The article by Cummings, Midodzi, Wong & Estabrooks (2010) concerns the contribution of hospital nursing leadership styles to 30-day patient mortality.
The Journal
This article was published in Nursing Research, a prominent nursing journal which has a peer-review system. Its impact factor is 1.856, which is fairly high. It is associated with the Eastern Nursing Research Society and the Western Institute of Nursing. It does not allow for authors to pay for their articles to appear.
The Article
The article was written by various nurses who evidently have expertise and qualifications. It was supported by a New Investigator Award and a Population Health Investigator Award (Cummings et al., 2010) and was therefore industry supported. There are no other conflicts of interest.
The title is extremely informative and gives insight into the topic of the journal article. It is descriptive and can be used to make a value judgment about the content of the article. It does not imply unsubstantiated conclusions.
The abstract is another strong point for this article. It gives the background, objective, methods, results, conclusions, and key words for the article and does not only give conclusions that support the article. It would be easy enough to make a judgment about how useful the article was for inclusion in other research based on this abstract.
The introduction gives a lot of information about the background for the study with reference to other pieces of research on nursing leadership styles. It also gives a rationale for the need of understanding how these leadership styles affect patient outcomes in a clear, unbiased, and logical manner.
The methods for the study were simple and clearly explained. The researchers took data from ninety acute care hospitals in Alberta and categorized them into give leadership styles (Cummings et al., 2010). This was then combined with the data about patient mortality rate. One issue with this methodology is the categorization into leadership styles is somewhat subjective, although based on existing research, and might reflect the researcher’s opinions of the leadership style rather than the actual working method of the hospital.
A number of different statistical tests were used and the authors noted that they used SPSS to make these analysis. The baseline characteristics were compares using Kuskal-Wallis testing, whilst the main analysis was based on hierarchical logistic regression with logit link (Cummings et al., 2010). Unfortunately, there is little discussion of why these statistical techniques were considered appropriate.
The results showed that moderately resonant, mixed, and moderately dissonant had the highest levels of patient mortality compared with high resonant and high dissonant styles. This suggests that having a distinct leadership style is better for patient mortality than having a variety of or weak leadership styles. Overall, it was found that 5.1% of the 72.2% difference between patient mortality rates could be explained with reference to nursing leadership styles (Cummings et al., 2010).
The discussion shows that the objectives of the research were met, and are put into the context of the available literature. There are no references to unpublished work or speculation, and the conclusions are supported by the data outlined in the results section.
The bibliography is extensive and contains all the information needed to judge references. There are not too many references to the author’s own publications and a focus on primary literature.
Applications
The applications of this study are wide-ranging. It highlights the need to understand the effect that nursing leadership styles can have on patients. Whilst the statistical significance of the research was not that high, the fact that it can be applied to a large number of clinical scenarios means that it is clinically relevant.
References
Cummings, G. G., Midodzi, W. K., Wong, C. A., & Estabrooks, C. A. (2010). The contribution of hospital nursing leadership styles to 30-day patient mortality. Nursing Research, 59(5), 331–339.
