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Creating a Culture of Excellence:
Empowering nurse techs and nurse secretaries by implementing
A nurse tech/nurse secretary council
Monette Mabolo, MBA, MSN, NEA-BC; Tamekia Lockhart, NT
Burning Clinical Question Practice Change Evaluation
Will implementing a nurse tech/nurse secretary
council help improve employee engagement score
and quality of patient care?
Background/Triggers
Results
• The unit’s employee engagement score has been at an
all time low.
• A random poll was conducted on all nurse tech and
secretaries regarding implementing their own council
where they can discuss how to improve their practice
and have everyone be involved in improving our score.
• 99% of the staff polled showed positive feedback about
establishing their own council
• Using the IOWA model, we examined evidence of best
practice. Our literature search yielded strong evidence to
support establishing a formal council, helps develop
leadership skills in frontline staff and inspired
commitment in their department’s outcomes.
• Nurse empowerment results from the power of the
nursing department and from the exercise of power by
nurses in local units ( Bogue, Joseph & Lebold, 2009).
Implementing the council has led to:
• Improved employee satisfaction and engagement score
• NDNQI score for job enjoyment was at top decile
• Improved quality of care such as 0 CAUTI for 31
months and CLABSI for 33 months
• Active community involvement such as raising funds
every year for “Heart and Stroke “ walk and adopted an
elementary school for the “backpack buddies” and
“Back to School Supplies” program.
• We found that instead of staff resisting change, they
embrace the change.
• The key to success is staff empowerment in making
appropriate changes according to best practice and
believing in excellence.
• Our team decided to use the Iowa Model to examine the
evidence of best practice
• A nurse tech and nurse secretary meeting was called and
discussion about the council began, outlining the pros and cons
of having a council
• The group voted on implementing the council, and by-laws was
developed and their chair and co-chair was selected
• The council will be facilitated by an RN, that will help guide their
meetings and decision making
• The first and important step was to ensure that the council was
based on principles of evidence based practice
• As a magnet designated organization, unit based council is part
of department shared governance.
• Problems/ideas were brought before the council for discussion,
and using evidence based principles, they presented proposals
to department leadership
Nursing Implications
• The nurse tech/nurse secretary council is represented by
all nurse tech and nurse secretary from all shifts. Since
the implementation of the council, there was a dramatic
improvement in employee engagement score from 48th
percentile to Tier 1 in the 2015 employee engagement
survey.
• Their commitment and ownership of their role has led to
31 months of CAUTI free by staff being proactive in Foley
care and working collaboratively with RN’s in avoiding
Foley use.
The Council in session
Staff Satisfaction score (employee engagement)
2014 48th percentile
2015 Tier 1
NDNQI scores: Job Enjoyment
Pre data: 3.5 (2014)
Post data: 5.06 (2015)
Employee engagement survey participation
2015 – 98%
2016 – 100%
References
3East Shared Governance
Practice Council Research Council NT/NS Council Charge Nurse
Council
Bogue, R.J., Joseph, L.M., & Lebold, C. (2009) Shared
governance as vertical alignment of nursing group power and
nurse practice council effectiveness Journal of Nursing
Management (17) 4-14.
Scribert, S.E., Silver, S.R., & Randolph, W.A. (2004) Taking
empowerment to the next level: A multilevel model of
empowerment, performance, and satisfaction. Academy of
Management Journal 47(3), 332-3349.