Promoting a Positive Floating Experience: Implementing a Standardized Tool Kit

Background: Increasing bedside nursing shortages prompt hospitals to utilize a floating staffing strategy. Nurses are required to float frequently from their home unit. Evidence shows that floating impacts nurses' satisfaction and retention. The increased nursing stress can decrease job performance and impact patients negatively. Local Problem: The University of Utah Hospital has a variable daily shortage of nurses that the Resource Float Pool cannot fulfill. The problem is that when nurses float to unfamiliar units, they are less likely to feel confident, supported, and welcome during their shift. In addition, charge nurses and staff nurses are burdened with questions from floats. Methods: Pre-intervention measures included meeting with the nursing directors and managers to establish baseline information about floating processes. Two pre-intervention surveys assessed charge and staff nurses) satisfaction with the current floating processes. Two post-interventions assessed float nurses and charge nurses for feasibility, usability, and satisfaction with the floating tool kits. Interventions. Phase one included surveying staff and charge nurses. Phase two of the intervention included implementing the tool kits for float nurses and charge nurse guidelines. The tool kit included resources such as a unit maps and guidelines, and a survey card with a QR code linked to the post-survey. The charge nurse floating guidelines comprised the float nurses' orientation to the unit, the patient-to- nurse assignment, assigning a "buddy" to the float nurse as a resource, and instructions for delivering the float nurse tool kit. Results: Discussions with nurse managers and directors(n = 4) revealed that unit-specific nurse guidelines for float nurses were available on the University of Utah Intranet; however, there was no hospital-standardized education or charge nurse float guideline. The pre-intervention staff nurse survey revealed that 68% (n=25/37) of the staff nurses do not know about the current unit-specific floating guidelines on the Intranet. Eighty-six percent (n=12/14) of the charge nurses agreed or strongly agreed that this project was feasible. Ninety-three percent (n=13/14) of charge nurses reported satisfaction with implementing the toolkit and charge nurse guidelines. Charge nurses expressed barriers regarding the 3 intervention as to who is responsible for developing the toolkits and the costs of the toolkits. Ninety-four percent of float nurses (n=17/18) strongly agreed or agreed that the float kit improved their float experience. Conclusion: Implementing and evaluating tool kits and charge nurse guidelines for floating nurses improved the float nurse experience. The floating nurses found that the usability of the nursing floating kit improved their work experience. The charge nurses found satisfaction and feasibility of toolkits.