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The strongest predictor of nurse job dissatisfaction and intent to leave is that of stress in the practice environment. Good communication, control over practice, decision making at the bedside, teamwork, and nurse empowerment have been found to increase nurse satisfaction and decrease turnover. In this article we share our experience of developing a rapid-design process to change the approach to performance improvement so as to increase engagement, empowerment, effectiveness, and the quality of the professional practice environment. Meal and non-meal breaks were identified as the target area for improvement. Qualitative and quantitative data support the success of this project. We begin this article with a review of literature related to work environment and retention and a presentation of the frameworks used to improve the work environment, specifically Maslow’s theory of the Hierarchy of Inborn Needs and the National Database of Nursing Quality Indicators™ Survey. We then describe our performance improvement project and share our conclusion and recommendations.

Aims/Objectives: To assess the feasibility of a nurse-led heart failure (HF) education program using the Self-Care Heart Failure Index (SCHFI) instrument. Background: HF is a frequent and burdensome condition requiring support with self-care management strategies and education. Translating best practice to health services is important in improving health outcomes. Design: Longitudinal quasi-experimental design. Methods: A convenience sample of (N = 41) patients with HF. We implemented a nurse-led education program with 30-day post-discharge home-based telephone follow-up. The SCHFI was used to measure self-care behaviors. 30-day readmission rates were assessed. Results: A significant difference was found in scores for self-care maintenance (p ≤ .001) and self-care management (p ≤ .001) subscales, not self-care confidence. There was no statistically significant difference between 30-day HF readmission rates. Conclusions: Findings suggest that the nurse-led evidence-based HF education program improved self-care behaviors and decreased 30-day readmissions. There is a need for continued development of interventions focused on improving patient self-care confidence.