Graduation Semester and Year

Fall 2024

Language

English

Document Type

Thesis

Degree Name

Doctor of Nursing Practice

Department

Nursing

First Advisor

Cathy Brown, DNP, RN, AGPCNP-BC, CNS

Second Advisor

Yungfei Kao, Ph.D.

Abstract

Background: Turnover rates of registered nurses working in intensive care units continue to increase significantly after the pandemic. Many nurses have left the profession due to the increased workload and stress during and after the COVID-19 pandemic. Having staffing challenges and turnover can affect the outcome of this patient population. Intensive care nurses experience workplace violence at an increasing volume. Also, robust nurse onboarding and training programs can help decrease turnover rates. The current national guideline does not address these concerns about nursing turnover. A guideline project was performed to identify needed recommendations based on evidence for stakeholders to rate with the intent of developing a guideline to address the specific issues causing nurse turnover in intensive care units.

Methods: A literature search was completed with the librarian's support in creating the literature review table with twenty articles. The evidence was graded using the Johns Hopkins Evidence-based Practice Guide. The population of stakeholders was a multidisciplinary team that included registered nurses, associate directors, assistant nurse managers, nurse practitioners, physician assistants, and physicians who work in adult ICUs. The software used was QuestionPro, using a Likert scale to rate the recommendations. Stakeholders rated the recommendations. Statistician consulted for analysis.

Results: Friedman’s two-way Analysis of Variance by Ranks (ANOVA) was used to analyze the results. The five recommendations, X2(4) = 6.021, p = .198, showed no significance. Six stakeholders fully completed the survey with consistent responses. Out of the five recommendations for the newly proposed guideline, healthy work environment assessments and mental and emotional tools were rated as excellent recommendations. Emotional intelligence assessments, peer mentors, and support groups were second as good recommendations to support the guideline.

Conclusions: The evidence presented to the stakeholders and their ratings support that a new proposed guideline is needed to address staffing challenges, burnout, and workplace violence. This can help sustain retention efforts and provide a healthy working environment.

Keywords

intensive care units, registered nurses, turnover, retention

Disciplines

Critical Care Nursing | Nursing Administration

License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.

Comments

•Dr. Brown, DNP, RN, AGPCNP-BC, CNS •My Executive Sponsors: •Michelle Williams, Ph.D., RN, RN-BC •David Marshall, JD, DNP, RN, FAAN, FAONL •Bernice Coleman, Ph.D., ACNP-BC, FAHA, FAAN •Margo Minissian, Ph.D., ACNP-BC, NEA-BC, FAHA, FAAN •Caroline Marshall, MLS •Statistician: Yungfei Kao, Ph.D.

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