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Barriers and enablers to advanced practitioners' ability to enact their leadership role: A scoping review

Elliott, N. (author)
Begley, Cecily, 1954 (author)
Gothenburg University,Göteborgs universitet,Institutionen för vårdvetenskap och hälsa,Institute of Health and Care Sciences
Sheaf, G. (author)
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Higgins, A. (author)
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 (creator_code:org_t)
Elsevier BV, 2016
2016
English.
In: International Journal of Nursing Studies. - : Elsevier BV. - 0020-7489. ; 60, s. 24-45
  • Journal article (peer-reviewed)
Abstract Subject headings
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  • Background: Advanced roles such as nurse practitioner, nurse consultant and advanced nurse or midwife practitioner are increasing across the world. In most countries, clinical practice, education, leadership and research are the four components that define the advanced practitioner's role. Of these, leadership is perhaps the most important part of the role, but its study has largely been neglected. There is a risk that failure to identify and respond to barriers to enacting the advanced practitioners' leadership role will limit the extent to which they can become strategic leaders for professional development, and jeopardise the long-term sustainability of the role. Objectives: To identify the barriers and enablers to advanced practitioner's ability to enact their leadership role. Data sources: A search of the research literature was undertaken in electronic databases (PubMed, CINAHL, PsycINFO, ProQuest Dissertation and Theses, from inception to 4-6th June 2015), unpublished research in seventeen online research repositories and institutes, and hand search of 2 leadership journals (March/April 2010-4th June 2015). Review methods: Using pre-set inclusion criteria, the 1506 titles found were screened by two authors working independently. The 140 full text reports selected were reviewed by two authors separately and 34 were included, and data extracted and cross-checked. Any disagreements were discussed by the scoping team until consensus was reached. Using content analysis, the barriers and enablers relating to leadership enactment were sorted into themes based on their common characteristics, and using a Structure-Process-Outcome conceptual framework were categorised under the four structural layers: (1) healthcare system-level, (2) organisational-level, (3) team-level, and (4) advanced practitioner-level. Results: Thirteen barriers to, and 11 enablers of, leadership were identified. Of these a majority (n = 14)were related to organisational-level factors such as mentoring, support from senior management, opportunity to participate at strategic level, structural supports for the role, and size of clinical caseload. Advanced practitioner-level factors relating to personal attributes, knowledge, skills and values of the advanced practitioner were identified. Conclusions: Although building leadership capabilities at advanced practitioner-level and team-level are important, without key inputs from healthcare managers, advanced practitioners' leadership enactment will remain at the level of clinical practice, and their contribution as change agents and innovators at the strategic level of service development and development of the nursing profession will be not be realised.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Health Sciences (hsv//eng)

Keyword

Advanced practitioner
Barriers
Enablers
Leadership
Leadership capacity
Nurse consultant
Nurse practitioner
Scoping review
advanced practice nurses
health-care
meta-synthesis
nursing roles
consultants
framework
specialist
perceptions
education
ireland
Nursing

Publication and Content Type

ref (subject category)
art (subject category)

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Elliott, N.
Begley, Cecily, ...
Sheaf, G.
Higgins, A.
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