Date of Conferral



Doctor of Nursing Practice (DNP)




Barbara Barrett


Poor nurse retention, job dissatisfaction, and reduced patient health outcomes are pervasive issues at the healthcare institution of this project. Institutional data reflects a continual decline in retention and job satisfaction rates, which in 2018 showed a 20% drop in retention and a 25% drop in job satisfaction. The institution’s annual survey identified perceptions about leadership styles that gave rise to negative nursing behaviors and the negative impact on patient care outcomes. The purpose of this systematic review project (SRP) was to identify the relationship between nursing leadership styles, job satisfaction, nurse retention, and patient care outcomes within a hospital environment. Watson's theory of human caring was the theoretical framework that guided the project. Eleven peer-reviewed articles that met the Preferred Reporting Items for Systematic Reviews and Meta-Analysis’s inclusion criteria were included in this project. The 11 articles were graded using Fineout-Overholt et al. hierarchy of evidence grading system and appraised using the Revised Standards for Quality Improvement Reporting Excellence 2.0 guidelines. The findings of this SRP revealed a positive relationship between transformational leadership style and/or a combination of transformational and transactional leadership styles with all three variables. Based on the findings, adopting transformational or a combination of transformational and transactional leadership styles can enhance job satisfaction, retention, and patient care outcomes, which will address the identified gap-in-practice and enhance the work environment that can promote positive social change.