Professional Rns Should Again Be Required to Wear Distinctive Uniforms
Margaret Mary West, PhD, RN, CNE
Debra Wantz, DNP, RN, CCNS, NEA-BC
Patricia Campbell, MSN, RN
Greta Rosler, MSN, RN, NEA-BC
Dawn Troutman, BSN, RN, CCRN, NE-BC
Crystal Muthler, BSN, RN, MHA, NEA-BC
Abstruse
The public image of nurse professionalism is important. Attributes of a professional person nurse, such as caring, attentive, compassionate, efficient, knowledgeable, competent, and approachable, or lack thereof, can contribute positively or negatively to the patient experience. Nurses at a hospital in central northeast Pennsylvania offer their story as they considered the impact of a wide variety of private compatible and dress choices. This article describes an evidence based practise project and survey created to increase understanding of patient perceptions regarding the professional image of nurses in this facility. Exploring patient perception of nurse image provided insight into what patients view as important. A team approach included the phonation of nurses at dissimilar levels in the process. Ultimately, this work informed a revision of the health organisation nursing wearing apparel code. The study team also reflects on challenges, next steps in the process, and offers recommendations based on their experiences.
Citation: W, M., Wantz, D., Campbell, P., Rosler, M., Troutman, D., Muthler, C., (January 31, 2016) "Contributing to a Quality Patient Experience: Applying Evidence Based Practise to Support Changes in Nursing Dress Code Policies" OJIN: The Online Journal of Issues in Nursing Vol. 21 No. 1, Manuscript four.
DOI: 10.3912/OJIN.Vol21No01Man04
https://doi.org/ten.3912/OJIN.Vol21No01Man04
Key words: Professionalism, nurse image, patient experience, patient perceptions, dress code, nursing uniforms, bear witness-based practice, shared governance
...how a nurse appears tin accept a meaning affect on how a patient perceives the nurse.The goal of healthcare is to provide the best possible outcomes and experiences for patients and families. To that cease, registered nurses (RNs) strive for professionalism in all aspects of care and interaction. First impressions are oftentimes formed in an instant, so how a nurse appears tin can take a meaning bear on on how a patient perceives the nurse. A uniform serves every bit a reflection of how the public identifies the role of the wearer (Bates, 2010).
Although consistently identified as members of one of the most trusted professions (Riffkin, 2014), contemporary nurses all the same struggle with image. In the media, nursing is portrayed in various means: from matronly in a white uniform with a cap to sensual and cute in a tight miniskirt (Kelly, Fealy, & Watson, 2012). In reality, the nurse uniform influences perceptions nearly nursing practice and thus contributes significantly to the overall paradigm of a nurse (Wocial, Sego, Rager, Laubersheimer & Everett, 2014a).
Nursing uniforms accept been a source of tension for well over a hundred years (Pearson, Baker, Walsh, & Fitzgerald, 2001). In the 19th century, Florence Nightingale promoted excellence by creating a vision that was intended to raise nursing to a respectable profession characterized by caring, compassion, and clinical competence. She established a standard compatible for nurses as part of her effort to professionalize nursing (Houweling, 2004). Although the definition of the image of nursing is complex and dynamic, over 80% of Americans continue to listing nursing equally the most trustworthy profession in every Gallup Poll since 2005 (Swift, 2013).
The paradigm of nursing is comprised of many components that identify nursing equally a healthcare profession. Cohen, Bartholomew, Swihart, and Tomajan (2014) noted research study findings in which nurses identified several actions that they felt shape patient perception of them, such every bit whether they introduce themselves to patients as the nurse, whether they call patients by their names, and the level of their professional person appearance. Study results indicated that xc% of the nurses felt that how they dressed had a slap-up impact on their paradigm.
The uniforms that most RNs wear have changed significantly in the terminal 20 years.The uniforms that most RNs article of clothing have changed significantly in the last xx years. Prior generations of healthcare personnel, particularly nursing staff, were required to follow stringent dress codes and work attire policies. White uniforms and nursing caps accept been replaced by colored scrubs that take cartoon or holiday print decorations. White polished nursing shoes have been replaced past multicolored sneakers and clogs (Dumont & Tagnesi, 2011). Forces external to healthcare, such every bit the media and online marketing, have promoted individual preference as the new expression of "teaming and unity," resulting in this more breezy attire.
Nurses at Geisinger Medical Center had concerns about the touch on of a broad variety of individual uniform and apparel choices noted in their facility. This article describes an evidence based practice projection and survey created to increment understanding of patient perceptions regarding the professional person image of nurses in this facility. Exploring patient perception of nurse image provided insight into what patients really view as important. A squad approach included the vocalism of nurses at different levels in the process. Ultimately, this piece of work informed a revision of the health system nursing dress lawmaking. The article also includes reflections from the written report team about challenges and next steps in the process, and offers recommendations based on their experiences.
Our Story
Feedback from patient rounds, interactions with family members, and colleagues at other Magnet® healthcare organizations indicated uncertainty about who nursing care providers were and how to identify dissimilar levels of nursing personnel.Geisinger Medical Middle is a hospital in central northeast Pennsylvania. In 2014, nurse leaders identified the need to re-evaluate current dress lawmaking policies in low-cal of mounting challenges related to lack of a consistent dress lawmaking and a perceived decline in the professional person appearance of the nursing staff. Feedback from patient rounds, interactions with family members, and colleagues at other Magnet® healthcare organizations indicated dubiety about who nursing intendance providers were and how to place dissimilar levels of nursing personnel. Nurse leaders began to talk over the need for an testify-based do (EBP) project to decide patient perceptions of professional prototype of nurses in the inpatient and outpatient settings inside Geisinger Medical Center (GMC).
At the same time, staff members had begun an online dialogue on our system intranet expressing concerns regarding the informal nature of the nursing staff attire, such as nurses wearing hoodies, leggings, fleece jackets, and t-shirts while working. Meantime, nursing staff on ane of the adult inpatient medical surgical units voiced concerns well-nigh variations in fellow staff members' patterns of wearing apparel and advent to unit leadership. Staff of all skill levels, many of whom had worked in healthcare/nursing for many years, began a dialogue about professional person appearance as it related to peers who were wearing clothing that did not come across traditional compatible standards.
Some patient statements indicated that staff members appeared "ready for the gym" or dressed like they were "at the lodge," not as professionals in a hospital.During this time, there was also discussions regarding patients' perceptions of professional appearance related to not only attire, only other expressions of individuality, such as jewelry, piercings, and tattoos. Some patient statements indicated that staff members appeared "ready for the gym" or dressed like they were "at the club," not every bit professionals in a hospital. Unit staff and leaders noted that patients and families often expressed that they could not differentiate the skill levels of staff members. Other staff contended that many patients and families who were in distress or crisis liked the lark of conversations virtually staff tattoos; they then shared stories of their ain body art, allowing for development of rapport in the patient-caregiver relationship.
Based on the staff's many conversations most patients' stories and opinions in terms of their own work life, professional person advent, and the patient experience, unit leadership identified a demand to address these concerns by considering revisions to the dress lawmaking policy. The electric current policy described acceptable types of wearable and stipulations about tattoos, only was not based on bodily patient perceptions of what elements of professional image translated to their perception of splendid care. Staff nurses and nurse managers decided to evaluate evidence on this topic to inform and update the policy to reverberate an show-based standard.
Creating an EBP Projection
The aim of our project was to assess what patients perceive to be the most professional appearance, communications, and deportment by a nurse.Nursing has a long and valued history of using research to bear on practice, beginning with the earliest pioneer, Florence Nightingale (Nightingale, 1859). Evidence-based do (EBP) is the conscientious and judicious use of current all-time bear witness in conjunction with clinical nursing knowledge and patient values to guide healthcare decisions (Jennings & Loan, 2001). The process begins with a question, followed by an extensive review of the literature to evaluate what answers and discussion already be. The aim of our project was to assess what patients perceive to exist the most professional person advent, communications, and actions past a nurse. The goal was to utilize the findings to create an evidence-based dress code policy that would support the almost professional epitome of nurses in our facility and hopefully contribute toward the best patient experience. This section will describe the projection as information technology evolved. The figure below outlines the timeline of our work.
Figure. Timeline
Step 1: Review of the Literature
The Geisinger Medical Center uses the Johns Hopkins Model of EBP (Dearholt & Dang, 2012). Nurses refined their EBP question, met with nurses from the organization Nursing Research and Evidence Based Do Council, and began the review of the literature.
Photo images and patient preferences . The importance of professional image has been a focus inside nursing for decades. Fogle & Reams (2014) wrote a cursory historical perspective of nurses' wearing apparel code. They concluded that consistency in nursing attire communicates professionalism and allows patients to identify nurses hands.
Windle, Halbert, Dumont, Tagnesi, and Johnson (2008), surveyed 430 patients at one hospital using a tool that included questions on power to place the nurse, professional person prototype of the RN, and how patients prefer to see their nurse dressed. The tool included 12 photos of nurses in various dress and patients identified the photograph they preferred. They rated nurses highly on image but had some difficulty identifying the nurse. Dumont and Tagnesi (2011) repeated the study with nurses wearing a big print RN on the identification bluecoat; the ability to identify the nurse significantly improved. Also, most patients preferred that nurses use their commencement names and did not like to exist chosen pet names, such every bit dear or sweetie.
Other studies (Albert, Wocial, Meyer, & Trochelman 2008; Kaser, Bugle, & Jackson, 2009) used the Nurse Epitome Scale (NIS) to assess patient perception of nurse professionalism, which likewise uses photos of nurse models and ratings related to characteristics such as confidence, competence, attentiveness, efficiency, caring, and professionalism. Some results of the studies were mixed. Patients did not hold that scrubs with cartoons or vacation decorations appeared less professional and some liked the same uniform concept simply did not accept a colour preference (Windle et al., 2008). Others preferred colors or all white and age of the patient impacted results (Albert et al., 2008; Kaser et al., 2009). Dumont and Tagnesi (2011) establish that most patients preferred different colors of uniforms rather than all white ones.
One conclusion of these studies is that dress is a very strong grade of nonverbal communication.Pearce et al. (2014) used an online survey and focus groups for both patients and nurses. Patients said it was very important to exist able to identify the RN, but only half said color and scrubs were the priority. Patients felt nurses should wear a compatible that allowed condolement and ease for job operation. Ane conclusion of these studies is that dress is a very strong form of nonverbal communication.
Studies that included body fine art . Hatfield et al. (2013); Clavelle, Goodwin, & Tivis (2013); and Pfeifer (2012) conducted studies using pictorial images of nurses, considering colour of uniforms, tattoos, and body piercings. Patients felt RNs appeared professional and were easily identified by a standardized compatible mode and color. They gave high scores for nursing prototype, appearance, and identification, with less support for color-coded uniforms. Patients regarded the nurses as professional with less focus on attire and more focus on how knowledgeable and confident the nurses appear, and how well they provide care. Patients cared that nurses were clean and neat, and that vesture fit properly and looked overnice. Most patients felt the white board and large RN badges were of import. An implication of these studies was to have the fourth dimension to probe patient preferences before implementing a policy alter.
Thomas et al. (2010) had patients, nurses, students, and faculty view 18 colour photos and rate a nurse'due south level of caring, skill, and knowledge based on how the nurse looks. Nurses wearing solid scrubs were rated significantly more skilled and knowledgeable than a nurse wearing print or t-shirt attire past all groups. All subjects rated the nurse with the most body art (e.g., piercings, visible tattoos) the least caring, skilled, and knowledgeable. Thomas et al.'s (2010) findings suggested that nurses wear a solid colour uniform with express visible trunk fine art. Pfeifer'southward (2012) inquiry demonstrated that gender did non affect results. Males with visible piercings were almost never deemed more than professional, and women with piercings other than earlobe were viewed even less favorably than their counterparts without piercings.
Dress code policies . Some manufactures discussed challenges of changing dress code policies. Everett (2012) described the procedure of moving nurses in a health organization to the same color uniform. Nurse and patient focus groups supported decisions nearly uniforms (east.g., each department wore a different color). Patients felt information technology was piece of cake to identify the nurse. Wocial, Sego, Rager, Laubersheimer, and Everett (2014b) conducted additional nurse focus groups in the same wellness organization, asking 10 questions about nursing image. Results showed it is not merely uniform color or style that influences the image of nurses. Nurses felt that a uniform must communicate well to patients and families who the nurse is. More uniforms, it is nurse behaviors (eastward.g., compassion, approachability, good manners, service-oriented) that define the patient experience. Nurses should concord each other accountable and convey balls to each other, patients, and families through actions. Simply, this balls is significantly influenced past how the nurse presents her or himself – the overall appearance.
Mitchell, Koen, and Moore (2013) also discussed dress lawmaking challenges. They presented the issue of religious discrimination focusing on dress and appearance and some courtroom cases that have provided guidance for employers.
...we ended that it was best to assess the perception of patients served at the micro level. Our conclusions. Most studies nigh RN identification and uniforms were done within a single hospital or health system. Most were not randomized, some lacked comparison groups, and many failed to control for extraneous variables that could potentially influence outcomes (Windall, 2008). The results of most studies suggested patients prefer nurses who are identifiable and professional in appearance. After synthesizing the literature findings, we concluded that it was best to assess the perception of patients served at the micro level. As a issue, nosotros developed tools locally, but informed by our literature search, did not apply large, national, randomized surveys. Later sharing the results with Geisinger nurses and leadership, we decided to create a survey with questions and photos to capture patient opinions at Geisinger most nurse professionalism and attire.
Step ii: Survey Development and Inquiry Procedure
Developing our survey . Nurse input, the review of the literature from the EBP project, patient input, and review of patient satisfaction comments informed the evolution of our survey. With permission, our survey was partially adapted from Dumont and Tagnesi'southward (2011) report. The survey included three sections: demographics, questions (xiv), and photos (6). Demographic queries included gender, birth year, number of admissions as Geisinger inpatient, and number of visits to a Geisinger clinic. The questions and photos addressed concerns most epitome that may relate to the patient's perception of his or her experiences.
Nurse input, the review of the literature from the EBP project, patient input, and review of patient satisfaction comments informed the development of our survey.Participants ranked each of the 14 questions on a Likert type scale from 1 (strongly disagree) to 5 (strongly concur). Questions inquired about verbal interactions, nurse advent, and ability to identify caregivers. For example, one question asked if the nurse's appearance made them feel confident that he or she had the ability to intendance for them. Other questions asked for opinions about whether nurses should wear t-shirts or multi-colored, patterned uniforms. Some questions asked participants if they adopt to exist chosen Mr. or Mrs., or by their first names.
The six nurse photograph pictures included the same male and female nurse models in each photo. Participants were asked to rank each photo on a Likert type calibration from 1 (less professional) to five (more professional). In the survey, a professional nurse was divers as one who is caring, attentive, confident, reliable, empathetic, efficient, cooperative, knowledgeable, competent, and outgoing (attributes noted in the literature review). One photograph had nurses dressed in solid navy scrubs. Other nurses wore long sleeved t-shirts with tie-dyed artillery and bluish hospital scrub pants. One photo illustrated a layered look for the tops and hospital blueish scrub bottoms. Other photos included nurses with solid scrubs with a tighter fit; holiday scrubs; and solid tops and bottoms in different colors. In addition to the varying uniform scrubs, in two photos the photography team added jewelry and tattoos since these were also discussed in the literature. We used six unlike copies of the survey, with photos in a different club in each set of surveys, to accomplish random presentation.
Table. Study Inclusion and Exclusion Criteria
| INCLUSION CRITERIA | EXCLUSION CRITERIA |
|
|
Members of the written report team talked with Operations Managers on each of the adult inpatient medical-surgical units and the adult outpatient clinics to explain the study. Study team members visited potential participants on developed medical-surgical units and developed outpatient clinics at GMC. The report team member talked with the inpatient charge nurse prior to gathering data, to identify patients who met the eligibility criteria. This prevented the team from approaching patients who did non wish to be disturbed or did non meet appropriate criteria. All potential participants were asked if they had previously completed the survey.
Information drove process . The survey took x to 15 minutes to complete. Report team members gave verbal, scripted directions to participants and asked if they were willing to complete the survey. So they gave each participant on an information letter explaining the survey and an invitation to participate. Finally, the report squad member gave the letter and survey to patients and instructed them to identify it in an envelope and seal it when finished. The study squad fellow member returned inside an hour to pick up the sealed envelope.
Stride 3: Summary of Survey Findings
Setting, population, and sample . The survey was distributed to Geisinger Medical Center adult patients in the inpatient and outpatient clinics. After blessing from the institutional review board (IRB), the nurse study team recruited a convenience sample of 200 outpatients and 200 inpatients. Specific inclusion and exclusion criteria are listed in the Table.
Our study addressed the patient experience indirectly, based on both patient perceptions that we have noted, and those in the literature. The purpose was to inform dress code decisions at the system level, and hopefully improve the patient experience past addressing known feedback. The scope of this work was non meant to capture every intricacy of the patient feel or explore specific correlations.
We used descriptive statistics to analyze 400 completed participant surveys to describe what patients perceived as the most professional person dress appearance and the most professional comments and actions by the nurse. Participants (57%) felt they could usually identify the registered nurse but it was ofttimes difficult to differentiate between the RN, licensed practical nurse (LPN), and the nursing banana (NA). Most (79%) agreed that nurses were dressed in a manner that helped them experience confident most their ability. Participants (80%) liked that "RN" was in large impress on the proper noun badge and felt that white boards in the room that identified the nurse's name were beneficial. Respondents (74%) felt that nurses look professional person when they are all dressed in the aforementioned uniform, but varied in opinion on whether solid colour (59%) or patterned (64%) was best. All felt strongly that t-shirts with sayings and pictures should not be permitted. Participants (63%) preferred to be called by Mr. or Mrs. and so by their kickoff proper name after the initial introduction. All agreed that no one liked to be called by the endearing terms honey or sweetheart. An expanse of concern was that patients (55%) were not able to identify all people that entered their room and did not know the section in which each person worked.
The photo identified as most professional was the solid navy scrubs (95% of participants). Participants (85%) ranked the photo with layered tops as less professional. Participants (85%) strongly disliked the photograph with necktie dye t-shirts and hospital scrub pants. Holiday scrubs had a mixed ranking (41% supported; 59% did not).
Upon collection of the surveys, many participants expressed desire for an expanse to write comments. After analysis, the report team summarized the results and presented them to hospital nursing councils and leadership teams.
Pace iv: Policy Change Procedure
Quango members felt that a more standard dress code policy for all employees (non just nursing) would improve the overall professional appearance of staff and provide consistency across departments. Council input. During annual review, the Nursing Retentivity and Communication Council (NRCC) was asked to update the dress lawmaking policy, if the council felt changes were indicated. Council members determined a need to detect staff to determine current adherence to the existing policy. Members observed all staff, including those employees outside of nursing, in the deli setting. Inconsistencies in adherence to the dress lawmaking policy, non only in nursing but beyond all departments, were noted during this observation. Quango members felt that a more standard wearing apparel code policy for all employees (not just nursing) would improve the overall professional person advent of staff and provide consistency beyond departments. The NRCC communicated concerns with the human resource (Hr) department; Hr indicated that each section set their own wearing apparel code.
Given this information, the NRCC members revised the nursing wearing apparel code policy to include several changes regarding neatness of appearance, excessive jewelry, and permitted tattoos to be exposed unless inappropriate (showing violence, drugs, sex, alcohol, or profanity). The revised dress code policy was canonical in August 2015, afterwards vetting by infirmary-wide shared governance councils. These councils included Nursing Services Quality Functioning Improvement Council, Nursing Research, Inpatient Manager Quango, Outpatient Manager Quango, and Professional Practice Council.
... an effort to detect all current versions of dress code polices for the health system identified approximately 70 discrete clothes code policies. Arrangement changes. Last year, an effort to notice all current versions of clothes code policies for the health arrangement identified approximately seventy discrete dress code policies. Leaders at GMC recognized that the presence of and then many unlike policies was disruptive and lacked any consistent uniformity across disciplines, departments, and campuses. These policies were collated into one concise document which was vetted and approved through the shared governance councils.
The Geisinger Medical Center nursing department is currently working to standardize dress color for RN staff. In a articulation press release, Chief Patient Feel Officers Susan M. Robel R.N. and Dr. Greg Burke (2015) stated, "The first impression we requite patients and visitors is determined not only by our tone and expertise, but also by our appearance and demeanor" (Sylvester, 2015, p. 2). They connected, "Recent studies accept shown that patients associate professional person attire with honesty, knowledge, and high quality care" (Sylvester, 2015, p. 2). This press release conspicuously conveyed to Geisinger employees, as well as our patients and families, the importance of professional attire.
Effective January 1, 2016, all RNs will transition to pewter grey and white scrub uniforms. The new uniform tops and scrub jackets will exist embroidered with the Geisinger logo and "Registered Nurse." In addition, nurses will be able to take certification initials embroidered on the left sleeve. A system task force has been assembled to accost specific nursing practice specialties, such as Pediatrics and Maternal Wellness, to standardize what nurses in these areas volition be permitted to wear.
Our Challenges
As the procedure has evolved, we accept noted challenges related to team tasks, advice, and cost. This department briefly describes past and nowadays challenges and our solutions, if solved.
Team challenges . It was piece of cake to get volunteers from hospital nursing leadership to be on the study team. One time assembled, the challenge became the ability to coordinate very busy schedules in order to formulate our thoughts and ideas for protocol development. The only user-friendly time to run across was during the lunch hour over the course of several weeks.
A major consideration was to determine whether to conduct the study at the hospital versus the system level. We and so had to become dorsum to system nursing leadership to obtain their input. In one case the protocol was finalized and IRB awarding completed, it took 2 months to finalize IRB approval.
Another time related claiming for the study team was administering the surveys on inpatient units and outpatient clinics. Prior to data collection, we needed to educate key leaders for these units and clinics about the purpose of study and convey that the squad would be nowadays to administer surveys. One time data analysis was completed, it took a couple of months to disseminate results to central pale holders, hospital-broad shared governance councils, and bedside nursing staff.
Because the new dress lawmaking is a major change for nurses' appearance, also equally a change in civilization, staff had many questions and concerns. Advice challenges. Considering the decision to change the RN clothes code afflicted so many nurses across several campuses, consistent communication was imperative. Corporate Communications released a system-wide email to notify staff nearly details of the change and provided a printing release to local newspapers to inform the public. Because the new apparel lawmaking is a major change for nurses' appearance, as well equally a change in culture, staff had many questions and concerns. To provide effective, consequent advice most this change, we created talking points that allowed nurse leaders to engage staff affected by the policy changes.
In our system, only RNs are transitioning to a standardized uniform at the present. LPNs and NAs volition transition at a future engagement. These staff members are naturally anxious about the color choice for their uniforms and transition timeline for that alter. Some other fundamental consideration is to anticipate questions and concerns of the staff and provide timely data.
Cost challenges . To create a uniform appearance for the pewter grayness and white uniforms, the system selected a single vendor to offer uniforms for purchase. The vendor came to campus on several dates and times convenient for nursing staff. Recognizing the financial impact of requiring purchase of new uniforms, nursing leadership provided each RN a $150 uniform allowance toward the starting time purchase of the required uniforms and a 25% disbelieve on those purchases. Following the vendor events, an online ordering organisation will continue to offering discounted prices to staff purchasing boosted uniforms.
Next Steps
Guidelines for exceptions will exist decided by direct intendance nursing staff members who serve on nursing councils.The next steps to fulfill our goal of providing the best possible patient experience involves the tedious piece of work of operationalizing this pregnant change for our nursing team members by working with the vendor described to a higher place. Simultaneously, we volition work within our shared governance support structure to seek input from nursing councils regarding exceptions to the uniform standards. For instance, staff members are asking if there are certain days that they may habiliment holiday-themed scrubs, or hospital-sponsored t-shirts. Guidelines for exceptions will be decided by directly care nursing staff members who serve on nursing councils. Councils will utilize the findings from the show based exercise projection and patient enquiry results to make these decisions.
A goal of this procedure for the coming twelvemonth will be to analyze patient experience data retrieved through routine collection (i.e. random surveys currently sent to patients), specially pertaining to patients' perceptions of nursing staff members treating patients courteously, working together, and overall perceptions of care. Once our changes are completely operationalized, nosotros could specifically query about the professional prototype of nursing staff in time to come patient questionnaires. This could be an opportunity to explicate to patients how their feedback was used to alter policy.
Some other next step of this project includes plans to examine whether a wearing apparel code policy alter has affected nurses' beliefs, perceptions, and thoughts on their ain level of professionalism. In the twelvemonth following implementation, our goal is to facilitate RN focus groups for subjective information sharing and discussions about how the modify has impacted work life, job enjoyment, professional demeanor, and squad relationships. Our aims will be to examine if straight intendance staff feel a college level of engagement and if they enjoy a stronger sense of partnership in their piece of work life, and to seek feedback about other ways that uniform standardization may accept changed their work life.
Our ultimate goal is to back up a superb patient experience by decreasing variation in appearance and increasing focus on quality of care.Implementation of the revised hospital dress lawmaking that standardizes nursing uniforms will be the first steps in a fundamental culture shift for our healthcare workforce at Geisinger Medical Center. These changes bear on upon the physical, mental, moral, and socioeconomic dynamics of the workplace and the employees therein. Our ultimate goal is to support a superb patient experience past decreasing variation in appearance and increasing focus on quality of care. As we motility towards implementation, this emphasis in professional image represents the paradigm that will serve as the platform for further examination of the perceptions and experiences of our patients.
Recommendations and Conclusion
The study team identified a number of tips and recommendations throughout the survey procedure and through discussions with patients and families. Patients stated that they would have appreciated an area within the survey for comments. This was further supported by the number of surveys with comments and ideas written all over the margins of the survey tool. Therefore, we recommend including a section for patient comments.
Although patients were given an invitation to participate and an informational alphabetic character that explained the survey, nosotros found that patients were more likely to consent if the purpose of the survey was explained by the study team member. In our interactions with patients, when we introduced ourselves as Geisinger nurses and emphasized that we were asking their input to aid united states meliorate our patients' experiences, most patients were willing to complete the survey.
In the outpatient setting, we plant that it was important to assure patients in the pre-date waiting room that if they were called for their date, we would await. Thus they did not feel rushed or feel compelled to turn down to participate for fear they might be interrupted for the appointment. It was helpful to tell them they could finish the survey afterwards their appointment, place information technology in the sealed envelope, give information technology to reception staff, and we would return for it after in the mean solar day.
As the survey tool was developed, it was of import to include staff from some of our Nursing Councils. As noted previously, the NRCC had spent months revising the dress policy and members actively participated in the evolution of the questions that were used in the survey. We also felt it was of import to assess various levels of nursing leadership support to ostend willingness to consider the results equally impetus to motility alee with changes in the dress code policy.
We strongly feel that the standardization of nurse uniforms in our health organisation will have a positive affect on the patient experience past promoting a consistent professional prototype and helping patients to identify RN caregivers.I expanse that we felt we could have done differently was a more formal approach to communication with inpatient and outpatient nurses nigh the time frame for the survey and more than word about survey questions. We propose an electronic mail to inpatient and outpatient managers that they could forward to each staff person, informing them of details. We too made the decision to have the members of the EBP report grouping complete data drove, because we felt they were non-biased and would not influence or bear on patient responses.
We recommend considering a variety of approaches to conducting the survey, including surveying nurses and patients, or just nurses rather than just surveying patients. All of those options are discussed in the literature.
In conclusion, this EBP project to increment our understanding of patient perceptions regarding the professional image of nurses in this facility has successfully resulted in an evidence-based policy modify for our nursing clothes lawmaking. We strongly feel that the standardization of nurse uniforms in our wellness system volition have a positive impact on the patient experience past promoting a consistent professional image and helping patients to identify RN caregivers. Our future plans to implement the standardized dress code to a wider level of providers and to continue to evaluate the potential affect on patient experience volition inform additional policy revisions equally needed. This article has provided a detailed description of the process, as well as challenges and recommendations, in the hope that our efforts may exist useful to other facilities addressing concerns related to professional person image and the patient feel.
Authors
Margaret Mary West, PhD, RN, CNE
Email: mmwest@geisinger.edu
Margaret Mary is the Director of System Nursing Inquiry for the Geisinger Health Arrangement. M. M. earned her Bachelor of Scientific discipline degree in Nursing from Bloomsburg University in Bloomsburg, PA, her Principal of Science in Nursing from Misericordia University in Dallas, PA, and her PhD in Nursing Inquiry and Education from Widener Academy in Chester, PA. Her career began in critical care nursing at Geisinger Medical Center, followed with capacity in education and administration with Penn Country University in Country College, PA and Thomas Jefferson University in Philadelphia, PA, until her present position with Geisinger. Nursing research and pedagogy have been the common threads throughout her career.
Debra Wantz Bucher, DNP, RN, CCNS, NEA-BC
E-mail: dwantz@geisinger.edu
Debra is currently the Operations Manager of 42-bed Level I Trauma, a Gold Beacon designated adult intensive care unit at Geisinger Medical Center. She earned a Bachelor of Science and a Master of Science degree in Nursing from Bloomsburg University in Bloomsburg, PA and a Doc of Nursing Practice from Thomas Jefferson University in Philadelphia, PA. She is certified both equally a critical care clinical nurse specialist through AACN and a Nurse Executive, Advanced through ANCC. Deb has worked at Geisinger most 30 years including equally a staff nurse and Team Coordinator in cardiac intensive care, a Clinical Nurse Specialist in the Advanced Center Failure Program and as an Operations Manager in Nursing Pedagogy. She has been the Chief Investigator on several nursing research studies and a Co-Investigator on several manufacture-sponsored pharmaceutical and device trials.
Patricia A. Campbell, MSN, RN
Email: pancampbell@geisinger.edu
Patricia is the Manager of Outpatient Nursing and the Coordinator of Pupil Nurse Affiliations at Geisinger Medical Heart. She is a graduate of the Geisinger School of Nursing, earned a Bachelor of Scientific discipline caste in Nursing at Bloomsburg Academy in Bloomsburg, PA and a Master of Science in Nursing Administration from the University of Pittsburgh. Pat has been employed at Geisinger for 32 years, including every bit a staff nurse in critical care, a Clinical Nurse Specialist in the renal transplant program and as an Operations Managing director in the outpatient clinics. She was also previously employed at Yale New Oasis Infirmary and Lehigh Valley Hospital. Pat is chair of the Geisinger Facilities Safety Committee and participates on the Hospital Quality Improvement Committee and equally the advisor to various nursing councils.
Greta Rosler, MSN, RN, NEA-BC
Email: gerosler@geisinger.edu
Greta is an Operations Manager at Geisinger Medical Eye and leads frontline teams on 3 medical surgical units and a wound ostomy team. In improver, she advises the hospital'south Professional Practice Council, with a daily focus on staff appointment and patient experience. Greta obtained her Bachelor of Science degree in Nursing from Bloomsburg University in Bloomsburg, PA, her MSN with a concentration in Leadership and Management from Walden Academy, Minneapolis, MN, and is a certified Nurse Executive, Advanced. She has worked across the inpatient and outpatient continuum of care, including in critical care settings, outpatient surgery, rehabilitation, long term acute care, and nearly recently, as a nurse leader in an academic medical eye.
Dawn South. Troutman, BSN, RN, CCRN, NE-BC
Electronic mail: dstroutman@geisinger.edu
Dawn is an Operations Manager for three Special Care Units at Geisinger Medical Center. Dawn has her Bachelor of Scientific discipline degree in Nursing from Bloomsburg University in Bloomsberg, PA. She began her nursing career as a Medical Surgical nurse at Geisinger, then transferred to the Special Care Unit where she enjoyed working as a staff nurse, and so Team Leader. Dawn has been a nurse at Geisinger Medical Center for over 23 years. She is also the lead manager for the Nursing Retention and Advice Committee. This quango was responsible for reviewing the dress code policy for nursing.
Crystal Muthler, MHA, BSN, RN, NEA-BC
Email: cmuthler@geisinger.edu
Crystal is the Primary Nursing Officer, Vice President of Nursing at Geisinger Medical Center. She received her Available of Scientific discipline degree in Nursing from Bloomsburg University in Bloomsburg, PA and her Chief in Health Services Administration from Marywood Academy in Scranton, PA. She holds a licensure/certification from the Pennsylvania State Board of Nursing and the ANCC-Nurse Executive Advanced – Lath Certified. Crystal started her journey with Geisinger 26 years ago as a staff nurse on a medical/surgical telemetry unit, worked as an Administrative Supervisor, Operations Manager, Clinical Director of the Surgical Suite and Associate Vice President of Nursing Services prior to her current role.
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© 2016 OJIN: The Online Periodical of Issues in Nursing
Article published January 31, 2016
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