Effects of a Flipped-Learning Empowering Leadership Program on Nurse Leaders, Staff, and Residents in Long-Term Care Facilities

Flipped Learning for Leader Empowering Leadership in Aged Care: A Pilot Cluster Quasi-Experimental Study

This pilot cluster quasi-experimental study tested a 12-week empowering-leadership training program delivered through flipped learning to nurse leaders in residential long-term care facilities, compared with a conventional brochure-based approach. Six facilities in central Taiwan participated: two (one public, one private) received the flipped-learning program for their leaders, and four (one public, three private) served as controls. The study examined effects at three levels: nurse leaders' own empowering leadership behaviors and facility-level nursing staff retention/turnover and resident hospitalization rates; nursing staff's perceptions of their leader's empowering behaviors, burnout, psychological empowerment, and job satisfaction; and residents' health status, quality of life, and satisfaction with care.

Inclusion Criteria:

Nurse Leaders:

• Age ≥ 20 years
• Employed as nursing director, supervisor, or head
• Employed at the facility for more than 6 months
• Willing to participate and able to give informed consent

Nursing Staff:

• Registered nurse, licensed practical nurse, or nursing assistant
• Employed at the facility for ≥ 3 months
• Age ≥ 20 years
• Informed consent given

Residents:

• Resided at the facility for ≥ 3 months
• Mini-Mental State Examination (MMSE) score ≥ 24
• No severe hearing impairment
• Not terminally ill
• Written informed consent given (or via authorized representative as applicable)

Exclusion Criteria:

Nurse Leaders:

- Indicated intent to leave the position within the next 6 months