Results of Multi-Department Collaboration to Reduce Casual Labor and Increase Nurse Satisfaction

Purpose:
Our facility's urban location is characterized by its low nurse/resident ratio ranking. increased use of casual labor/travel nurse staff has resulted over time. This presentation will share strategy and findings related to a inter-departmental initiative to maximize our core nursing staff workforce.

Significance:
Budgetary limits and low staff morale characterize a work environment where temporary staff dependency predominates. These factors influence patient care quality, satisfaction ratings and staff engagement with process and program changes. Our reliance on this staffing model required a major change.

Strategy and Implementation:
The goal of having “100% core nursing staff within two-years” was established. A multi-faceted action plan was outlined focusing on three major targets: influence of nurse administrators, enhanced interface between human resources and nurse managers, and educational innovations. As the foundation for change, the conceptual model, ‘Framework for Professional Nursing Practice' was developed. Instrumental to success of this framework was the novel education blueprint entitled, the ‘Journey of a Lifetime' that outlined educational offerings and competency expectations based on the developmental stage of the nurse. Specifically, an 18-month nurse residency schema for new graduates, numerous specialty nursing academies, nurse manager courses focusing on budgeting and hiring, and options for use of state-of-the art simulation-based learning were devised. Additionally, evidence-based educational plans were used to prepare experienced core staff for their roles as preceptors and mentors.

Evaluation:
Numerous measures were used to quantify outcomes. They included turnover and vacancy rates, and NDNQI, Gallup and Patient Satisfaction survey results. Positive findings from all these measures will be shared that substantiate initiative success.

Implications for Practice:
Collaboration from major stakeholders to increase nurse staffing can be successful when change strategy and measures of success are determined proactively. By sharing our findings, other institutions will benefit from lessons learned in addressing a common problem in our current work environment.