Aims: To explore nurses' perspectives on how leaders influence function-focused care, defined as care that preserves and restores older people's functional abilities.
Background: Hospitalised older people are at risk of functional decline. Although leaders have the potential to influence function-focused care, few studies have explored nurses' perspectives on how leaders influence function-focused care.
Methods: Thirteen focus groups were held with 57 acute care nurses. Semi-structured questions prompted discussion on nurses' perspectives, needs and strategies to meet their needs. Data were thematically analysed.
Results: Three themes were identified: (1) the emphasis in hospitals is on moving older people quickly through the system, not supporting their functioning; (2) leaders are generally seen as too disconnected from practice to design system efficiency initiatives that support older people's functioning and nurses' provisioning of function-focused care; and (3) leadership strategies to better support nurses in providing function-focused care to older people in the context of system efficiency.
Conclusions: Leaders should connect with practice to devise age-sensitive efficiency initiatives that support function-focused care. Nurses need support from leaders in four areas to provide function-focused care to older people in the current hospital context.
Implications: The findings provide direction on how leaders can facilitate function-focused care in the current health-care environment emphasising system efficiency.
Keywords: acute care; function-focused care; health-care system efficiency; older people; operational leaders.
© 2016 John Wiley & Sons Ltd.