/growth/,/growth/job-performance/,/growth/job-performance/npes/,

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UWHC,UWMF,

Learning and Development,Nursing,

Growth & Development,Job Performance

Nursing Practice Environment and Satisfaction

Nursing Practice Environment and Satisfaction - Growth & Development, Job Performance

Focus

 
 
 
RN Satisfaction - Foundations of Quality of Care   RN Satisfaction - Generational Issues
 
 
 
RN Satisfaction - Nurse Involvement in Hospital Affairs   RN Satisfaction - Staffing and Resource Adequacy

FAQ

What is National Database of Nursing Quality Indicators (NDNQI)?

The NDNQI provides comparative information to hospitals for use in quality improvement activities as well as develops national data on the relationship between nurse staffing and patient outcomes. It was established in 1998 as a part of the American Nurses Association (ANA) Safety and Quality Initiative.

What is the NDNQI Nurse Satisfaction Survey?

The NDNQI RN survey captures the voices of more than 250,000 nurses and over 700 participating hospitals annually to provide insights to drive quality improvements with those directly responsible for the patient experience. These focused RN surveys measure job satisfaction and evaluate the practice environment.

Why should I take this survey?

Results of these Magnet-compliant RN surveys help health care organizations identify needs of nurses, improve nurses’ work environment and enhance retention and recruitment.

The unit-level focus of the NDNQI RN surveys enables areas to develop more effective, finely targeted improvements, and also help health care organizations understand the relationship between the nursing sensitive quality indicators, staffing data and RN survey data.

How will this affect my nursing practice?

This is an opportunity to provide insight to what contributes to a positive work environment and enhance the work environment for nurses. An adequate (>50%) response rate is recommended for confidence that the data represents the unit environment.

Where do the results go?

The information is used both within UW Health as well as outside UW Health. Individual responses are not given back to us from NDNQI, only group (unit/area) data is given to UW Health from NDNQI.

From a UW Health perspective, each unit with more than 5 responses will receive unit/area results, this ensures the protection of anonymity of the RN participants responses. The organization’s results will also be reviewed for trends, areas of strength and areas for improvement and will be compared to previous survey results. UW Health will also submit unit-based results as part the redesignation document for Magnet t in 2018.

NDNQI will add UW Health’s results to the results of over 250,000 nurses to look at trends of the profession and health care environment.

How will my demographic information be used?

Since anonymity of the survey is important, demographic data is NOT given at a unit/clinic level. However, the demographic data of all nurses who took the survey is batched and provided at an organizational level.
NDNQI will also add UW Health’s demographic data to the results of over 250,000 nurses to look at trends of the profession and health care environment.

How will the identified problems be addressed?

Units will review their results and develop action plans based on categories needing improvement. This is tasked to the Unit Council of Chairs and/or the Magnet Champions.

Nursing leadership will review the results and support the unit/clinic specific improvement work. Nursing leadership also identifies organizational wide opportunities of improvement and action plans are developed and implemented.

What is some of the work occurring at an organizational level to address needs identified in the survey?

One action item is the inclusion of monthly presentations by high performing units to nursing leadership. 4 different areas of RN satisfaction were picked:

After the start of these presentations, inpatient nurse managers were encouraged to develop a second unit based action plan created by unit leadership in addition to the one that was created by staff in the unit council.
In addition to these sessions, here are the 3 plans for improvement from the organization wide A3s that continue to be worked on.

Improving RN Satisfaction at UW Health related to Nursing Participation in Hospital Affairs
  • CNO and Associate CNO attended ceremony at TAC on May 4, 2016
  • New governance structure, including nursing coordinating council goes live in July 2016
  • CNO and Associate CNO rounding to inpatient units in April and May and again in August/September, 2016
  • Nursing Quality Awards delivered to inpatient units by CNO and Associate CNO in May 2016
  • Leader Rounding by CNO on following inpatient units done twice a month: F45, F4M5 and B65
  • Leader Rounding by Associate CNO on following inpatient units done twice a month: F8/4, D6/4, F4/4, and B6/4
  • Associate CNO rounds on all inpatient units for HAI rounds
  • Provide forum for direct care nurses to highlight improvement work related to the nursing work environment during Nursing Grand Rounds in August, 2016
  • Town Hall type meetings (videotaped) led by CNO/Associate CNO at major clinic locations
  • Daisy awards presented at work location of RN – Monthly
  • Provide Zero Hero certificates to nursing units who have achieved significant milestones in CAUTI, CLABSI, CDI, and fall prevention in addition to the quarterly and yearly zero hero awards
  • Include content about nurse participation in hospital affairs in Magnet newsletter
Improving RN Satisfaction at UW Health related to Nurse Manager Ability, Leadership and Support
  • Nurse managers to use the recognition tool kit on UConnect
  • Shift recognition to include unit based events – such as Daisy awards, nursing quality awards, hand hygiene awards, zero-hero awards
  • Add recognition to the video display boards in public locations
  • Leadership encouraged to develop unit based “Leader” RN Satisfaction action plan in addition to staff created action plan
Improving Organization
  • Obtain approval for additional 159.4 FTE in nursing
Wide RN Satisfaction in Staffing and Resource Adequacy
  • 30.8 NA FTE for inpatient units (maximum of 8 patients per NA for all 3 shifts)
  • 25.9 NA FTE for PSA coverage
  • 12.7 FTE for volume (11.7 RN and 1.0 NA)
  • 53.3 FTE for short term sick leave, LOA, orientation hours (52.3 RN and 1.0 NA)
  • 36.7 CTL FTE (for CTL to start shift without a patient assignment)
  • Educate unit staff on new FTE by CNO and Associate CNO rounding on patient units –April – May 2016
  • Reinforce new FTE and follow up discussion with unit staff by CNO and Associate CNO rounding on patient units – August – September 2016
  • Track recruitment progress for new FTE and provide monthly updates on progress
  • Nursing directors to ask nursing staff in rounding about additional FTE, manage expectations for transition time when in hiring phase
  • Nursing leaders to thank staff for floating while waiting for new staffing models to be implement
  • Focus on multiple communication strategies to the unit level by sharing information to unit council of chairs and having them present to their individual unit councils and also provide content in the “In Brief”

 

Will I have protected time to take the survey?

The survey can be accessed from any computer with internet access. It is recommended that a plan be worked out on the unit level to allow time during your shift to complete the survey.

What are potential strategies for supporting increased response rate on units/clinics?

What should I clock into while taking survey?

What is the time frame for taking this survey?

The survey is three weeks long and will occur in October 2016.

What are a few examples of improvements that have been made from previous surveys?

D46 developed an action plan to improve Nursing Foundations for Quality of Care. In 2013, D46 results in this category were 3.06, below the unit specific mean of 3.13. D46 decided to focus on increasing their certification rate to improve this metric. D46 has continued to work on their action plan and in 2015 improved their results to 3.35 which is above the unit specific mean of 3.17.

DHC Endoscopy developed an action plan to improve the Nurse Manager Ability, Leadership and Support of Nurses. In 2013, their result in this category was 2.50 which was below the Endoscopy unit mean of 2.97. An action plan was created and implemented and is still being utilized, including weekly updates, NM meeting with staff 1:1 bimonthly and the NM works a few hours every month on the unit. DHC Endoscopy had a tremendous improvement in 2015 in this category. Their result was 2.96 above the mean of 2.90.

My unit is too small to get individual results. Why should I take the survey?

NDNQI will not report on units/clinics with less than 5 surveys returned because of the potential compromise to anonymity. Although results will not be available at a unit/clinic level for areas with less than 5 responses, the results will be included in the overall organization’s results. The organization’s results are reviewed for trends, areas of strength and areas for improvement and will be compared to previous year results.

NDNQI will also include UW Health’s results, including results from those from units/clinics with less than 5 responses, to the results of over 250,000 nurses to look at trends of the profession and health care environment.

Are there any examples of past hospital-wide changes that have been done to improve satisfaction?

After the 2015 NDNQI survey, a number of improvement plans were developed from a system-wide perspective. For example, one of the improvement plans developed addresses “Nurse Participation in Hospital Affairs.” Action items outlined in this plan include, revise existing nursing shared governance structure with input from direct care nurses; provide increased opportunities for the CNO and Associate CNO to be present; provide forum for direct care nurses to share unit specific improvement work.

Resources

Improving RN Satisfaction at UW Health Related to Nurse Manager Ability, Leadership and Support

Improving RN Satisfaction at UW Health Related to Nursing Participation in Hospital Affairs

NDNQI RN Satisfaction Survey FAQ

Staffing Shape-up