Provide one example, with supporting evidence, of clinical nurses' participation in nursing recruitment activities and the impact on vacancy rates. Supporting evidence must be submitted in the form of a graph with a data table that clearly displays the data.
OR
Provide one example, with supporting evidence, of clinical nurses' participation in nursing retention activities and the impact on turnover rates. Supporting evidence must be submitted in the form of a graph with a data table that clearly displays the data.
Background/Problem
In the 3rd quarter of 2013, it was identified that the turnover rate on 3 East was up to 8.70%. This higher-than-average rate of turnover was impacting staffing, overtime, and moral. During a staff meeting on 3 East, a brainstorming session took place, and the staff nurses identified an area that could prove to help increase retention. The nurses identified that being part of the interview process of prospective staff could help identify nurses that would blend well with their cohesive team, and empower the nurses on 3 East to seek out high performers that are passionate about the Magnet model. After being coached by Elizabeth Alexander, MS RN,CN-E, Director of Medical Surgical, on how to interview potential nursing candidates, nursing staff on 3 East began the interview process and offered a four-hour shadow experience to potential nursing staff in June of 2013.
Goal Statement
The goal on 3 East was to decrease the nursing turnover rate with an ultimate goal of 0%. This was with the understanding that some turnover is uncontrollable. RN's move out the area, receive advanced degrees resulting in new jobs, and retire.
Overall, we wanted our turnover to be in manageable range with no controllable turnover.
Data requirements
FF Thompson Hospital uses National Database for Nurse-sensitive Quality Indicators (NDNQI) to report and gain turnover data. NDNQI has a different definition of turnover than that of Magnet. For this example, we have used the Magnet definition of turnover, and while we have had movement of 3 East nursing staff from either a full-time position to part time, or transfer to another unit for a new experience, the Magnet definition states: "Turnover is the number of employees who resigned, retired, expired, or were terminated divided by the number employed during the same period." As the nursing staff have had internal employee movement instead of a separation from the hospital, we have considered this a 0% turnover.
Participants:
Initially all job descriptions and decision matrixes were reviewed and edited as needed (See exhibits EP11EO.1-EP11.EO.6). These changes would ensure consistency in rating of potential staff coming on board.
Nursing Involvement in Recruitment/Retention Activities:
Exhibit EP11EO.1 New Graduate Decision Matrix
Exhibit EP11EO.2 New Hire Decision Matrix
Exhibit EP11EO.3 Med-Surg Staff RN Job Description
Exhibit EP11EO.4 Licensed Practical Nurse Job Description
Exhibit EP11EO.5 Charge Nurse Med-Surg Job Description
Exhibit EP11EO.6 Patient Care Tech Job Description
Job descriptions and decision matrices were reviewed and edited as necessary in 2013. In late 2012 our process for interviews changed dramatically on 3E/3W.
Next, the interviewing/shadowing process was outlined. The Director and/or Charge Nurses conducted the initial interviews and then the individuals who ranked highest on the decision matrix would come back and shadow for 4-6 hours with a bedside RN/PCT and the decision matrix would be completed and the results correlated and based on this information offers would be made.
Finally, once these individuals were hired, the RN or PCT that the new hire shadowed with would routinely be used as a primary preceptor.
Outcome
Since instituting these changes turnover of staff has declined significantly. After implementation, the 4th quarter of 2013, and the first and second quarter of 2014 have met the Magnet-defined turnover goal of 0%. Clinical Nurse's feel more engaged in the interview process and oncoming associates have a familiar face to welcome them to the nursing unit.