Part 1: Evidence-based facility design using Transforming Care at the Bedside principles.

An academic hospital used Transforming Care at the Bedside (TCAB) principles as the framework for generating evidence-based recommendations for the design of an expansion of the current hospital. The interdisciplinary team used the table of evidence-based data to advocate for a patient- and family-centered, safe, and positive work environment. A nurse project manager acted as liaison between the TCAB design team, architects, and facilities and design consultants. Part 2 of this series describes project evaluation outcomes.

Caring for inpatient boarders in the emergency department: improving safety and patient and staff satisfaction.

Hospital capacity constraints lead to large numbers of inpatients being held for extended periods in the emergency department. This creates concerns with safety, quality of care, and dissatisfaction of patients and staff. The aim of this quality-improvement project was to improve satisfaction and processes in which nurses provided care to inpatient boarders held in the emergency department. A quality-improvement project framework that included the use of a questionnaire was used to ascertain employee and patient dissatisfaction and identify opportunities for improvement. A task force was created to develop action plans related to holding and caring for inpatients in the emergency department. A questionnaire was sent to nursing staff in spring 2012, and responses from the questionnaire identified improvements that could be implemented to improve care for inpatient boarders. Situation-background-assessment-recommendation (SBAR) communications and direct observations were also used to identify specific improvements. Post-questionnaire results indicated improved satisfaction for both staff and patients. It was recognized early that the ED inpatient area would benefit from the supervision of an inpatient director, managers, and staff. Outcomes showed that creating an inpatient unit within the emergency department had a positive effect on staff and patient satisfaction.

Nurse manager perceptions of role satisfaction and retention at an academic medical center.

OBJECTIVE: The aim of this study was to explore the perceptions of inpatient acute care nurse managers (NM) employed at an academic Magnet® hospital about factors that influence NM retention, including current work environment, satisfaction, work-life balance, sucssful NM traits, and personal development and educational needs. BACKGROUND: Nurse managers are challenged with increased workloads impacting their ability to implement all role components. METHODS: A qualitative descriptive study design used focus group methodology to explore perceptions of the NM role. RESULTS: Nurse managers identified staff recognition, support, peer relationships, collaboration, and ability to make positive change as factors influencing their decision to remain in the role. Burnout factors included workload issues, work-life imbalance, and difficulty sustaining positive relationships. Traits supporting success were communication, resiliency, integrity, and a visionary outlook. Suggestions for NM development and education were identified. CONCLUSIONS: Findings can be used to improve NM satisfaction, work-life balance, recruitment, retention, and succession planning.

Factors affecting nurse retention at an academic Magnet® hospital.

OBJECTIVE: : The aim of this study was to examine the factors affecting the retention of registered nurses (RNs) and validate the revised Casey-Fink Nurse Retention Survey (2009). BACKGROUND: : Creating an organizational culture of retention may reduce nurse turnover. Focusing on why nurses leave and identifying factors why nurses stay are essential. METHODS: : A descriptive survey design gathered data from RNs with 1 or more years of experience providing direct patient care and employed in inpatient/ambulatory settings in an acute care, academic, Magnet hospital. CONCLUSIONS: : There were no statistically significant relationships between nurse respondents' perceptions of work environment/support/encouragement and age or years of experience. However, there were significant differences between inpatient and ambulatory nurse responses in several key areas including job satisfaction, mentorship, and educational support. Overall, nurses reported feeling a lack of support and recognition from managers. Results provide evidence to support improved strategies to foster nurse retention.