Date of Graduation

Fall 12-1-2018

Document Type


Degree Name

Doctor of Nursing Practice (DNP)


School of Nursing and Health Professions




Executive Leader DNP

First Advisor

Dr. Robin Buccheri, PhD, RN, NP, FAAN

Second Advisor

Dr. Marjorie Barter, EdD, RN, CNL, CENP


Problem: Several studies have examined the role of the nurse and reveal that job-related stress, defined as an overload of high acuity patients, physical and emotional demands of the job, and lack of autonomy, may impact engagement and teamwork (Garrosa et al., 2010). Evidence suggests a direct correlation between high levels of staff engagement and teamwork improves quality outcomes for the organization. Therefore, it is imperative that we measure staff engagement and teamwork on our nursing units to ensure that quality indicators are met and that as an organization we provide safe patient care.

Context: The purpose of this Doctor of Nursing Program (DNP) evidence-based change of practice project was to apply the elements of a professional practice model on a 48-bed medical-surgical-telemetry unit at a medium sized (225 licensed beds) tertiary medical center to measure the effect on nurse engagement and teamwork. The main stakeholders in this project were nursing administration, the unit management team, and staff nurses working on the interventional unit. The unit was chosen due to several indicators: decline in staff morale, lack of perceived teamwork amongst the staff, and the exodus of key staff members due to the demands of the role.

Interventions: Using a pre-test, post-test design, nursing staff on the telemetry unit were enculturated with a professional practice model (known as the Voice of Nursing [VON]) along with its six core values and defined lean principles. Interventions consisted of a workshop, post workshop meetings, development of a visual board, and enhancement of an existing unit-based team known as Creating Lasting Change (CLC) to drive change on the unit.

Measures: Measures chosen to study the intervention’s processes and outcomes targeted: a) nurse knowledge regarding the VON professional practice model, b) staff engagement, c) intent to stay with the organization, d) culture of teamwork, and e) improvement in the quality metric of patient falls.

Results:The findings after implementing a professional practice model compared to pre-study findings are as follows:

  • Nurses had a clearer understanding of the professional practice model (increased by 33%)

  • Improved engagement on the interventional unit (improved by 4%)

  • Intent to stay within the organization (increased by 11%)

  • An improved culture of teamwork (improved by 9%)

  • Decreased falls from a total of 4 to zero during the last three months of the project (June-August 2018)

Conclusion: The purpose of implementing and enculturating the elements of a professional practice model demonstrated the intent to get to the hearts and minds of nurses and create an environment in which nurses are engaged, and a culture of teamwork exists. An engaged work force helps encapsulate a safe, efficient, and effective environment for not only the nurse but for their patients.

Included in

Nursing Commons