EP12EO

 

RN Turnover EP12EO

 

Provide one example, with supporting evidence, of the organization meeting a targeted goal at the organization level, for improvement in the nurse turnover rate associated with clinical nurses' participation in nursing retention activities.

  • Applicant organizations may use a maintenance goal if the organization nurse turnover rate is < 10%.

 

 

Example: Catholic Health Initiatives St. Vincent Hot Springs Decreased Nurse Turnover Rates with the Participation of Clinical Nurses in Retention Activities

Targeted Goal for Improvement

The Catholic Health Initiatives (CHI) St. Vincent Hot Springs’ (SVHS) targeted goal for organization-level nurse turnover is to decrease by 1% by the end of year two from the baseline of 25.9% in October 2021. (Evidence EP12EO-1, CHI St. Vincent Hot Springs Nurse Turnover Rate Graph)

 

Nursing Retention Activities with Clinical Nurses’ Participation

Activities that led to a decrease in the CHI SVHS nurse turnover rate involving clinical nurses included:

  • In December 2021 and May 2022, clinical nurses gave their feedback during a pulse employee survey, an annual employee survey, and leaders rounding on employees. The feedback included clinical nurses requesting more ways to focus on wellness. In July 2022, CHI SVHS implemented a coworker gym. The gym is in the hospital and open 24/7 for all clinical nurses and employees to use.
  • In 2022, clinical nurses gave their feedback during the registered nurse (RN) engagement survey, annual employee survey, pulse employee survey, leader rounding with clinical nurses, and one-on-one sessions between clinical nurses and managers. Their feedback included requesting more pay by many clinical nurses, as during the COVID 19 pandemic, other hospitals were giving clinical nurses retention bonuses and travel nurses were working here that were making more money than clinical nurses employed at CHI SVHS. CHI SVHS leadership listened and, in 2022 and 2023, completed market adjustments in compensation for clinical nurses. The market adjustments were instrumental in retaining nurses at the bedside during the peak of COVID-19 admissions. Several bonuses were given to clinical nurses during the peaks of COVID-19 and extended COVID-19 incentive pay. In addition, a $1.50 differential was added to the base rate of all clinical nurses. The differential was developed as a bonus for all bedside clinical nurses. Clinical nurses participating in giving feedback and CHI SVHS leadership listening assisted tremendously in improving CHI SVHS nurse turnover rate.
  • Clinical nurses shared many stories on workplace violence situations to leaders and through occurrence reporting. In January 2023, CHI SVHS started a Workplace Violence (WPV) Council focused on WPV and initiatives to improve the safety of clinical nurses and other coworkers. Members of the council include clinical nurses. Many improvements have been made at CHI SVHS with the feedback of clinical nurses, including securing areas in the emergency department. The triage doors were unable to shut or lock during an emergency or lockdown. This was corrected and fixed in October 2023. The WPV council is a retention activity that clinical nurses participated in to improve the nurse turnover rate.
  • In March 2023, newer clinical nurses on night shift were giving feedback that there were processes they were unsure of and that they did not feel they had the resources they needed on the medical surgical units. Medical surgical nurse managers worked evenings and weekends to serve as a resource and develop relationships with the clinical nurses and coworkers, so they would feel comfortable coming to them with issues or concerns. This nursing retention activity that included clinical nurses helped improve the nurse turnover rate.
  • In August 2023, stay interviews were implemented. Many leaders were involved in leadership training to improve CHI SVHS nurse turnover rates and learn best practices from other leaders during unprecedented times. Stay interviews targeted newer clinical nurses (less than one year). The stay interviews included the following questions: If you could change one thing about your job or company, what would it be? What keeps you working here? What do you enjoy most about your role? What can I do more of or less of, as your manager? What might tempt you to leave? Approximately seven clinical nurses from each inpatient unit were interviewed. The nurse managers received feedback that the clinical nurses understood their leader’s investment in them throughout their employment to grow professionally. The interviews were insightful in increasing communication within the unit among peers. Nursing leaders had crucial conversations about educational opportunities that increase teamwork with peers who lack communication skills.
  • CHI SVHS has a robust shared governance model. Throughout 2023, at the Interprofessional Practice Council (IPC), clinical nurse members requested to wear CHI SVHS t-shirts and holiday shirts on specific days of each month. Leaders listened and approved this request. The clinical nurses have shared many times how this is something so simple but raises the morale for clinical nurses and coworkers throughout the hospital. Simple things like approvals to wear cheerful holiday clothing when appropriate have had a huge impact on improving nurse turnover rates.
  • CHI SVHS IPC council meets monthly. At each meeting, the clinical nurses and other voting members read all the DAISY nominations for the month and vote on the winners. The DAISY winners are revealed at the monthly leadership forums where all staff, including clinical nurses, are welcome to attend to celebrate the DAISY recipients for the month. DAISY celebrations improve retention because of the public recognition and acknowledgment of the excellent care provided by nurses and other team members. The celebrations are positive affirmations of their hard work for the entire nursing team.
  • Managed by clinical nurses, the Clinical Ladder Facebook page posts opportunities for volunteering. Volunteer activities promote retention through teamwork, engagement, and helping others in a charitable or giving manner, not connected to a nurse’s primary role.

 

CHI SVHS has received the Best Place to Work in Arkansas for five years in a row (2018 to 2023). Clinical nurses and all other coworkers were included in taking the survey and then participated in a celebration every year to include tee shirts and celebratory gatherings.