The cost of recruiting and training nurses is a significant budget item in most hospitals, especially when there is a shortage of nurses. Hiring nurses who, in addition to clinical competency, have values that align with an organization's mission and philosophy improves retention and reduces turnover. Researchers at a large urban hospital designed a study to identify key attributes and behaviors of high-performing nurses and to develop an assessment tool that could be used in hiring nurses, developing staff, and managing performance.

In the first phase of the five-phase study, focus groups comprising nurses, managers, nursing assistants, allied health professionals, physicians, patients, and families underwent semistructured interviews in which they were asked to name the most important characteristics and behaviors of outstanding nurses. Content analysis of the responses yielded seven general themes: teamwork, patient advocacy, communication with patients and families, caring, approach to care, work attitude, and personal attributes. Key words and phrases from each category were then used to create a list of possible assessment items, which was whittled down to a 16-item scale that could be used to screen applicants for nursing jobs.

The scale was then adopted for use in screening applicants. Nurse managers reported that it was easy to use and accurately reflected the characteristics of outstanding nurses. The authors explain that the scale has several potential uses in addition to identifying nurses whose attributes align with the organization's culture: it could also be used as a self-assessment tool for nurses and in performance management. Evaluation is ongoing.

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