Relationship between Transformational Leadership Style and Nurse Reported Intent to Stay In Acute Care Hospitals: A Review

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Primary Author:</td>
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April L. Nguyen, BSN, RN ,CEN      </td>
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Co-Principal Investigators/Collaborators:</td>
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Azizeh Sowan Ph.D., RN</td>
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Organization:</td>
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University of Texas Health and Science Center at San Antonio</td>
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Abstract</h2>
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Purpose</h3>
<p>To understand the effect of transformational leadership style on nurse intent to stay by reviewing updated literature in an effort to inform practice and reduce turnover rate. </p>
<h3>
Background</h3>
<p>Some studies on transformational leadership style supported the significant impact of the leader behavior and practices on nurses’ decision to stay or leave their current position in acute care hospitals. However, there is a limited adoption of this leadership style in hospitals and systematic reviews of quantitative studies are unavailable to synthesis the results of the individual studies. </p>
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Materials & Methods</h3>
<p>We reviewed four of the latest and best available evidence about the effect of a transformational leadership style compared to non-transformational style on nurse intent to stay in the job, published between 2008 and 2014. Electronic databases included CINAHL and OVID. A manual search of evidence was additionally elicited. Key terms used were leadership, transformational leadership, nursing manager, and staff intent to stay and/or registered nurse retention. </p>
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Results</h3>
<p>Only 4 recent studies were pertinent to the topic, with one systematic review of qualitative studies. The limited available recent research on transformational leadership demonstrated that transformational leadership style positively impacts nurse intent to stay in acute care settings. Studies also supported the need for administration and executives of acute care hospitals to establish and implement a formal transformational leadership training-program for leaders and managers, and ensure successful completion and further growth of those in place to lead. </p>
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Conclusion</h3>
<p>The limited formal leadership training programs, high-cost, hospital investment, and lack of formal succession plans are barriers to promote transformational leadership programs. Expected solutions include: education, budget and supportive funding, nurse leader commitment, and establishment and implementation of an organizational leadership institute. Implementation and sustained change in practice of training leaders to be transformational will greatly impact nurse retention rates by reducing turnover and giving staff nurses the environment and managerial support by which they root, grow and flourish within an organization. </p>
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Bibliography</h3>
<ul>
<li>
2013 National Healthcare & RN Retention Report. (2013). Retrieved from http://www.nsinursingsolutions.com/Files/assets/library /retention-institute/NationalHealthcareRNRetentionReport2013.pdf</li>
<li>
Brown, P., Fraser, K., Wong, C. A., Muise, M., & Cummings, G. (2013). Factors influencing intentions to stay and retention of nurse managers: a systematic review. Journal of Nursing Management, 21, 459-472.</li>
<li>
Conion, R., & Rinaldi, E. (2012). An unhealthy problem: Many hospitals and healthcare organizations lack a formal succession-management plan. Retrieved April XX 2014 from http://www.sibson.com/publications/perspectives/Volume_20_Issue_3/pdfs/u...
<li>
Cowden, T., Cummings, G., & Profetto-McGrath, J. (2011). Leadership practices and staff nurses’ intent to stay: A systematic review. Journal of Nursing Management, 19, 461-477. http://dx.doi.org/10.1111/j.1365-2834.2011.01209.x</li>
<li>
Duffield, C. A., Roche, M. A., Blay, N., & Stasa, H. (2010). Nursing unit managers, staff retention and the work environment. Journal of Clinical Nursing , 20, 23-33. http://dx.doi.org/10.1111/j.1365-2702.2010.03478.x</li>
<li>
Dwyer, D. (2012). Top five most important turnover causes from healthcare. Retrieved from http://www.humansystemsdev.com/articles/top-five-most-important-turnover...
<li>
ENA 2005 national emergency department benchmark guide. (2005). Retrieved from https://www.ena.org/publications/ena/Pages/Benchmark-Study-2005.aspx</li>
<li>
Force, M. V. (2005). The relationship between effective nurse managers and nursing retention. Journal of Nursing Administration, 35(7/8), 336-341.</li>
<li>
Fried, B. J., & Fottler, M. D. (2008). Human resources in healthcare: Managing for success (3rd ed.). Chicago, IL: Health Administration Press.</li>
<li>
Gardner, B. D. (2010, August). Improve RN retention through transformational leadership styles. Nursing Management, 8-12. http://dx.doi.org/10.1097/01.NUMA.0000384003.09214.ed</li>
<li>
Heede, K. V., Florquin, M., Bruyneel, L., Aiken, L., Diya, L., Lesaffre, E., & Sermeus, W. (2011). Effective strategies for nurse retention in acute hospitals: A mixed method study. International Journal of Nursing Studies, 50, 185-194. http://dx.doi.org/10.1016/j.ijnurstu.2011.12.001</li>
<li>
Hinson, T. D., & Spatz, D. L. (2011, March). Improving nurse retention in a large teritary acute-care hospital. The Journal of Nursing Administration, 41(3), 103-108.</li>
<li>
Luhby, T. (2013). Medicare payment rates: $15,000 for one hospital, $26,000 for another. CNN Money: A service of CNN, fortune & money. Retrieved from http://money.cnn.com/2013/05/22/news/economy/medicare-payments-hospitals...
<li>
Magnet Recognition Program ® Model. (2014). American Nurses Credentialing Center (ANCC). Retrieved March 5, 2014, from http://www.nursecredentialing.org/Magnet/ProgramOverview/New-Magnet-Mode...
<li>
Melnyk, B. M., & Fineout-Overholt, E. (2011). Evidence-based practice in nursing and healthcare: A guide to best practice (2nd ed.). Philadelphia, PA: Wolters Kluwer/Lippincott Williams & Wilkins.</li>
<li>
Raup, G. H. (2008, June 12). The impact of ED nurse manager leadership style on staff nurse turnover and patient satisfaction in academic health center hospitals. Journal of Emergency Nursing, 34(5), 403-409. http://dx.doi.org/10.1016/j.jen.2007.08.020</li>
<li>
Rivers, R., Pesata, V., Beasley, M., & Dietrich, M. (2011, October). Transformational leadership: Creating a prosperity-planning coaching model for RN retention. Nurse Leader, 48-51. http://dx.doi.org/10.1016/j.mnl/2011.01.013</li>
<li>
Rosseter, R. J. (2014). Nursing shortage fact sheet. American Association of Colleges of Nursing. Retrieved March 4, 2014, from http://www.aacn.nche.edu/media-relations/NrsgShortageFS.pdf</li>
<li>
Smith, M. A. (2011, September). Are you a transformational leader? Nursing Management, 42(9), 44-50. http://dx.doi.org/10.1097/01.NUMA.0000403279.04379.6a</li>
<li>
Transformational leadership. (2014). Retrieved March 16, 2014, from http://www.jbs.cam.ac.uk/programmes/execed/open-programmes/transformatio...
<li>
Transformational leadership. (2014). Retrieved March 16, 2014, from https://scs.georgetown.edu/programs_nc/CE0127/transformational-leadershi...
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<p>© Improvement Science Research Network, 2012</p>
<p>The ISRN published this as received and with permission from the author(s).</p>