Nurses' perspectives on how operational leaders influence function-focused care for hospitalised older people.
AIMS
To explore nurses' perspectives on how leaders influence function-focused care, defined as care that preserves and restores older people's functional abilities.


BACKGROUND
Hospitalised older people are at risk of functional decline. Although leaders have the potential to influence function-focused care, few studies have explored nurses' perspectives on how leaders influence function-focused care.


METHODS
Thirteen focus groups were held with 57 acute care nurses. Semi-structured questions prompted discussion on nurses' perspectives, needs and strategies to meet their needs. Data were thematically analysed.


RESULTS
Three themes were identified: (1) the emphasis in hospitals is on moving older people quickly through the system, not supporting their functioning; (2) leaders are generally seen as too disconnected from practice to design system efficiency initiatives that support older people's functioning and nurses' provisioning of function-focused care; and (3) leadership strategies to better support nurses in providing function-focused care to older people in the context of system efficiency.


CONCLUSIONS
Leaders should connect with practice to devise age-sensitive efficiency initiatives that support function-focused care. Nurses need support from leaders in four areas to provide function-focused care to older people in the current hospital context.


IMPLICATIONS
The findings provide direction on how leaders can facilitate function-focused care in the current health-care environment emphasising system efficiency.
['Fox|Mary T|MT|', 'Butler|Jeffrey I|JI|']
D000328:Adult D000368:Aged D001291:Attitude of Health Personnel D017144:Focus Groups D005851:Geriatric Nursing D006801:Humans D007857:Leadership D008875:Middle Aged D009718:Nurse Administrators D009726:Nurses D010465:Perception D036301:Qualitative Research D000078329:Workforce
operational leaders function-focused care older people acute care health-care system efficiency