Nutrition - leadership

Leadership qualities

Every member of the nursing team can display leadership qualities (Royal College of Nursing 2009). Engagement and relationship skills are fundamentally important in leading improvement (Health Foundation 2011). In the context of nutrition and hydration this encompasses the following:

• executive nurses having the responsibility for ensuring that nutritional care is prioritised at board level and that systems are in place to support this
• team leaders being responsible for enabling effective organisation of care so that the provision of food and nutrition will be prioritised and patients, clients and users experience care that meets their needs as they see them
• all nurses in their leadership role being responsible for enabling others to provide good nutritional care (RCN Nutrition Now).

Leadership in nutrition and hydration

Different approaches to leadership are appropriate to different contexts of care, or need to be blended in different situations. High performing leaders recognise this and are adept at applying a range of strategies.

Whatever the context of care the following activities should be integrated into daily routines. 

• Remaining visible and accessible in the clinical area to the clinical team, patients and service users. Examples include being approachable to visitors and enabling team members to ask questions.
• Working with the team in different ways, for example alongside junior colleagues in the provision of direct care and enabling learning in and from practice or by undertaking a care plan review.
• Monitoring and evaluating standards of care provided by the clinical team. For example, enabling eflective review at staff handover or by bringing staff together to review clinical and workforce data using balanced score cards.
• Providing regular feedback to the clinical team on standards of nursing care provided to and experienced by patients and service users. Feedback can be provided at the end of each interaction with staff members, the end of the shift or at staff handover.
• Creating a culture for learning and development that will sustain person-centred, safe and effective care. Examples include implementing systems for evaluating practice, clinical supervision, shared governance or decision making and a focus on patterns of behaviour, and providing a challenging and supportive environment for staff (McKenzie and Manley 2011).

The Care Quality Commission report (CQC 2011) looking at standards of dignity and nutrition in hospitals identified leaders as crucial to setting the norms for conduct and reducing variability in practice. Within the hospital setting the leadership role of the ward sister / charge nurse is critical in providing this role and in establishing a culture of learning and development and an appropriate care environment (Royal College of Nursing 2011; University of Birmingham Health Services Management Centre 2011).

See also the relevant sections in the  online resource Patient safety and human factors:

• human factors - leadership
• action on leadership.

References

These resources were last accessed on 31 January 2013. Some of them are in PDF format - see how to access PDF files.

CQC (2011) Dignity and nutrition inspection programme: national overview. London: CQC.

Health Foundation (2011) What’s leadership got to do with it? Exploring links between quality improvement and leadership in the NHS. London: Health Foundation.

McKenzie C, Manley K (2011) Leadership and responsive care: Principles of Nursing Practice H (PDF 94KB). Nursing Standard 25(35) 4 May pp.35-37.

Royal College of Nursing (2009) RCN Learning Zone: Exploring leadership. Learning Zone website [you will need your RCN membership number to access this].

Royal College of Nursing (2010) Principles of Nursing Practice. Principle H. RCN website.

Royal College of Nursing (2011) Making the business case for ward sisters/team leaders to be supervisory to practice (PDF 2.22MB). London: RCN.

University of Birmingham Health Services Management Centre (2011) Time to care? Responding to concerns about poor nursing care. Policy Paper 12. Birmingham: University of Birmingham: HSMC.