Study design


Leadership frameworks/ strategies


Data source

Jeon et al. (2015).

Aim: Determining the legitimacy of the clinical leadership framework

A Delphi method

Residential aged care facilities in rural and metropolitan settings

Clinical Leadership Qualities Framework.

After the consultation, the suitability and face validity of the leadership framework was established.

Survey on Sixty-nine experts in aged care facilities

Twigg & McCullough (2014).

Aim: To identify strategies in the literature supporting nurse retention through enhancement of positive work environments

Literature review

Creating a positive work environment

Strategies creating conducive work environment include; staff empowerment, shared governance structure, staff independence, leadership support, and skill mix and organizational relationships

Medline, and ProQuest databases

Shield et al. (2014).

Aim: understanding the process and reasons for promoting culture change (CC) practices


4149 United States NHS

Promoting cultural change practices

Reasons for affecting CC practices vary; strategies for implementing CC practices are different; NHS consider staff mix when implementing the practices; enactment of changes is challenging, and strategies for change are tailored to the challenges encountered; training and effective communication are vital; staff leadership is key to enacting changes.

NH Directors of Nursing (DONs) and Administrators (NHAs)

Shier et al. (2014)

Aim: to find out ways of promoting cultural changes in organizations

A comprehensive review of peer-reviewed and grey literature

Promoting cultural changes

Close relationships, staff support, appreciation, staff training

Online databases

Prgomet et al. (2017)

Aim: to study front line workers and their perceptions on altering policy landscape


Australian aged care organization

Promoting policy changes

Altering policy landscape enhances communication; facilitates front line commitment; enhances management of organizational changes

Care workers and six case managers

Ouyang et al. (2015).

Aim: to explore the effect of psychological empowerment and organizational commitment.


Tertiary hospitals in China

Promoting organizational commitment

Nurse satisfaction is influenced by psychological empowerment. Organizational commitment promotes the implementation of new initiatives.

A questionnaire filled by 726 nurses from tertiary hospitals

Oliver et al. (2014).

Aim: describing perceptions of structural empowerment


The large healthcare system in the North-eastern United States

Promoting organizational empowerment

Structural empowerment comes to a result of staff support, formal power, and informal power.

Interview with Clinical nurse managers

Van der Voet (2014)

Aim: examining efficiency as well as specificity of change management


Dutch public organization

Fostering organizational changes

The leadership role is important during organizational change


Bennett et al., (2014).

Aim: exploring perspectives of mealtime management


Five Residential aged care facilities

Embracing policy changes

Limited consideration of meal times in policy is a barrier in mealtime management.