Applying Caring Theory Guided Leadership to Inspire, and Improve Quality

Objective:  To demonstrate how Caring Theory guided leadership can improve staff satisfaction and patient outcomes.

Key Words:  caring, caritas, staff satisfaction, quality outcomes       

Intro: Can implementing Watson’s Caring Theory in an ICU increase nurse staff satisfaction, create a healthy work environment, and improve patient outcomes?   The ANCC’s Magnet program promotes theory-guided leadership. When loving kindness, Watson’s 1^st Caritas Process, is practiced, departmental goals cannot only be reached, but exceeded.                                                                                                      

Methods: Using the ANCCs National Database of Nursing Quality Improvement Survey, (NDNQI),  and Press Gainey  Employee Partnership Survey, as  measurement tools, we found that applying Watson’s Caring Theory, and Caritas Processes, at the managerial level, resulted in a marked increase in RN work environment satisfaction scores.  Our department achieved a Professional Environment Score of the 95% on the NDNQI.                                                                                

Results:  Nurses’ responses to all questions on the NDNQI Survey scored in the 90^th percentile or above.   In addition to a T score of 70 in response to the Job Enjoyment question, increased RN satisfaction scores related to better quality outcomes.  Applying Caritas Process #4, the Director developed caring trusting relationships with all staff, not just knowing staff names and faces, but knowing the spirit filled person behind the face.   These trusting relationships led to the structural empowerment of staff.  Once the staff felt trusted and empowered they set about searching for ways to improve care on the department.  Through staff nurse driven research activities, the staff has cut Foley days by more than 50%, and decreased the VAP rate by 74%.  Four research abstracts were accepted for presentation at national, and international, conferences in 2014.  Another abstract, regarding the effects of nurse workplace satisfaction on patient safety was accepted for presentation at the 2015 American Association of Critical Care Nurses National Teaching Institute and Exposition.                                                                           

Conclusion: Caring Theory guided leadership has resulted in structural empowerment, and the implementation of new knowledge and practices.  Financial resources were saved by improved retention and recruitment.   Improved clinical outcomes, improved work environment, and improved patient outcomes, have led to meeting organizational goals                        

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