Abstract: Objective: To investigate the status quo of head nurses' leadership practices and analyze its influencing factors, so as to provide scientific basis for improving the leadership of head nurses. Methods: A cross-sectional survey was conducted among 2486 nurses selected from 4 teritary hospitals in Beijing, Shanxi and Ningxia using convenience sampling during May 2024 to investigate the leadership practice and empowering behavioral of head nurses and teamwork among nurses in their departments. Multiple linear regression was employed to analyze the influencing factors of head nurses' leadership practice. Results: The average score obtained utilizing the Leadership Practice Inventory was 9.17±1.39, and the score of each dimension from high to low were Model the Way, Enable Others to Act, Encourage the Heart, Challenge the Process and Inspire a Shared Vision. Multiple linear regression analysis showed that different types of hospitals, empowerment behaviors and teamwork were the main influencing factors of head nurses' leadership practices, which accounted for 77.4% of the total variation (P<0.001). Conclusion: The leadership practices of head nurses is at a relative high level, however, they need to work harder in terms of Challenging the Process and Inspiring a Shared Vision. Head nurses can improve their leadership by increasing empowerment behaviors and prompting teamwork.

Key words: head nurses; leadership practice; status quo; influencing factor