AN EXAMINATION OF THE IMPACT OF NURSE MANAGERS COMPETENCIES IN HEALTHCARE DELIVERY

CHAPTER ONE

INTRODUCTION

Background of the study 

The function of the nurse manager (NM) in healthcare is complex and complicated. Translating organisational strategic vision, values, and objectives into action at the unit level is the primary responsibility of nurse managers (NMs). In addition to provide clinical and administrative leadership, NMs are in charge of all patient care services on the unit around-the-clock (Gunawan & Aungsuroch, 2019). The official and informal roles of NM involve making sure that high-quality, reasonably priced nursing care is given in order to support favourable patient outcomes. NMs are capable of comprehending, interpreting, and incorporating concepts into the delivery of high-quality healthcare (Gunawan and Aungsuroch, 2019).

The modern decentralisation of healthcare has moved the NM role's emphasis from clinical to managerial. It is crucial that NMs manage in a way that ensures efficiency and effectiveness given the crucial role nurses play in the healthcare system, particularly at the unit level (Aiken, 2021). In general, nurses and midwives are not happy with their workplace and have a poor opinion of the quality of treatment provided in public hospitals (Asamani, Naab, Maria, & Ofei, 2018). This prompts grave concerns about the public health system's potential deficiency in nursing management skills. For this reason, NMs must create a work environment that uplifts the organisation, the value system of nurses, and health results. However, identifying key competencies—particularly NMs' management competencies—that are essential to the healthcare system's efficacy and efficiency is a necessary step in the general management process.

According to Gunawan and Aungsuroch (2019), management competencies are the appropriate set of behaviours, abilities, and knowledge that a person possesses and may be the basis for long-term organisational success. According to Jashari (2018), management competencies are a collection of abilities, know-how, mindset, and conduct that an individual needs in order to function well in a variety of roles and organisational settings. Regardless of the kind of unit they oversee, NMs must acquire the competences necessary to carry out their primary responsibilities at the unit effectively. Thus, it is crucial to determine the fundamental managerial skills that NMs need in order to operate effectively and efficiently. Numerous attempts have been undertaken by researchers to determine the management abilities needed to succeed as an NM. 

For example, research conducted in China has determined that the most important elements for the management and professional development of nurses are clinical practice, medical ethics, nurse-nurse collaboration, teaching, coaching, assessment and decision-making, personal and professional development, research, critical thinking, and interpersonal relationships (Wei et al., 2018). Comparably, Pearce (2018) noted that crucial management competencies needed for unit-level managers in the US include technical skills, human skills, conceptual skills, leadership skills, and financial management skills. On the other hand, Nathambo (2019) highlighted that NMs in South Africa felt that people management and self-management abilities were the most important management competences needed at the unit, followed by "hard management skills" and skills involving the capacity for strategic thought. Therefore, expertise and abilities related to providing healthcare bear less significance.

The increasing complexity of healthcare systems has drawn more emphasis in recent years to the role of nurse managers in the delivery of healthcare. In order to monitor clinical operations, guarantee resource efficiency, and enhance patient outcomes, nurse managers are essential. Maintaining high standards of healthcare delivery requires their competencies, which include leadership, decision-making, communication, and personnel and resource management (Zydziunaite & Suominen, 2019). The need for skilled nurse managers has increased as healthcare demands rise, especially with ageing populations and rising rates of chronic disease (Aiken, 2021).

Studies indicate that the performance of healthcare teams and the standard of patient care are directly impacted by the abilities of nurse managers. Effective nurse leadership has been linked to better patient outcomes, lower staff turnover, and increased staff satisfaction, according to studies (Cathcart, 2018). Additionally, healthcare professionals report better levels of engagement in settings where nurse managers exhibit excellent interpersonal and leadership abilities, which is crucial for enhancing the quality of healthcare delivery as a whole (Riley, 2020). As a result, improving nurse managers' competencies via ongoing professional development has gained importance in a large number of international healthcare facilities.

The dynamic landscape of healthcare, influenced by both technological breakthroughs and regulatory modifications, highlights the critical role that competent nurse managers play. Nurse managers now have more responsibilities than ever before. In addition to overseeing clinical staff, they also need to stay up to date on changes in healthcare regulations and embrace advances in digital health (Sfantou, 2017). Nurse managers must acquire new skills due to the introduction of new technologies into healthcare settings, such as telemedicine and electronic health records. These skills are especially important for technology management and data interpretation (Spetz et al., 2019).

Despite the recognition of the critical role nurse managers play, there remains a gap in understanding the specific competencies that most significantly influence healthcare delivery. This study seeks to examine the competencies of nurse managers in healthcare institutions, with the aim of identifying which skills and attributes are most impactful in improving patient care and healthcare team performance.

 Statement of the problem

Since nurse managers are in charge of organising nursing activities, allocating resources, and guaranteeing the quality of patient care, their competencies are vital to the efficiency of healthcare delivery. Competent nurse managers have an even more crucial role in Nigeria, where the healthcare system struggles with issues like low staffing, scarce resources, and dilapidated facilities. Nevertheless, there is a paucity of empirical data evaluating the degree to which nurse managers' competencies impact the calibre of healthcare services. Research has shown that inefficiencies and a drop in the quality of patient care are frequently caused by nurse supervisors who lack effective communication skills, sound leadership qualities, and sound decision-making abilities (Adamu & Olaide, 2022).

Furthermore, many nurse managers in Nigeria lack enough training in critical abilities such strategic planning, team leadership, and conflict resolution, despite efforts to improve hospital management (Ojo et al., 2023). These competency gaps are worrisome, particularly in view of recent changes to Nigeria's healthcare system that aim to achieve universal health coverage. As patient care demands expand, the requirement for nurse managers with strong leadership ability becomes more crucial. It is therefore imperative to investigate how the competences of nurse managers affect the provision of healthcare in Nigeria, with a focus on patient outcomes, staff productivity, and overall healthcare efficiency (Afolabi & Ibrahim, 2023). In order to achieve sustainable healthcare development in Nigeria, closing this gap would offer insights into bettering healthcare management methods.

1.3 Objectives of the Study 

The primary objective of this study is to examine the impact of nurse managers competencies in healthcare delivery. Specifically the study seeks:

To analyze whether there is a relationship between nurse managers’ competencies and staff job satisfaction and retention rates in healthcare institutions.

To assess the current level of managerial and leadership competencies among nurse managers in healthcare facilities.

To identify the key competencies required by nurse managers for effective healthcare delivery in hospitals and healthcare institutions.

To examine the impact of nurse managers’ competencies on quality of patient care outcomes in healthcare settings.

1.4 Research Questions

The following research questions will be answered in this study:

Is there a relationship between nurse managers’ competencies and staff job satisfaction and retention rates in healthcare institutions?

What is the current level of managerial and leadership competencies among nurse managers in healthcare facilities?

What are the key competencies required by nurse managers for effective healthcare delivery in hospitals and healthcare institutions?

What are the impact of nurse managers’ competencies on quality of patient care outcomes in healthcare settings?

1.5 Research Hypothesis

The stated hypothesis will validate this study:

Ho1: There is no significant impact of nurse managers competencies in healthcare delivery.

Ha1: There is a significant impact of nurse managers competencies in healthcare delivery.

1.6 Significance of the study

First, by showing how good nurse management can enhance patient care, this study provides insightful information for healthcare organisations. Skilled nurse supervisors guarantee adherence to clinical recommendations, patient safety is given top priority, and improved health results are achieved. Hospital administrators can use this knowledge to create focused training and development initiatives that will improve the competencies of their nurse supervisors. Consequently, enhanced patient care quality, less medical errors, and increased patient satisfaction can all be advantageous to healthcare delivery systems.

The study is also significant for healthcare policy makers because it offers empirical support for the necessity of policy changes that give nursing teams' leadership development top priority. Health ministries and regulatory organisations can set criteria for nurse leadership training that are in line with international best practices by concentrating on the competences of nurse managers. 

Additionally, by highlighting the importance of nurse managers in employee performance and retention, this study advances the subject of healthcare management. Skilled nurse supervisors can create a healthy work atmosphere, lessen employee burnout, and increase nurses' job satisfaction. Consequently, this improves worker productivity and team cohesion, resulting in more effective healthcare services. Thus, the results of this study can help hospital administrators comprehend how staff wellbeing and hospital efficiency are directly impacted by strategic investments in nurse manager training.

Ultimately, the research has importance in advancing evidence-based nursing practices. Through an analysis of the relationship between the competencies of nurse managers and the provision of healthcare, the research can provide useful suggestions for incorporating leadership and management abilities into nursing programs. This contributes to sustainable healthcare delivery models by guaranteeing that aspiring nurse managers are equipped to handle the demands of the field. 

1.7 Scope of the study

The study aims to examine the impact of nurse managers competencies in healthcare delivery. Empirically, this study assesses whether there is a relationship between nurse managers’ competencies and staff job satisfaction and retention rates in healthcare institutions, the current level of managerial and leadership competencies among nurse managers in healthcare facilities, the key competencies required by nurse managers for effective healthcare delivery in hospitals and healthcare institutions and the impact of nurse managers’ competencies on quality of patient care outcomes in healthcare settings.

1.8 Limitation of the study

Like in every human endeavour, the researchers encountered slight constraints while carrying out the study. The significant constraint was the scanty literature on the subject owing that it is a new discourse thus the researcher incurred more financial expenses and much time was required in sourcing for the relevant materials, literature, or information and in the process of data collection, which is why the researcher resorted to a limited choice of sample size. Additionally, the researcher will simultaneously engage in this study with other academic work. However in spite of the constraint all these constraint were downplayed to give the best.

1.9 Definition of terms

Nurses: Nurses are healthcare professionals trained to care for individuals, families, and communities to help them achieve and maintain optimal health. They provide medical care, administer medications, monitor patient conditions, and offer support and education to patients and their families.

Nurse managers: Nurse managers are healthcare professionals responsible for overseeing the daily operations of nursing staff in a hospital, clinic, or healthcare facility. They manage nursing teams, ensure quality patient care, handle administrative tasks, and coordinate between nurses and other healthcare professionals.

Impact: Impact refers to the strong effect or influence that one thing has on another. It can be positive or negative and may involve changes or consequences resulting from an action, event, or situation.

Competencies: Competencies are the combination of knowledge, skills, abilities, and behaviors that individuals need to effectively perform tasks or roles. They are the qualities that enable someone to be successful in a specific job or activity.

---

---