Nursing Unit Resuscitation~Using the ABC's of Attitude, Behavior, Communication and Collaboration

Purpose:
A healthy work environment is vital for recruitment and retention of nurses. Improved patient safety and outcomes are two important benefits of a stable nursing staff. When the turnover rate was 18% in the SICU exit interviews and NDNQI survey results were reviewed to identify areas for improvement.

Significance:
Exit interview comments focused on feeling unmotivated unchallenged and lacking managerial support. NDNQI survey results showed an average response to job enjoyment,patient care decisions retention and teamwork. A change in leadership and a staff involvement program decreased turnover rate to 6.9%

Strategy and Implementation:
Leaders play a pivotal role in retention of nurses by shaping the clinical and cultural environment. Staff identified that the unit had no life and needed resuscitated. The unit was resuscitated with ABC's - Attitude, Behavior, Communication and Collaboration. The staff embraced the need to have a positive attitude, behave professionally communicate effectively and collaborate skillfully. The ABC's are reflected in annual evaluations. Communication classes were mandated for all staff members. A mission statement was created and adopted through these classes. Staff development and engagement was the next focus. Developing staff to be leaders of the future by assisting with teaching new hires, increasing knowledge with continuing education, becoming involved with shared governance, and beginning nurse driven research has led the unit to be motivated, has increased autonomy and increased job satisfaction. By engaging and motivating staff, NDNQI survey results also improved.

Evaluation:
One result of creating a healthy work environment was receiving the Beacon Award from the AACN! Other validated results is a ZERO turnover rate since December 2007. Patient safety has increased as evidenced by a decrease in falls, a decrease in med errors, and projects with protocols driven by staff

Implications for Practice:
Building relationships was the first step in creating a healthy work environment. A monthly UNO (Unit Night Out) was started. Staff recognition was another area of focus. An employee of the month program was established, and an annual recognition dinner is held to honor staff for achievements.