Date of Graduation

Winter 12-18-2015

Document Type


Degree Name

Doctor of Nursing Practice (DNP)


School of Nursing and Health Professions



First Advisor

K.T. Waxman, DNP, RN, FAAN, University of San Francisco

Second Advisor

Judith Lambton, DNS, RN, Professor Emerita University of San Francisco

Third Advisor

Mary E. Foley, PhD, RN, FAAN, Clinical Professor University of California, SF



A nurse manager’s ability to effect positive change and inspire others to higher levels of achievement is related to his or her leadership style in the practice setting, as well as the culture present in the organization as a whole. The aim of this Doctor of Nursing evidence-based change in practice project was to create an educational modality that supported training nurse leaders through innovation and creative problem solving in today’s acute healthcare setting.

A survey was administered to 48 frontline managers in a Northern California healthcare system to access the gaps and voids in their ability to integrate transformational leadership as a model for performance. Survey results guided a process for manager development in the domains of execution competencies of accountability, change leadership, impact and influence/team building, and organizational awareness. The learning modality selected for this leadership development was the use of simulation scenarios that incorporated the four identified elements from the survey results to augment didactic transformational knowledge. Simulation has been positively associated with the development of transformational leadership skills. An evidence-based business case demonstrates the outcomes, including the return on investment for the retention of nurse managers in a role that has seen a high turnover in this Northern California healthcare system. The manager, adept in transformational leadership skills, can drive the alignment of staff at the unit level to establish a culture that offers patient quality care in a safe environment.

Included in

Nursing Commons