Recent Research About Nursing, August 2013

Jul 31, 2013, 9:30 AM

This is part of the August 2013 issue of Sharing Nursing's Knowledge.

Nurse Manager Turnover Associated with Poorer Patient Outcomes

High turnover among hospital nurse managers can have negative effects on patient outcomes, according to a new study by a group of scholars that includes Robert Wood Johnson Foundation Executive Nurse Fellows alumna Karen Stefaniak, PhD, RN.

Stefaniak and colleagues used 27 months of data from 23 critical care and medical/surgical nursing units in two U.S. hospitals. Of the 23 nursing units in the study, 13 experienced "interim nurse management" during the period of the study, meaning that a nurse manager had recently left and an acting nurse manager was fulfilling his or her duties. Ten of the units had stable management. The data also included information on patient fall rates and pressure ulcer rates; these items were studied because they were deemed to be particularly "nurse-sensitive" indicators.

The results favored nursing units with stable management. Patients in medical/surgical units with nurse manager turnover were more likely to suffer falls, and patients in intensive care units with turnover were more likely to have pressure ulcers.

The authors conclude that nurse manager turnover "may negatively impact patient outcomes." They write: "One reason for this may be because nurse managers enable the flow of information between the broader organization and their patient care areas. When practice changes are made, nurse managers are often the primary conduit to ensure that their staffs are aware of and comply with the practice change. Equally important, when nursing staff develop innovative process improvements, nurse managers often facilitate the spread of the innovation from the nursing unit out to the broader organization."

The study was published online on July 18, 2013 by the Journal of Nursing Management.

Read an abstract of the study.

Nurse Managers Play Important Role in Healthy Nurse-to-Nurse Relationships

A study in the May issue of MedSurg Nursing highlights the important role that nurse managers play in fostering healthy nurse-to-nurse relationships in hospitals.

Researcher Linda Weaver Moore, CNS, PhD, RN, and colleagues at the Xavier University College of Social Sciences, Health, and Education surveyed more than 400 registered nurses about their everyday interactions with their nurse colleagues, gathering responses from 82. A number of the questions were open-ended, and researchers conducted a qualitative analysis of responses, identifying key pieces of data and trends in the responses.

They found that just over 20 percent of the nurses had considered leaving the profession because of poor relationships with their nurse colleagues, and 55 percent had considered leaving or had actually left a particular nursing job for that reason. In addition, some respondents pointed to difficulties integrating new nurse graduates into units, observing that new nurses were most likely to succeed if they demonstrated "a willingness to learn and listen" and to be "open to constructive feedback."

Many respondents focused on the role of nurse managers, with 56 percent indicating that their nurse managers contributed to positive relations among nurses. Some noted that their nurse managers encouraged nurses in their units, were willing to confront conflicts, and promoted a friendly and inclusive environment. On the negative side, some respondents pointed to a need for more respectful and supportive nurse management, and others noted that their managers did not empower nurses to make decisions or resolve conflicts. As one respondent wrote, "The nurse manager holds the key to a positive, healthy unit."

Read an abstract of the study.

This commentary originally appeared on the RWJF Human Capital Blog. The views and opinions expressed here are those of the authors.