Implementing Change
Innovativeness of nurse leaders
KAREN CLEMENT-O’BRIEN D N P , R N 1, DENISE F. POLIT P h D 2,3 and JOYCE J. FITZPATRICK P h D , R N , F A A N 4
1Director, Albany Medical Center, The Center of Learning & Development, Albany, NY, 2President, Humanalysis, Inc., Saratoga Springs, NY, USA, 3Adjunct Professor, School of Nursing, Griffith University, Gold Coast, Queensland, Australia and 4Elizabeth Brooks Ford Professor of Nursing, Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
Introduction
The support of nurse leaders for the implementation
of practice innovations is crucial to establishing an
environmental culture that adopts and values evidence-
based practice standards. The ANCC Magnet Recog-
nition Program [American Nurses Credentialing Center
(ANCC) 2008] guides organizations to promote out-
comes and superior performance. The Magnet program
components were developed to evaluate how work
environments support excellence in nursing practice.
Demonstrations of innovations in nursing practice are
the outcome of transformational leadership, empower-
ing structures and processes and exemplary professional
practice in nursing. To achieve Magnet status, the chief
nursing officers (CNOs) of acute health care organiza-
Correspondence
Karen Clement-O�Brien Albany Medical Center
The Center of Learning &
Development
31 Nicklaus Drive
Gansevoort
New York
NY 12831
USA
E-mail: kxc196@case.edu
C L E M E N T - O ’ B R I E N K . , P O L I T D . F . & F I T Z P A T R I C K J . J . (2011) Journal of Nursing Management
19, 431–438
Innovativeness of nurse leaders
Aim The purpose of the present study was to describe the innovativeness and the rate of adoption of change among chief nursing officers (CNOs) of acute care
hospitals, and explore the difference in the innovativeness of CNOs of Magnet
hospitals vs. non-Magnet hospitals. Background There is little evidence to guide the description of innovativeness for
nurse leaders, crucial to the implementation of evidence-based practice standards.
Method CNOs of acute care hospitals of New York State participated in a mailed
survey which incorporated the Scale for the Measurement of Innovativeness. The
response rate was 41% (106/261).
Results The majority of the sample was prepared at the master�s level with 5– 10 years of experience in the CNO role. A significant relationship was found
between the innovativeness scale scores and the innovativeness diversity index. The
CNOs who completed more leadership courses had implemented significantly more
types of innovations and had higher innovativeness scale scores.
Conclusion Graduate level education, years of CNO experience and leadership course
completion were identified as significantly influencing innovativeness of CNOs.
Implications for nursing management The characteristics of innovativeness for
nurse leaders presented in the present study may assist organizations, CNOs and the
Magnet recognition programme to describe innovativeness that supports organi-
zations to continuously improve the quality of patient care.
Keywords: change, innovativeness, nurse leader, scale for the measurement of innovativeness
Accepted for publication: 22 September 2010
Journal of Nursing Management, 2011, 19, 431–438
DOI: 10.1111/j.1365-2834.2010.01199.x ª 2011 The Authors. Journal compilation ª 2011 Blackwell Publishing Ltd 431
tions are evaluated on evidence of innovativeness.
However, there is little evidence to guide the description
of innovativeness for nurse leaders.
Purpose of the study
The purpose of the present study was to describe the
innovativeness and the rate of adoption of change
among CNOs of acute care hospitals. In addition, the
degree of innovativeness of CNOs of Magnet hospitals
and non-Magnet hospitals was compared. Examples of
innovativeness, according to the Magnet sources of
evidence criteria, were identified.
Conceptual framework
The Diffusion of Innovation Theory (Rogers 2003)
provided a framework for this study. The innovation-
decision making process describes how an individual
moves through the learning of a new idea, develops an
attitude and determines whether he or she will fully
implement and adopt an innovation or reject the new
practice.
Rogers (2003, pp. 245–252) categorized individuals
into groups according to their rate of adoption of an
innovation. These categories were defined statistically,
based on the number of standard deviations from the
mean adoption time. Individuals that fall within the
innovator classification are people who are considered
mavericks; they are more willing to travel and to take
risks to achieve personal interests or causes in which they
are heavily invested. Those in the early adopter category
are opinion leaders who are socially very well connected
and promote the local change. Early adopters are wat-
ched by others to see the dynamics and the impact of
innovation on their practice area. Members of the early
majority category learn more from other people than
from theory and science. They will listen to others and
will adopt an innovation if it readily helps them with an
immediate need. The late majority watches the early
majority, and the laggards bring up the rear; they are
traditionalists who make wise decisions for the good of
the organization at large (Berwick 2003).
The manner in which nursing practice has historically
been disseminated was frequently based on traditions
and experience (Sleep et al. 2002). The ability to
implement evidence-based practice is a challenge and
has been reported to take as long as 17 years in the
medical community (Liang 2007), with 10–20 years
before innovations are fully put to use (Ervin 2002).
Generating good practice ideas through research is not
the problem; getting good ideas to be used is the chal-
lenge, and the essence of the diffusion of innovation
(Berwick 2003).
Research questions
The research questions that guided this study were: (1)
What is the innovativeness of acute care hospital chief
nursing officers? (2) What is the rate of adoption of
change among acute care hospital chief nursing officers?
and (3) Is there a difference in the degree of innova-
tiveness of chief nursing officers of Magnet hospitals
compared with CNOs of non-Magnet hospitals?
Background
Characteristics of the leader
There is support in the literature for the view that the
characteristics of the leader influence change and the
motivation for adoption in an organization (Leonard-
Barton & Deschamps 1988, Longo 2007, Damanpour
& Schneider 2008). The main characteristics of the
leader that were found to influence change were their
motivation, leadership and commitment (Longo 2007).
Support from top management and championship
may have a significant effect on an adoption decision.
Leaders must first accept change before assisting others
with the change process (Rogers 2003). Innovation
takes time and there must be a perceived value for
adoption to occur. Gaining internal support for adop-
tion of an evidence-based practice change was one
challenge identified by Bradley et al. (2004) among 32
hospital administrators and leaders.
Innovativeness and change
The leader is key to preparing an organization for
change. If it is perceived that the leader does not value
the change or that the leadership team does not share
the same desire for the goal, staff are less likely to be
willing to accept the change (Litaker et al. 2008). Based
on their case studies, Kimball et al. (2007) and Morji-
kian et al. (2007) found that nurse leaders reported that
innovation depends on teamwork, building leadership
capacity and participation on all levels. This is a critical
strategy for generating new ideas, sustaining the change
momentum and being effective as a change agent. The
resources and support that nurse leaders provide made a
difference in the optimal utilization of evidence-based
nursing practice (n = 43; P < 0.05) (Wang & Ahmed
2004, Alfred & Byers 2005). Nurse leaders may have a
significant influence on the attitude of staff towards the
K. Clement-O�Brien et al.
432 ª 2011 The Authors. Journal compilation ª 2011 Blackwell Publishing Ltd, Journal of Nursing Management, 19, 431–438
use of evidence-based practice and the implementation
of practice changes within their organization (Larrabee
et al. 2007). Lukas et al. (2007), in a longitudinal study
of descriptions of successful change, found that all ele-
ments (impetus to transform, leadership commitment to
quality and change, improvement initiatives, alignment
and integration) of the change matrix need to be part of
the organizational transformation and all are required
to interact collaboratively to maintain urgency for
change and forward movement of the organization.
Organizations are more likely to continue to use
implementation methods that they have used previously,
but these are not necessarily the best for the culture or
the outcomes to be achieved. Facilitation of practice by
clinical teams was shown to be the most effective strat-
egy 79% of the time and educational programmes least
effective at 42% (81% response rate) (Wallace et al.
2001). Collins et al. (2000) found the use of opinion
leaders superior to traditional methods, in enhancing
compliance with scientifically supported practice
guidelines. Cadden (2007) reported that multiple inter-
vention strategies, based on assessment of potential
barriers to change, are more likely to be effective than a
single intervention. Structured and systematic ap-
proaches were found to support organizational learning.
Higher levels of science-based and practice-based inno-
vativeness were associated with better clinical hospital
performance (Salge & Vera 2009).
Change leadership is described as continuously seek-
ing or encouraging others to seek opportunities for
innovative approaches to address organizational prob-
lems. Over a 3-year period, change management was
consistently identified as a learning and development
need of leaders (Wolf et al. 2005).
The literature review includes several qualitative
studies of populations such as health care staff at large,
government officials and a limited number of nurse
leader groups (Leonard-Barton & Deschamps 1988,
Wallace et al. 2001, Longo 2007, Litaker et al. 2008).
Measures of change have focused on attitudes, the
number of products implemented, characteristics of
nurse leaders and practice change implementations
(Grover 1993, Bradley et al. 2004, Alfred & Byers
2005, Larrabee et al. 2007, Damanpour & Schneider
2008). Rate of adoption to change among nurse leaders
and Magnet status comparisons were not found in the
literature. The present study was designed as a
beginning description of these variables among nurse
executives in acute care hospitals in New York State.
There is also no literature found comparing innova-
tiveness of nurse executives in Magnet-designated
hospitals and non-Magnet designated hospitals.
Methods
The study was approved by the Institutional Review
Board before data collection. The setting for the study
was acute care hospitals in the State of New York
(n = 261). The sample included the registered nurse
designated as the CNO at each facility. All CNOs,
regardless of length of service, were invited to partici-
pate in the study. Surveys were addressed and mailed
generically to the CNO at each facility.
Instrument
The operational definition for the rate of adoption was
the assignment of subjects to the categories of innova-
tiveness: innovators, early adopters, early majority, late
majority and laggards as described by Rogers (2003).
The instrument used to measure the innovativeness
variable was the Scale for the Measurement of Innova-
tiveness, which was designed to measure an individual�s willingness to change, not actual adoptive behaviour.
The scale allows assignment of respondents to categories
of innovativeness (Berwick 2003, Rogers 2003). The
total score on the scale is 70 with higher total scores
indicative of a greater degree of innovativeness and
greater willingness to change (Hurt et al. 1977). In
assessing the instrument�s reliability, Hurt et al. (1977) and Pallister and Foxall (1998) obtained Cronbach�s alphas at 0.83 and 0.80, respectively. In the present
sample the reliability of the instrument was tested by
calculation of the alpha coefficient (r = 0.72) which is
lower than the reliability scores obtained previously.
To further describe innovativeness of the sample, the
number and types of innovations implemented were
collected. These options were based on Magnet sources
of evidence for innovation (ANCC 2008): (1) the
structure and process by which nurses are involved with
the evaluation and allocation of technology and infor-
mation systems to support practice, (2) nurses� partici- pation in architecture and space design to support
practice, (3) an improvement in practice as a result of
nurse involvement in technology and information sys-
tem decision making, or (4) an improvement resulting
from nurses� participation in architecture and space design. The survey tool also included an open-ended
question for the purpose of collecting from CNOs their
perception of one of the �most innovative projects they have implemented�. The qualitative data were catego- rized according to the Magnet sources of evidence for
innovation (ANCC).
Other data collected were information about partici-
pation in leadership courses by type and number. The
Innovativeness of nurse leaders
ª 2011 The Authors. Journal compilation ª 2011 Blackwell Publishing Ltd, Journal of Nursing Management, 19, 431–438 433
categories of leadership courses were listed according to
the leadership curriculum of the University of Pennsyl-
vania, Wharton School of Business for Nurse Executives.
Demographic and background variables measured
included: age, gender, ethnicity, highest degree earned,
number of years at degree level and number of years in
the CNO role. Data regarding the organization included
Magnet status and number of years employed in a
Magnet organization if applicable.
Procedures
The subjects were asked to complete the survey tool and
return the survey via mail within a 3-week period. One
week after the tool was distributed a follow-up postcard
was sent as a reminder. One week later another follow-
up postcard was mailed to the administrative assistant
of the CNO. Each survey tool was coded with a number
for the purpose of tracking each tool sent and to do a
targeted second mailing to those who had not re-
sponded 6 weeks after the first survey mailing. Once the
sample was obtained the association of the coded tool
to the hospital from which it came was discarded. As an
incentive for CNOs to complete the survey, the cover
letter explained that a donation of one dollar would be
made to Nurses House, a national fund for nurses in
need, upon receipt of the completed tool.
Results
Characteristics of the sample
The target population for this study was CNOs of acute
care hospitals of New York State. The number of par-
ticipants returning the survey was 133 or 51%. Of the
133 subjects, 106 (79.7%) met the inclusion criteria for
the study, CNO of an acute care hospital of New York
State, for a response rate of 41% (106/261). Those
excluded from the study were not employed in an acute
care facility (n = 27, 20.3%). The participants included
99 females (93.4%) and seven males (6.6%). The age
range of participants was as follows: 31–39 (n = 5,
4.7%); 40–49 (n = 13, 12.3%); 50–59 (n = 67, 63.2%)
and 60–65 (n = 21, 19.8%) years. The level of educa-
tion of the participants was as follows: 12 participants
(11.3%) had bachelor�s degrees or less; 82 (77.4%) were at the master�s level; and 12 (11.3%) were at the doctoral level of preparation. The majority of the
participants were white females (n = 99, 93.4%), age
50–59 (n = 67, 63.2%) years, at the master�s level of education preparation (n = 82, 77.4%), with 5–
10 years� experience in the CNO role (n = 40, 37.7%).
Results related to the research questions
Research question 1: �What is the innovativeness of acute care hospital chief nursing officers who work in
New York State?� Overall, the mean score for the innovativeness scale for the sample was 59.81 [standard
deviation (SD) = 6.82; range 40–70]. Five participants
had perfect innovativeness scale scores of 70; two had
scores of 37. The innovativeness diversity index, the
number of types of innovations, ranged from 0 to 5. The
overall mean score was 2.93 (SD = 1.28).
�Do characteristics of CNOs predict their innova- tiveness scores?� The relationships among age, educa- tion and CNO years of experience, innovative scale
scores and the innovativeness diversity index were
analysed. The age groups (<50 for 31–39 and 40–
49 years) and education level ( £ BS for diploma, associate and baccalaureate) were collapsed because of
small numbers per cell. Higher levels of education cor-
related with higher scores on the innovativeness diver-
sity index (F = 4.47, P = 0.01). The number of years as
a CNO, when using collapsed three-group categories
(<5 years for <1 year, 1–3 years and 3–4 years), was
significantly related to the innovativeness diversity in-
dex (F = 4.37, P = 0.01) (see Table 1).
�Is the innovativeness scale score correlated with number of different types of innovation projects?� Using Pearson�s correlation, a significant relationship was found between innovativeness scale scores of the sample
and their innovativeness diversity index, r = 0.34,
P < 0.00.
Research question 2: �What is the rate of adoption of change among acute care hospital chief nursing officers
of New York State?� The rate of adoption of change and the willingness to change groupings were distributed
according to Rogers (2003) categories. The innova-
tiveness scale scores ranged from 37 to 70. The inno-
vator group was populated by participants with a
perfect score of 70, representing 4.7% of the sample.
The sample was significantly non-normal (Kolmogoriv–
Amirnov test of normality P = 0.01) and significantly
positively skewed (Shapiro–Wilk P = 0.00). The fre-
quency and percentage for the remaining groups were:
early adopters, 13 (12.3%); early majority, 35 (33.0%);
late majority, 37 (34.9%); and laggards, 16 (15.1%).
The education level, in the three-group categories, is
significantly related to the willingness to change classi-
fications (r = 15.93, P = 0.04) (see Table 2).
Research question 3: Is there a difference in the de-
gree of innovativeness of chief nursing officers of
Magnet hospitals compared with chief nursing officers
of non-Magnet hospitals?
K. Clement-O�Brien et al.
434 ª 2011 The Authors. Journal compilation ª 2011 Blackwell Publishing Ltd, Journal of Nursing Management, 19, 431–438
There is considerable similarity in the two groups in
terms of demographics, the innovativeness scale scores,
the innovativeness diversity index and the willingness-
to-change categories. The average scores of the Magnet
group (mean = 59.5) and the non-Magnet group
(mean = 59. 88) on the innovativeness scale score (t =
0.21, P = 0.83) were similar. Using a chi-square test
(v2 = 3.13, P = 0.54), there was no difference in the distribution of willingness-to-change categories be-
tween groups. Those in Magnet hospitals were more
likely to be both laggards and innovators, but the
differences were not significant.
Additional analysis
Question number 12 asked participants to �Describe one of the most innovative projects you have implemented�. The more experience, the greater number of different
types of innovation projects reported. The overall theme
of �one of the most innovative projects� responses in- cluded: building or renovating emergency departments;
development and implementation of an electronic
medical record and other information technology to
support safe patient care; implementation of shared
governance structures; implementation of a nursing
model of care; design and development of new con-
struction; and development of an unique nurse role.
Discussion
In the acute care hospital setting, the influential role of
the chief nursing officer is instrumental in effecting
change in the clinical practice environment. The will-
ingness to change among CNOs influences the success
of the diffusion of an innovation. This study is unique
because of the focus on the descriptive characteristics of
innovativeness of the CNO, the Magnet status com-
parison and the statewide sampling of CNOs of acute
care hospitals. The recordings of examples of the
CNOs� most innovative projects are also unique. Most previous research on this topic is qualitative and does
not provide a descriptive analysis of the innovativeness
of nurse leaders.
Greater experience correlated with larger numbers
and different types of innovation projects. The man-
ager�s personal characteristics have a significant direct effect on the adoption of innovation (Greenhalgh et al.
2004, Damanpour & Schneider 2008). The present
study would suggest that the manager�s education level and professional experience influence their willingness
Table 1 Innovativeness scores by age, edu- cation, chief nursing officer (CNO) years of experience
Innovativeness scale score Mean (SD) F
Innovativeness diversity index Mean (SD) F
Age <50 60.22 (6.24) 0.04 3.11 (1.61) 0.26 50–59 59.69 (6.59) 2.87 (1.14) 60+ 59.86 (8.25) 2.95 (1.43)
Educational attainment £ BS 57.92 (7.18) 2.72 2.25 (1.49) 4.47**
MS 59.50 (6.8) 2.90 (1.23) Doctorate 63.83 (5.7) 3.75 (.97)
CNO years experience <5 years 58.06 (6.95) 2.11 2.58 (1.38) 4.37** 5–10 years 60.20 (7.3) 2.83 (1.32) >10 years 61.40 (5.67) 3.47 (.90)
Significance *P < 0.05, **P < 0.01; d.f. = 2.
Table 2 Willingness to change category by education and chief nursing officer (CNO) years of experience
£ BS N (%)
MS N (%)
Doctorate N (%)
<5 years N (%)
5–10 years N (%) 10 years N (%)
N (% of total) 12 (11.3) 82 (77.4) 12 (11.3) 36 (34.0) 40 (37.7) 30 (28.3) Laggards 1 (8.3) 14 (14.0) 1 (8.3) 6 (16.7) 6 (15.0) 4 (13.3) Late majority 7 (58.3) 26 (31.7) 4 (33.3) 18 (50.0) 12 (30.0) 7 (23.3) Early majority 4 (33.3) 30 (36.6) 1 (8.3) 10 (27.8) 12 (30.0) 13 (43.3) Early mdopters 0 (0.0) 9 (11.0) 4 (33.3) 1 (2.8) 8 (20.0) 4 (13.3) Innovators 0 (0.0) 3 (3.7) 2 (16.7) 1 (2.8) 2 (5.0) 2 (6.7)
r = 15.93, P = 0.04 r = 10.431, P = 0.24
Innovativeness of nurse leaders
ª 2011 The Authors. Journal compilation ª 2011 Blackwell Publishing Ltd, Journal of Nursing Management, 19, 431–438 435
to change and the number of innovative projects
implemented. The main drivers of change are the
characteristics of those driving the change: their moti-
vation, leadership and commitment (Longo 2007).
The CNOs recorded examples of their most innova-
tive projects and their level of involvement in the pro-
jects. Schroeder et al. (1986) observed that a hands-on
approach from top management was critical to the
technical, managerial and institutional support of an
innovation. The leader provides the context for change
(Greenhalgh et al. 2004). Key strategies for the CNO as
a change agent include building a business case and
communicating effectively about an innovation. The
current study suggests that CNOs of organizations
where more projects are implemented, with a higher
innovativeness diversity index, may create an environ-
ment that is positioned to accept change and have a
readiness to integrate change into the manner in which
daily work is accomplished. The leader builds a case
and is effective with the communication needed to bring
about change. The nurse leader needs to prepare
the environment, educate the staff, involve staff in the
change process and communicate the value of the
innovation. Without the support of leaders, who in
turn support staff with the use of evidence-based prac-
tice, moving clinical practice forward is very difficult
(Penz & Bassendowski 2006).
There was no difference in the innovativeness of
CNOs of acute care hospitals by Magnet status. The
results would suggest that hospital Magnet status does
not predict the innovativeness of the CNO. However,
the results do suggest that the innovativeness diver-
sity index of the CNO reflects their personal innova-
tiveness.
Limitations of the study
The selection of the statewide setting limits the gener-
alizability of the findings; however, it was the most
appropriate setting for the study of innovativeness of
CNOs and Magnet status. The series of mailings were
effective because of the consistency and repetitive nat-
ure; however, it was expensive. As there was no course
description for each leadership course listed or course
objectives, an assumption was made that there was
consistent interpretation of the meaning of each course
by title. The listings of the types of innovations imple-
mented were presented as they appear in the ANCC
Magnet Recognition Program criteria (2008). This was
done to minimize erroneous translation; however, the
phrases were long and complex, which may have
influenced the interpretation of statements. The open-
ended question asked for �one of the most innovative projects implemented�; however, it did not ask for the strategies utilized to implement the innovation, or how
the CNO involved staff in the innovation. The inno-
vative leader, with higher scores, may be more willing
to respond to the survey and share more experiences
than the low scorer. The willingness-to-change portion
of the survey recorded a reliability of 0.72 (alpha
coefficient), which is lower than Hurt et al.�s (1977) scores of 0.83 and 0.80. Respondents may have been
able to interpret which of the answers was the desirable
response. The CNO would want to be scored positively
toward innovativeness.
Implications for nursing management
As there is little evidence found in the current literature
to guide the description of innovativeness for nurse
leaders, the present study adds to this body of knowl-
edge. Graduate level education, years of CNO experi-
ence and leadership course completion were identified
as significantly influencing innovativeness of CNOs.
These characteristics of the CNO may support organi-
zations and health care at large to implement the evi-
dence-based practice needed to continuously improve
the quality of care delivered and patient outcomes. The
CNOs related many initiatives they had implemented to
meet the regulatory demands of the CMS, the Joint
Commission (TJC) and the Institute for Healthcare
Improvement (IHI). The present study identifies char-
acteristics of the CNO that can support the demands of
the health care industry. The open-ended comments
speak of the desires of nurse leaders to improve practice
and make practice safer, more effective and more sat-
isfying to the nurse. The present study strived to identify
the characteristics that support these initiatives. The
greater number of achievements, longer time of expe-
rience and advanced education support innovativeness.
Generating good practice ideas through research is not
the problem, but getting good ideas to be used is the
challenge, and the essence of the diffusion of innovation
(Berwick 2003). Leaders with the characteristics de-
scribed in the present study support the diffusion of
innovation dissemination.
Leadership is instrumental to practice standard sus-
tainability (Gustafson et al. 2003). The present study
supports the development of nurse leaders through
completion of leadership courses that may support
CNOs to achieve greater success in project implemen-
tation. CNOs, as hospital leaders, are often the indi-
viduals with accountability for implementation of
innovations. The endorsement and active support from
K. Clement-O�Brien et al.
436 ª 2011 The Authors. Journal compilation ª 2011 Blackwell Publishing Ltd, Journal of Nursing Management, 19, 431–438
top management play a key role in project adoption
(Grover 1993).
Recommendations for future research
The leader provides the context for change (Greenhalgh
et al. 2004). The structure of the communication,
organizational process and strategies that are used
influence the spread of the innovation. Innovation de-
pends on teamwork; however, building leadership
capacity and participation on all levels becomes a crit-
ical strategy for generating new ideas and sustaining the
change momentum (Kimball et al. 2007). For the fu-
ture, study of the time it takes to implement projects,
the sustainability of projects and further work to iden-
tify successful strategies for implementing innovations
would enrich the body of nursing knowledge. The staff
is able to act on new opportunities when the leadership
team is strong and shares a common goal (Litaker et al.
2008). If internal support is not in place, adoption of an
evidence-based practice change remains a challenge
(Bradley et al. 2004). The nurse leader needs to be in-
volved in the change process.
Conclusion
Graduate level education, years of CNO experience and
leadership course completion were identified as signifi-
cantly influencing innovativeness of CNOs. The
opportunity to identify the willingness to change among
nurse leaders has helped identify characteristics that
support a more rapid diffusion of an innovation and the
delivery of quality patient care (IOM 2001). The main
drivers of change are the characteristics of those driving
the change: their motivation, leadership and commit-
ment (Longo 2007). Personal characteristics have a
significant direct effect on the innovation adoption
(Damanpour & Schneider 2008).
The ANCC Magnet criteria are focused on evidence
that promotes outcomes and superior performance. The
description of the innovativeness of leaders presented in
this research may assist organizations and their CNOs to
organize descriptions for Magnet recognition pro-
gramme evaluation, as well as add to the description of
sources of evidence for innovation provided by the
ANCC. The identification of the leader characteristics
that support a willingness to change among nurse leaders
will assist nurse leaders to: lead change, assist the work-
force to accept and adopt changes in a more efficient and
timely manner; assist organizations to achieve a more
rapid diffusion of an innovation; and assist staff to deliver
safe, effective, patient-centred, timely, efficient and
equitable patient care (IOM 2001). Staff are able to act on
new opportunities when the leadership team is strong and
shares common goals (Litaker et al. 2008). If internal
support is not in place, adoption of an evidence-based
practice change remains a challenge (Bradley et al. 2004).
The results provide evidence to support health care
organizations to meet public and regulatory demands.
The characteristics of innovativeness for nurse leaders
presented in the present study may assist organizations,
CNOs and the Magnet recognition programme to de-
scribe innovativeness that supports organizations to
continuously improve the quality of patient care.
Acknowledgements
The authors would like to thank Carol M. Musil, PhD, RN, FAAN, Professor of Nursing, Case Western Reserve Univer- sity, Cleveland, Ohio and Mary Jo LaPosta, MS, PhD, RN, Vice President/Chief Nursing Officer, Saratoga Hospital, Saratoga Springs, New York, for their guidance and support throughout the Doctor of Nursing Practice Thesis Defense.
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