Improving Nursing Satisfaction: A Unit Based Practice Council's Plan

Purpose:
The goal of this project was to increase NDNQI RN survey scores, on a Medical/Surgical unit, at or above 75% through the use of an impact plan formulated by the Unit Based Practice Council. Specific questions that we addressed were: enough time with patients and enough time to document.

Significance:
The effectiveness of the nursing practice environment is critical to nursing satisfaction, nursing retention, and patient outcomes (Black, 2011). Furthermore, it is vital that bedside nurses' needs are understood and addressed as they are an integral performance center within a hospital.

Strategy and Implementation:
In October 2011 the nurses took the first NDNQI RN Survey and the results promoted the 3 South Unit Based Practice Council (UBPC) to develop and implement an action plan based on the two lowest scoring questions. During the second meeting the UBPC completed the impact plan, which was then presented to leadership for collaboration efforts. This innovative method allowed the impact plan to be defined and implemented at the UBPC level with leadership collaboration versus developed and driven by leadership. Strategies for patient time included: communication board, leadership collaboration with positioning of vacant positions and peer interviews, and continuation of reporting of staffing numbers at staff and UBPC meetings. Strategies for documentation time included collaborating with leadership on staffing issues including: reading and documenting of telemetry monitor strips and timing of patient assessments.

Evaluation:
At baseline, nurses reported enough time with patients (41%) and time to document (31%) compared to the national benchmarks of 50% and 64%. May 2012 goals include: patient to RN ratio of 5:1, adequate interdisciplinary staffing, and an increase in the 2 target scores to 75% or higher.

Implications for Practice:
• Improves team building and collaboration • Improves patient safety and quality of care • Increased cost effectiveness with improved time management • Decreasing RN turnover rate and increasing RN retention