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Research Literature, Design Approach and Sampling

Subject: Nursing
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Nursing is a crucial factor that determines the level of patient experience in a hospital or health organization.  It is the primary determinant of different areas in the health sector such as patient satisfaction, employee satisfaction and delivery of quality healthcare services (Stanley, 2017 and Prosser, 2016). The achievement of all this factors depends significantly on the leadership present in the hospital team. The paper aims to indentify the leadership styles that can positively influence nursing activities and reasons why it is the corner stone of success.

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PICOT Questions in this research paper are such as is leadership an important element in determining the levels of consumer satisfaction and employee satisfaction. Does it have a role in the nursing field when delivering healthcare services to patients? and is it a necessity to improve overall organisational performance?

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Research Literature

Dellasega, C. (2013). Toxic Nursing: Managing Bullying, Bad Attitudes, and Total Turmoil. Indianapolis, US: Sigma Theta Tau International. ProQuest ebrary.

The research study looks into the challenges that face many practitioners in the medical field. The study used secondary sources such as online blogs to obtain data, which is a qualitative study. In addition, it used a sample of 99 nurses from the 21 online blogs to support the hypothesis of the study, which is the many challenges that nurses go against other nurses are present because of poor leadership management. The challenges arise from bullying and conflicts that result in other issues in the medical field such as intimidation, abuse of authority, retaliation, exclusion, gossip and threats of loss of jobs.

The results of the study is that the sources of all issues, which are bullying and conflict has more than 6 Million and 10 Million hits in the nursing field. The strength of the study is that it found out the reasons why such challenges still exists. The solution for such challenges was to identify other strategies for conflict resolution other than compromise. The literature does support the PICOT question as many of the issues arise from poor leadership skills.

Grobler, S. W. & Plessis, Y. (2016). Requisite leader behavioral competencies for sustainable organisational performance. Acta Commercii, 16(1), 1-8. doi:10.4102/ac.v16i1.347

The article looks into the relationship present between leadership behavior and organization performance. The study undertook a qualitative approach specifically the constructivist grounded theory. Data for the article was from in-depth interviews. The findings of the research are that leadership does directly affect organisational performance. The strength of the articles it looked into performance elements such as innovation, focus, employee well-being and recognition. The limitation is that there is no correspondence of the factors in the PICOT question.

The relation has to be after reading the reporting to draws out the indirect relations of the determinants. The solution is that organization should incorporate proper and effective leadership frameworks into its structure. The literature does support the PICOT question as it aims to demonstrate if leadership can affect determinants such as employee or patient satisfaction and delivery of quality health services, which are also tools of measure for organisational performance.

Martsolf, G. R., Gibson, T. B., Benevent, R., Jiang, H. J., Stocks, C., et al. (2016). An Examination of Hospital Nurse Staffing and Patient Experience with Care: Differences between Cross-Sectional and Longitudinal Estimates. Health Services Research, 51(6), 2221-2241. doi:10.1111/1475-6773.12462

The article tries to identify an association nurse staffing and patient assessment of the healthcare provider. The research paper uses a quantitative approach. Data is from previous hospital records from the year 2009-2011. The results of the study were that the level of positive influence in the healthcare organization was small and limited to inpatient experience. The literature of the report will assist to support the hypothesis that low level of positive influence arise from poor leadership styles that fail to motivate the nurses, creating an undesirable experience with patients.

Oake, J. S., Davies, T. O., Houle, A., & Beiko, D. (2017). Exploring the business of urology: Change management. Canadian Urological Association Journal, 11(6), 163-166. doi:10.5489/cuaj.4525

The paper looks into the concept of change and the different strategies that organization apply to be flexible to that change. The research is significant to the PICOT question as it looks into how change affects the operations in the healthcare sector. The finding of the study show that there are core values the organisation must apply to ensure that it effectively adapts to change, which are preparation, conviction, purpose and clarity. The strength of the study is that it looks into change in behavior to incorporate such values. The researchers describe strategies the companies can use to successfuly incorporate change, one of them being leadership.

Teddy C. & Priyono (2016) The Influence of Leadership Styles, Work Environment and Job Satisfaction of Employee Performance—Studies in the Surabaya. International Education Studies; Vol. 9

The purpose of the article is to define and describe the various leadership styles. In addition, it researches its influence on the work environment, employee performance and job satisfaction. The study uses quantitative approach with a sample of 45 people. The results of the study are that leadership does have a significant impact on the workplace, performance and employee satisfaction. The literature in the report supports to prove the hypothesis under discussion.

Woten, M. B., & Uribe, L. M. (2016). PatientSatisfaction and the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Survey. CINAHL Nursing Guide.

The purpose of the study is to determine the effectiveness of leadership among team members to encourage motivation thus ensuring quality patient care. It identifies factors that determine leadership effectiveness in an organization. The information for the study comes from public reports.  The report is a Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Survey, which analyzes consumer assessment to determine the significance of leadership in patient and employee satisfaction.

The strength of the research is it does provide some mathematical formulas the research can use to measure the level of satisfaction and quality of health services. The limitation of the study is it has no distinct relation between the variables of measure in this research paper that the researcher identified in the article. The literature in the book is useful in answering the PICOT question as it illustrates the need for organization leadership to improve quality or care.

Theoretical Framework

There are different theoretical models that can explain the relationship between leadership and patient/ consumer satisfaction with service delivery. The models are such the expectation fulfillment model developed by Linder-Pelz in 1982. It predicts experience and determines what can result in satisfaction. It uses measuring variables such as value, expectation, entitlement and occurrences (‘Chapter III: Theoretical And Conceptual Framework’ n.d).

Hagedorn theory of satisfaction developed in 2000, which uses various variables of measure to determine the level of job satisfaction that can exist in an organization. Another model is the leadership model, developed by Avolio and Bass in 2004. It looks into transformative leadership and its significance in determining motivation and satisfaction (Foon, 2016).

The other model is cognition model of satisfaction developed by Oliver in 1993, which establishes a relationship between three variables such as performance, outcome and expectation. Dynamic Process of Service Quality developed in 1993 by Boulding and Zeithaml. It uses perception and service delivery variables to determine if expectations can result in increase in satisfaction. Zones of tolerance model that uses the comparison deliverable to determine customer satisfaction which are desired service and adequate service (‘Chapter III: Theoretical And Conceptual Framework’ n.d).

Research Design

There are two different research designs, which are qualitative and quantitative studies. The studies will undertake both. The reason for this is that the research paper will not be using its own samples. The samples will come from the literature from the secondary sources of the paper. The articles are both qualitative and qualitative reports creating the need to use both research designs (Specter, 2008).

The type of qualitative research designs used in the reports is such as grounded theory from Grobler & Plessis (2016) report. The quantitative research designs present in the secondary sources the study used are such as survey and correlation research. The secondary sources will avail any necessary data that can measure the variables of this topic against leadership styles in health organisations.

Sampling Methods

The report will be both qualitative and quantitative. It will utilize the samples present in other studies to determine the extent leadership styles affect the dominants of this report, which are patient satisfaction, employee satisfaction and service delivery. The samples will be chosen at random will depend if they have a relation to the parameters the research aims to measure. There will be analysis and observation of the data from the samples to draw accurate conclusions regarding the hypothesis under discussion.


The report identifies many challenges in the nursing field originate from leadership. The study also illustrate that leadership is important for successful performance of hospitals as it can improve both employee and patient satisfaction and improve delivery of healthcare service. The finding of the study is that there is a direct relation between leadership and quality/satisfaction.

1. Chapter III: Theoretical And Conceptual Framework (n.d) Retrieved from http://shodhganga.inflibnet.ac.in/bitstream/10603/919/10/10_chapter%203.pdf

2. Foon, M. S. (2016). The Theoretical Framework of Transformational and Transactional Leadership Styles in Enhancing Job Satisfaction of Nurse Educators in Malaysia. International Journal of Social Science and Humanities Research, Vol. 4, Issue 1, pp: (590-595).

3. Prosser, S. (2016). Effective People: Leadership and Organization Development in Healthcare, Second Edition. Milton: CRC Press.

4. Stanley, D. (2017). Clinical leadership in nursing and healthcare: Values into action. Chichester, West Sussex, UK: Wiley Blackwell.

5. Spector, P. E. (2008). Research designs. Beverly Hills, Calif: Sage Publ.

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