Strategies for the Facilitation of Self-Leadership Among Ward Nurses in a Nurse-Led Critical Care Outreach Service

SAGE Open Nurs. 2023 Apr 17:9:23779608231167804. doi: 10.1177/23779608231167804. eCollection 2023 Jan-Dec.

Abstract

Introduction: Nurses are responsible for monitoring and providing nursing care to patients. The early detection of a patient who is starting to deteriorate - and the activation of critical care outreach services (CCOS) - can improve patient outcomes. However, the literature indicates that CCOS are underutilised. Self-leadership is a process whereby persons influence their own behaviour.

Objective: The purpose of this study was to develop strategies for the facilitation of self-leadership in ward nurses that will enable them to act proactively and promptly in utilising CCOS at a private hospital group in South Africa.

Methods: A sequential exploratory mixed-method research approach was followed to develop strategies for the facilitation of self-leadership in nurses that will enable them to utilise CCOS proactively when a patient starts to deteriorate. An adapted version of Neck and Milliman's self-leadership strategic framework was used as the methodological steps of the study.

Results: The quantitative analysis extracted eight factors, which were used as the departure point to develop strategies for the facilitation of self-leadership among nurses in a CCOS. Five strategies were developed that related to self-motivation, role models, patient outcome, assistance and guidance from CCOS, and the power of self-confirmation; these strategies aligned with the themes and categories extracted from the qualitative data analysis.

Conclusion: There is a need for self-leadership among nurses in a CCOS.

Keywords: critical care outreach service; nurse-led critical care outreach; patient deterioration; patient outcome; quality; self-leadership; strategies.