Recognize the Hive and Thrive

Oregon Health and Science University, Portland Oregon

Nov 20, 2024

CSI Summary

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CSI Presentation

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CSI Toolkit

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Project Topic:

Decreasing nurse turnover

Hospital, City and State:

Oregon Health and Science University, Portland Oregon

Unit:

Neuroscience Intensive Care Unit

CSI Participants:

  • Shannon Hirst, MNE, RN, CNRN
  • Kurt Bitter, BSN, RN, SCRN
  • Alyssa Major, BSN, RN, SCRN
  • Firen Towanda, ADN, RN

Project Goals/Objectives:

  1. Increase Healthy Work Environment Assessment Tool (HWEAT) aggregate score from 3.84 to 4.2
  2. Increase HWEAT Meaningful Recognition score from 3.49 to 4.18
  3. Decrease nurse turnover by 20%

Project Outcomes:

  1. Increased HWEAT aggregate score from 3.84 to 4.07
  2. Increased HWEAT Meaningful Recognition score from 3.49 to 3.72
  3. In addition to Meaningful Recognition other HWE standards increased as well: True Collaboration, Effective Decision Making, Appropriate Staffing, and Authentic Leadership
  4. Nurse turnover decreased from 4 RNs to 3 RNs
  5. Project outcomes resulted in an estimated annual fiscal impact of $96,514

Project Overview:

From October 2022 to October 2023, our unit experienced high rates of turnover, with an average annual turnover rate of 18.5%. One of the lowest scoring categories from the initial HWEAT survey for the unit was ‘Meaningful Recognition’, scoring at 3.49 indicating a “somewhat healthy” work environment.

In an effort to decrease turnover by increasing nurse satisfaction on our unit, we implemented a project to improve how nurses are recognized for the work they do and the years of service they have dedicated to our unit. We began by implementing a bee theme on our unit to create a cohesive and inclusive hive. To do this we handed out bee-themed badge charms to signify first independent shift off orientation, one, five, and ten years in the NSICU. For our project kickoff, these charms were handed out to all nurses along with snacks and “hive-mind” stickers that we created. We did a revamping of our staff kudos recognition board with a bee and honeycomb backdrop and honeycomb shaped kudos cards that headline: “Better Bee-lieve it!” as a way for staff to recognize each other. A bee mascot was introduced and a vote was held on her name, landing on Miss Beehaven. Finally, we rolled out personal mailboxes that are honeycomb shaped and t-shirts with bee, hive and brain themes that can be bought at our unit swag store.

Our project has been well received and popular amongst staff. It started out as a project for nurses but has expanded to include doctors, advanced practice providers, pharmacists, environmental services, and health unit coordinators. After seven months, we re-sent the HWEAT survey to all our nurses and did see an increase in work environment satisfaction. Our data showed an increase in the following HWEAT categories: Aggregate score from 3.84 to 4.07, Meaningful Recognition from 3.49 to 3.72, True Collaboration from 3.44 to 3.53, Effective Decision Making from 4.49 to 4.61, Authentic Leadership from 3.79 to 3.99, and our biggest improvement was Appropriate Staffing from 4.09 to 4.86.

While our nurse turnover only decreased by one nurse post-project, we had many new hires (17 compared to 11 preclinical), and more travelers (5 vs 3) chose to stay. We also had 2 new former nursing practicum students and 1 new RN who was a non-nursing staff in our unit.

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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.