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dc.contributor.authorHavig, Anders Kvale
dc.contributor.authorSkogstad, Anders
dc.contributor.authorKjekshus, Lars Erik
dc.contributor.authorRomøren, Tor Inge
dc.date.accessioned2014-10-03T07:49:09Z
dc.date.available2014-10-03T07:49:09Z
dc.date.issued2011-11-28eng
dc.identifier.issn1472-6963
dc.identifier.urihttps://hdl.handle.net/1956/8588
dc.description.abstractBackground: Leadership and staffing are recognised as important factors for quality of care. This study examines the effects of ward leaders’ task- and relationship-oriented leadership styles, staffing levels, ratio of registered nurses and ratio of unlicensed staff on three independent measures of quality of care. Methods: A cross-sectional survey of forty nursing home wards throughout Norway was used to collect the data. Five sources of data were utilised: self-report questionnaires to 444 employees, interviews with and questionnaires to 13 nursing home directors and 40 ward managers, telephone interviews with 378 relatives and 900 hours of field observations. Separate multi-level analyses were conducted for quality of care assessed by relatives, staff and field observations respectively. Results: Task-oriented leadership style had a significant positive relationship with two of the three quality of care indexes. In contrast, relationship-oriented leadership style was not significantly related to any of the indexes. The lack of significant effect for relationship-oriented leadership style was due to a strong correlation between the two leadership styles (r = 0.78). Staffing levels and ratio of registered nurses were not significantly related to any of the quality of care indexes. The ratio of unlicensed staff, however, showed a significant negative relationship to quality as assessed by relatives and field observations, but not to quality as assessed by staff. Conclusions: Leaders in nursing homes should focus on active leadership and particularly task-oriented behaviour like structure, coordination, clarifying of staff roles and monitoring of operations to increase quality of care. Furthermore, nursing homes should minimize use of unlicensed staff and address factors related to high ratios of unlicensed staff, like low staff stability. The study indicates, however, that the relationship between staffing levels, ratio of registered nurses and quality of care is complex. Increasing staffing levels or the ratio of registered nurses alone is not likely sufficient for increasing quality of care.en_US
dc.language.isoengeng
dc.publisherBioMed Centraleng
dc.rightsAttribution CC BYeng
dc.rights.urihttp://creativecommons.org/licenses/by/2.0eng
dc.subjectNursing homeseng
dc.subjectLeadershipeng
dc.subjectStaffingeng
dc.subjectQuality of careeng
dc.titleLeadership, staffing and quality of care in nursing homeseng
dc.typePeer reviewed
dc.typeJournal article
dc.date.updated2013-08-23T09:34:39Z
dc.description.versionpublishedVersion
dc.description.versionPeer Reviewed
dc.rights.holderCopyright 2011 Havig et al; licensee BioMed Central Ltd.
dc.rights.holderAnders Havig et al.; licensee BioMed Central Ltd.eng
dc.source.articlenumber327
dc.identifier.doihttps://doi.org/10.1186/1472-6963-11-327
dc.identifier.cristin864496
dc.source.journalBMC Health Services Research
dc.source.4011


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Except where otherwise noted, this item's license is described as Attribution CC BY