Case Study: Pennsylvania Hospital 2024 Achievement Award

Workforce Innovators—Large Division

Clinical Nurse Ambassadors:  Innovative Peer Support Improving Well-being, Clinical Practice, and Retention Among the Nursing Community on Night Shift

The Goal

The Clinical Nurse Ambassador program represents a pioneering response to challenges in nursing staff dynamics, particularly among new-to-practice (NTP) registered nurses (RN) on night shifts. This initiative emerged due to a significant increase in NTP RN hires (from nine in 2018 to 70 in 2023), a high RN turnover rate (13 percent during 2022), and a reliance on temporary RN staffing.

Intervention

The Director of Nursing Education developed a clinical nurse ambassador program to support the clinical and well-being needs of nurses on the night shift. A team of five experienced nurses from diverse clinical backgrounds provides shoulder-to-shoulder clinical support, professional development, and promotes well-being in real time. Each ambassador, a clinical nurse without a patient assignment, is assigned to work one shift per week. They round on all clinical nursing units, focusing on new hires including NTP RNs.

Ambassadors respond to clinical emergencies, facilitate skills education, validate competencies, and bring resources to the night shift. Ambassadors use a worksheet to document all encounters with staff.

Results

During its first year, the ambassadors:

• Engaged in more than 1,000 encounters with NTP staff
• Handled more than 100 clinical emergencies
• Played a pivotal role in staff well-being and competency validation

This innovative approach led to a decrease in nurse turnover to 12 percent and a 46.8 percent reduction in temporary RN hires during 2023. The program's adaptability, efficient use of resources, and support from nursing leadership contribute to its success, while also emphasizing health equity by supporting a diverse nursing staff, thus improving overall quality of care.

 

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Topics: Quality Initiatives, Workforce

Revision Date: 2/20/2024

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