Using Maslow's Pyramid and the National Database of Nursing Quality Indicators™ to Attain a Healthier Work Environment

Lisa Groff Paris, DNP, RNC-OB, C-EFM; Mary Terhaar, DSNc, RN

Disclosures

Online J Issues Nurs. 2011;16(1) 

In This Article

Abstract and Introduction

Abstract

The strongest predictor of nurse job dissatisfaction and intent to leave is that of stress in the practice environment. Good communication, control over practice, decision making at the bedside, teamwork, and nurse empowerment have been found to increase nurse satisfaction and decrease turnover. In this article we share our experience of developing a rapid-design process to change the approach to performance improvement so as to increase engagement, empowerment, effectiveness, and the quality of the professional practice environment. Meal and non-meal breaks were identified as the target area for improvement. Qualitative and quantitative data support the success of this project. We begin this article with a review of literature related to work environment and retention and a presentation of the frameworks used to improve the work environment, specifically Maslow's theory of the Hierarchy of Inborn Needs and the National Database of Nursing Quality Indicators™ Survey. We then describe our performance improvement project and share our conclusion and recommendations.

Introduction

The strongest predictor of nurse job dissatisfaction and intent to leave a job is stress in the practice environment (Zangaro & Soeken, 2007). The varied causes of job stress include patient acuity, work schedules, poor physician-nurse interactions, new technology, staff shortages, unpredictable workload or workflow, and the perception that the care provided is unsafe (Bowles & Candela, 2005; Leurer, Donnelly, & Domm, 2007; Shader, Broome, Broome, West, & Nash, 2001; Zangaro & Soeken, 2007).

In contrast, a healthy practice environment is characterized by an engaged nursing staff who exercise control over nursing-related issues, ground their practice in the evidence, and collaborate with colleagues from diverse disciplines (Kramer & Schmalenberg, 2008). Such an environment is associated with favorable clinical outcomes and a stable, satisfied workforce (Gallup, 2005). Good communication, control over practice, decision making at the bedside, teamwork, and nurse empowerment are aspects of the practice environment that increase satisfaction and decrease nurse turnover (DiMiglio et al., 2005; Heath, Johanson, & Blake 2003; Kalisch, Curley, & Stefanov, 2007).

Although much can be learned from experiences reported by others, care must be taken to critically assess perceptions of nurses at each individual facility, and each unit within that facility, to determine which practice environment improvement strategies would be most effective in a given situation. The National Database of Nursing Quality Indicators™ (NDNQI®) 2009 RN Survey with Practice Environment Scale, henceforth called the NDNQI 2009 RN Survey with Practice Environment Scale, can help individualize practice improvement interventions to a given unit.

We will begin this article with a review of literature related to work environment and retention and a presentation of the frameworks used to improve the work environment, specifically Maslow's theory of the Hierarchy of Inborn Needs and the National Database of Nursing Quality Indicators™ Survey. We then describe our performance improvement project and share our conclusion and recommendations.

Comments

3090D553-9492-4563-8681-AD288FA52ACE
Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as:

processing....