Strategies to Create and Sustain a Healthy Work Environment and Improve Nurse Satisfaction

Purpose:
The NDNQI RN Survey was conducted for the first time in the Spring 2008. While the survey results were at or slightly above benchmark, we established a goal to improve perceptions of autonomy, decision making, and professional status by creating a more healthy work environment

Significance:
Nurse satisfaction is one component of how the quality of nursing care is judged. A healthy work environment is a fundamental driver of nurse satisfaction, as is staff involvement in priority setting and strategy development. Organizational commitment is needed to create and sustain change.

Strategy and Implementation:
Engagement is an essential component of nurse satisfaction and nursing excellence. Engagement is also essential when an organization seeks to create a healthy work environment. Deliberate decisions were made to improve the structures and processes of nurse engagement at the organizational, departmental and unit level. An empowered staff nurse council advocated for the integration of a healthy work environment plan in both the nursing strategic plan and the hospital strategic plan. Nurse leadership on multidisciplinary teams was expanded to ensure that nursing has a leadership role on every initiative that involves or impacts nursing practice. Peer-driven, unit rounding was implemented to promote discussion of data, and to share experiences and best practices across care areas. Lastly, new nursing leadership roles were created to sustain this culture, including the creation of an environmental sustainability manager and an outcomes director.

Evaluation:
Identified outcomes were measured with the 2009 and 2010 NDNQI RN Survey. At both times, scores were above benchmark on all scales, with scores on the following scales above the 75th percentile: decision-making, autonomy, professional status, professional development, and nursing administration.

Implications for Practice:
Successfully creating and sustaining a healthy work environment extends beyond nursing. Creating the change takes time and requires participation at all levels of the organization. Focused strategies need to continuously be developed, evaluated and may require investment in new resources.