Decreasing Nurse Turnover in the CICU

Retaining nurses is an ongoing struggle nationwide, especially in critical care settings like the pediatric CICU. To decrease voluntary turnover at the Children's Health℠ CICU, Critical Care leaders developed a program focused on employee engagement, work-life balance, mentorship and support. This innovative program helped decrease turnover by 5 percent.  

Learn more about how we strive to retain our CICU nurses through this poster created by our CICU Leadership Team. 

Background

The complexity of pediatric cardiac intensive care patients is on the rise due to advances in medical and surgical technology (Pittman, 2019). This chronic and high acuity environment can be difficult for bedside nurses, both physically and emotionally. Retaining nurses is an ongoing struggle nationwide, more specifically in critical care settings.

• Health care organizations are losing millions of dollars trying to balance the nursing shortage and turnover.
• Voluntary nursing turnover leads to inadequate staffing, job burnout, moral distress and decreased employee satisfaction.

Lead By

• Emily Hernandez, BSN, RN
• Brandi Brown, BSN, RN, CCRN
• Ashlee Fernandez, BSN, RN
• NaShawn Finley, MBA-HM, BSN, RN, CCRN-K

Objective

Decrease voluntary RN turnover rate by 5% from a rate of 17% to 12% in the pediatric CICU environment after 1 year.

Methods

• Unit employee recognition program implemented in the cardiac ICU.
• Healthy Work Environment group organized monthly social events.
• Nurse mentorship work group created to support new hires.
• CICU leadership team instituted early employee engagement prior to new employee orientation.
• Voluntary nurse turnover data statistics were collected from 2017 to create a target goal reduction of 5% in 1 year.
• Professional practice development guideline tool was created to influence nursing practice growth.
• Creative staffing shift options were implemented to support work life balance.
• Moral Distress team initiated to support bedside staff with coping and emotional distress.
• Increased leadership visibility in the CICU.

Results 

• The CICU voluntary turnover rate decreased by 5.6% after implementing tactics.
• Participation in employee engagement work groups increased due to a growing interest to create a healthy work environment.
• Other units within the organization have adopted these methods to decrease RN turnover.

Conclusions

• Voluntary turnover can potentially decrease through implementation of tactics that directly impact bedside nurses.
• Award programs show nurses that they are appreciated for their hard work and recognize them for their contributions to the unit.
• Mentorship helps nurses adapt to their unit’s environment and provides ongoing role support.
• Leaders must promote a culture of employee engagement to motivate their nursing staff and increase job satisfaction. Lack of emotional support can decrease nurse retention.

References 

• Children’s Health (2018). Critical Care Nurse Turnover. PowerPoint presentation.
• Pittman, T. (2019, September 6). Volume increasing, outcomes improving at Duke Pediatric and Congenital Heart Center. Retrieved November 7, 2019