JONA Volume 45, Number 2, pp 113-119 Copyright B 2015 Wolters Kluwer Health, Inc. All rights reserved. THE JOURNAL OF NURSING ADMINISTRATION Effects of Nursing Position on Transformational Leadership Practices Susan Herman, DNP, RN, NEA-BC, CENP Mary Gish, DNP, RN, NEA-BC Ruth Rosenblum, DNP, RN, PNP-BC OBJECTIVE: This study sought to identify significant differences in nursing leadership strengths by position title. BACKGROUND: Recent reports show aspects of transformational leadership (TL) related to position, age, and educational level. This study focuses on dif- ferentiating the strength of leadership practices across the range of nursing management positions. METHODS: The Leadership Practices InventoryV Self-assessment survey, and a variety of demographic questions, were used to anonymously poll voluntary members of the Association of California Nurse Leaders. RESULTS: Nursing positions of director level and above were strongest in leadership practices. Those at manager and below were identified as needing addi- tional leadership development. LPI-S subscales Enable Others to Act and Model the Way were strongest. CONCLUSION: Those at the manager level and below will benefit most from additional education and train- ing. Even upper levels of management would gain from enhancing the LPI practices of Challenge the Process and Inspire a Shared Vision. Today’s healthcare environment is rapidly changing in order to meet the challenges of technology, access, quality, and cost. Porter-O’Grady and Malloch 1 ad- vocate that nurse leaders must be capable of trans- forming healthcare to meet these significant demands. Pearson et al 2 conducted a systematic review of key at- tributes enabling nurse leaders to create a supportive work environment. They found that collaboration, emo- tional intelligence, education, positive organizational climate, professional development, and positive leader- ship attitudes all contributed to the supportive environ- ment needed to optimize quality of patient and staff outcomes. The Institute of Medicine’s Future of Nursing 3 report emphasized the necessity of the nursing profes- sion to lead transformation of interdisciplinary care to support this changing healthcare environment. In order to lead change, create a vision of the future, and engage others in this important effort, nurse leaders must be transformational leaders. A review of the literature also underscores the no- tion that transformational leadership (TL) practices are critical to the success of the chief nursing officer (CNO) role. To date, prior studies have not established how those leadership practices evolve throughout the admin- istrative positions common in the nursing profession. To provide further understanding, this study was con- ducted to evaluate TL practices over a wide demographic of nursing management. For this purpose, Association of California Nurse Leaders (ACNL) members vol- untarily and anonymously responded to a Leadership Practices InventoryVSelf-assessment (LPI-S) survey of exemplary leadership practices developed by Kouzes and Posner. 4 The ACNL provided a beneficial demographic for this study. ACNL is composed of nurse leaders, spann- ing throughout California. The members’ educational JONA  Vol. 45, No. 2  February 2015 113 Author Affiliations: Magnet Program Director (Dr Herman), Lucile Packard Children’s Hospital Stanford, Palo Alto; Professor (Dr Gish), California State University Fresno, Department of Nursing; Professor (Dr Rosenblum), Valley Foundation School of Nursing, San Jose State University, California. The authors declare no conflicts of interest. Correspondence: Dr Herman, Lucile Packard Children’s Hos- pital Stanford, 700 Welch Rd, Ste 310 A, Palo Alto, CA 94304 (sherman@stanfordchildrens.org). Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (www.jonajournal.com). DOI: 10.1097/NNA.0000000000000165 Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.