Impact of Leadership Style and Structural Empowerment on Nursing Group Power in ICU Settings: A Cross-Sectional Study

Abstract

Background: Power is an essential resource for nursing teams, especially in the complex high-risk environment in intensive care units (ICUs), where effective collaboration, prompt intervention and comprehensive patient care are vital. However, the factors influencing nursing group power in ICUs remain largely unexplored. Aims: To examine the association between head nurse leadership styles, structural empowerment and nursing group power among nurses employed in ICU settings. Study Design: This cross-sectional study employed a convenience sample of 120 registered nurses from various ICUs within a general hospital (response rate of 89.5%). Data were collected between July and August 2024 through self-administered questionnaires. Results: Unlike other leadership styles examined, transformational leadership uniquely demonstrated consistent positive relationships with all six components of structural empowerment and nursing group power. Moreover, transformational leadership by the head nurse (β = 0.262, p = 0.004), access to opportunities (β = 0.184, p = 0.021), access to information (β = 0.244, p = 0.004) and levels of informal power (β = 0.160, p = 0.047) were all positively associated with nursing group power, collectively explaining 48.3% of the variance. Conclusion: Our results emphasise the importance of transformational leadership, access to opportunities and information and informal power as contributors to nursing group power. Relevance to Clinical Practice: Healthcare organisations should prioritise fostering transformational leadership skills among ICU head nurses and strengthening structural empowerment frameworks. This involves implementing targeted leadership training programmes, enhancing access to professional development opportunities and information resources and fostering informal power networks. These actions can enhance nurses' collective power, improve collaboration and optimise team dynamics in ICUs, ultimately contributing to better patient care and organisational goal achievement.