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Leadership in Nursing: Experiences from the European Nordic Countries (eBook)

Thóra B. Hafsteinsdóttir, Helga Jónsdóttir, Marit Kirkevold, Helena Leino-Kilpi, Kirsten Lomborg, Ingalill Rahm Hallberg (Herausgeber)

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2019 | 1st ed. 2019
XI, 342 Seiten
Springer International Publishing (Verlag)
978-3-030-10964-6 (ISBN)

Lese- und Medienproben

Ebook-Leseprobe (PDF)

This book explores the leading role played by nursing science in the European Nordic countries. Recognized leaders in nursing research from Denmark, Finland, Iceland, Norway and Sweden, reflect on the leadership of nurses, the societal developments and the state of nursing science in their country, and the successes and remaining challenges nurses are facing. The book highlights representative leadership projects focusing on e.g. evidenced-based clinical practice, education and research that have impacted patient and healthcare outcomes in each country.

The book shows how nursing, as a scientific discipline, has been developing rapidly in these five Nordic countries. They have more nurses per capita than other countries (OECD 2016) and healthcare is provided to all citizens. Moreover, nursing qualification in the Nordic countries was based on university education early on, and there are more professors of nursing than in other countries. Accordingly, this book on Leadership in nursing within the Nordic countries shares essential and pioneering expertise that will benefit nurses and nurse scientists around the globe.

Dr. Thóra B. Hafsteinsdóttir, RN, PhD, is a professor of nursing at the Faculty of Nursing, University of Iceland and a senior researcher at the Department of Nursing Science, Julius Center, University Medical Center Utrecht, and Department of Health care at the University of Applied Sciences, Utrecht the Netherlands. Since 2014 she is a director of the Board of Directors of Sigma Theta Tau International, honor society of nursing international. Dr. Hafsteinsdóttir received her BSc degree in 1984 from University of Iceland, her MSc in 1994 from University of Wales and her PhD in 2003 from University of Utrecht. Her research has focused on nursing rehabilitation of patients with stroke and on leadership research, PhD education and leadership development of nurses. She chairs the Dutch Leadership Mentoring in Nursing Research for postdoctoral nurses and the Nursing Leadership Educational Program for Doctoral Nursing Students and Postdoctoral Nurses in Europe, the Nurse-Lead project, a collaboration between seven partners in six European countries which include Iceland, Netherlands, Finland, Germany, Lithuania and Portugal. Dr. Hafsteinsdóttir serves on numerous national and international committees. She gives lectures nationally and internationally. Her recent research received funding from the Research Fund of the University of Iceland, NordForsk, the Nordic Economic and Social Research Council, The Netherlands Organisation for Health Research and Development, ZonMw and the Erasmus + Programme.

Dr. Kirsten Lomborg, RN, MScN, PhD is a professor at Department of Clinical Medicine, Aarhus University and from 2018 partly employed at Steno Diabetes Center Copenhagen, Denmark. She received her registered nursing certificate in 1980 and has continued to qualify for the highest level of education in nursing science combined with several supplementary educations in didactics, leadership, and research management. From 2007 to 2012 Kirsten Lomborg was the head of Section for Nursing at Aarhus University, Denmark. Throughout her career, she has strived for the connection between nursing theory and practice and close collaboration between clinical practice, education, research and management. In 2013 she was appointed professorship with special responsibility in patient involvement. This responsibility has since been her driving force and has resulted in several national contributions and international publications along with the establishment and lead of the Research Programme in Patient Involvement at Aarhus University Hospital, Denmark. Her research interests include person-centred care, shared decision-making, self-management support, and personal care planning, often combined with new technical and structural solutions where patient-reported outcome measures form an important element of developing value-based healthcare that works on the users' premises.

Dr. Helena Leino-Kilpi, RN, PhD is a professor and chair, Head of the Department of Nursing Science, University of Turku, Faculty of Medicine, and Nurse director (part-time) in Turku University Hospital in Finland. She is nationally and internationally well-known expert in the field of nursing and health sciences, a registered nurse with clinical expertise in surgical-intensive nursing care, MEd and PhD in nursing science. Main teaching area of Helena Leino-Kilpi is health care and nursing ethics. She has supervised more than 50 graduated PhDs in nursing science, has been chairing years the Finnish National Doctoral Network in Nursing Science, taught research ethics in the European Academy of Nursing Science and is a member of the management board of the Baltic Sea Region Doctoral Network. Her research is in three main areas, in health care and nursing ethics, clinical nursing and health care education. Her research is strongly international and she has published around 500 scientific, referee-based publications. She has several international and national academic duties, is Honorary Doctor in the University of Klaipeda, (Lithuania), and a Fellow of European Academy of Nursing Science

Dr. Helga Jonsdottir, RN, PhD, FAAN, is a Professor at the Faculty of Nursing, School of Health Sciences, University of Iceland and holds a joint position as an academic chair of nursing care for chronically ill adults at Landspitali University Hospital Reykjavik Iceland. She received her baccalaureate degree in nursing from the University of Iceland in 1981 and a master's degree in nursing in 1988 from the University of Minnesota in the USA. In 1995 she defended her doctoral thesis in nursing from the same school. Jonsdottir's research has focused on developing partnership-based nursing care for chronically ill patients and their families. Along with practice development, assessment of complex health problems, e.g. hemispatial neglect, has recently become prominent in her research. The translation of science through academic-practice partnership has extended from University of Iceland and Landspitali University Hospital to include chronic care populations in the hospital, intensive care units, in out-patient clinics -pulmonary, neurological and elderly- to research and interdisciplinary and international collaboration at University Medical Center, Utrecht the Netherlands and some universities in Scandinavia. These activities have received funding from the Research Fund of the University of Iceland, Rannis, the Icelandic Center for Research, NordForsk, the Nordic Economic and Social Research Council and the Erasmus + Programme.

Dr. Marit Kirkevold, RN, Ed.D. is a professor of nursing science at the University of Oslo, Norway. She completed basic training as a professional nurse at Oslo University college in Norway in 1981 and a Bachelor of nursing at Long Island University, NY in 1984. She received a Master of Arts and a Master of Education Degree in nursing from Columbia University, NY in 1986 and a Doctor of Education from Columbia University, NY in 1989. Kirkevold's research has focused on long term care of older people and nursing care of persons suffering from chronic conditions. She also has an interest in the historical development of nursing science. She initiated and led a Norwegian teaching nursing home program between 1997 and 2003 and has led the Research Center for Habilitation and Rehabilitation Services and Models (CHARM) during the last six years. She is currently the head of a National research school aimed at developing research capacity within the municipal health and care services in Norway and leader of the research group on psychosocial wellbeing following stroke. Kirkevold has been the main supervisor for almost 30 PhD candidates. She has been a professor of nursing science at Aarhus University in Denmark for a number of years, and has established research collaboration with several Danish colleagues. She is currently guest professor at Gothenburg University in Sweden and has been involved in international research collaboration in the area of aged care, psychosocial rehabilitation and wellbeing and person-centered dementia care for a number of years.

Dr. Ingalill Rahm Hallberg, RN, spec in mental health, RNT, PhD, FEANS, FAAN is professor emeritus at Lund University, in Sweden. She is honorary member of the Swedish Medical Society. She worked about 20 years as a nurse, mainly in mental health. After obtaining her PhD she was elected pro-dean at the medical faculty, Lund University for six years. She also was the head of the Vårdalinstitutet during six years and there she built up this interdisciplinary research environment. Thereafter she was assistant vice chancellor at Lund University. Before retirement she was also pro-vice chancellor at the university. She has been the main supervisor of 29 nurses obtaining a PhD and co-supervisor to eight nurses obtaining their PhD. She has published more than 225 original papers in international peer reviewed papers, several books or book chapters, internationally as well as in Swedish. Her current research is exploring the relationship between body and mind, specifically 'The molecular fingerprints of psychological resilience in breast cancer patients', a study initiated by her. In addition she is researching the care of people with dementia in nine Swedish municipalities.

Contents 5
About the Editors 7
1: Introduction on Leadership, Nursing and the Nordic Countries 12
1.1 Historical Development of Nursing Science 16
1.2 Nursing Education Reforms 20
1.3 Organization of Health Services 22
1.4 Goal of This Book 23
1.5 Organization of This Book 24
References 24
Part I: Nursing Leadership in Denmark 29
2: The State of Nursing Science in Denmark 30
2.1 Introduction 30
2.1.1 Nursing Education 31
2.1.2 Academic Positions at Universities 31
2.1.3 Nursing Authorisation in Denmark 31
2.1.4 Professional Community and Unity 32
2.2 The Welfare and Healthcare System in Denmark 32
2.2.1 Patient and Public Involvement 34
2.3 The Danish History of Academic Nursing: Looking Back 35
2.3.1 Discussion on Nursing Values 36
2.3.2 Theoretical and Practical Nursing: A Collaboration in Development 37
2.3.3 Support from the Novo Nordisk Foundation 37
2.4 Opportunities and Challenges Calling for Leadership in Nursing 38
2.5 Conclusion 40
References 40
3: Evidence-Based Clinical Practice 42
3.1 A Translational Research Model 42
3.2 A Research Programme Integrating Evidence into Clinical Practice: An Example 44
3.3 Shared Decision-Making and Dialysis Choice 44
3.3.1 Dialysis Choice 46
3.3.2 The Development Process 46
3.3.3 The Intervention Shared Decision-Making and Dialysis Choice 48
3.3.4 Pilot Test 48
3.4 Evaluation and First Results 51
3.5 The Implementation Process 52
3.6 Conclusion 53
References 53
4: Higher Education in Nursing in a Changing Danish Society 55
4.1 Introduction 55
4.2 The Danish Master’s Degree in Nursing Takes Form 56
4.3 The Danish Welfare State 57
4.4 Critique of the Competition State 59
4.5 Higher Education and Building: The Heritage from the German Humboldt University 59
4.6 The Bologna Process and the Bologna Declaration 60
4.7 Competencies as a Management Tool 61
4.8 University Education with a Double Aim 61
4.9 Educating Nurses to Become Reflective Practitioners 62
4.10 Conclusion 62
References 63
5: Pioneers in an Old Culture. Developing and Leading a Research and Development Capacity Building Program 65
5.1 Capacity Building 65
5.1.1 Culture 66
5.1.2 Knowledge Transfer and Developing Research and Development Capacity 66
5.2 Working with Research and Development Capacity Building Within a University Hospital 68
5.2.1 Background, Vision and Strategy 68
5.2.2 Concrete Initiatives 69
5.2.3 Educating and Recruiting Researchers 70
5.2.4 Establishing Professorships and Nursing Research Program 71
5.3 Conclusion 73
References 73
Part II: Nursing Leadership in Finland 75
6: State of Nursing Science in Finland 76
6.1 Introduction 76
6.2 Establishment and Development of the New Discipline of Nursing Science 77
6.3 Characteristics of the Discipline of Nursing Science 80
6.3.1 Critical Mass in Nursing Science 80
6.3.2 Nursing Research Within the Finnish Health-Care System 82
6.3.3 Quality of Nursing Research 83
6.4 Development of Nursing Research 84
6.4.1 Finnish Nursing Science: A Strong and Versatile Discipline 85
6.4.2 Research Funding: A Prerequisite for Research 87
6.5 Conclusions 87
References 88
7: Leading Evidence-Based Practice in Finnish Healthcare 90
7.1 Introduction 90
7.2 Determinants for Evidence-Based Practice in Finnish Healthcare 91
7.2.1 Governmental Steering by Guidelines and Programmes 92
7.2.2 Studies About the Situation of Evidence-Based Nursing 93
7.3 Framework for Evidence-Based Practice in Finnish Healthcare 93
7.3.1 Special Positions and Roles to Support Evidence-Based Practice 94
7.3.2 National-Level Support for Evidence-Based Nursing 95
7.3.3 Operational Model for Evidence-Based Consistent Practices (OMCP) 96
7.4 Developing and Leading Evidence-Based Ulcer Care 97
7.4.1 Leading the Organization, Structures and Practice for Ulcer Care 97
7.4.2 Leading by Knowledge: Leading Evidence-Based Ulcer Care 99
7.4.3 Wound and Ulcer Mapping as a Source of Knowledge 99
7.4.4 Patient Safety Notification as a Source of Information 100
7.4.5 Patient Documentation as a Source of Information 100
7.4.6 Pressure Ulcer as Quality Indicator in Nursing Care 100
7.5 Conclusion 101
References 102
8: Nursing Education and Nurse Education Research in Finland 106
8.1 Introduction 106
8.2 Nursing Education in Finland 107
8.3 State of the Art in Nursing Education Research and Practice 108
8.4 Outcomes of Nursing Education 109
8.4.1 Generic Competence 110
8.4.2 Specified Competence 112
8.5 The Role and Competence of the Nurse Educators 114
8.6 Collaboration Between Nursing Education and Health-Care Facilities 115
8.7 Conclusions 117
References 118
9: Professional Practice Competence Framework for the Nurse Leader 122
9.1 Introduction 122
9.2 Competence Framework for Professional Nursing Practice 122
9.3 The Nurse Competence Scale 124
9.4 Leadership Interventions for Nurses’ Professional Development 124
9.4.1 Novice Nurses and Advanced Beginners 124
9.4.2 Competent Professional Practice 126
9.4.3 Proficient Nurses, Experts in Evidence-Based Nursing 127
9.5 Advanced Practice Nursing and Academic Partnership 128
9.6 Conclusions 129
Appendix: Selected Publications Related to Nurses’ Professional Practice Competency Framework 1995–2018 130
References 132
Part III: Nursing Leadership in Iceland 135
10: State of Leadership in Nursing Science in Iceland 136
10.1 Introduction 136
10.2 Reforms in Nursing Education as the Ground for Nursing Science 137
10.2.1 University Education in Nursing 138
10.3 Autonomy Over Nursing Practice and of Nursing in the Academia 141
10.3.1 Autonomy of Nurses Over Their Care 141
10.3.2 Autonomy of Nursing in the Academia 142
10.4 Expansion of Nursing Science 143
10.4.1 Collaboration Between the University of Iceland and Landspitali the National University Hospital 144
10.4.2 Resources to Promote Nursing Research 145
10.5 The Rise of Knowledge Generation 148
10.6 Conclusions 149
References 150
11: Complexity Leadership in the Collaboration Between Academia and Clinical Nursing: Searching for Harmony 153
11.1 Leadership: A Call for a Broader Perspective 153
11.2 Complexity Leadership of Nursing Faculty in Joint Positions 154
11.3 Strategic Institutional Support 155
11.4 Academic Freedom 156
11.5 Embracing Reciprocal Relationships 157
11.6 Cases for Reflection 158
11.6.1 Bringing the Three Icelandic Cases Together 161
11.7 Conclusions 162
References 162
12: Towards the Future: The Education of Nurses in Iceland Reconsidered 165
12.1 Introduction 165
12.2 Educational Development 166
12.3 Threats to Quality of Nursing Practice 169
12.4 The Tension Between Natural Science and Lived Realities in Nursing Education 170
12.5 Partnership Between Academia and Practice 170
12.6 Educational Reforms of the Undergraduate Nursing Education 171
12.6.1 Educational Qualifications for Entry Into Practice 171
12.6.2 The Revised Programme 171
12.6.3 The Clinical Learning Model: A Community of Learning 173
12.7 Graduate Education 174
12.7.1 Master’s Education 174
12.7.2 Doctoral Education 175
12.8 Conclusions 177
References 177
13: A Nurse-Managed Follow-Up Practice for Patients After Discharge from the Intensive Care Unit: Development, Testing and Implementation 180
13.1 Introduction 181
13.1.1 Nurse-Led Follow-Up of Patients After Discharge from Intensive Care 183
13.1.2 Development of the Nurse-Led Follow-Up Intervention 183
13.1.3 Implementation of the Nurse-Led Follow-Up Intervention 185
13.2 Effectiveness of the Nurse-Led Follow-Up Intervention: The Quasi-Experiment 185
13.2.1 Recovery of Health Status 186
13.2.2 Psychological Recovery 186
13.3 Exploration of the Findings 187
13.4 The Nurse-Managed ICU Follow-Up Practice: The Next Steps 188
13.5 Conclusion 190
References 190
Part IV: Nursing Leadership in Norway 195
14: Historical Development and the State of Nursing Science in Norway 196
14.1 Introduction 196
14.2 The Early Beginnings of the Nursing Profession 196
14.3 Higher Education for Nurses 199
14.4 Academic Nursing Institutions at the Traditional Universities 200
14.4.1 Nursing Education and Research at the University of Tromsø 200
14.4.2 Nursing Education and Research at the University of Bergen 201
14.4.3 Nursing Education and Research at the University of Oslo 203
14.5 Academic Nursing in the University College System 205
14.6 Academic Development in the Specialized Health-Care Services 207
14.7 Academic Development in the Primary Health-Care Services 210
14.7.1 Teaching Nursing Homes 211
14.7.2 Centres for Care Research 211
14.8 Conclusions 212
References 213
15: Research Development in the Clinical Field 216
15.1 Introduction 216
15.2 The Department of Intensive Care Medicine 217
15.3 Historical Background 218
15.4 Building Research Capacity in the Clinical Field: A Long Journey 218
15.4.1 The Clinical Ladder Program (1995–2018) 220
15.4.2 Implementation Strategies 221
15.4.3 From Single Clinical Studies to a Research Program (2002–2018) 223
15.4.4 Nutrition in Critically Ill Patients 223
15.4.5 Pain Treatment and Sedation in ICU Patients 224
15.4.6 Clinical Assessment Tools 225
15.4.7 Pain, Sedation, and Delirium 225
15.4.8 Other Research 226
15.5 Phase 4: Implementing Research Findings into Nursing Practice 226
15.5.1 Knowledge Application 226
15.5.1.1 Administrative Challenges and Advantages 227
15.5.2 Today’s Achievement 228
15.5.3 Implications for Nursing Leadership and Outstanding Challenges 229
15.6 Conclusions 229
References 230
16: Research in Nursing Education in Norway 232
16.1 Introduction 232
16.2 Historical Overview of the Development of Nursing Education Research 232
16.2.1 Pioneers in Nursing Education Research 233
16.2.2 Master Education in Nursing 234
16.2.3 Doctoral Education in Nursing 237
16.3 Nursing Education Research: Factors Influencing the Development 243
16.3.1 Critical Mass of Researchers 243
16.3.2 Professionalization and Academization of Nursing 244
16.3.3 Research Funding 245
16.3.4 Research Leadership 245
16.4 Conclusions 247
References 247
17: Developing a Clinical Nursing Research Programme: The Case of Promoting Psychosocial Well-Being in Stroke Survivors 251
17.1 Introduction 251
17.2 Exploring Current Practice: Using Clinical Ethnography to Uncover Essential Foundations of Acute Stroke Nursing Care 251
17.2.1 The Interpretive Function of Stroke Nurses 253
17.2.2 The Consoling Function of Stroke Nurses 253
17.2.3 The Conserving Function of Stroke Nurses 253
17.2.4 The Integrative Function of Stroke Nurses 254
17.3 Exploring Personal Experiences Using Longitudinal Qualitative Approaches: The Case of Stroke Survivors 254
17.4 Moving from Qualitative Results to Nursing Intervention Research: Developing and Testing the Feasibility of a Psychosocial Intervention 256
17.4.1 Development of the Intervention 256
17.4.2 Evaluation of the Intervention 257
17.4.3 The Needs of Younger Stroke Survivors 259
17.5 Studying the Effectiveness of a Clinical Intervention: Promoting Psychosocial Well-Being Following Stroke: A Randomised Controlled Trial 260
17.6 Lessons Learnt and Future Research Needs 260
17.7 Methodological Challenges 261
17.8 Conclusions 262
References 262
Part V: Nursing Leadership in Sweden 266
18: Nursing Science in Sweden: Internal and External Forces Contributing to Its Development 267
18.1 Introduction 267
18.2 The Early Development 268
18.3 The Development of Nursing as a Scientific Discipline 273
18.4 A Straight Way for Nurses to Enter a Doctoral Program 275
18.5 Why Should the Health-Care System Care About Nursing Science? 276
18.6 The Current Landscape of Nursing: An Academic Discipline 277
18.7 Current Nursing Education and Access to Nurses 279
18.8 Professors in Nursing Science and PhD in Nursing 280
18.9 Conclusions 281
References 282
19: Clinical Practice Project Implementing Evidence-Based Practice 284
19.1 Introduction 284
19.2 Swedish National Quality Registries 284
19.3 The Quality Register Project 285
19.4 Advanced Nursing Students Working with Quality Registries 286
19.5 Guidelines Implementation in Clinical Practice 287
19.6 From Evidence to Clinical Practice Guidelines 288
19.7 Using Research to Change Clinical Practice 289
19.8 Changing Clinical Practice: The Ambulance Care 290
19.9 Evidence-Based Design of Healthcare Environments 290
19.10 Urinary Retention and Bladder Distension 291
19.11 Improved Safety and Quality of Care for Patients with a Hip Fracture 292
19.12 Leadership in Nursing and the Magnet Model 293
19.12.1 Transformational Leadership 296
19.12.2 Structural Empowerment 296
19.12.3 Exemplary Professional Practice 297
19.12.4 New Knowledge, Innovation and Improvements 297
19.12.5 Empirical Quality Results 297
19.13 Combining Teaching, Research and Clinical Work Supporting Optimal Patient Outcomes 298
19.14 Measures Required for Quality Improvement 298
19.14.1 Measures Required at the Micro Level 299
19.14.2 Measures Required at the Meso Level 299
19.14.3 Measures Required at the Macro Level 299
19.15 Conclusions 299
References 300
20: Nursing Leadership in Transition: From Matriarch and Instructor to University Teacher and Researcher 303
20.1 Introduction 303
20.2 Nursing Education Reform from 1916 to the Present 304
20.3 Nurses Access to Postgraduate Education 307
20.4 Research into Healthcare Pedagogy 310
20.5 The State of Nursing Science and Research Competence Today 314
20.6 Leadership in Changing Times Bridges Different Perspectives 315
20.7 Conclusions 317
References 318
21: Nursing Research in Sweden: Academic Leadership 321
21.1 Introduction 321
21.2 The First Generation of Academic Nurse Leaders 323
21.3 Recruiting the Next Generation of Nurse Researchers 327
21.4 Contributing Knowledge for Practise 328
21.5 Recent Exploration of Nurses’ Doctoral Theses 329
21.6 Swedish Nursing Research Investigated 331
21.7 A Centre of Excellence: A Leadership Perspective 333
21.8 The Voice of Doctoral Students 334
21.9 Other Funding Bodies Followed 335
21.10 Conclusion 336
References 337

Erscheint lt. Verlag	30.4.2019
Zusatzinfo	XI, 342 p. 31 illus., 26 illus. in color.
Sprache	englisch
Themenwelt	Medizin / Pharmazie ► Pflege
Schlagworte	clinical practice • Clinical research project • educational project • Improving Nursing Science • Nursing Leadership
ISBN-10	3-030-10964-X / 303010964X
ISBN-13	978-3-030-10964-6 / 9783030109646

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