Nursing leadership in intensive care units and its relationship to the work environment

Balsanelli, Alexandre Pazetto; Cunha, Isabel Cristina Kowal Olm

doi:10.1590/0104-1169.0150.2531

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Revista Latino-Americana de Enfermagem

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Original Articles • Rev. Latino-Am. Enfermagem 23 (1) • Jan-Feb 2015 • https://doi.org/10.1590/0104-1169.0150.2531 copy

Nursing leadership in intensive care units and its relationship to the work environment¹ 1 Paper extracted from doctoral dissertation "Leadership of nurses in ICU and its relation to the work environment", presented to Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, SP, Brasil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

AIM:

To establish whether there is any relationship between the work environment and nursing leadership at intensive care units (ICUs).

METHOD:

Correlational study conducted at four ICUs in southern São Paulo (SP), Brazil. The study population was comprised of 66 pairs (nurses and nursing technicians) established by lottery. The nurses responded to three instruments: 1) characterization; 2) a validated Portuguese version of the Nursing Work Index Revised (B-NWI-R); and 3) Grid & Leadership in Nursing: ideal behavior. The nursing technicians responded to 1) characterization and to 2) Grid and Leadership in Nursing: actual behavior, relative to the corresponding randomly-assigned nurse. The data were analyzed by means of analysis of variance (ANOVA) at p ≤ 0.05.

RESULTS:

The work environment was not associated with actual nursing leadership (p = 0.852). The public or private nature of the institutions where the investigated ICUs were located had no significant effect on leadership (p = 0.437). Only the nurse-physician relationship domain stood out (p = 0.001).

CONCLUSION:

The choice of leadership styles by nurses should match the ICU characteristics. Leadership skills could be developed, and the work environment did not exert any influence on the investigated population.

Descriptors
Nursing; Leadership; Intensive Care Units; Health Facility Environment

Actual leadership styles	Brazilian Nursing Work Index Revised(B-NWI-R)
	N	Minimum	Maximum	Mean	Standard deviation	95% CI*
	N	Minimum	Maximum	Mean	Standard deviation	Lower	Upper
	66	1.00	3.00	1.95	0.40	1.85	2.05
1.1	1	2.07	2.07	2.07	-	-	-
1.9	6	1.60	2.53	2.12	0.34	1.76	2.48
5.5	9	1.33	2.60	1.93	0.45	1.59	2.28
9.1	8	1.47	2.20	1.90	0.29	1.66	2.14
9.9	42	1.00	3.00	1.93	0.43	1.80	2.06

Brazilian Nursing Work Index Revised (B-NWI-R) domain	Group	N	Minimum	Maximum	Mean	Standard deviation	95% CI*		p
Brazilian Nursing Work Index Revised (B-NWI-R) domain	Group	N	Minimum	Maximum	Mean	Standard deviation	Lower	Upper	p
Autonomy	All	66	1	3.4	1.92	0.49	1.79	2.04
	1.1	1	2	2	2	-	-	-
	1.9	6	1.6	2.4	2.03	0.32	1.7	2.37	0.977
	5.5	9	1	3.2	1.87	0.7	1.33	2.41
	9.1	8	1.2	2.4	1.9	0.41	1.55	2.25
	9.9	42	1	3.4	1.91	0.49	1.76	2.06
Control over practice setting	All	66	1	3.57	2.01	0.51	1.88	2.13
	1.1	1	2	2	2	-	-	-
	1.9	6	1.71	2.86	2.24	0.55	1.66	2.81	0.847
	5.5	9	1.57	2.71	1.97	0.36	1.69	2.25
	9.1	8	1.43	2.57	1.95	0.41	1.6	2.29
	9.9	42	1	3.57	2	0.55	1.82	2.17
Nurse-physician relationship	All	66	1	3	1.85	0.47	1.74	1.97
	1.1	1	2.33	2.33	2.33	-	-	-
	1.9	6	1	3	2	0.76	1.2	2.8	0.632
	5.5	9	1	2.67	1.96	0.51	1.57	2.36
	9.1	8	1	2.67	1.79	0.56	1.32	2.26
	9.9	42	1	2.67	1.81	0.4	1.69	1.93
Organizational support	All	66	1	3.1	1.96	0.43	1.86	2.07
	1.1	1	2.2	2.2	2.2	-	-	-
	1.9	6	1.8	2.6	2.22	0.37	1.83	2.61	0.539
	5.5	9	1.4	2.7	1.97	0.45	1.62	2.31
	9.1	8	1.4	2.1	1.84	0.28	1.61	2.07
	9.9	42	1	3.1	1.95	0.46	1.8	2.09

Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo Av. Bandeirantes, 3900, 14040-902 Ribeirão Preto SP Brazil, Tel.: +55 (16) 3315-3451 / 3315-4407 - Ribeirão Preto - SP - Brazil
E-mail: rlae@eerp.usp.br

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[1] Corresponding Author: Alexandre Pazetto Balsanelli Universidade Federal de São Paulo. Escola Paulista de Enfermagem Rua Napoleão de Barros, 754 Vila Clementino CEP: 04024-002, São Paulo, SP, Brasil E-mail:pazetto@terra.com.br