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Longitudinal Charge Nurse Leadership Development and Evaluation

Krugman, Mary PhD, RN, NEA-BC, FAAN; Heggem, Laura BSN, RN, CCRN; Kinney, Lisa Judd BA; Frueh, Margaret MS, RN

Journal of Nursing Administration: September 2013 - Volume 43 - Issue 9 - p 438–446
doi: 10.1097/NNA.0b013e3182a23b26

OBJECTIVE: The study’s aim was to examine longitudinal outcomes of a leadership program for permanent and relief charge nurse from 1996 to 2012 using action research and Kouzes and Posner’s The Leadership Challenge conceptual frameworks.

BACKGROUND: Charge nurses hold significant oversight of patient safety, quality, and team functioning. This study contributes knowledge regarding charge nurse leadership and organization outcomes associated with these essential roles over time.

METHODS: Data were collected over 6 time periods using Kouzes and Posner’s The Leadership Practices Inventory (LPI) and internally developed action research tools. Surveys were aligned with leadership and work environment changes to examine outcomes.

RESULTS: Charge nurse leadership LPI mean ratings improved. Relief charge nurses reached similar LPI outcomes by 2012, with no statistical differences in mean or domain scores. Action research methods facilitated executive decision making during change processes. Demographics shifted with younger charge nurses with less practice experience serving as charge nurses in the most recent years.

CONCLUSIONS: Charge nurse leadership reported significant gains despite institutional changes and uneven delivery of educational interventions.

Supplemental Digital Content is available in the text.

Authors Affiliations: Director, Nursing Innovation & Outcomes (Dr Krugman), Charge Nurse III (Ms Heggem), Professional Research Assistant (Ms Kinney), and Director, Transplant Administrator (Ms Frueh), University of Colorado Hospital, Aurora.

The authors declare no conflicts of interest.

Correspondence: Dr Krugman, University of Colorado Hospital, 12401 E 17th Ave, Mail Stop A020, Aurora, CO 80045 (

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