Self-efficacy of nurses as clinical leaders – scoping review

Abstract

Introduction: The practice of the clinical nurse leader (CNL) focuses on continuous clinical leadership, which involves four key activities: facilitating effective communication; strengthening intra and interprofessional relations; construction and maintenance of teams; and involvement of support staff [1]. The aim of this Scoping Review was to map and analyze the scientific evidence about nurses’ self-efficacy/self-confidence in the development of competencies associated with clinical leader practice; analyze the self-efficacy / self-confidence of nurses in the transition from the role of CNL. Methods: A total of 18 articles were obtained and filtered according to the inclusion/exclusion criteria, remaining 7 articles. The first step consisted of the research carried out in the electronic databases CINAHL and MEDLINE with the following keywords: nurs * , Clinical Leader, self-efficacy. Every clinical context was important in order to obtain as much scientific evidence as possible concerning this recent role. Secondly, all the indexed terms and keywords were researched in the same databases. In the third step, the list of bibliographic references of the identified articles was analyzed in order to research additional studies. Data extraction and analysis of the studies were based on the Joanna Briggs Institute’s criteria. Results: The CNL was defined as a nurse directly involved in the provision of clinical care, which promotes continuous care improvement by influencing others [2]. Effective CNL has five attributes: vision, capacity for interaction, motivation, creativity and support; as well as 5 types of CNL: explorer, valorized, facilitator, modifier and modeler [1–5]. These experts have clinical leadership qualities and competencies as practice developers of their teams: affectivity, vision, motivation, empathy, experience, knowledge, effective communication, political skills, facilitator, and clinical competencies [1–6]. These professionals significantly improve patient safety and quality of nursing care [1–4]. Discussion and conclusions: The CNL is needed to structure care delivery and support team practices such as communication, collaboration, teamwork, and staff engagement to improving the work environment and the quality and outcomes of nursing care [4,5,7]. Thus, on one hand, the CNL improves the quality of the care to the client and on the other improves the preparation of nurses, providing them the necessary competences to reach professional excellence. Consequently, the CNL contributes to optimize the performance of health organizations and of health systems [5]. Nursing managers can use this evidence to develop interventions that strengthen CNL self-confidence. This innovative role can be adopted anywhere in the world to improve the quality of health systems and has strong implications for health policies and clinical practice contexts [3].