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OBJECTIVE: To understand the effect of unit-level nursing leadership on the relationship of structural empowerment and nursing self-efficacy to professional nursing practice behaviors. BACKGROUND: Nursing leadership at both organizational and unit levels is a major influence on professional nursing practice. The interaction between environmental factors, such as structural empowerment and unit-based nursing leadership, and self-efficacy for nursing practice may determine whether a nurse's practice behaviors are either professional or more task-focused. METHODS: A nonexperimental, comparative survey design was used. Instruments included the Conditions for Work Effectiveness-II, Caring Efficacy Scale, Manager's Activities Scale, and Nurse Activity Scale. Multigroup path analysis demonstrated the effects of strong and weak nursing leadership on variables of interest. RESULTS: Nursing leadership contributed to the effects of empowerment and self-efficacy on practice behaviors. Strong nursing leadership also contributed to an additional relationship between empowerment and self-efficacy. Nursing leadership helped to explain 46% of the variance in nursing practice behaviors overall. CONCLUSIONS: Nurses may be able to practice more professionally when they perceive strong nursing leadership. By providing more access to structural empowerment factors for staff, strong unit-level nursing leadership may also influence nurses' self-efficacy, which in turn leads to more professional practice behaviors.
Milisa Manojlovich (Fri,) studied this question.