Factors associated with clinical leadership among cardiovascular nurses in China: a multicentre cross-sectional study

Objectives This study aimed to investigate the current level of clinical leadership among cardiovascular nurses and identify its associated factors.Methods A multicentre cross-sectional study was conducted among 411 cardiovascular nurses from three tertiary hospitals in China between January and June 2025. Data were collected using the Clinical Leadership Scale, Nursing Work Environment Scale and General Self-Efficacy Scale. Descriptive statistics, univariate analysis, Pearson correlation and multiple linear regression were used for data analysis.Results The mean total score of clinical leadership was 63.53 ± 9.81 (mean item score 4.24 ± 0.82), indicating an above-average level. Higher scores were found in motivating others and role modelling, whereas challenging the status quo was the lowest-performing dimension. Professional title, working department, clinical leadership training, nursing work environment and general self-efficacy were independent positive influencing factors (all p < 0.05). Nursing work environment and general self-efficacy were strongly and positively correlated with clinical leadership (r = 0.738, 0.584; both p < 0.01).Conclusions Clinical leadership among cardiovascular nurses is relatively high and is affected by both organisational and individual psychological factors. Targeted leadership training, improved nursing work environment and enhanced self-efficacy can effectively strengthen clinical leadership in cardiovascular nursing practice.