An evidence-based protocol for nurse retention

Registered nurse turnover can drastically affect the quality of patient care while costing more than 1 billion dollars. The ongoing nursing shortage makes it hard to replace nurses, necessitating a novel approach to reduce nurse turnover. The authors discuss an evidence-based protocol that improves organizational commitment among nurses as a way to retain nurses through facilitating autonomy, improving communication, and offering recognition and rewards to nursing staff.     

Staff nurse retention: strategies for success

At the same time the demand for nurses is on the rise, the supply is dwindling. Recruitment and retention are the two main factors which can be adjusted to affect supply. Recruitment has become increasingly difficult in the past two or three years due to decreasing enrollment in nursing education programs and increased demand for nurses in alternative delivery systems. Therefore staff nurse retention has become an issue of major importance. This article will begin by briefly delineating need and expectancy theories which in part explain job satisfaction and, hence, retention. Secondly, findings from the Magnet Hospital Study are summarized. Creative retention strategies will then be explored, concluding with a framework for developing a strategic plan for successful staff nurse retention.     

The nurse practitioner role in evidence-based medication strategies.

Nurse Practitioners at Brigham and Women's Hospital Weiner Center for Preoperative Evaluation use evidence-based medication strategies in their assessment of high risk elective surgical patients. Our objective is to identify those patients who meet the criteria for perioperative beta blockade and for deep vein thrombosis prophylaxis. Nurse practitioners were provided with education and training in using established guidelines in identifying those patients at risk. The nurse practitioner communicates with the appropriate member of the health care team (anesthesiologist, primary care physicians, surgeons, and anticoagulation service) and provides patient education. This process improves the utilization of these guidelines with improved patient outcomes.     

Nurse-Friendly Hospital Project: enhancing nurse retention and quality of care

The present shortage of nurses in the United States is expected to continue. Nurse shortage, the nature of the work environment, and employers' expectations and attitudes, among other factors, influence both nurse retention and quality of patient care. The Nurse-Friendly Hospital Project was designed to improve nurses' work environment in rural and small hospitals in Texas. Findings demonstrate improvements in nurse retention, nurse staffing, and quality of care.     

A resource-based perspective on retention strategies for nurse epidemiologists

AIM: This paper is a report of a study to evaluate the intent of epidemiologists to remain in their chosen career and identify the variables that contributed to or predicted their intent to stay. BACKGROUND: Recently, emerging new infections, such as severe acute respiratory syndrome or bird flu, have placed significant occupational and psychological stress on epidemiologists, especially in South-East Asia, resulting in a high intent to change their career. In the light of possible staff shortages, retention strategies for epidemiologists have gained importance. METHODS: A self-administered questionnaire survey and stratified sampling were used to collect data from 351 epidemiologists including nurse epidemiologists in Taiwan in 2005; response rate was 70.6%. Correlation analysis and hierarchical multiple regression analysis were used to examine relationships among occupational stress, psychological stress, human resources and intent to stay in their career. RESULTS: Occupational stress, psychological stress and human resources had an impact on epidemiologists' intent to stay in their career. Results show that the relationship between occupational stress (operation and personal safety hazard) and intent to stay could be influenced by organizational capital, and the relationship between emotional distress and intent to stay could be influenced by a broad spectrum of human resources (organizational, social and human capital). CONCLUSION: The severe acute respiratory syndrome epidemic raised worldwide attention and challenged epidemiologists' intent to stay. Results indicate that human resources play an important role in this issue. Managers should enhance human resources in organizations as much as possible to attenuate epidemiologists' stress, which may, in turn, strengthen their intent to stay.     

The rural nurse work environment and structural empowerment

Rural health care organizations struggle to attract and retain nurses, yet much of the research has focused on characteristics of the nurse work environment or empowerment in urban hospitals. The purpose of this study was to examine the nurse work environment in rural areas across settings by describing the relationship between structural empowerment and characteristics of the nurse work environment. Nurses ( N = 97) working in home care agencies and hospitals were surveyed. Significant differences were found between the groups, with home care nurses having significantly higher empowerment scores than medical/surgical nurses. A strong correlation was found between characteristics of the nurse work environment and empowerment. Policy makers are using evidence to guide development of policies, but much of the research has been conducted in urban hospital settings. This study begins to provide evidence that differences exist between urban and rural areas and between practice settings.     

Changes in nurse attitudes: management strategies for today's environment

Since the initiation of prospective payment reimbursement policies, significant changes have occurred in health care organizations and in the attitudes of nurses who work within them. In turn, these changes have necessitated development of new management strategies whereby nursing executives provide their staff with a motivating, satisfying work environment. This article summarizes a 5-year national study of nurses'attitudes and describes some strategies that are now proving effective for managing today's nursing staff.     

How healthcare work environments influence nurse retention

The purpose of this literature review was to determine the effect of healthcare work environments on nurse retention. The studies comprising this review describe factors that contribute to unhealthy work environments and implicate them as significant factors influencing nurse retention. The themes identified by nurses for purposes of retention included a desire for autonomy, empowerment, and decision-making opportunities in the environments in which they work.     

Innovative strategies for nurse recruitment and retention in behavioral health

Successfully recruiting licensed nurses to work in behavioral health is challenging. This article describes and illustrates methods one hospital successfully used to attract, orient, and mentor new graduate nurses to work in mental health. The New Horizons program included a paid internship for new graduate vocational nurses, a mental health curriculum, preceptorship, a state board review course, and a new graduate program. Since 2003, the program has recruited 37 new graduates for the unfilled licensed staff vacancies in mental health who continued their professional education and pursued degrees as registered nurses. The evaluations indicated that more than 100% of graduates rated the program as excellent as well as recommended it to their friends, and retention has been more than 90%. New Horizons graduates have received promotions; one has assumed a new role as a clinical resource nurse who teaches nursing orientation. All stakeholders including nurse management, patients, other disciplines, and coworkers have high praise for the program graduates. The program increased the cultural diversity of the mental health staff because the graduates included high percentages of African Americans, Hispanic Americans, and Asian Americans and less than 10% of White Americans. Adult learning technologies were used including teaching with films, role-playing, case studies, reflective thinking, evidence-based practice, and group performance improvement projects. Research-based fact sheets were used for the course and continued education. These 1-page fact sheets help nurses apply the evidence to improve nursing practice.     

The nurse as investor: using the strategies of Sarbanes-Oxley corporate legislation to radically transform the work environment of nurses

Experts in creative management recommend that managers routinely explore the practices of other disciplines to develop innovative strategies for their organizations. The author examines the provisions of the Sarbanes-Oxley Corporate Responsibility Act of 2002, designed to ensure sound corporate fiscal practices, and proposes a model using the same actions to radically transform the nursing work environment.     

护士对医院工作环境相关需求因素的调查

目的探讨护士对医院工作环境相关因素的需求情况,为基层管理人员提供管理依据。方法用盖洛普Q12调查表,对152名护士进行调查,了解护士对12个问题的认可程度。结果护士对工作环境较满意的方面有包括能明确对自己工作的要求,在单位有1位最要好的朋友,有做好工作所需要的材料和设备3个维度,认可度分别达到97．00％,87．5％和87．50％;对环境中管理人员和同事的认可度等在50．50％一74．00％;个人潜能发展方面受到重视的满意度较低在40．75％-45．75％。不同学历护士对Q2、Q8、Q9、Q12等4个问题的回答差异有统计学意义（P〈0．05）。结论护士对医院提供的基本工作环境满意,对个人潜能发挥较不满意。基层护士长对护士们的管理工作中,不仅要兼顾不同层级人员的需求,同时尊重护士的独立自主性,这将有利于进一步提高护士的工作积极性。     

Managing a large class environment: Simple strategies for new nurse educators

The average class size in nursing programs is increasing. Large class environments present multiple barriers for facilitating learning. Nurse educators must implement creative strategies to establish student–teacher relationships, class engagement, and evaluation methods. These challenges may seem overwhelming to a new faculty member entering the teaching environment. This article provides simple strategies for new faculty members to use for overcoming the learning barriers associated with larger class sizes.