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Background
Healthsystemperformanceisreceivingincreasedattentionas
healthcaresystemsacrosstheglobeexaminewaystodecrease
costandimprovequality(Bevan2010).Forexample,theWorld
HealthOrganization(WHO)hasformedtheWHOHealth
MetricsNetwork,whichassistscountriesinsettingupsystems
thatprovideaccurate,reliablehealthinformationandmeasures,
manyofwhichareimpactedbynursingcare(WHO2009).Cur-
rently,bedsidenursesworkinenvironmentswheresuperbclini-
calskillsareinsufficientforprovidinghighqualitycaredueto
thebarriersfoundwithincomplex,oftendysfunctionalhealth
caresystems(Halletal.2008).Therefore,inordertodeliver
qualitycareatthebedside,nursingleadershipmustplayacentral
roleinimprovingqualityoutcomes(Huston2008).However,
confusionexistsaboutthelevelanddefinitionofnursingleader-
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