creating a culture of excellence: empowering ... - cone … department and from the exercise of...

Creating a Culture of Excellence:

Empowering nurse techs and nurse secretaries by implementing

A nurse tech/nurse secretary council

Monette Mabolo, MBA, MSN, NEA-BC; Tamekia Lockhart, NT

Burning Clinical Question Practice Change Evaluation

Will implementing a nurse tech/nurse secretary

council help improve employee engagement score

and quality of patient care?

Background/Triggers

Results

• The unit’s employee engagement score has been at an

all time low.

• A random poll was conducted on all nurse tech and

secretaries regarding implementing their own council

where they can discuss how to improve their practice

and have everyone be involved in improving our score.

• 99% of the staff polled showed positive feedback about

establishing their own council

• Using the IOWA model, we examined evidence of best

practice. Our literature search yielded strong evidence to

support establishing a formal council, helps develop

leadership skills in frontline staff and inspired

commitment in their department’s outcomes.

• Nurse empowerment results from the power of the

nursing department and from the exercise of power by

nurses in local units ( Bogue, Joseph & Lebold, 2009).

Implementing the council has led to:

• Improved employee satisfaction and engagement score

• NDNQI score for job enjoyment was at top decile

• Improved quality of care such as 0 CAUTI for 31

months and CLABSI for 33 months

• Active community involvement such as raising funds

every year for “Heart and Stroke “ walk and adopted an

elementary school for the “backpack buddies” and

“Back to School Supplies” program.

• We found that instead of staff resisting change, they

embrace the change.

• The key to success is staff empowerment in making

appropriate changes according to best practice and

believing in excellence.

• Our team decided to use the Iowa Model to examine the

evidence of best practice

• A nurse tech and nurse secretary meeting was called and

discussion about the council began, outlining the pros and cons

of having a council

• The group voted on implementing the council, and by-laws was

developed and their chair and co-chair was selected

• The council will be facilitated by an RN, that will help guide their

meetings and decision making

• The first and important step was to ensure that the council was

based on principles of evidence based practice

• As a magnet designated organization, unit based council is part

of department shared governance.

• Problems/ideas were brought before the council for discussion,

and using evidence based principles, they presented proposals

to department leadership

Nursing Implications

• The nurse tech/nurse secretary council is represented by

all nurse tech and nurse secretary from all shifts. Since

the implementation of the council, there was a dramatic

improvement in employee engagement score from 48th

percentile to Tier 1 in the 2015 employee engagement

survey.

• Their commitment and ownership of their role has led to

31 months of CAUTI free by staff being proactive in Foley

care and working collaboratively with RN’s in avoiding

Foley use.

The Council in session

Staff Satisfaction score (employee engagement)

2014 48th percentile

2015 Tier 1

NDNQI scores: Job Enjoyment

Pre data: 3.5 (2014)

Post data: 5.06 (2015)

Employee engagement survey participation

2015 – 98%

2016 – 100%

References

3East Shared Governance

Practice Council Research Council NT/NS Council Charge Nurse

Council

Bogue, R.J., Joseph, L.M., & Lebold, C. (2009) Shared

governance as vertical alignment of nursing group power and

nurse practice council effectiveness Journal of Nursing

Management (17) 4-14.

Scribert, S.E., Silver, S.R., & Randolph, W.A. (2004) Taking

empowerment to the next level: A multilevel model of

empowerment, performance, and satisfaction. Academy of

Management Journal 47(3), 332-3349.