundamental for successful EBP implementation and improved patient care. By utilizing and refining tools like the ILS and iLEAD, we can better understand and enhance point of care leadership in nursing. This, in turn, empowers nurses to deliver high-quality, evidence-based care. This review provides valuable insights for researchers, educators, and nurse leaders seeking to develop and implement effective leadership strategies at the POC. Further research is crucial to ensure the availability of robust and contextually relevant point of care leadership tools for nurses.
