CSI HWE

No One Cares Alone

Seattle Children's Hospital, Seattle, Washington

CSI Summary

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Summary

CSI Presentation

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Presentation

CSI Toolkit

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Toolkit

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Project Topic:

Peer Support and Nursing Wellness

Hospital, City and State:

Seattle Children's Hospital, Seattle, Washington

Unit:

Cardiovascular Intensive Care Unit (CICU)

CSI Participants:

  • Vivian Jones, BSN, RN, CCRN
  • Celeste Mirabal, BSN, RN, CCRN
  • Emily Rallo, BSN, RN, CPN
  • Sarah Zielinski, BSN, RN

Project Goals/Objectives:

  1. Decrease overall Burnout Assessment Tool (BAT) score 20%
  2. Increase AACN Healthy Work Environment Assessment Tool (HWEAT) True Collaboration score
  3. Decrease sick time use 10%
  4. Decrease turnover20%

Project Outcomes:

  1. Increased HWEAT True Collaboration score from 3.19 to 3.27
  2. All HWEAT standard scores increased
  3. Increased CICU nurse turnover by 2 nurses
  4. Increased use of sick time calls from 283 to 796
  5. Decreased BAT aggregate scores 17%

Project Overview:

In March 2024, a group of 5 nurses in the CICU created and implemented a peer-to-peer support and nursing wellness program for the CICU nursing staff. The project was developed in response to baseline data from two surveys: Healthy Work Environment Assessment Tool (HWEAT) and the Burnout Assessment Tool (BAT), as well as nurse turnover rates and sick time use. In May 2024 the turnover rate was 14.18%, with an average of 8 sick calls per shift. The unit’s HWEAT True Collaboration score was 3.19 and our average BAT score was 82.

The CSI team began wellness rounding in July 2024 for 8 hours a week, from 3-11 pm. This time was spent supporting RNs during moments of distress and having therapeutic conversations. We also focused on connecting staff with existing wellness resources offered by the hospital and escalating trends to unit leadership. Special attention was given to staff involved in codes, patient deaths, and medical mistakes.

The results of our December 2024 HWEAT and January 2025 BAT proved that our peer-to-peer support program has decreased overall burnout scores by 17% and all HWEAT standard scores increased. Use of sick time and turnover rates increased and could be the result of our staff taking better care of themselves and identifying their next areas of growth. Exit survey interviews revealed that people leave for many reasons other than burnout. Perhaps the turnover and sick leave rate data points were not the right ones to measure for this project.

Permission to Reuse Materials
The materials associated with this AACN Clinical Scene Investigator (CSI) Academy project are the property of the participating hospital noted above, not AACN. Requests to use content contained in the CSI team’s summary, presentation or toolkit should be directed to the hospital. We suggest reaching out to the hospital’s Communications, Marketing or Nursing Education department for assistance.

Disclaimer
The AACN CSI Academy program supports change projects based on quality improvement methods. Although CSI teams seek to ensure linkage between their project and clinical/fiscal outcomes, data cannot be solely attributed to the project and are estimations of impact.