A quality improvement initiative: Motivations and barriers to hospital nursing employee participation in workplace wellness program

Purpose: The purpose of this evidence-based quality improvement (QI) study was to identify the characteristics that are associated with participation in hospital-based workplace wellness programs among hospital nursing employees. The goal was to identify the perceived motivations for and barriers to participation in hospital-based workplace wellness programs faced by hospital nursing employees such that it may provide a basis for increased participation by hospital employees in workplace wellness programs in the future.

Background & Significance: The incidence of chronic diseases has increased dramatically in the last century and physical inactivity is epidemic. The workplace is an ideal setting for health promotion activities because of the amount of time people spend at work. A research study from Truven Health Analytics found that hospital employees in the U.S. are less healthy than the general workforce, cost more in healthcare spending than the general employee population, and are more likely to be hospitalized than the overall working adults in the U.S. Despite significant health education among healthcare professionals, it appears that health knowledge often does not translate into their own healthy behaviors.

Method: A one-time anonymous Wellness Participation Survey questionnaire was disseminated to eligible advanced practice providers and registered nurses engaged in clinical practice in two large public teaching hospitals as determined by the hospital administration and the nursing leadership. A transmittal letter soliciting participation in the Wellness Participation Survey with instructions and pertinent information to submit the survey electronically using the online REDCap platform was sent to the eligible participants. The completion and return of the survey questionnaire were considered the respondents’ informed consent to participate in the QI study project. In order to protect the identity and confidentiality of the participants and their responses, no names or identifiable personal information was solicited.

Results & Conclusion: The Wellness Participation Survey was sent to a total of 120 eligible hospital nursing employees. A total of 87 participants responded: 52 worked at the state hospital and 35 at the county funded hospital. Of the 87 respondents; 75% were clinical nursing staff and 25% were advanced practice providers. More females responded than males (Female (75, 86.2%); Male (12, 13.8%) and maximum responses received were from age groups 31-40 and 41-50 years. Response rate among White Caucasians and Asian or Pacific Islanders was higher compared to other ethno-racial backgrounds. The survey results found that two-thirds of the respondents were aware of established hospital-based wellness programs and a third were not aware of program availability. Less than half of the respondents (48.2%) were correctly aware of the availability of wellness programs for their families but the majority (51.8%) either erroneously said “No” or “Did not know.” Results showed that the average and median number of perceived program benefits at the county hospital was lower than for the state hospital, which reflected the true situation. Ninety three percent out of 87 respondents said “Yes” to increased participation if incentives were provided. Gift cards and cash incentives were more popular in the two middle-aged groups (31-40 and 41-50 years) than they were in the youngest and oldest age groups. Results revealed non-availability of a gymnasium at workplace for hospital employees, long working hours, lack of incentives, and work-related stress were ranked highest perceived barriers for participation in workplace wellness programs by all job types.