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Effective Nursing Leadership Skills and Approaches

Continuous Quality Improvement and Patient Satisfaction

Nowadays rapidly changing world sets new opportunities and challenges in the field of nursing. Nevertheless, proposed by Florence Nightingale as the top priority, permanent improvement and patient satisfaction remain important. McFadden, Stock, and Gowen (2015) define quality improvement as a combination of knowledge, skills, and characteristics of a service that provides the opportunity to meet existing or perceived needs of patients continuously.

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From the point of view of a patient, his or her family, and society, quality of nursing care should ensure that patients stay satisfied with the provision of nursing assistance in general, both as a result and a process (McFadden et al., 2015). This means that the conditions in which nursing intervention was performed, professionalism of nurses, their personal qualities, communication, and the result of care should correspond to patients’ expectations.

From the standpoint of health care, quality improvement of nursing care is the performance of functional duties in strict compliance with legal and regulatory documents, which means the professional competence of nurses expressed in the ability to work in a team, create and maintain a positive working environment, and ensure patient safety.

Nursing Leaders and Managers Implementing the Issue

There is a range of strategies, methods, and techniques that may be used by nursing leaders and managers. However, not all of them proved to be effective to reach the key goal of patient satisfaction. The review of the related scholarly literature shows that the roles performed by nurse managers and leaders are different. In particular, nurse managers are expected to ensure productivity of nursing care by performing administration tasks.

They focus on the attitude of nurses to their professional duties, the distribution of their working hours, the organization of the workplace, the promotion of personal qualities of nurses, the material and technical equipment of the department, and other issues. In this connection, a nurse manager should use all the available resources to organize the process of health care, thus shaping the very foundation for the continuous quality improvement.

Among the variety of theories and principles, the method of benchmarking seems to be one of the best options to be implemented by nurse managers. Ettorchi-Tardy, Levif, and Michel (2012) claim that benchmarking in health care refers to the “process of comparative evaluation and identification of the underlying causes leading to high levels of performance” (p. 109). Benchmarking contributes to openness and efficiency as it provides the organization with early warning signals of its backlog, finds out the level of organization in comparison with the other institutions, and leads to the rapid implementation of new approaches with the minimized risk.

Nurse managers using benchmarking approach are likely to increase the effectiveness of the provision of nursing services, allocate resources rationally, and also reduce the number of costly ineffective treatment methods.

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Consistent with nurse managers, nurse leaders may apply benchmarking, yet in accomplishing different outcomes. For example, the study by Ettorchi-Tardy et al. (2012) shows that such a method may increase staff motivation to achieve significant results. I think that a nurse leader is a stable and experienced person who has the ability to prioritize and coordinate the efforts of team members. It is the individual who leads the organization based on consolidation and integrity of staff.

At this point, it is essential to emphasize that nurse satisfaction acts as one more important factor affecting patient satisfaction. Rather often, nursing teams with fewer employees achieve better results than those that are composed of a large number of specialists. Therefore, the role of a leader is to ensure that each team members feels comfortable while performing his or her job. As noted by Janicijevic, Seke, Djokovic, and Filipovic (2013), nurse satisfaction affects care quality and improvement, since an unsatisfied nurse cannot provide the required level of services because of stress and fatigue. Using communication strategies, a leader is expected to motivate others, thus serving as the landmark to focus on.

Even though nurse leaders and managers perform different functions, they aim at the common goal of health care quality improvement. Therefore, it is necessary for them to work in collaboration, consider each others’ views, and try to address any challenges that occur in the course of health care quality improvement, as it is emphasized by Janicijevic et al. (2013) in their recent research. Both of them are involved in decision-making, effectiveness of which requires them to know not only what and how staff works, but also why they do it, what meaning they put into their work, and what satisfaction they receive from their services (Kallas, 2014). In other words, success of either a leader or a nurse depends on resolving common tasks, individual needs of team members, and their ability to communicate with them.

Personal and Professional View

In my opinion, nursing leaders and managers should be considered in their integrity as a means of leadership and engagement. It seems to me the choice of the specific management or leadership style depends on the changing situation. The concepts of styles are to be considered in terms of the situational theory, which is also called the theory of unforeseen circumstances. It focuses on the nurse’s adaptability and ability to change the style depending on the organization’s goals and paying attention to the expectations and motivations of the staff. At this point, continuous monitoring and evaluation of the activities of nurses should contribute to the constant improvement of the quality of medical care in a medical institution.

More to the point, the introduction of a system of assessing the quality of nurses’ activities ensures the better performance of the tasks assigned to them, and, therefore, helps to solve the main problem – patient satisfaction. It allows organizing the systematic quality control over the activities of nursing staff, which is to be conducted according to uniform criteria and objectives. All the errors in the performance are to be taken into account, and work is being done to eliminate them. I believe that this method allows achieving strengthening of professional growth, better care for patients, and their increased satisfaction with the services provided.

Summing it up, I would like to emphasize that the approach that best fits my professional and personal philosophy relates to the situational theory of nursing. Depending on certain circumstances, I prefer to change my strategies to remain aware of the situation and be prepared to act timely and appropriately. In an attempt to ensure continuous quality improvement and patient safety, I will try to conduct regular evaluations and implement corresponding changes. In general, proper attitude towards staff and the situation as well as skilful use of knowledge and available resources identify good nurse leaders and managers.


Ettorchi-Tardy, A., Levif, M., & Michel, P. (2012). Benchmarking: A method for continuous quality improvement in health. Healthcare Policy, 7(4), 101-119.

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Janicijevic, I., Seke, K., Djokovic, A., & Filipovic, T. (2013). Healthcare workers satisfaction and patient satisfaction – Where is the linkage? Hippokratia, 17(2), 157-162.

Kallas, K. D. (2014). Profile of an excellent nurse manager: Identifying and developing health care team leaders. Nursing Administration Quarterly, 38(3), 261-268.

McFadden, K. L., Stock, G. N., & Gowen III, C. R. (2015). Leadership, safety climate, and continuous quality improvement: Impact on process quality and patient safety. Health Care Management Review, 40(1), 24-34.

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