Perceived importance and performance of clinical leadership in practice: A cross-sectional study of nurses and midwives of all grades

J Nurs Manag. 2019 Nov;27(8):1738-1746. doi: 10.1111/jonm.12867. Epub 2019 Oct 16.


Aim: To explore the differences in perceived importance and actual performance of clinical leadership for all grades of nurses and midwives engaged in clinical practice.

Background: Clinical leadership is central to the provision of person-centred care. However, little is known about how nurses and midwives perceive this in practice.

Methods: Data were collected on a sample of nurses and midwives in the Republic of Ireland, using a cross-sectional study design (n = 324). The clinical leadership needs analysis instrument was used to measure perceived importance and performance of clinical leadership in practice. Grades of nurses/midwives included; staff, manager, advanced practitioner and senior manager.

Results: Senior managers were more likely to report significantly higher scores than staff grades for perceived importance of Technology & Care Initiatives (p < .01) and Financial & Service Management (p = .02). Performance of Staff & Care Delivery was significantly higher for senior managers than staff grades [F(5,309) = 6.06 p < .01].

Conclusion: There was a mismatch between the perceived importance and actual performance of clinical leadership in practice between different grades of staff.

Implications for nursing management: Leadership training for all grades and mentoring of staff grades can promote the building of confidence and empower staff in leading clinical practice.

Keywords: CLeeNA; importance of clinical leadership; midwives; nurses; performance of clinical leadership.

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Female
  • Humans
  • Ireland
  • Leadership*
  • Male
  • Middle Aged
  • Nurse Midwives / classification
  • Nurse Midwives / psychology
  • Nurses / classification
  • Nurses / psychology*
  • Perception*
  • Surveys and Questionnaires
  • Work Performance / standards*