Capstone Solution Description

Capstone Solution Description

Primarily, leaders have a crucial role in keeping nursing staff motivated to remain in the same workplace. Such is the case given that work environments with poor leadership are likely to experience high level of staff turnover due to increased levels of staff demotivation (). As such, nurse leaders must seek to develop innovative ways that will increase rate of nursing retention. In line with this recommendation, this section of the EBP project seeks to build a case on how innovative leadership styles such as transformational leadership (proposed in the PICOT question) can ease the challenge of low nursing retention levels.Precisely, the PICOT question on focus is: “In nurses working in an inpatient setting with high acuity, does use of transformational compared to transactional leadership style increase the rate of nursing retention over one year?”.Central to the analysis is the detailed account of the proposed solution, its alignment with the organizational culture, and the expected outcomes.

Proposed Solution

Of significance to the resolution of the nursing retention problem noted in the study setting is the use of transformational leadership behaviors within the confines of complexity leadership theory (CLT). Malloch, (2014) is of the opinion that utilization of transformational behaviors within CLT in various settings has shown to increase the level of job satisfaction of nurses and intent to remain within the same institution. Given such efficacy, it is worth using the transformational leadership behaviors in improving the nursing retention rates within this institution.

Primarily, the transformational leadership behaviors within the confines of CLT entails three types of leading, namely, administrative, enabling, and adaptive leadership.Central to the development of these behaviors are two strategies that are the worth noting. Firstly, nursing leaders within the study area will undergo a 2-hour education session for the entire study period. The education session will mainly target to enlighten the participants of the study on the practical details of transformational leadership as envisaged within the CLT framework. Also, the session will seek to inculcate a drive among the participants of setting individual goals. According to Marquis, and Huston, (2015) goal setting is a crucial characteristic of transformational leaders, which enables them to achieve their ultimate vision.

The second step for accomplishing the transformational leadership behaviors is the individual coaching of the nurse leaders.Coaching is a fundamental strategy used by managers and leaders to inspire desired behaviors that are vital for realization of set goals (Weiss, &Tappen, 2015). The individual coaching will occur every two weeks throughout the study period. During the coaching session, the coach will discuss with the participant about the self-evaluation and assessor results, supervise, and follow-up a participant. Notwithstanding, further reading resources and role-playing will form part of the coaching sessions.

Organization Culture

The proposed solution is consistent with the organizational culture since it resonates with the mission statement of the institution. Such is the case given that the transformational leadership seeks to institutionalize teamwork within the study setting, which is in line with the organizational mission of creating partnerships (Texas Department of State Health Services, 2013). Given such an alignment with the institutional mission statement, it is indisputable that utilization of transformational leadership behaviors is line with the culture of the study setting.

Expected Outcomes

The expected outcomes for this project based on the PICOT question as well other studies include nursing retention rate, intent to stay, turnover and staff satisfaction levels. Nursing retention rate is the primary outcome of interest. On the contrary, turnover and staff satisfaction levels are the secondary outcomes that may become pivotal during project evaluation.

Fundamental to the achievement of these outcomes is the use Multifactor Leadership Questionnaire Form 5x-Short (MLQ5). That is the case given its proven reliability and validity across systematic reviews focusing on this issue.

Also, worth noting are the possible barriers to the realization of the expected outcomes. A case in point of likely hindrances is the partial administrative commitment to EBP projects. Such a situation is likely to slow the realization of the expected outcomes due to the resistance posed by the administration. Additionally, failure of the institutional leaders to embrace change is another likely hindrance to the achievement of the expected outcomes (Hirschman, Shaid, McCauley, Pauly, &Naylor, 2015).

Lastly, the realization of the outcome of interest influences various health indicators in ways that are worth mention. For instance, increased nursing retention level if achieved by use of transformational leadership, it translates to quality care. That is for sure since high nursing retention levels means hospitals can have appropriate nurse-patient ratios. Consequently, the nurses are able to meet individual patient’s needs in a timely manner, which is a component of quality care (Lenhart, 2017). As such, realization of improved nursing retention positively affects the quality of care.




Hirschman, K., Shaid, E., McCauley, K., Pauly, M., & Naylor, M. (2015). Continuity of care: the

transitional care model. The Online Journal of Issues in Nursing, 20(3).DOI: 10.3912/OJIN.Vol20No03Man01

Lenhart, N. K. (2017). Nursing Leadership Influence on Evidence-Based Practice Culture and Integration (Doctoral dissertation, Walden University).

Malloch, K. (2014). Beyond transformational leadership to greater engagement: Inspiring innovation in complex organizations. Nurse Leader, April 2014, 60 – 63.

Marquis, B. L., & Huston, C. J. (2015). Leadership roles and management functions in nursing: Theory and application.

Texas Department of State Health Services. (2013). The Texas Department of State Health Services – Austin State Retrieved 06 March 2018, from

Weiss, S. A., &Tappen, R. M. (2015). Essentials of nursing leadership and management.