Abstract
Positive patient and nurse outcomes depend upon improved clinical nurse work environments. Improvements can be confirmed through environmental surveys that have sufficient participation to yield accurate data. Professional clinical nurses in hospitals face a unique work complexity that inhibits survey participation. What procedures/incentives are effective in increasing survey participation? Are procedures/incentives effective with nonnurses applicable to nurses? These questions were answered through a focused literature review, a case-study analysis of procedures and incentives used by M.D. Anderson Cancer Center that resulted in a 93% response rate on an environmental Web-based survey, operational data from environmental surveys administered to staff nurses in 286 hospitals nationally and internationally, and an e-mail survey of nurse leaders/managers in 7 strategically selected hospital units. Incentives effective with nurse populations differed from those of nonnurse populations in several areas. Benchmarking and gap analysis-assessment, comparison to internal or external referents, introduction of needed improvements, and reassessment-are best leadership/management practices and are essential elements of the research and quality improvement efforts characteristic of Magnet hospitals. As the use of surveys for quality improvement and workforce management increases, nurse leaders need to know what procedures and incentives encourage response rates large enough to produce valid, representative data.