Improving Nurse Engagement with Dedicated Education Units

Saturday, 7 November 2015

Angela D. Heckman, MSN, RN, PHCNS, CNE
School of Nursing, Indiana University Kokomo, Kokomo, IN, USA

Now more than ever, healthcare delivery systems need knowledgeable, practice ready, engaged nurses as members of every healthcare team; however a lack of engaged nurses and practice ready new graduates has forced health system and academic leaders to form partnerships.  These academic-practice partnerships, intended to strengthen nursing practice, are crucial to address the monumental demands of value-based purchasing and the recommendations of the Future of Nursing Committee.  Recently, an acute care facility in central Indiana and a local university established an academic-practice partnership to implement a Dedicated Education Unit (DEU).  Although the original intent of the DEU was to enhance the clinical learning experience of student nurses, the academic-practice leaders involved with implementation of the DEU believes the project would positively affect nurse engagement and patient satisfaction.

The research question for the project is “Does implementing a dedicated education unit in an acute care setting improve nurse engagement?”  Three objectives related to implementation of the DEU project were identified:  Nurse engagement will improve on the DEU; nurse engagement will be higher on DEU units than on a control unit; and patient satisfaction scores will improve on the DEU.

The theoretical framework for this scholarly project encompassed one theory and three models to provide the structure and guidance required for a well-designed study.  These include Lewin’s Change Theory, the Logic Model, the JD-R Model of Work Engagement and the DEU Model of Clinical Education

The study site chosen for the DEU Project is an acute care hospital in north central Indiana.  The DEU Project uses a convenience sample involving approximately 50 nurses.  There are 13 nurses on the medical surgical (MS) unit and 14 nurses on the coronary care progressive unit (CCPU).  In addition, there are approximately 20 nurses on the telemetry medical surgical (TMS) unit, which serves as the control unit. 

The instrument selected to answer the research question is the Utrecht Work Engagement Scale (UWES).  Work engagement is the construct in the UWES instrument and the three grouped underlying dimensions are vigor, dedication and absorption.  Researchers have used the UWES instrument to measure work engagement among a variety of occupational groups.    

The DEU Project utilizes a two-prong approach to answer the research question and measure the objectives.  The hypothesis is that the DEU Project will result in improved nurse engagement.  The first evaluation approach is a quasi-experimental design since there is a control unit.  The second evaluation approach is a mixed-method correlational pre – post survey design for the units participating in the DEU Project.  Two types of surveys are used to measure outcomes, UWES and an investigator-developed DEU survey.  Patient satisfaction data using Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) will also be trended.  Triangulation of data from the above two surveys and trending of HCAHPS scores provide sufficient evidence to answer the research question.