Date of Graduation

Summer 8-2-2023

Document Access

Project/Capstone - Global access

Degree Name

Master of Science in Nursing (MSN)


School of Nursing and Health Professions


Kaiser cohort MSN capstone

First Advisor

Dr. Sara Horton-Deutsch

Second Advisor

Dr. Liesel Buchner

Third Advisor

Dr. David Ainsworth


Reduce Turnover and Improve Job Satisfaction


Background: The medical center’s Maternal Child Health Department comprises 10 labor and delivery beds, 22 postpartum beds, and a 16-bed Level II NICU. The unit is overseen by six ANMs, a manager, and a director. The unit comprises approximately 160 employees, most being bedside registered nurses (RNs). The hospital prioritizes achieving Magnet status, where nurse job satisfaction is prioritized. The concern is that the department’s culture is not aligning with Magnet guidelines due to a lack of leadership within the unit.

Problem: A review of the department’s ANM team showed an unstable turnover rate between January 2020 and December 2022. A lack of filled positions increased demand for those in middle management, causing more demand for job duties and leading to burnout.

Interventions: The project aim is to increase the confidence level of eight ANMs/managers in their leadership skills using a pre-and post-survey, from a baseline of 10% to 50%, by utilizing a TL-focused education program by July 31, 2023.

Outcome Measures: The outcome measure focused on a pre and post-self-survey from the middle managers on their perceived preference and comfort level with TL. Participation in the survey was anonymous and not shared.

Results: A total of 8 participants were involved in the survey, which met 100% of response expectations. The survey was designed to apply ratings to questions about the participants’ feelings and perceptions of TL. The outcome indicators are divided into categories and number ranking. The survey is only a learning tool to support participants’ understanding of TL

Conclusion: The categories exposed the middle managers’ strengths and weaknesses when looking at leadership factors. The results of the survey were different from what was expected. Using People Pulse results as a tool for overall job satisfaction of the microsystem, the middle managers’ results were surprising. Although a recent People Pulse survey indicated that job satisfaction within the microsystem was low, the results of the informal learning survey around TL were positive. Multiple studies indicate that TL improves job satisfaction, leading to an unexpected pre/post-survey outcome.