Ignite and Inspire the Spirit of Improvement through Staff Empowerment and Self-Efficacy

Dearmon, Valorie A.

Monday, 18 November 2013

Valorie A. Dearmon, RN, DNP NEA-BC¹
Lisa Mestas, RN, MSN²
Ellen B. Buckner, DSN, RN, CNE¹
Linda Ann Roussel, RN, DSN, NEA, BC³
(1)College of Nursing, University of South Alabama, Mobile, AL
(2)University of South Alabama Medical Center, Mobile, AL
(3)Community Health, Outcomes & Systems, School of Nursing, University of Alabama at Birmingham, Birmingham, AL

Learning Objective 1: identify leadership strategies for harnessing the wisdom of frontline nurses and facilitating engagement for quality improvement.

Learning Objective 2: synthesize organizational and human behavioral theory and evidence-based research to promote self-efficacy and staff empowerment as antecedents to frontline engagement and commitment.

Frontline engagement is a process of harnessing the wisdom of frontline nurses specifically on improved quality and a safer healthcare system. Nurse leaders are challenged to find best practice strategies to transform practice environments and improve outcomes as recommended by the Institute of Medicine (2004, 2010). Self-efficacy, a personal resource characterized by the belief in one’s ability to act and effect change (Bandura, 2001), and empowerment, the power to act and make things happen (Kanter, 1993), are two psychological mechanisms closely linked to staff engagement. Higher self-efficacy and empowerment have been shown to lead to higher work engagement and increased productivity (Salanova, Lorente, Chambel, & Martinez, 2011; Schaufeli, & Salanova, 2007). Transformational leadership, which fosters relationships and narrows the gap between formal positions of authority and point of care providers, clearly influences nurses’ self-efficacy (Salanova et al., 2011; Cummings, et al., 2010) and promotes staff empowerment (Patrick, Spence-Laschinger, Finagen, 2011).

Frontline Innovations was implemented at the University of South Alabama as a collaborative partnership between the Medical Center and the College of Nursing. Following participation in STAR-2 study of operational failures (Stevens & Ferrer, 2011), a committee was established to foster staff nurse engagement in process improvement, to promote interdisciplinary collaboration, and to transition the locus of control of nursing practice to frontline providers. Frontline Innovations created a mechanism for problem-solving and re-energized organization at the unit and institutional levels. Accomplishments included improved EHR processes, implementation of effective medication protocols, and cost savings for the hospital. Results supported the translation of evidence into practice. Self-efficacy and empowerment increased nurses’ effectiveness and optimism for improved processes. This experience offered nursing a voice which ignited and inspired enthusiasm for interprofessional collaboration and continued improvement. The engagement strategy implemented in this organization can be applied to nursing settings world-wide to effect change.

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