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Perceções do enfermeiro gestor sobre mudança organizacional em instituições de saúde: Scoping Review
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As mudanças organizacionais nas instituições de saúde são constantes e intensificaram-se com a reestruturação do Serviço Nacional de Saúde português (Decreto-Lei n.º 102/2023), que reforça a integração entre cuidados primários e hospitalares. Este contexto impõe novos desafios aos enfermeiros gestores, cujo papel de liderança é determinante na condução de processos transformadores e na adesão das equipas. Objetivo: Mapear e sintetizar a evidência científica sobre o papel do enfermeiro gestor perante a mudança organizacional em instituições de saúde.
Metodologia: Realizou-se uma scoping review segundo as orientações do Joanna Briggs Institute (JBI). Incluíram-se estudos qualitativos e quantitativos em português, inglês e espanhol, sem restrição temporal. As pesquisas foram efetuadas nas bases Medline®, CINAHL®, MedicLatina®, Academic Search Complete®, SCOPUS®, Web of Science, Portal da Biblioteca Virtual em Saúde, OpenAir e RCAAP. A triagem e seleção das fontes foram realizadas por dois revisores independentes, com base nas recomendações PRISMA-ScR.
Resultados: Dos 30 estudos incluídos, emergiu que o enfermeiro gestor assume um papel multifacetado como líder, mediador e facilitador da mudança organizacional. A sua atuação exige competências técnicas, relacionais e adaptativas, sendo o estilo de liderança transformacional o mais associado a resultados positivos, equipas motivadas e ambientes de trabalho saudáveis. As dimensões perceções, atitudes, comportamentos e competências interagem de forma dinâmica, sustentando processos de mudança eficazes e sustentáveis.
Conclusão: A eficácia do enfermeiro gestor na mudança organizacional depende do equilíbrio entre liderança baseada na evidência, competências adaptativas e suporte institucional, promovendo a inovação, a resiliência e a qualidade dos cuidados.
Organizational change in healthcare institutions is a continuous process that has been intensified by the recent restructuring of the Portuguese National Health Service (Decree-Law No. 102/2023), which reinforces the integration between primary and hospital care. This context imposes new challenges on nurse managers, whose leadership role is crucial in driving transformative processes and fostering team engagement. Objective: To map and synthesize the existing scientific evidence on the role of nurse managers in organizational change within healthcare institutions. Methods: A scoping review was conducted following the Joanna Briggs Institute (JBI) methodology. Qualitative and quantitative studies in Portuguese, English, and Spanish were included, with no time restrictions. The search was performed in Medline®, CINAHL®, MedicLatina®, Academic Search Complete®, SCOPUS®, Web of Science, the Virtual Health Library Portal, OpenAir, and RCAAP. Source selection and screening were carried out independently by two reviewers, following the PRISMA-ScR guidelines. Results: From the 30 studies included, findings revealed that nurse managers play a multifaceted role as leaders, mediators, and facilitators of organizational change. Their performance requires technical, relational, and adaptive skills, with transformational leadership emerging as the most effective style in promoting positive outcomes, engaged teams, and healthy work environments. The dimensions of perceptions, attitudes, behaviors, and competencies are interdependent and collectively support effective and sustainable transformation processes. Conclusion: The effectiveness of nurse managers in leading organizational changes depend on the alignment between evidence-based leadership, adaptive competencies, and organizational support, fostering innovation, resilience, and quality of care.
Organizational change in healthcare institutions is a continuous process that has been intensified by the recent restructuring of the Portuguese National Health Service (Decree-Law No. 102/2023), which reinforces the integration between primary and hospital care. This context imposes new challenges on nurse managers, whose leadership role is crucial in driving transformative processes and fostering team engagement. Objective: To map and synthesize the existing scientific evidence on the role of nurse managers in organizational change within healthcare institutions. Methods: A scoping review was conducted following the Joanna Briggs Institute (JBI) methodology. Qualitative and quantitative studies in Portuguese, English, and Spanish were included, with no time restrictions. The search was performed in Medline®, CINAHL®, MedicLatina®, Academic Search Complete®, SCOPUS®, Web of Science, the Virtual Health Library Portal, OpenAir, and RCAAP. Source selection and screening were carried out independently by two reviewers, following the PRISMA-ScR guidelines. Results: From the 30 studies included, findings revealed that nurse managers play a multifaceted role as leaders, mediators, and facilitators of organizational change. Their performance requires technical, relational, and adaptive skills, with transformational leadership emerging as the most effective style in promoting positive outcomes, engaged teams, and healthy work environments. The dimensions of perceptions, attitudes, behaviors, and competencies are interdependent and collectively support effective and sustainable transformation processes. Conclusion: The effectiveness of nurse managers in leading organizational changes depend on the alignment between evidence-based leadership, adaptive competencies, and organizational support, fostering innovation, resilience, and quality of care.
Descrição
Palavras-chave
Enfermeiro gestor Enfermeiro administrador Mudança organizacional Transformação organizacional Instituições de saúde