Behaviors and strategies in clinical leadership in nursing: scoping review

Introduction: Clinical leadership in nursing refers to the demonstration of informal leadership skills and behaviors by nurses in clinical practice. It contributes to the construction of innovative and structured healthcare models, which result in the continuous improvement of the quality of care and the satisfaction of health needs. Objective: Mapping the scientific evidence on the behaviors of clinical nurse leaders and the strategies that promote clinical nursing leadership in healthcare organizations. Methods: Scoping review according to the guidelines of the Joanna Briggs Institute. The search was completed in MEDLINE Complete, CINAHL Complete, Scopus, Web of Science, ProQuest and Repositório Científico de Acesso Aberto de Portugal. Primary studies published in Portuguese, English or Spanish were included. Results: A total of 2407 records were identified, of which 24 were included in the review. 47 clinical leadership behaviors in nursing and 18 strategies to promote these behaviors were identified (strategies related to the nurse (n=3), the multi-professional team (n=5), the healthcare organization (n=8) and entities external to the healthcare organization (n=2)). Most of the behaviors are task-oriented (n=25), with behaviors related to clinical practice prevailing (n=18). Conclusion: Leadership behaviors are associated with effective communication skills, decision making, clinical experience, support, mentoring, education and team building. Strategies should be defined to facilitate the development and enhancement of leadership behaviors in clinical practice.