Walden University ScholarWorks Walden Dissertations and Doctoral Studies Walden Dissertations and Doctoral Studies Collection 2015 Using Appreciative Inquiry to Improve RN Retention in a Clinical Float Pool Janet Buck Walden University Follow this and additional works at:https://scholarworks.waldenu.edu/dissertations Part of theNursing Commons This Dissertation is brought to you for free and open access by the Walden Dissertations and Doctoral Studies Collection at ScholarWorks. It has been accepted for inclusion in Walden Dissertations and Doctoral Studies by an authorized administrator of ScholarWorks. For more information, please [email protected]. Walden University College of Health Sciences This is to certify that the doctoral study by Janet Buck has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Review Committee Dr. Mary Tan, Committee Chairperson, Health Services Faculty Dr. Camilla Jaekel, Committee Member, Health Services Faculty Dr. Andrea Jennings-Sanders, University Reviewer, Health Services Faculty Chief Academic Officer Eric Riedel, Ph.D. Walden University 2015 Abstract Using Appreciative Inquiry to Improve RN Retention in a Clinical Float Pool by Janet Buck MSN, Walden University, 2010 ASN, Excelsior College, 1990 Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice Walden University August 2015 Abstract In an Idaho-based hospital, the registered nurse (RN) turnover rate in the float pool was excessively high. The purpose of this project was to examine the effect of Appreciative Inquiry (AI) on a RN’s sense of community (SOC) in a float pool and an RN’s intent to stay employed after attending an AI event. Although much had been written about nursing retention, AI, and SOC separately, there was nothing on how AI could be used to increase a RN’s SOC or intent to stay employed. AI is a change management framework that has been used to engage employees in a meaningful way. The goal of this project was to engage RN float staff in a 6-hour AI workshop to generate ideas on improving the work environment. The SOC theory by McMillan and Chavis provided the context for measuring RN perception. It was anticipated that participation would lead to an increased SOC and an increased likelihood of staying employed in the float pool. The Sense of Community Index 2 survey was administered pre and postworkshop to a convenience sample of RNs (n = 22) recruited from the float pool. Additionally, RNs were asked before and after the workshop how likely they were to leave their current position in the next 12 months. Data analysis was a paired t test based on a 1-group pretest and posttest design. Demographic data were collected to describe the sample population. The results, although not statistically significant, showed both an increased SOC and an increased intent to leave following the AI workshop. The findings show that AI may be useful for increasing SOC. However, as a tool for nursing retention, both AI and SOC require better understanding. It is hoped this study will provide leaders with a starting point for further investigation into how AI and SOC can be used to improve the nursing work experience. Using Appreciative Inquiry to Improve RN Retention in a Clinical Float Pool by Janet Buck MSN, Walden University, 2010 ASN, Excelsior College, 1990 Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice Walden University August 2015 Acknowledgments First, and foremost, it was the unconditional support of my husband that enabled me to complete this educational journey. Without his ongoing encouragement this would not have been possible. I would also like to thank Dr. Mary Tan for her persistence in helping me navigate the many hurdles encountered along the way and her kind tolerance of my many phone calls. Dr. Diana Meyer and Dr. Laura Tivis provided an unending and amazing ocean of knowledge that, to this day, continues to motivate me to become a better person, a better nurse, and a better role model. Table of Contents List of Tables ..................................................................................................................... iv List of Figures ......................................................................................................................v Section One: Overview of the Evidence-based Project .......................................................1 Introduction ....................................................................................................................1 Background ....................................................................................................................2 Problem Statement .........................................................................................................3 Purpose Statement ..........................................................................................................4 Goals and Outcomes ......................................................................................................4 Significance and Relevance to Practice .........................................................................5 Project Questions ...........................................................................................................5 Evidence-Based Significance of the Project ..................................................................6 Definitions of Terms ......................................................................................................7 Limitations .....................................................................................................................8 Summary ........................................................................................................................8 Section Two: Review of the Scholarly Evidence ..............................................................10 Introduction ..................................................................................................................10 Literature Search Strategy............................................................................................10 Float Pools ...................................................................................................................10 Nursing Turnover .........................................................................................................12 Impact on Quality of Care ............................................................................................14 Retention strategies ......................................................................................................15 i Appreciative Inquiry ....................................................................................................16 Theoretical Frameworks ..............................................................................................17 Sense of Community Framework ................................................................................17 Summary ......................................................................................................................20 Section Three: Approach ...................................................................................................21 Introduction ..................................................................................................................21 Design and Methods ....................................................................................................21 Population and Sampling .............................................................................................22 Data Collection ............................................................................................................22 Data Analysis ...............................................................................................................25 Project Evaluation Plan and Dissemination .................................................................25 Summary ......................................................................................................................25 Section Four: Findings, Discussion, and Implications.......................................................27 Summary of Findings ...................................................................................................27 Discussion of Findings .................................................................................................29 Implications of Findings ..............................................................................................30 Practice .........................................................................................................................30 Future Research ...........................................................................................................31 Social Change ..............................................................................................................31 Projects Strengths and Limitations ..............................................................................32 Strengths ................................................................................................................32 Limitations .............................................................................................................32 ii Recommendations for Remediation of Limitations in Future Work .....................32 Summary and Conclusions ..........................................................................................33 References ..........................................................................................................................41 iii List of Tables Table 1. Appreciative Inquiry Workshop Agenda ............................................................ 39 Table 2. Mean Survey Scores and p-Values ..................................................................... 42 Table 3. Likelihood of Leaving Before and After the Appreciative Inquiry Workshop .. 43 iv