Quality Improvement Strategies to Develop Charge Nurse Education Workshops

Sunday, November 1, 2009

Patricia L. Thomas, PhD, RN
College of Health Professions-McAuley School of Nursing, University of Detroit-Mercy, Detroit, MI

Learning Objective 1: identify quality improvement tools to support charge nurse workshop curriculum development.

Learning Objective 2: describe a structured process to create meaningful charge nurse development within their organization.


Nurse Managers are expected to develop staff in the assumption of the Charge Nurse Role. Many nurse leaders feel ill prepared to systematically define strategies to address the gaps between a nurse’s knowledge and execution of the charge nurse role.  After reviewing staff satisfaction surveys, comments regarding the stress and anxiety experienced by charge nurses, and finding little support in the published literature to guide an action plan, Nurse Managers enlisted quality improvement strategies to create an organization specific, comprehensive charge nurse development series.


Two hour meetings during a two month period were scheduled with the Nurse Managers to establish content for Charge Nurse education. The first session focused on brainstorming to create a position statement to document charge nurse role responsibilities. Nurse Managers identified behaviors, knowledge, skills, and attitudes of successful charge nurses then rank ordered the concepts. From his list, they drafted a position statement that included an overview of charge nurse responsibilities, general expectations, and daily responsibilities. The position statement was shared with all the nurses in the organization, supplemented by PowerPoint presentations to highlight past experiences and future expectations. The Chief Nursing Officer held Townhall meetings to lend visible support for the Charge Nurse role and planned educational series.

After developing the position statement, Nurse Managers analyzed the feedback from employee surveys that included common experiences and frustrations in the Charge Nurse role. Seven themes were established around leadership/management definitions and behaviors; conflict management; scope of practice, licensure, and malpractice; delegation; communication and decision making; socialization and mentoring; and the image of nursing. Based on these themes, educational modules were developed to include didactic and interactive learning experiences facilitated by Nurse Educators and Nurse Managers.


The process to establish charge nurse education followed steps commonly reserved for clinical quality improvement. While the enthusiasm for a structured and deliberate process waxed and waned, feedback from staff nurses who completed the workshops buoyed the Nurse Managers to a successful end. Nurse Managers were inspired by the observed changes in leadership behavior and execution of the charge role, sharing emails and comments made by charge nurses that demonstrated the effectiveness of the content in the workshops. Nurse Managers developed appreciation for quality improvement tools and team building as they created meaningful educational content and interactive learning experiences for their staff. Based on the results with the charge nurse group, completing this process for nurse preceptors is planned.