Abstract

Our team noticed a deficit in meaningful recognition from our HWEAT survey results. Our team identified what meaningful recognition meant to our staff to understand our area of deficit and evaluate current literature. Meaningful recognition plays a key role in employee satisfaction, motivation, and overall work performance, with reduced nurse turnover.1 Our staff defined meaningful recognition as personal appreciation. Nurse recognition has been viewed as a critical component of a healthy work environment.2 Our staff utilized many forms of recognition, including our organization’s electronic recognition program “Kudos,’ verbal recognition, hand-written notes, Daisy nominations, and yearly evaluations. “Expressions of thankfulness are an important stimulus for motivation in the workplace.”3 Our project, “Gratitude is the Attitude,” highlighted our team’s definition of meaningful recognition. The project lasted over one year and included various projects throughout to keep staff engaged such as educational carts, recognition bulletin boards, wellness activities, and utilized “Kudos.” Meaningful recognition not only boosts morale but can also improve team cohesion and reduce burnout.4 Finally, we concluded this project by repeating our initial survey.

As a result of this nurse-led project, there has been an increase in the culture of gratitude in the NICU. The team established goals which included, a 75% increase in participation in the "Kudos" program, an increase in the HWEAT meaningful recognition score, and a decrease in the RN turnover rate by 2%. All healthy working environment standards increased following the project. A steady increase was noted in the number of RN participants from the start of the initiative through tracking “Kudos” user data. Developing collective gratitude would improve work engagement.5 The team hypothesized that the decrease in RN turnover from 12 nurses in 2023 to 10 in 2024 could be due to the initiative. The team felt that our project impacted turnover by reducing RNs who may have considered voluntarily leaving but chose to stay due to the evolved unit culture.

Other outcomes from this project included an increase in "Kudos" program usage between the multidisciplinary teams including providers, clerks, respiratory therapists, therapy teams, and ancillary staff, all integral roles in the unit. The unit has been sustaining this effort by creating the Healthy Work Environment Committee to continue these efforts.

Notes

Presenter notes available in attached slide deck.

References:

1. Sweeney CD. The Value of Recognition. Nursing Administration Quarterly. 2021;45(3):253-261. doi: https://doi.org/10.1097/naq.0000000000000478

2. Joseph ML, Kelly L, Hovda Davis MB, Zimmermann D, Ward D. Creating an Organizational Culture and Climate of Meaningful Recognition for Nurse Managers. JONA: The Journal of Nursing Administration. 2023;53(7/8):370. doi:https://doi.org/10.1097/NNA.0000000000001302

3. Elena Gabriela Nicută, Diaconu Gherasim LR, Constantin T. “Thank You for Your Good Work”: the Impact of Received Gratitude on Employees’ Work Motivation. The Journal of Psychology. 2023;158(2):1-18. doi:https://doi.org/10.1080/00223980.2023.2271637

4. Dulko D, Kohal BJ. How Do We Reduce Burnout In Nursing? Nursing Clinics of North America. 2022;57(1):101-114. doi: https://doi.org/10.1016/j.cnur.2021.11.007

5. Komase Y, Akiyama H, Kawakami N. Effects of the Collective Gratitude on Work Engagement: A Multilevel Cross-sectional Study. Journal of Occupational and Environmental Medicine. 2022;64(11):e729-e735. doi:https://doi.org/10.1097/JOM.0000000000002683

Description

Delving into the analysis of an inpatient neonatal intensive care unit using the Healthy Work Environment Assessment Tool (HWEAT), a team of nurses uncover the areas of improvement including meaningful recognition. This team created interventions which promoted a healthy work environment amongst staff and an improved HWEAT score.

Author Details

Devin Angiulo, MSN, RNC-NIC; Catherine M. Lawless, BSN,RNC-NIC; Jenna Matteo, BSN; Lauren Miller, MSN, RNC-NIC

Sigma Membership

Non-member

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Other

Research Approach

Other

Keywords:

Workforce, Stress/Coping, Acute Care, Neonatal Intensive Care, Meaningful Recognition, Occupational Achievement, Psychological Stress, Stress Management

Conference Name

Creating Healthy Work Environments

Conference Host

Sigma Theta Tau International

Conference Location

Washington, DC, USA

Conference Year

2026

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Date of Issue

2026-04-24

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Gratitude is the Attitude: Increasing Meaningful Recognition and Staff Collaboration in the NICU

Washington, DC, USA

Our team noticed a deficit in meaningful recognition from our HWEAT survey results. Our team identified what meaningful recognition meant to our staff to understand our area of deficit and evaluate current literature. Meaningful recognition plays a key role in employee satisfaction, motivation, and overall work performance, with reduced nurse turnover.1 Our staff defined meaningful recognition as personal appreciation. Nurse recognition has been viewed as a critical component of a healthy work environment.2 Our staff utilized many forms of recognition, including our organization’s electronic recognition program “Kudos,’ verbal recognition, hand-written notes, Daisy nominations, and yearly evaluations. “Expressions of thankfulness are an important stimulus for motivation in the workplace.”3 Our project, “Gratitude is the Attitude,” highlighted our team’s definition of meaningful recognition. The project lasted over one year and included various projects throughout to keep staff engaged such as educational carts, recognition bulletin boards, wellness activities, and utilized “Kudos.” Meaningful recognition not only boosts morale but can also improve team cohesion and reduce burnout.4 Finally, we concluded this project by repeating our initial survey.

As a result of this nurse-led project, there has been an increase in the culture of gratitude in the NICU. The team established goals which included, a 75% increase in participation in the "Kudos" program, an increase in the HWEAT meaningful recognition score, and a decrease in the RN turnover rate by 2%. All healthy working environment standards increased following the project. A steady increase was noted in the number of RN participants from the start of the initiative through tracking “Kudos” user data. Developing collective gratitude would improve work engagement.5 The team hypothesized that the decrease in RN turnover from 12 nurses in 2023 to 10 in 2024 could be due to the initiative. The team felt that our project impacted turnover by reducing RNs who may have considered voluntarily leaving but chose to stay due to the evolved unit culture.

Other outcomes from this project included an increase in "Kudos" program usage between the multidisciplinary teams including providers, clerks, respiratory therapists, therapy teams, and ancillary staff, all integral roles in the unit. The unit has been sustaining this effort by creating the Healthy Work Environment Committee to continue these efforts.