Improving outcomes by empowering nurses to lead change in an acute stroke unit

BACKGROUND: There is increasing awareness of the link between nursing staff satisfaction, patient satisfaction, and clinical outcomes. Therefore, it would benefit health care organizations to critically appraise and implement cost-effective strategies and practices that address nursing staff engagement and encourage behavior that improves patient satisfaction and outcomes. The aim of this quality improvement (QI) project was to empower and inspire nurses to provide optimal, evidence-based care that enhanced the patients' experience and optimized clinical outcomes in a specialized stroke unit. METHODS: The authors employed the Plan-Do-Study-Act model embedded within the Daily Team System QI framework to structure the implementation strategies for maximum effectiveness. Data measurements included NDNQI RN Satisfaction Surveys; Press Ganey Patient Satisfaction Surveys; and Nurse Sensitive Quality Indicators for falls, hospital acquired pressure injuries (HAPIs), catheter-associated urinary tract infections, and hand hygiene adherence. Analysis was descriptive and allowed for inferences to be drawn about how the implemented strategies positively impacted outcomes. RESULTS: There were significant improvements across measured clinical outcomes for falls, HAPIs, and hand hygiene adherence. Patient satisfaction scores increased, and RN satisfaction survey results demonstrated that implemented strategies had a positive effect on nursing staff's experience and behavior. CONCLUSION: The changes and improvements were relatively easy to implement and were highly impactful across measured outcomes. Empowering nurses to lead quality initiatives and using a structured change management framework benefits patients and fosters a more fulfilled, effective nursing team.