Liderazgo transformacional en la gestión de servicios de enfermería: impacto en la calidad del cuidado
DOI:
https://doi.org/10.69821/REMUVAC.v3i1.312Palabras clave:
liderazgo transformacional, enfermería, calidad del cuidado, seguridad del paciente, clima laboralResumen
El liderazgo transformacional en la gestión de enfermería se ha vinculado con mejoras clínicas y organizacionales, aunque sus efectos no siempre se expresan de manera directa. Esta revisión narrativa con enfoque cualitativo tuvo como propósito explorar la evidencia publicada entre 2020 y 2025 sobre la relación entre liderazgo transformacional y calidad del cuidado, seguridad del paciente y clima laboral en servicios de enfermería. Se realizó una búsqueda estructurada en bases de datos indexadas y se aplicó un proceso de selección documentado conforme a PRISMA. Tras el cribado y la evaluación a texto completo, se incluyeron 31 artículos para la síntesis temática. Los hallazgos se organizaron en tres ejes: (1) calidad y seguridad, donde predominan asociaciones con cultura y clima de seguridad, coordinación del cuidado y calidad percibida; (2) clima organizacional, con tendencias hacia mayor satisfacción, compromiso y menor burnout; y (3) mecanismos y condiciones, destacando comunicación de alto impacto e inteligencia emocional como rutas explicativas, junto con barreras estructurales que modulan los efectos. Se concluye que el liderazgo transformacional puede contribuir a mejoras sostenibles cuando se acompaña de soporte organizacional y condiciones laborales adecuadas.
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Aiken, L. H., Sloane, D. M., Bruyneel, L., Van den Heede, K., Griffiths, P., Busse, R., Diomidous, M., Kinnunen, J., Kózka, M., Lesaffre, E., McHugh, M. D., Moreno-Casbas, M. T., Rafferty, A. M., Schwendimann, R., Scott, P. A., Tishelman, C., van Achterberg, T., & Sermeus, W. (2014). Nurse staffing and education and hospital mortality in nine European countries: A retrospective observational study. The Lancet, 383(9931), 1824–1830. https://doi.org/10.1016/S0140-6736(13)62631-8
Algeri, E., Silveira, R., Tomaschewski-Barlem, J., Costa, M., Stigger, D., & Dan, C. (2022). Authentic leadership in nurses’ professional practice: an integrative review. Revista Brasileira De Enfermagem, 75(1). https://doi.org/10.1590/0034-7167-2021-0972
Almeida, D., Figueiredo, A., & Lucas, P. (2024). Nurses’ Well-Being at Work in a Hospital Setting: A Scoping Review. Healthcare, 12(2), 173. https://doi.org/10.3390/healthcare12020173
Al‐Thawabiya, A., Singh, K., Lenjawi, B., & Alomari, A. (2023). Leadership styles and transformational leadership skills among nurse leaders in Qatar, a cross‐sectional study. Nursing Open, 10(6), 3440-3446. https://doi.org/10.1002/nop2.1636
Bhatti, S., Bale, S., Gul, S., Muldoon, L., & Rayner, J. (2024). The impact of leadership style in team-based primary care – staff satisfaction and motivation. BJGP Open, 8(3), BJGPO.2023.0246. https://doi.org/10.3399/bjgpo.2023.0246
Boamah, S. A., Spence Laschinger, H. K., Wong, C. A., & Clarke, S. P. (2018). Effect of transformational leadership on job satisfaction and patient safety outcomes. Nursing Outlook, 66(2), 180–189. https://doi.org/10.1016/j.outlook.2017.10.004
Burns, J. M. (1978). Leadership. Harper & Row.
Caldwell, M., Pabico, C., Robertson, S., Hayes, K., Carson, W., & Kleinpell, R. (2024). Behind the numbers. Nursing Management, 55(10), 8-13. https://doi.org/10.1097/nmg.0000000000000177
Cummings, G. G., Tate, K., Lee, S., Wong, C. A., Paananen, T., Micaroni, S. P. M., & Chatterjee, G. E. (2018). Leadership styles and outcome patterns for the nursing workforce and work environment: A systematic review. International Journal of Nursing Studies, 85, 19–60. https://doi.org/10.1016/j.ijnurstu.2018.04.016
Donabedian, A. (1988). The quality of care. How can it be assessed. JAMA, 260(12), 1743–1748. https://doi.org/10.1001/jama.260.12.1743
Fowler, K. (2023). High-impact communication in nursing leadership. Nursing Management, 54(5), 14-25. https://doi.org/10.1097/nmg.0000000000000001
Frangieh, J. and Jones, T. (2022). Factors facilitating or inhibiting the capacity for effective leadership among front‐line nurse managers: A scoping review. Journal of Nursing Management, 30(7), 2653-2669. https://doi.org/10.1111/jonm.13776
Frangieh, J. and Jones, T. (2022). Factors facilitating or inhibiting the capacity for effective leadership among front‐line nurse managers: A scoping review. Journal of Nursing Management, 30(7), 2653-2669. https://doi.org/10.1111/jonm.13776
Gambashidze, N., Wagner, A., Manser, T., Rieger, M., Martus, P., & Hammer, A. (2025). A multi-group path analysis of medication documentation quality using cross-sectional survey data: Impact of leadership, job satisfaction, patient-related burnout, and patient safety culture. Plos One, 20(9), e0330499. https://doi.org/10.1371/journal.pone.0330499
Garcés Proaño, D. L., Ibarra Paillacho, M. E., & Gallard Muñoz, I. E. (2025). Impacto del liderazgo transformacional en enfermería sobre la calidad de la atención hospitalaria. Revista Científica Internacional Arandu UTIC, 12(4), 2044–2062. https://doi.org/10.69639/arandu.v12i4.1798
González‐García, A., Pinto‐Carral, A., Marqués‐Sánchez, P., Quiroga‐Sánchez, E., Bermejo‐Martínez, D., & Pérez‐González, S. (2025). Characteristics of nurse managers’ conflict management Competency. A systematic review. Journal of Advanced Nursing, 81(4), 1717-1733. https://doi.org/10.1111/jan.16600
Institute of Medicine. (2000). To err is human: Building a safer health system. The National Academies Press. https://doi.org/10.17226/9728
International Council of Nurses. (2021, January 13). ICN COVID-19 update report: COVID-19 infections and deaths among nurses and other healthcare workers. https://www.icn.ch/sites/default/files/inline-files/ICN%20COVID19%20update%20report%20FINAL.pdf
Karlsson, E., Karlsson, N., Fernemark, H., Seing, I., Skagerström, J., Brulin, E., … & Nilsén, P. (2024). A Cross‐Sectional Survey of Swedish Primary Healthcare Nurses’ Discontent With Their Current Job. Journal of Nursing Management, 2024(1). https://doi.org/10.1155/2024/2786600
Kim, H. Y., Kim, H. J., & Yeun, E. J. (2025). Impact of Resilience, Emotional Exhaustion, and Communication Competency on Organizational Commitment Among Nurses in a Tertiary Hospital Setting in South Korea: A Cross-Sectional Study. Sage Open, 15(4), 21582440251385661. https://doi.org/10.1177/21582440251385661
Kolomboy, F., Palutturi, S., Rivai, F., Saleh, L., Masudin, M., & Amiruddin, R. (2021). Spiritual-Based Transformational Leadership Style at Anutapura Regional General Hospital, Palu. Open Access Macedonian Journal of Medical Sciences, 9(E), 524-529. https://doi.org/10.3889/oamjms.2021.6119
Linnik, L., Sepp, J., & Reinhold, K. (2023). Enhancing Patient Safety Through Leadership: A Comprehensive Literature Review on the Role of Head Nurses in Hospital Settings. Economics and Business, 37(1), 220-235. https://doi.org/10.2478/eb-2023-0014
Liu, N., Wang, L., & Yin, J. (2023). Impact of transformational leadership on the person–organization fit of Chinese nurses: The moderating effect of emotional intelligence. Nursing Open, 10(7), 4586-4596. https://doi.org/10.1002/nop2.1706
Ljudmila, L., Jaana, S., & Karin, R. (2023). Enhancing patient safety through leadership: A comprehensive literature review on the role of head nurses in hospital settings. Economics and Business, 37, 220–235. https://doi.org/10.2478/eb-2023-0014
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., ... & Alonso-Fernández, S. (2021). Declaración PRISMA 2020: una guía actualizada para la publicación de revisiones sistemáticas. Revista española de cardiología, 74(9), 790-799. https://doi.org/10.1016/j.recesp.2021.06.016
Moloney, W., Fieldes, J., & Jacobs, S. (2020). An Integrative Review of How Healthcare Organizations Can Support Hospital Nurses to Thrive at Work. International Journal of Environmental Research and Public Health, 17(23), 8757. https://doi.org/10.3390/ijerph17238757
Mostafa, A., Farley, S., & Zaharie, M. (2020). Examining the Boundaries of Ethical Leadership: The Harmful Effect of Co-worker Social Undermining on Disengagement and Employee Attitudes. Journal of Business Ethics, 174(2), 355-368. https://doi.org/10.1007/s10551-020-04586-2
Niinihuhta, M. and Häggman‐Laitila, A. (2022). A systematic review of the relationships between nurse leaders' leadership styles and nurses' work‐related well‐being. International Journal of Nursing Practice, 28(5). https://doi.org/10.1111/ijn.13040
O’Donovan, R., Rogers, L., Khurshid, Z., Brún, A., Nicholson, E., O’Shea, M., … & McAuliffe, É. (2021). A systematic review exploring the impact of focal leader behaviours on health care team performance. Journal of Nursing Management, 29(6), 1420-1443. https://doi.org/10.1111/jonm.13403
Ofei, A. M. A., Poku, C. A., Paarima, Y., Barnes, T., & Kwashie, A. A. (2023). Toxic leadership behaviour of nurse managers and turnover intentions: the mediating role of job satisfaction. BMC Nursing, 22(1). https://doi.org/10.1186/s12912-023-01539-8
Rothbart, K., Leddy, J., Brady, C., Kruse, D., & Lancaster, R. (2024). Exploring Determinants of Nurse Retention. Nursing Administration Quarterly, 48(4), 305-316. https://doi.org/10.1097/naq.0000000000000654
Salemo, C. and Fitzpatrick, M. (2023). Nurse Leader Development Programs. Nursing Management, 54(9), 35-46. https://doi.org/10.1097/nmg.0000000000000050
Seljemo, C., Viksveen, P., & Ree, E. (2020). The role of transformational leadership, job demands and job resources for patient safety culture in Norwegian nursing homes: A cross-sectional study. BMC Health Services Research, 20, 799. https://doi.org/10.1186/s12913-020-05671-y
Sturm, H., Rieger, M., Martus, P., Ueding, E., Wagner, A., Holderried, M., … & Maschmann, J. (2019). Do perceived working conditions and patient safety culture correlate with objective workload and patient outcomes: A cross-sectional explorative study from a German university hospital. Plos One, 14(1), e0209487. https://doi.org/10.1371/journal.pone.0209487
Tsapnidou, E., Μουδάτσου, Μ., Katharakis, G., Koukouli, S., Rovithis, M., Kelesi, Μ., … & Stavropoulou, A. (2025). The Impact of Toxic Leadership on Nurse Retention: A Scoping Review. Healthcare, 13(18), 2341. https://doi.org/10.3390/healthcare13182341
Wong, C. A., Cummings, G. G., & Ducharme, L. (2013). The relationship between nursing leadership and patient outcomes: A systematic review update. Journal of Nursing Management, 21(5), 709–724. https://doi.org/10.1111/jonm.12116
World Health Organization. (2020). State of the world’s nursing 2020: Investing in education, jobs and leadership. https://www.who.int/publications/i/item/9789240003279
World Health Organization. (2021). Global patient safety action plan 2021–2030: Towards eliminating avoidable harm in health care. https://www.who.int/publications/i/item/9789240032705
Yıldırım, N., Kantek, F., & Yılmaz, F. (2021). Relationships between leadership orientations and emotional intelligence in nursing students. Perspectives in Psychiatric Care, 58(3), 903-909. https://doi.org/10.1111/ppc.12871
Yuka, H. and Yoshioka, S. (2020). Emotional Intelligence and Work Perceptions Among Nurse Managers. Yonago Acta Medica, 63(4), 343-352. https://doi.org/10.33160/yam.2020.11.021
Zaghini, F., Fiorini, J., Piredda, M., Fida, R., & Sili, A. (2020). The relationship between nurse managers’ leadership style and patients’ perception of the quality of the care provided by nurses: Cross-sectional survey. International Journal of Nursing Studies, 101, 103446. https://doi.org/10.1016/j.ijnurstu.2019.103446
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