Abstract

The Purpose: This ground-breaking project will help rural hospitals in underserved counties in PA enhance patient care delivery systems through improving the retention of nurses and the quality of patient care directly related to nursing activities. The project will benefit rural and underserved populations by stabilizing the nursing workforce which is essential to provide access to quality health care.

The Needs to be Addressed: A robust healthcare work force is essential for an effective health services delivery system. However, an aging population, expanding career opportunities for those who might enter nursing, the advancing age of the majority of nurses, a smaller cohort of younger nurses, poor work cultures, and an increasing demand for nurses are converging to create a serious unmet need for Registered Nurses in PA and across the nation. Due to the unique nurse recruitment and retention challenges faced by rural hospitals the nursing shortage is of critical concern. Data suggest that the nursing shortage will continue to grow and further threaten access to health care, especially for vulnerable populations in rural/underserved areas.

Proposed Services: We will partner with 5 rural hospitals to build capacity to implement features in the nursing work environment that are associated with attracting and retaining nurses and delivering excellent care. Project objectives are to: (1) improve collaboration and communication among registered nurses and with other members of the health care team, (2) increase registered nurse involvement in decisions about nursing work and patient care, and (3) increase cultural competence, including awareness and respect for multigenerational nurse workforce diversity and sub-culture diversity across nursing work units. ?Upward spirals? of positive change will be unleashed through an innovative set of change strategies grounded in positive organizational scholarship, complexity science, and participatory action research. The project is novel because it will highlight those things that are being done well as a foundation for change?rather than dwelling on ?what is wrong?. Project strategies include: appreciative inquiry, data collection and feedback (hospital sense-making), positive deviance principles, learning collaboratives, mentoring by American Nurses Credentialing Center magnet hospitals and networking/web-interactions. This work will serve as a model that can be replicated by other hospitals across the nation to improve the retention of Registered Nurses.