Nursing Assignments Based on Patient Acuity: the Road to Nursing Job Satisfaction

Challenges in the healthcare industry, including nursing shortages and low nursing retention, have resulted in nurses’ job dissatisfaction. Improving work environment and workload can lead to improved and equitable nursing shift assignments, which may improve nursing job satisfaction. The purpose of this EBP project was to (a) implement a patient acuity tool in the hospital unit, (b) assess its effectiveness in appropriating nursing shift assignments, and (c) evaluate its effect on nursing job satisfaction. The Evidence Based Medicine (EBM) Model was used as a guide to facilitate the transition of the best evidence into practice. As suggested within the evidence, utilization of a patient acuity tool in appropriating nursing shift assignments should increase nursing job satisfaction as compared with assignments based on charge nurse’s judgment alone. Based on an extensive review of the best available evidence from the literature and professional input from staff nurses, a patient acuity tool was created. Upon organizational and academic approval, education of the staff nurses on tool utilization was completed and the project was implemented. To determine the effectiveness of the tool, pre-and post-implementation, the Nursing Workplace Satisfaction Questionnaire (NWSQ) was administered. Paired sample t tests were conducted to analyze mean pre-and post-test scores in all three domains (intrinsic, extrinsic and relational) of the NWSQ. Statistically significant differences (t (19) = -2.67, p\u3c.05), were only found in one item of the intrinsic domain addressing whether the participants were able to learn on the job (M = 1.75, SD = .55, M = 2.1, SD = .85). No other items? on the survey were statistically significant (p \u3e .05). All of the project participants stated that the use of the tool was quick and easy, 60% noted marked improvement in equity of shift assignments and 85% would like to continue using the tool after project completion. Also, 55% of participants reported better balanced nursing shift assignments with the tool utilization. Incorporation of the acuity tool in the clinical setting over a longer period of time might improve nursing job satisfaction