Registered nurses’ confidence related to undertaking a leadership role in residential aged care: A clinical leadership self-assessment survey

Background: The Australian Royal Commission emphasizes the importance of registered nurse leadership in providing safe, high-quality care to older adults in Residential aged care. Nurse leadership has important ramifications for effective multidisciplinary care as well as recruitment and retention of the aged care workforce. Registered nurse leadership plays a crucial role in enhancing resident outcomes in Residential aged care, however there are limited studies examining self-perceptions of confidence and competence of nurses running Residential aged care, particularly after hours. 

Aim: To examine registered nurse leadership via self-reported confidence and competence in Residential aged care. 

Methods: A cross-sectional research design with ten facilities in Western Australia was used, including a survey tool that relied on the Clinical Leadership Competency Framework. Cronbach's alpha test was used to ascertain internal reliability and replicability. The Strengthening the Reporting of Observational studies in Epidemiology guidelines was used to guide the study. Inferential statistics were used for data analysis. Data collection occurred over a six-month period, involving registered nurses employed by a single Residential aged care provider in Perth, Western Australia. Participants rated their leadership confidence on a 5-point Likert-type scale ranging from 1 (never) to 5 (all the time). 

Findings: From a sample of 100 registered nurses working in aged care after-hours, 90% reported high levels of self-confidence. The survey results showed that those who have more than 10 years of experience reported highest confidence in managing services. Registered nurses over 50 years old self-reported highest confidence in personal qualities, managing, and improving service domains. 

Discussion: Registered nurses run residential aged care, and this time of aged care reform provides an opportunity to examine associations between registered nurse leadership and resident outcomes and provide avenues for improvements in working environments and resident experiences. 

Conclusion: The findings have important implications for Residential aged care providers in establishing effective leadership mentoring programs to support registered nurses in improving their confidence and ability.