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Description
INNOVATION
Introduction/Objective:
Retention of nurses in the pediatric cardiac intensive care unit (CICU) is essential for optimal patient outcomes, as nurse experience significantly impacts patient mortality and hospital-acquired conditions. In April 2022, our CICU faced high voluntary turnover among direct bedside nurses. Our immediate goal was to reduce this turnover, with a longer-term objective of improving overall nurse retention.
Methods:
We established global and SMART aims by comparing organizational benchmarks for nurse turnover with unit-specific data from human resources. Co-managers and eight nurse team leaders conducted stay interviews with direct bedside nurses during the first half of 2022. These interviews revealed that key drivers for nurse retention included staff and leadership engagement, while a healthy work environment, professional development, and a positive ethical climate were secondary factors. Based on these findings, we worked with executive, physician, and human resources stakeholders to implement several interventions. These included increasing paid time off (PTO), holding listening sessions with Heart Center leadership and human resources, enhancing clinical advancement roles, involving nurses in the hiring process, and organizing monthly sessions on resilience, ethics, staff support, and engagement. These strategies were rolled out starting in the third quarter of 2022 and continued throughout 2023.
Results:
In April 2022, voluntary nurse turnover in our CICU was 38.1%, the highest since the current co-managers began their roles in December 2021. The benchmark for acceptable turnover is ≤13%. By April 2023, voluntary turnover had decreased by 78%. The rolling 12-month turnover rate for 2023 was 13.1%, marking a 27.8% improvement from 2022's rate of 18.1%.
Conclusion:
Targeted interventions can significantly improve nurse retention in pediatric CICUs. Enhancing engagement among nurses and leaders has proven crucial for maintaining a dedicated workforce. Despite progress, further efforts are needed to address turnover among first-year nurses. Assessing staff wellbeing with a reliable tool could provide insights to better support the workforce and further reduce turnover, fostering a resilient team and a positive workplace culture.
Publication Date
9-27-2024
Keywords
Innovation, PICU, Pediatric Intensive Care, Nursing Turnover
Disciplines
Pediatric Nursing
Recommended Citation
Brown, Deniro; Daigle, Lindsey; Brown, Brandi; Gerstmann, Julia; Hernandez, Emily; O’Brien, Delaney; Conrad, Casey; Whittington, Christina; Wren, Lindsey; and Barbero, Gustavo, "A Transformative Leadership Approach to Reducing Nursing Turnover in a Pediatric Cardiac Intensive Care Unit" (2024). 2024. 18.
https://scholarlycollection.childrens.com/nursing-anf2024/18
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
