Date of Award

Winter 2011

Document Type


Degree Name

Doctor of Philosophy (PhD)


Health Services Research

Committee Director

Karen Kalowicz

Committee Member

Qi Harry Zhang

Committee Member

Debra Anderson


Problem statement. The dynamic nature of the healthcare industry has triggered changes in nurse executive functions. The job has expanded into entrepreneurial roles to be able to provide the most cost effective services while maintaining good quality outcomes for the residents. The new responsibility requires a different set of knowledge and competencies that is usually achieved through advanced education. It is not known whether nurse executives in long term care in Virginia possess the skills to influence both the financial and quality outcomes of the facility.

Methods. This descriptive research study examined the relationship of the nurse executives' technical, human, and conceptual skills and levels of education to the facilities' financial performance and resident outcomes. Further, this study compared the perceptions of chief executive officers (CEO) and nurse executives regarding the skills required of nurse executives to be effective managers. A combination of web-based and mail surveys were sent to all CEOs and nurse executives of Virginia nursing homes. Ninety-eight CEOs and nurse executives (18.4%) participated in the study.

Results. There were no statistically significant differences between CEOs' and nurse executives' perception of the importance of knowledge and competencies related to human, technical, and conceptual skills of nurse executives for effective management. Both CEOs and nurse executives perceived human skills as the most important expertise for effective management.