Increasing Patient Safety and Staff Satisfaction When Floating

Purpose: To increase culture of safety and a positive experience surrounding RN staff reassignment (floating) to meet shift staffing and organizational needs within both acute and critical care inpatient units.

Why: Floating is a known source of dissatisfaction for nurses. The results of a nurse satisfaction survey and internal RN float experience survey expressed a reduced level of comfort in giving their best care, imposed upon nursing work flow and decreased job satisfaction. Nurses who floated reported potential gaps in care, missed treatments and a knowledge gap of an unfamiliar patient population and environment.

How: The hospital-level Resource and Innovation Shared Nursing Leadership (SNL) Council developed and disseminated an on-going, daily float survey via email to all nurses who floated, asking specific and open-ended questions about their experiences. Data was analyzed over a 6-month period and sent to the respective units, along with suggested interventions. Suggested interventions included: identified back-up nurse, brief orientation and unit tour, unit resource guide with important phone numbers, and universal access badge. The council requested that unit-based leadership share the results and engage their unit SNL council to develop an action plan to improve the experience of nurses floating to the respective units. After the interventions were implemented, the results for the subsequent 6-month period were analyzed for comparison.

So What: 6 months post implementation, overall, the results were positive. There was a 68% decrease in the RN reporting a “very discouraged” mood about floating. Results showed improvement in assignment of a backup nurse by 8% and RN offered an orientation by 69%. Nurses reported an overall decrease of 59% in feeling they may have missed treatments or care when floating to another unit.

Implication: After the interventions, nurses report an overall increased positive and confident outlook when floating to another unit and reported delivering higher quality care. Healthcare organizations can use these interventions to improve the positive experience of the RN when floating to other units, and improving patient safety, quality of care provided and RN satisfaction.