Gaps in front-line nurse managers’ quality improvement education and participation prevent them from “realizing their full potential” for optimizing population outcomes and patients’ care experience, and lowering per capita costs, according to a study published in the Journal of Nursing Administration.
“We can’t close the gaps in quality improvement without a better understanding of what the educational gaps are in the nurse manager population, because nurse managers are formally charged with leading the delivery of patient care,” Maja Djukic, PhD, RN, assistant professor at the College of Nursing, New York University, said in a news release. “There hasn’t been a clear picture of what’s missing for front-line nurse managers in the U.S., and this study is an important step forward in identifying gaps and strategizing about effective responses.” Djukic is one of the authors of the study, “Educational gaps and solutions for early-career nurse managers’ education and participation in quality improvement.”
The study, part of the RN Work Project, funded by the Robert Wood Johnson Foundation, focused on early-career FLNMs (those with head nurse or assistant head nurse roles, who have been in practice as RNs for fewer than four years). In the study, only 30% of the nurses reported being very prepared with QI skills by their nursing education programs or employers. More than half reported having good organizational support for QI, but just 35% reported participating in a specific clinical QI effort aimed at improving patient care on their units more than once a month, and about 30% reported being rewarded for their contributions to QI, according to the study.
“Correcting imbalances between what front-line nurse managers are prepared to do and what they’re expected to do, in terms of quality improvement, could be a transformative moment in our national healthcare journey,” Christine Kovner, PhD, RN, FAAN, Mathy Mezey Professor of Geriatric Nursing at the College of Nursing, New York University, said in the release. “We are not yet where we want and need to be in improvement goals. Nurses at all practice levels, led by front-line nurse managers, are poised to make important progress on multiple issues, particularly hospital-acquired conditions, readmissions and patient satisfaction.”
Researchers identified two areas that need significant improvement: repeating the improvement cycles, which involves measuring current performance, assessing gaps in practice, applying QI tools and methods to address those gaps, and measuring changes until desired improvements are achieved; and monitoring sustainability of improvements. They also recommended teaching FLNMs about root cause analysis, using national patient safety resources and using information technology and strategies (such as personal digital assistants and checklists) that help reduce the mental demands of work, such as relying on memory, according to the release.
The RN Work Project is a 10-year study of newly licensed RNs that began in 2006. It is the only multi-state, longitudinal study of new nurses’ turnover rates, intentions, and attitudes including intent, satisfaction, organizational commitment and preferences about work, according to the release. The study uses data from nurses in 34 states and the District of Columbia. Read more about the RN Work Project at http://rnworkproject.org.