Even though their direct impact on patient outcomes is limited, nurse unit managers do play a significant role both in the quality of care the nurses on their team provide, overall quality and how patients perceive their care, according to a new report.
Press Ganey's annual report on nursing compared data from the National Database of Nursing Quality Indicators with the group's own patient experience research to determine the role nurse managers play in care quality. Across all unit types, the study found that nurse managers are a major driver when it comes to patient experience.
"Nurse managers at the unit level exert substantial influence on the work environment of nurses at the bedside, and, ultimately, on performance across measures of safety, quality and patient experience," the report found.
Nurse managers' direct impact on patient outcomes was less consistent, however, with statistically significant relationships between units with nurse managers and missed care in step-down and medical-surgical units, falls in ambulatory care units and pressure injuries in rehabilitation units.
Three main drivers emerged as playing a major role in nurse satisfaction: autonomy, professional development and adequate staffing. Autonomy, proper staffing and nurse-nurse interactions had the most direct influence on care quality, according to the report.
These drivers highlight areas upon which quality improvement efforts can focus, according to the report. After completing its study, Press Ganey surveyed 195 nurse managers to gather best practices for fostering a positive work environment. Suggestions included:
- Conduct leader rounds to increase the visibility of management.
- Ensure that nursing staff is involved in decisions that directly impact their practice environment.
- Adopt a leadership council on the unit level.
- Eliminate rotating shift schedules.
- Be empathetic and caring when connecting with staff members.
- Use peer reviews and audits to measure progress toward quality improvement.