Implementation and case-study results of potentially better practices for staffing in neonatal intensive care units.
OBJECTIVE
Five NICUs that participate in the Vermont Oxford Network Quality Improvement Collaborative have implemented several potentially better practices in an attempt to decrease nurse turnover by 50%. These potentially better practices focus on orientation, rewards and recognition, healthy work environment, nurse-physician collaboration, and nursing autonomy.


METHODS
Each unit implemented some or all of the potentially better practices. An Excel spreadsheet tool for tracking turnover rates was developed and used to measure the impact of the potentially better practices on retention. Rates were measured quarterly.


RESULTS
After implementation of the potentially better practices, turnover rates fell at all of the NICUs ranging from 13% to 64%.


CONCLUSIONS
Nurse retention is multifactorial. Implementation of the potentially better practices had a positive influence on nurse satisfaction but a varied impact on nurse retention. The impact of larger issues such as pay and staffing levels is significant and may not be influenced at the unit level.
Rikli
Joan
J
Neonatal Center, DeVos Children's Hospital, Neonatal Center, 100 Michigan St E, Grand Rapids, MI 49503, USA. joan.rikli@spectrum-health.org
Hegwood
Pat
P
Atwater
Amy
A
Bauman
Barbara
B
Brown
Betty Beverly
BB
Carteaux
Pat
P
Hartmann
Elaine
E
Hilton
Shadin
S
Michael
Laura
L
Norton
Lori
L
Secrest
Joel
J
Sprague
Pam
P
Plsek
Paul
P
D017144:Focus Groups; D006801:Humans; D007318:Inservice Training / Q000379:methods; D007363:Intensive Care Units, Neonatal / Q000458:organization & administration*; D007588:Job Satisfaction; D017283:Neonatal Nursing; D010561:Personnel Staffing and Scheduling; D010563:Personnel Turnover; D019555:Physician-Nurse Relations; D017009:Professional Autonomy; D011785:Quality Assurance, Health Care; D012201:Reward; D014481:United States; D017132:Workplace