ASSESSMENT OF HEAD NURSES’ ATTITUDES AND DELEGATION PRACTICES IN HOSPITAL SETTINGS

Abstract

Background: Delegation is an essential leadership function in nursing management and supports effective workload distribution, timely patient care, and professional development of nursing staff. In busy hospital settings, head nurses are expected to assign tasks appropriately while maintaining accountability and supervision. However, negative attitudes, lack of confidence, fear of criticism, and trust-related concerns may affect delegation behavior and reduce its effectiveness in clinical practice.

Objective: To assess the attitudes of head nurses toward delegation and evaluate their delegation practices in a hospital setting.

Methods: A descriptive cross-sectional study was conducted at Services Hospital Lahore over nine months, from June 2025 to February 2026. A total of 100 head nurses were selected through purposive sampling. Data were collected using a structured questionnaire consisting of demographic information, attitude-related items, and delegation practice-related items. Responses were recorded on a five-point Likert scale ranging from strongly disagree to strongly agree. Participants who could read and understand English completed the questionnaire independently, while those requiring assistance were guided by the researchers. Data were coded and analyzed using SPSS version 25. Frequencies, percentages, means, and standard deviations were calculated.

Results: Among 100 participants, 53% were aged 26–30 years, 39% were 31–35 years, and 8% were older than 35 years. Females represented 90% of the sample, while males represented 10%. Regarding education, 46% had BSN, 36% had Post RN, and 18% had GNM qualification. Most participants had 4–10 years of experience (54%), while 46% had more than 10 years of experience. Overall, 64% of head nurses had a negative attitude toward delegation and 36% had a moderate attitude, while no participant showed a positive attitude. In contrast, 84% demonstrated good delegation practices and 16% demonstrated moderate practices. The mean attitude score was 3.45 ± 0.63, while the mean delegation practice score was 3.52 ± 0.78.

Conclusion: The study concluded that head nurses demonstrated generally good delegation practices, but their attitudes toward delegation remained negative to moderate. This mismatch indicates the need for structured delegation training, confidence-building strategies, clearer role expectations, and supportive nursing leadership to improve effective delegation in hospital settings.

Keywords: Attitude of Health Personnel; Delegation, Professional; Hospitals; Leadership; Nurse Administrators; Nursing Staff; Task Performance and Analysis.