Building Social Support and Moral Healing on Nursing Units: Design and Implementation of a Culture Change Intervention
The healthcare industry continues to experience high rates of burnout, turnover, and staffing shortages that erode quality care. Interventions that are feasible, engaging, and impactful are needed to improve cultures of support and mitigate harm from exposure to morally injurious events. This quality improvement project encompassed the methodical building, implementation, and testing of RECONN (Reflection and Connection), an organizational intervention designed by an interdisciplinary team to mitigate the impact of moral injury and to increase social support among nurses. This quality improvement project was conducted in a medical intensive care unit (MICU) in a rural, academic medical center. We employed an Evidence-Based Quality Improvement (EBQI) approach to design and implement the RECONN intervention while assessing the feasibility, acceptability, and preliminary effectiveness via surveys (<i>n</i> = 17). RECONN was found acceptable and appropriate by 70% of nurses who responded to surveys. Preliminary effectiveness data showed small to moderate effect sizes for improving social support, moral injury, loneliness, and emotional recovery. Further evaluation is warranted to establish the effectiveness and generalizability of RECONN to other healthcare settings.
Authors
- Timothy J. Usset (ORCID: https://orcid.org/0000-0002-8643-2415)
- April Prunty
- Rebecca Brown (ORCID: https://orcid.org/0000-0001-5110-2750)
- Joel Bradley (ORCID: https://orcid.org/0000-0003-4636-1269)
- Joseph M. Currier (ORCID: https://orcid.org/0000-0002-8843-2996)
- Jeffrey M. Pyne (ORCID: https://orcid.org/0000-0001-9501-6053)
- Renèe Pepin (ORCID: https://orcid.org/0000-0002-8011-1012)
- Shoshana H. Bardach (ORCID: https://orcid.org/0000-0002-1342-5863)
- Stephanie W. Edmonds (ORCID: https://orcid.org/0000-0002-7307-8023)
- Christopher L. Hubble
- Rebecca Wurtz (ORCID: https://orcid.org/0000-0002-0501-7317)
- Cassandra M. Godzik (ORCID: https://orcid.org/0000-0002-3356-9303)
- Brant J. Oliver (ORCID: https://orcid.org/0000-0002-7399-622X)
- Andrew J. Smith (ORCID: https://orcid.org/0000-0002-4412-7244)
- J. Irene Harris (ORCID: https://orcid.org/0000-0001-6548-1966)
Institutions
- Dartmouth College (US)
- Dartmouth Institute for Health Policy and Clinical Practice (US)
- Dartmouth–Hitchcock Medical Center (US)
- University of Minnesota (US)
- Abbott Northwestern Hospital (US)
- Allina Health (US)
- Central Arkansas Veterans Healthcare System (US)
- MaineHealth (US)
- Minneapolis VA Health Care System (US)
- University of Maine (US)
- University of Arkansas for Medical Sciences (US)
- University of South Alabama (US)
- University of Colorado Colorado Springs (US)
Publication Details
- Journal
- Behavioral Sciences
- Published
- 2024-09-10
- DOI
- https://doi.org/10.3390/bs14090796
- Citations
- 7
- Primary Topic
- Healthcare professionals’ stress and burnout
- Type
- article
- Field-Weighted Citation Impact
- 5.95
Funders
- Dartmouth College