Date of Award


Degree Name

EdD Doctor of Education

Dissertation Committee

Daniel M. Miller, PhD, Chair; Mary Woods Scherr, PhD, Member; Catherine E. Loveridge, PhD, Member


Chief Executive Officer--CEO, Chief Nursing Officer, Leadership studies, magnet hospital, nursing, organizational effectiveness, recognition


In the ever-changing environment of health care, good leaders are of utmost importance to the effective functioning of the hospital. Leadership in the hospital setting requires innovativeness and courage. This means the passion to discover, create and experience the unknown. Until recently why some hospitals attract and retain good nurses while others do not was unknown. The magnet hospital concept identified attributes that supported the professional practice of nursing which, in turn increased nurse recruitment and retention. The objective of this study was to compare Chief Nursing Officer (CNO) and Chief Executive Officer (CEO) perceptions of their innovativeness and leadership preferences in magnet hospitals and matched non-magnet hospitals as well as differences in the perceived organizational effectiveness. This study was a survey-based cross-sectional, non-experimental study. The basic statistical design for testing the hypotheses was a 2 (Chief Officer type: CNO vs. CEO) x 2 (hospital type: magnet vs. non-magnet) mixed design ANOVA. A web-based survey supported the collection of leadership attributes, innovativeness, and perceived organizational effectiveness as well as obtained demographic information. The two major findings were the predicted staff status (CNO vs. CEO) by hospital type (magnet vs. non-magnet) interactions for innovativeness and the leadership practice of “enabling.” The pattern of results suggests that most CNOs and some CEOs use innovative approaches and have the skills to develop co-operative relationships and teams. Magnet CNOs demonstrated the highest scores. This study supports the American Nurses Credentialing Center's emphasis on the role of the CNO in adopting magnet standards and strategies. Further research on the “magnet CNO effect” is encouraged.

Document Type

Dissertation: Open Access