Learning Objectives:

1. Describe the elements of an integrated holistic education and practice model.

2. State the impact of the model on RN retention, patient satisfaction, work environment and cost savings.

Purpose:

To inform healthcare decision makers and practitioners of the benefits of a holistic model of practice in an acute care setting.

Relevant information and knowledge:

To be presented through description of model and presentation of findings.

Summary of Presentation:

Although there have been many nursing shortages over the years, the current one has lasted approximately ten years and has reached critical proportions in many areas of the US.  Efforts to increase recruitment have focused on monetary or material enticements, but they are not effective in keeping nurses in the workforce.  The purpose of this research was to evaluate the effect of an Integrative Healing Arts Program (IHAP) on nurse retention, patient satisfaction and the work environment.  The research was funded by the Robert Wood Johnson Foundation in response to the New Jersey Health Initiatives RFP for innovative solutions to RN turnover.

The IHAP is an integrated holistic education and practice model, suitable for novice to expert nurses.  Nurses are prepared for holistic practice through study of theoretical, philosophical, and ethical frameworks and application of evidence-based best practices.  Central to the model is self-care and self-renewal for nurses and creating healing environments in the workplace. The model is easily incorporated into shared governance structures and is frequently used for Magnet model of care standards. The integral nature of the model produces benefits for nurses, patients, families, and organizations.  The universal nature of the model makes it applicable in any setting.

Methods:  Data were collected using focus group interviews, The Peer Group Caring Interaction Scale [PGCIS], The Organizational Climate for Caring Questionnaire [OCCQ], Press Ganey patient satisfaction scores for nursing on the test units, and RN turnover rates.  There were 3 data collection points: before, midway, and at the end of the intervention (IHAP) program. 

Results:  The study showed that caring interactions between nurses increased, the RN perception of the organization as caring improved, and patient satisfaction rose to over 90%. RN turnover on the study units at the end of the study decreased to zero and has remained very low one year later resulting in significant cost savings.

Conclusions/Implications for Practice:

Implementing an integrative holistic education and practice model resulted in personal/professional transformation, improved work environment, improved nurse retention, improved patient satisfaction and cost savings to the healthcare facility. The facility has applied the cost savings towards increasing RN holistic practitioner FTE(s) and further expansion of the model. Future research will focus on the potential of the model to improve quality indicators.