The following article is credited to Mary Harper, PhD, RN, NPDA-BC®, Patsy Maloney, EdD, RN, NPD-BC, NEA-BC, and Julie Aucoin, DNS, RN, NPD-BC.

 

In 2015, the Association for Nursing Professional Development (ANPD) commissioned a study to examine the relationships among numbers of nursing professional development (NPD) practitioners and organizational outcomes in acute care hospitals in the United States (US) (Harper et al., 2016).

Findings from this study suggest that higher numbers of NPD practitioners, specifically according to bed size of the organization, are significantly correlated with higher patient satisfaction with nurses’ communication and discharge instructions.

The investigators conclude that, “The current healthcare environment’s focus on pay for performance requires that NPD practitioners demonstrate a measurable impact on outcomes to remain viable” (p. 247).

Subsequently, in 2016, the NPD scope and standards predicted the importance of “promoting learning as an investment in human capital and cost avoidance” (Harper & Maloney, 2016, p. 27) and the need to demonstrate return on investment for NPD initiatives (Harper & Maloney, 2016). The clarion call had been sounded.

Outcomes demonstrating the organizational value of NPD practice are being found in the literature. This is affecting orientation time, turnover, leadership including externships, and financial savings to institutions. There is also a marked impact on patient satisfaction, including improvements in empathic communication. Patient satisfaction data gathered by the Centers for Medicare & Medicaid Services are important determinants of patient choice and value-based incentive payments.

Importantly, although many studies have evaluated the impact of NPD initiatives on organizations, only this ANPD study measures correlations among the number of NPD practitioners and organizational outcomes. This makes the research both unique and valuable as more data in the field is collected, and represents a valued contribution to the literature.

Purpose 

The study had four main goals, which were to:

1. Determine the average number of individual employees and registered nurses (RN) for whom an NPD practitioner is responsible.

2. Determine average numbers of NPD practitioners based on hospital size (beds).

3. Explore relationships among HCAHPS, Hospital Compare data, and National Database of Nursing Quality Indicators (NDNQI) scores and NPD staffing levels.

4. Compare NPD staffing levels in adult and pediatric acute care hospitals.

A comparison of NPD staffing levels in adult and pediatric acute care hospitals is now available.

Research Methods

A descriptive, cross-sectional design was used in the form of a survey. The survey included questions relating to organizational descriptors, employee metrics, patient satisfaction and outcomes; NPD department size, structure, and span of responsibility; workload allocation; and NPD practitioner characteristics.

The sampling frame consisted of the approximately 6,090 acute care hospitals in the US. Email invitations to participate were sent to a convenience sample of 19,000 individuals on the ANPD mailing list, 217 Children’s Hospital Association member organizations, and 3,256 Society of Pediatric Nurses members.

Individual and hospital-level data were summarized using descriptive statistics, including means, medians, standard deviations, ranges, number of participants (Ns), and percentages.

For the organizational outcome correlations, children’s hospitals were removed from analysis due to missing and incomplete data. Additionally, children’s hospitals consider several different quality metrics.

Implications for NPD practice

The study informs where NPD practice has been and where it is leading to. NPD practitioners face unique challenges as hospital mergers and acquisitions change the medical landscape. New frontiers hospital and medical operations are also in effect. NPD leadership requires business acumen, organizational alignment, communication, and relationship building as expanded capabilities are created from new markets, service lines, and the like.

Additionally, the study finds that NPD practitioner characteristics have changed very little in practitioner background (education) and the specific workload of a practitioner doesn’t vary from its core responsibilities (e.g., onboarding, management).

This combination paves the way for enhancements to NPD leadership and continued financial success for institutions that utilize for NPD practitioners. NPD practitioners must know their individual organization’s data and be able to articulate the specific impact of NPD initiatives upon these metrics.

Access the full study.