Paper
Friday, July 13, 2007
This presentation is part of : Issues in Nursing Administration
Building Evidence-Based Nurse Work Environments to Recruit and Retain Nurses
Donna S. Havens, PhD, RN, FAAN, School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
Learning Objective #1: describe the application of principles from complexity science and positive organizational science to enhance the nursing work environment.
Learning Objective #2: describe strategies that can be used globally to build hospital capacity to implement evidence-based organizational features to enhance nursing work and patient care.

Preserving health system capacity through stabilization of the nurse workforce is important globally. More than 20 years of research links the presence of certain organizational features such as (1) effective collaboration and communication among nurses and other health care professionals and (2) meaningful nurse involvement in organizational and clinical decision making processes with nurse recruitment and retention and positive patient outcomes. However, while the literature identifies what “should” be done little is known about “how to make it happen” or “how to make it stick”.  This presentation describes the lessons learned from our 5-year federally funded initiative to build hospital capacity to implement these evidence-based features in 6 community hospitals in Pennsylvania—most in rural and underserved areas. Our work is guided by principles from Complexity Science, Action Research, Positive Organizational Science, and the research literature linking features of the nursing work environment with nurse recruitment, retention, and excellent patient care. Implementation of strategies such as Appreciative Inquiry, data collection and feedback, learning collaboratives, networking, and mentoring by hospitals recognized for excellent nursing practice and excellent patient care (ANCC Magnet Hospitals), have unleashed small and large “wins” and built a vital learning community that is self-organizing to sustain this effort. This presentation bridges the gap between current research-based knowledge and use of that knowledge by demonstrating how hospitals can implement pragmatic approaches to implement best practice organizational features to stem nurse workforce shortages. This project serves as a model for replication to build, retain, and sustain the nurse workforce globally.