Stepping Stones to Wellness Unit Based Health Promotion
Mary Val Palumbo DNP, APRN
Barbara Liberty, RN
Evelyn Sikorski CSW, CEAP
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Project Team
Fletcher Allen Health Care
UVM College of Nursing and
Health Sciences
 Barbara Liberty RN, FAHC
 Mary Val Palumbo DNP,
RN Lead Employer Health
Management, Community
APRN, GNP-BC
Health Improvement
Associate Professor UVM
 Evelyn Sikorski CSW, CEAP,
CNHS
Mgr Employee and Family
 Nurse practitioner
Assistance Program & Health
Management
students in GRNU 396,
 Lindsay Harbour, Safety
Optimizing Health
Specialist, Safety & Industrial
Course-Service Learning
Hygiene
Component
 Cathy Hamilton, Ergonomic
Specialist, Safety & Industrial
Hygiene
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Background
 When exposed to work related stressors, nurses
employing ineffective coping strategies, coupled
with poor self-care, are at risk for developing stress
symptoms, health related problems, and burnout.
 Young nurses balancing work and home
responsibilities are particularly vulnerable to poorer
emotional health1.
 The physical work of nurses is dangerous and is
highly ranked for work related injury2.
Older nurses’ workplace injuries are the main
cause of their early exit from the workforce3.
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Background
It is important for
employers to recognize
the connection between
nurse’s physical and
emotional health within
the context of the nurse
work environment.
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Background
With the relationship of work stress and
musculoskeletal injury to absenteeism and
turnover well documented4, the financial
case for nurse health promotion is sound;
but what are the most effective methods and
how should outcomes be measured?
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Purpose
This quality improvement project evaluated
a six month program initiative of unit-based
psycho-educational interventions offered in
collaboration with Employee Wellness and
the nurse practitioner student service
learning project.
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Purpose
It was hypothesized that this wellness
protocol would demonstrate a unit level
decrease in:
1. aggregate unscheduled time off
2. worker compensation claims
3. safety related injuries
Satisfaction with the wellness program
offered on the unit would be demonstrated.
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Methodology
Unit based intervention delivered to one hospital
medical unit with 80 employees including:
1.
2.
3.
4.
an educational protocol detailing nutrition, stress
management, relaxation techniques, safe patient
handling and movement strategies
physical activity promotion
environmental redesign (signage)
incentives for participation and behavior change
(average $35/unit employee).
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Methodology
A comparison of aggregate organizational
and subjective participant data in
intervention year data (FY 11) with preintervention data (FY 10) including:
unscheduled time off, worker compensation
utilization, safety information obtained from
the Human Resource, and participant
satisfaction.
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Methodology
There were 210
staff interactions
with the “Wellness
Cart” over 8 weeks.
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Methodology
The “wellness cart”
displaying a physical
activity theme
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Methodology
Graduate nursing
students visited the
unit each week
on three shifts
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Results
 Participation increased in the Wellness
Program – “Know Your Numbers” from 0
participants in FY10 to 60 out of 77
employees participating in Biometric
Screening in FY11 (0% to 78%).
 Worker compensation utilization – short term
disability claims decreased to 0.
 There was no significant change in patient
handling incident reports and safety related
injuries.
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Results
 Savings were calculated by using 75% of the
difference in unscheduled hours off between
the mean of the previous three year and
period of the intervention. Average hourly
rate of pay including fringe ($48.34) was
then multiplied by the unscheduled hours off
= $11,409.17
 In comparison with a unit of similar size, no
decrease in total unscheduled time off was
shown during the same timeframe.
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Results
 Total cost of Wellness Program delivery = $7,664.00
 This includes:
 Biometric screening ($15.00),
 Wellness RN time for delivery and coordination ($45.80),
plus incentives ($35.00) per unit employee.
 Total cost per person for the six month Wellness
Program = $95.80
$11,409.17 (difference in unscheduled time off)
- $7,664.00 (cost of program)
$3,745.17 (Return on Investment)
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Results
Participant satisfaction survey results (n = 48
60% response rate)
 71% agreed that the screening and wellness
coaching supported their health and wellbeing while at
work;
 65% agreed that the program had a positive impact
on the unit as a whole;
 64% agreed that their health knowledge increased;
 45% agreed that the program improved their work
productivity.
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Conclusions
This unit-based wellness program was a 6month comprehensive and integrated
program with a primary focus on self-care
and health education. The program paid for
itself and may have contributed to a return
on investment of $3,745.17 in unscheduled
time off. This unit-based wellness program
using incentives, yielded high participation
and satisfaction.
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Limitations
 This quality assurance project lacks the
rigor and controls necessary for a
research study.
 Since it was conducted on one hospital
unit, replication is recommended.
 Further research utilizing larger samples,
testing unit-based nurse health promotion
activities, is indicated.
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Implications
This project found that
bringing health
promotion activities
directly onto a hospital
unit was cost effective
and satisfactory to the
participants, as well
as, nurse practitioner
students.
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Implications
Creating a comprehensive, visible, and
easily accessible program of evidencebased nurse wellness offerings, ranging
from interventions for nurses’ physical and
emotional health to workplace safety and
hazards protection would likely influence
RNs’ health perceptions, create a safety
climate, and impact retention.
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Acknowledgements
 John Herko, HR Manager, Benefits
 Cindy MacKechnie, Coordinator, Employee &
Family Assistance Program
 Kristine Buck, Community Health Educator,
Frymoyer Community Health Resource Center
 Peter MacDonald, Financial Specialist,
Business Analysis
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References
 Palumbo, M. V., et al., Registered Nurses’ Perceptions
of Health and Safety Related to Their Intention to Leave.
AAOHN J, 2010; p. 95-103
 Waters, T., et al., NIOSH research efforts to prevent
musculoskeletal disorders in the healthcare industry.
Orthop Nurs, 2006. 25(6): p. 380-9.
 Letvak, S., Health and safety of older nurses. Nursing
Outlook, 2005. 53(2): p. 66-72.
 Davey, M., et al., Predictors of nurse absenteeism in
hospitals: a systematic review. Journal of Nursing
Management, 2009. 17(3): p. 312-30.
 Gauci, B. and I. Norman, Factors influencing turnover
and absence of nurses: a research review. International
Journal of Nursing Studies, 1997. 34(6): p. 385-94.
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Questions
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