Strategies to advance nursing excellence

A thoughtful, deliberate nursing strategy is a necessary part of efforts to be patient-centric and to achieve patient experience goals. Nursing communication and leadership skills, teamwork and the use of evidence-based practices in nursing support transforming performance.

Below are important practice strategies under two aspects; surveying and identifying causes of results. Key suggestions are provided along with an overview discussion by past Chief Nursing Officer of Press Ganey, Christie Dempsey.

1. Survey nurses about their work environment and job satisfaction, and monitor their level of engagement

Finding meaning in nursing

Key suggestions:

• Evaluate nurses’ perceptions of their work environment and job satisfaction levels using the National Database of Nursing Quality Indicators (NDNQI), Practice Environment Scale (PES) and Job Satisfaction Scales-revised (JSS-R) nursing surveys
• Use collaborative meetings to obtain insight into caregiver’s perceptions of their work environment
• Make informed improvements to the nursing strategy with a comprehensive assessment of nursing metrics: job satisfaction, engagement, and perceptions of the safety environment

Building nurse resilience

Key suggestions:

• Assess the nursing practice environment, and monitor nursing-sensitive quality outcomes using valid measures from a national or international database that offers comparative data—such as the National Database of Nursing Quality Indicators (NDNQI)
• Empower top-of-scope practice in nurses
• Considering mentoring and developing career ladders to better engage the nursing staff in owning quality and outcomes
• Prepare all nurses to be leaders, mentors, and educators

Developing your nurse managers

Key suggestions:

• Understand your nursing structure for staffing, skill mix, education, and specialty certification as compared to peers and as compared to top performers in nurse sensitive metrics. High use of agency or floating nurses can be detrimental to patient experiences
• Assess the clinical quality and patient perceptions of care
• Assess clinical core measure performance to target areas that would benefit from improvement efforts
• Routinely administer patient experience surveys and take advantage of opportunities to add custom questions to address priority improvement initiatives
• Use pulse surveys and point of care surveys to integrate real-time data for faster and more targeted improvement efforts

2. Identify the common causes of underperforming clinical metrics

Key suggestions:

• Use all of the above data to identify work units and cultural elements for targeted improvement
• Employ quality professionals trained in cause analysis to analyze data across all domains to identify
  the common causes of poor performance