Evidence of DAISY's Impact

The DAISY Award is meaningful recognition of extraordinary, compassionate nursing care.  There is a growing body of evidence underscoring the impact of meaningful recognition.   The evidence falls into three areas:  impact on the organization’s work environment, nurse engagement, and the patient/family experience.  The DAISY Award has been used as a proxy in research studies to represent meaningful recognition.

The American Association of Critical-Care Nurses identified meaningful recognition as one of the 6 elements of a Healthy Work Environment (1).  DAISY provides the opportunity on a regular basis to recognize and celebrate all the “right” that happens in the delivery of nursing care.  Research, demonstrates that through The DAISY Award, teamwork is nourished, enhancing a sense of trust within the unit and potentially the organization as a whole. Reading the DAISY Nomination Stories during the Award presentation raises up role models for patient care that are extraordinary and compassionate, bringing an organization’s mission and values to life. And while none of the nurses who receives The DAISY Award thinks they should be honored for “just doing their jobs,” they report a deep sense of pride.

Relevant to Nurse Engagement, research reveals that nurses who have been nominated for The DAISY Award report higher levels of Compassion Satisfaction and lower levels of Compassion Fatigue(2,5).  Compassion Fatigue is defined as the combination of burnout and secondary traumatic stress. Nurses who feel valued and recognized are more likely to have increased loyalty and enthusiasm for their workplace and for the work that they do.  This is critical in helping to retain and recruit great nurses, as we manage the nursing shortage.  Generating high numbers of nominations for the award is a real asset to improving nurse engagement through The DAISY Award.

 Most importantly, there is the impact of meaningful recognition on the Patient and Family Experience. The nomination stories are rich in data that can describe what is important to patients, their families and others who encounter great, compassionate nursing care.  In one study that used The DAISY Award as a proxy for examining meaningful recognition, it was found that "…when a hospital explicitly rewards compassionate acts by its staff and supports its staff during tough times, it is associated with patients more highly rating the care experience and being more likely to recommend the hospital"(3). By honoring extraordinary acts of compassion, recognition can positively influence the patient’s perception of their experience.  

The DAISY Award provides a means for patients and families to say thank you. Over 1,000,000 DAISY nominations have been submitted to date in an effort to recognize and thank nurses for the care provided.  The recognition of compassionate care transcends cultures, as it is used in 17 countries to honor compassionate and extraordinary nursing care.  Clearly, the Barnes family, DAISY’s founders, were not the only people who needed to say thank you to nurses.

As Dr. Cindy Lefton has shared through her research in the use of meaningful recognition with The DAISY Award, “Reconnecting with our profession through the feedback from patients, families, and colleagues regarding those moments when a nurse masters the art and science of nursing and celebrating these successes will increase the strength of our workforce and make our work environments healthier” (4).

 To summarize: 

A Healthy Work Environment, with meaningful recognition like The DAISY Award embedded in its culture, may contribute to an engaged nursing workforce and higher measures of patient satisfaction.


  1. American Association of Critical-Care Nurses.  Standards for Establishing and Sustaining Healthy Work Environments:  A Journey to Excellence, 2nd edition, 2016; 29-31.
  2. Kelly L, Runge J, Spencer C, Predictors of compassion fatigue and compassion satisfaction in acute care nurses.  J Nurs Scholarsh, November 2015; 47(6), 522-528.
  3. McClelland LE, Vogus TJ, Compassion practices and HCAHPS: does rewarding and supporting workplace compassion influence patient perceptions? Health Serv Res, 2014; 49(5),1670-83.
  4.  Lefton, C. Strengthening the workforce through meaningful recognition.  NURSING ECONOMIC$. November-December 2012; Vol. 30/No. 6; 331-338.
  5. Kelly, L. A., & Lefton, C. (2017). Effect of meaningful recognition on critical care nurses' compassion fatigue. American Journal of Critical Care, An Official Publication, American Association of Critical-Care Nurses, 26(6), 438-444. 10.4037/ajcc2017471 [doi].

In addition: Dr. Lesly Kelly is an expert in Compassion Fatigue and well-published in tools to offset it - like The DAISY Award! Watch this excellent video from PBS, featuring Dr. Kelly and great DAISY Nurses at BannerUniversityMedicalCenter.  View video here