Digital Commons Network^™

The Effect Of Organizational Justice On Work Engagement And Burnout Among Hospital Nurses In Japan, Nicholas M. Raposo, Johan Vamstad, Dabin Hwang, Yayoi Saito, Anna Klarare

Creating Healthy Work Environments (CHWE)

Purpose: To examine the effects of organizational justice (OJ) on work engagement (WE) and burnout (BO) among hospital nurses in Japan, and to test whether job satisfaction (JS) moderates these relationships.

Background: Nurse WE and BO affect individual wellbeing, workforce resilience, and healthcare quality and safety.^1,2 OJ, representing workplace fairness and equality, is a key job resource that impacts employee performance and wellbeing.^3,4 In Japan, where WE is relatively low,⁵ the effects of OJ on nurse WE and BO – and how OJ interacts with JS, a salient correlate of WE and BO –^4,6 remain unexplored. …

Advancing Practice-Ready Nursing Education: Strategic Planning That Builds Tomorrow Together, Larry Z. Slater, Kristie Cloud, Taylor Cooper

Creating Healthy Work Environments (CHWE)

In the face of accelerating change across healthcare and higher education, preparing students for practice-ready success requires more than a strategic plan, it demands a cultural shift grounded in leadership alignment and inclusive engagement (Weston, 2022). One school of nursing (SON) launched a 10-month strategy and leadership alignment initiative aimed at building a high-functioning leadership team, clarifying foundational identity, meaningfully engaging stakeholders, and co-creating a bold yet practical strategic plan ready for implementation.

The initiative unfolded through a series of interconnected efforts. Leadership development sessions built a shared sense of purpose among SON leaders. A survey paired with a full-day …

Aacn Hwe Standards: Bridging Clinical Excellence And Academic Resilience, Michelle Kidd

Creating Healthy Work Environments (CHWE)

For over 20 years, the American Association of Critical-Care Nurses (AACN) has championed Healthy Work Environment (HWE) standards as essential for nursing excellence. While HWEs improve patient and staff outcomes, they may be underutilized in academia. As faculty and clinical staff face record burnout and turnover, the nursing pipeline's survival depends on a unified HWE approach that bridges clinical practice and academia through intentional collaboration.

Self-Care, Resilience, And Mindfulness In Nursing: A Qualitative Meta-Analysis, Meredith Joyner

Creating Healthy Work Environments (CHWE)

Background: Nurses across all practice settings face persistent stress, compassion fatigue, and burnout, which compromise personal well-being and patient outcomes. Evidence increasingly supports mindfulness and self-care as essential strategies for sustaining resilience and professional effectiveness.

Purpose: This presentation synthesizes current evidence on self-care, resilience, and mindfulness among nurses and nursing faculty to identify effective approaches that enhance well-being and professional performance.

Methods: A qualitative meta-analysis of twelve peer-reviewed studies indexed in CINAHL (2013–2024) was conducted. The studies, representing cross-sectional, mixed-methods, and qualitative designs, were analyzed thematically to identify shared concepts, interventions, and outcomes related to nurse self-care and resilience.

Results: …

Creating A Shared Culture Of Well-Being In The Academic Setting, Jennifer Ahlquist, Andrea Kwasky

Creating Healthy Work Environments (CHWE)

This presentation outlines scalable strategies for promoting a healthy workplace in academic settings and beyond. Drawing on the WHO's Healthy Workplace Framework, the founder and chair of the University of Detroit Mercy College of Health Professions Wellness Committee describes the committee’s evolution from a suicide-prevention focus to a comprehensive culture of well-being that supports personal resilience, professional excellence, and compassionate preparation of future health professionals.

Organizational Theory And Nurse Burnout: A Secondary Data Analysis Before And After Covid-19, Bridget Webb, Jennifer Mallow, Suzy Mascaro Walter, Kesheng Wang, Tina Antill Keener, Tim Cunningham

Creating Healthy Work Environments (CHWE)

Background: Nurse burnout is a global health priority that has been compounded by Coronavirus 2019 (COVID-19). Organizational theory states that nurse burnout is directly impacted by operant mechanisms (nurse characteristics, nurse specialization) and hospital-wide models. The purpose of this study is to determine the relationship between hospital wide models (evidence-based care, team-based care, discharge planning, care coordination), operant mechanisms (nurse characteristics and specialization), and outcomes (nurse burnout) before and after COVID-19.

Design: A cross-sectional design was applied, using secondary data analysis.

Methods: A secondary data analysis using the 2018 and 2022 NSSRN data set was used to …

Building A Culture Of Psychological Safety In The Nicu Through Leadership Rounds, Erica Huckaby, Julie Veselinovic, Tomica Franklin

Creating Healthy Work Environments (CHWE)

In 2024, the GLINT survey conducted in our neonatal intensive care unit (NICU) showed a psychological safety score of 61 out of 100, with nurses reporting avoidance of speaking up because they feared negative reactions from physicians and leadership. These results identified a critical need for leadership interventions.

NICU nursing leaders (nurse managers and director of nursing) implemented evidence-based leadership rounds which have been shown to enhance communication and psychological safety in critical care environments (Diabes et al., 2021). Rounds were conducted on all shifts and included five main components: workflow assessment, concern identification, immediate need evaluation, staff recognition for …

Evaluating And Addressing Workplace Violence: Strategies For A Safer Healthcare Environment, Bini K. John, Jesse Cozzetti

Creating Healthy Work Environments (CHWE)

Purpose: Evaluate the impact of current standard practice on workplace violence (WPV). Evaluate the workers' compensation claims from WPV. Develop a proposal for implementing a Behavioral Response or Consulting Team (BRT) among staff in a tertiary-level inpatient hospital.

Relevance/Significance: The most common type of workplace violence (WPV) in a healthcare setting is violence from patients and visitors toward healthcare staff (AHRQ, 2023). A nationwide survey of 1,000 registered nurses found that eight in 10 nurses experienced workplace violence in 2023 (NNU, 2024). The study aims to identify the current standard practice that affects the incidence of workplace violence over two …

Patient Follow-Ups For Hospital Nurses: Addressing Nurse Well-Being After Rapid Response Events, Quean Brown, Cristin Phillips, Molly Liddell, Katherine Thompson, Tala Fuad Hatem Abu Zahra, Jacqueline Christianson

Creating Healthy Work Environments (CHWE)

Background: Bedside registered nurses (BRNs) in the hospital setting care for patients who may unexpectedly deteriorate. When nurses witness patient deterioration, it is helpful for them to engage in meaning-making and contextualization to facilitate compassion satisfaction, mitigate secondary traumatic stress, and improve job satisfaction (Kopacz et al., 2019; Sattler & Smith, 2020). When a rapid response team (RRT) intervention is called and the patient warrants transfer to intensive care (ICU), BRNs rarely receive formal follow-up regarding the outcomes of their patients. Lack of feedback regarding critical situations may contribute to secondary traumatic stress, moral distress, decreased job satisfaction among BRNs, …

Comparing Nurse Well-Being Across The Career Trajectory: An Analysis Of The Healthynurse Survey, Alison F. Cuccia

Creating Healthy Work Environments (CHWE)

Background: Nurses face persistent challenges in maintain well-being (Lönnqvist et al., 2025; Priano et al., 2018), which may contribute to the nurse staffing crisis. This analysis examines differences in well-being among nurses in different stages of their career trajectory.

Methods: Data from the HealthyNurse survey collected June 2024-May 2025 were examined (n=5006). Outcomes included fatigue, anxiety, depression, social ability, and physical functioning, measured using Patient-Reported Outcome Measurement Information System short form scales. Moderate to vigorous physical activity (MVPA, minutes/week), days of strength training per week, the Healthy Eating Index, and BMI were also measured and used as outcomes. …

Medication Reconciliation In The Emergency Department: Whose Job Is It?, Courtney N. Loecker, Lori Gaver, Jadyn Brooks, Monica Hanus, Ally Smart

Creating Healthy Work Environments (CHWE)

Background: Medication reconciliation is a critical component of hospital admission, reducing medication errors, improving patient safety, and ensuring continuity of care.^1–3 Uncertainty persists over which healthcare providers (i.e., nurses, pharmacists, physicians) are primarily responsible for performing medication reconciliation when patients are admitted from the emergency department (ED).⁴ Understanding frontline nurses’ perspectives about medication reconciliation is key to informing practice improvements and patient outcomes.

Purpose: This project aimed to identify nurses' perspectives about current medication reconciliation practices including responsibility, barriers, and solutions to enhance safety, workflow efficiency, and interprofessional collaboration.

Methods: Guided by the Plan Do Study Act framework …

Well-Being For Novice Nurses With The Powerful Feeling Of Belonging Through Mentorship, Shelli Anne Marie Chernesky, Natalie Bermudez, Diane Kramer

Creating Healthy Work Environments (CHWE)

Nursing is a known profession to help others by providing an environment of healing that includes elements of physical and psychological comfort. Our project looks at the importance of belonging as a form of supportive protection for the acute care novice nurse by using mentorship to help navigate the everchanging clinical environment. Mentoring has a direct correlation with belonging for nurses, being part of something with shared goals. Mentorship supports professional development while endorsing career pathway direction. Demanding clinical environments increase nursing responsibilities. Therefore, healthy work environments can be compromised and produce physical fatigue and mixed feelings leading to decreased …

From Novice To Target: Reducing New Graduate Nurse Bullying, A Quality Improvement Project, Christina Matousek, D'Ana Brooks, Joy Elwell, Ivy M. Alexander, Tracy Carafeno

Creating Healthy Work Environments (CHWE)

Background: The bullying of new graduate nurses is often considered a rite of passage in the nursing profession.¹ Bullying within nursing has led to poor professional development, reduced self-confidence, and has the potential to negatively impact patient outcomes; with links to increased medication errors, falls, and hospital costs.^1,9 Within a comprehensive cancer center, high rates of nurse bullying have been reported. Currently, this institution lacks staff education regarding bullying and the negative impacts it poses to staff and patients.

Purpose: The purpose of this quality improvement project was to reduce the bullying of new graduate registered nurses (RNs), …

Examining Efforts, Rewards, Burnout, And Intention To Leave Among Full-Time Nursing Faculty, Jacqueline Christianson, Kathryn J. Malin, Jessica Leiberg, Lisa Grabert, Jessica Zemlak

Creating Healthy Work Environments (CHWE)

Background: The nursing faculty shortage is a contributor to the nursing shortage. Intention to leave the full-time faculty role for non-retirement reasons, including poor effort-reward balance or burnout, may be a underacknowledged contributor to the faculty shortage (Leiberg et al., 2025; Malin et al., 2024). The Effort-Reward Imbalance model predicts both burnout and intention to leave as an outcome of poor balance between efforts required by work and rewards obtained through work (Siegrist & Li, 2020). The purpose of this study was to examine the relationships between efforts, rewards, burnout, and intention to leave among full-time nursing faculty using the …

Embedding Trauma-Informed Care In Nursing Education: Strategies For Healthy Work Environments, Rachel Ann Elliott, Kathryn Pfaff, Edward Cruz, Sherry Morrell, Adrian Guta

Creating Healthy Work Environments (CHWE)

Background: Trauma is ubiquitous within society; it is experienced by people who access healthcare, and their care providers, including nursing students who experience high rates of adverse childhood experiences (Gilroy et al., 2024). Although trauma-informed care (TIC) is an established approach that addresses the widespread health effects of trauma (Wathen et al., 2021), its systematic integration in nursing education curricula is lacking (Pfeiffer & Grabbe, 2022). This leaves new graduate nurses ill-equipped to competently support clients and families who have experienced trauma, compromising a safe culture of care (Ross et al., 2025).

Purpose: To explore individual, relational, structural, and organizational …

Care Among Crisis: Trauma And Building Resiliency With Wildfire Respondents, Zurisadai A. Inzunza, Monika Scherer, Maximus Balliet, Zoe Hollingsworth, Adrienne Martinez-Hollingsworth

Creating Healthy Work Environments (CHWE)

In January 2025, over 230 employees were rapidly deployed from a Federally Qualified Health Center (FQHC) system to support the medical and social needs of Eaton wildfire evacuees at the Pasadena Convention Center (PCC). Of the thousands of Pasadena and Altadena residents displaced, many of the employees were directly impacted. As environmental disasters are becoming more frequent, organizations can implement measures to reduce the psychological impact by promoting coping strategies to improve mental wellbeing for nursing professionals.^1,2

Research has shown that volunteer responders who are highly motivated report lower levels of burnout.³ There is a gap in research …

Scoping Review On Exploring Nunchi In Healthcare Among Korean American And Immigrant, Hannah J. Kim, Minseung Chu, Changhwan Kim, Helen Haebitna Park-Chong, Rebekah L. Hayes, Eve Melton, Jennie De Gagne

Creating Healthy Work Environments (CHWE)

Nunchi is a unique Korean concept often described as the ability to “read the room” by perceiving and responding to subtle interpersonal cues. It reflects a nuanced form of social attunement that involves sensitivity to context, anticipation of others’ needs, and adaptive behaviors to maintain harmony in relationships. In healthcare and nursing, where effective communication, teamwork, and leadership are essential, nunchi may play a critical role. This review explores how nunchi has been defined, conceptualized, operationalized, and applied in nursing and healthcare literature, and discusses its potential implications in healthcare settings where individuals from diverse backgrounds collaborate.

The review guided …

Trauma-Informed Academic Practice Partnerships To Support Nursing Students’ Transition To Practice, Lori Dawn Mcelroy, Stacy King

Creating Healthy Work Environments (CHWE)

The transition from nursing student to professional nurse is a vulnerable phase marked by stress, uncertainty, and emotional fatigue. These challenges can lead to burnout and attrition, making healthy work environments essential for fostering resilience and retention. Trauma-Informed Education (TIE) strategies centered on safety, trust, empowerment, and peer support offer a framework to support students and new nurses. When integrated into academic-practice partnerships, TIE strategies enhance clinical learning, promote well-being, and strengthen the workforce.

The project explores how trauma-informed strategies embedded in academic practice partnerships create psychologically safe environments for nursing students transitioning into practice. Goals are to impact transition …

Factors That Empower Nurses To Lead In Support Of Healthy And Sustainable Work Environments, Lori Murray, Deanna Jan Emory, Thomas Kippenbrock

Creating Healthy Work Environments (CHWE)

Background: Effective, empowered nurse leaders are central to the development of a healthy work environment and workforce (Morvati et al., 2024). Student and early career nurse involvement in professional organizations is thought to encourage leadership growth and potential by promoting leadership skills, self-efficacy, networking and providing a sense of belonging to the profession (Beal, 2022). However, there is limited empirical evidence identifying the specific factors that influence a nurse’s decision to pursue or accept leadership positions. Understanding key factors, such as mentorship, professional organization involvement, and organizational support, is essential for addressing leadership gaps within the nursing workforce. This evidence …

Facilitators And Barriers To Engagement In A Virtual Mindfulness Program Among Healthcare Workers, Yu-Ping Chang, Tess Bernardo, Allie Nickel, Linda Steeg

Creating Healthy Work Environments (CHWE)

Purpose: Healthcare professionals experience ongoing stress and burnout from heavy workloads and emotional demands. Mindfulness-Based Stress Reduction (MBSR) has strong evidence for enhancing emotional regulation, resilience, and well-being. Despite its proven benefits, adoption remains limited across individuals and organizations. Identifying key facilitators and barriers is essential for sustainable integration into healthcare practice. This presentation explores healthcare workers’ perceived barriers and facilitators to participating in an eight-week virtual MBSR program.

Methods: We conducted a qualitative study using individual interviews with healthcare workers who completed the virtual MBSR program delivered by certified trainers aimed at improving workplace resilience. Four trained research staff …

Resilience, Social Support, And Burnout: Building Healthy Work Environments For Emergency Nurses, Timothy R. Burns

Creating Healthy Work Environments (CHWE)

Background: Emergency department (ED) nurses work in high-stakes environments that increase exposure to stress, trauma, and burnout. Identifying protective factors that strengthen well-being is essential to building and sustaining healthy work environments.

Purpose: This study examined how years of experience, social support, and resilience influence burnout, secondary traumatic stress, and compassion satisfaction among ED nurses across the United States.

Methods: A cross-sectional design was used. Participants completed a demographic form, the Professional Quality of Life Scale (ProQOL), the Connor–Davidson Resilience Scale (CD-RISC), and the Lubben Social Network Scale. Data were analyzed using multiple and hierarchical regression to identify predictive relationships …

Bridging The Gap: Empowering First-Generation Nursing Students To Transform Workforce Diversity, Kimberly L. Walsh

Creating Healthy Work Environments (CHWE)

Background/Significance: The U.S. nursing workforce remains insufficiently diverse, limiting culturally responsive care for minority and underserved communities. Nursing education is pivotal to diversifying the pipeline. First-generation nursing students (FGNS)—often from underrepresented backgrounds—can help close this gap, yet they face barriers such as financial strain, limited support networks, and unfamiliarity with academic expectations. Evidence is limited regarding which demographic and academic factors most strongly differentiate FGNS success from that of non-first-generation nursing students (NFGNS) in pre-licensure programs.

Purpose: To examine and compare demographic and academic success factors for FGNS and NFGNS in U.S. pre-licensure RN programs to inform targeted retention and …

Improving Undergraduate Nursing Student Self-Care Agency With The Moodfit App, Sarah C. Young, Susan Patton

Creating Healthy Work Environments (CHWE)

The prevalence of nursing burnout syndrome is estimated to range from 14 to 38% (Ge et al., 2023); North America has the highest rate at 38%. Two systematic reviews and meta-analyses found the global prevalence of burnout syndrome in nursing students ranging from 23 to 35% (Kong et al., 2023, Hernandez-Mariano et al., 2024). Arian and colleagues (2023) found student nurse burnout positively correlates with academic semester. As students progress through each term, burnout risk increases.

The American Association of Colleges of Nursing (2021) includes the demonstration of “…healthy, self-care behaviors that promote wellness and resiliency” (p.53) as an essential …

Exploring The Perspectives Of Nurse Leaders On Motivational Interviewing For Workplace Well-Being, Quinais S. Yu

Creating Healthy Work Environments (CHWE)

Background: Nurse leaders face challenges in supporting staff well-being while managing their own, and effective communication is crucial.

Aim: This study explored nurse leaders' perceptions of factors influencing well-being, challenges they face, the impact of Motivational Interviewing skills, and their training needs in MI.

Methodology: Employing a qualitative, exploratory design, the study gathered insights from nurse leaders in Hong Kong clinical settings through individual semi-structured interviews, analyzed using thematic analysis.

Key Findings: Nurse leaders perceive MI as a valuable tool for effective communication and addressing staff ambivalence towards self-care. They emphasized the need for improved work environments, work-life balance, career …

Factors Influencing Healthy Work Environments For Hospital-Based Nurse Practitioners In The U.S., Hyunmin Yu, Kathryn A. Connell, Sarah Delgado, Heather Brom, J. Margo Brooks Carthon, Amanda Bettencourt, Corinna Sicoutris, Deena Kelly Costa, Vicki Good, Matthew D. Mchugh

Creating Healthy Work Environments (CHWE)

Background: Nurse practitioners (NPs) are a rapidly growing segment of the U.S. healthcare workforce^1,2 and are increasingly integral to patient care in hospital settings.^3,4 Despite their expanding roles,⁵ little is known about the work environment factors that affect their well-being in hospital settings.⁶ This study aims to explore the factors that influence hospital-based NPs’ healthy work environments (HWEs) and identify strategies to enhance their well-being and support retention.

Methods: This qualitative descriptive study used directed content analysis⁷ to examine responses from 493 NPs across 264 hospitals in 10 U.S. states with varying scope-of-practice laws. …

Creating A Safe And Welcoming Environment For New Nurses Through Effective Preceptor Training, Heidi Keeler, Jodie Boswell

Creating Healthy Work Environments (CHWE)

The purpose of this presentation is to emphasize the critical role of nurse preceptors in supporting new nurses as they transition into clinical practice. It aims to highlight the importance of structured preceptor training to foster a safe, welcoming, and inclusive work environment. This presentation explores the essential role of preceptors in facilitating that transition with the use of the Ulrich Precepting Model. By focusing on the roles of Facilitator, Protector, and Socialization Agent, the presentation seeks to equip preceptors, educators and leadership with the tools and strategies necessary to promote psychological and physical safety, cultural assimilation, and professional growth …

Rethinking Psychological Safety In The Work Environment: Nursing Students' Perspectives, Olivia Nyarko Mensah, Elizabeth Boatemaa, Anita Fosua, Egya Gyanzah Eshun, Mary Ani-Amponsah

Creating Healthy Work Environments (CHWE)

Background: When the right working environment is created, it fosters the right behaviour in employees, A conducive environment is one that allows people to freely express themselves and escalate their concerns without fear of repercussion, victimization or undue consequences, it helps enhance work satisfaction (Ip et al., 2025; Turner et al., 2023). The classroom and the clinical work environment if appropriate and conducive should be such that it allows and not hinder free expression which can go a long way to ensure participation, satisfying individual concerns and group achievement (O’Connor et al., 2022). The central problem of the study was …

Lol! Laugh Out Loud With Laughter Yoga, Shalini Shrikanth

Creating Healthy Work Environments (CHWE)

Laughter Yoga (LY) is a structured mind-body practice that combines deep breathing techniques from yoga with intentional, simulated laughter. There are no jokes, cartoons, or comedy involved, laughter begins as a voluntary action and soon becomes genuine through the shared social energy of the group. The body responds to this intentional laughter with the same physiological and psychological benefits as spontaneous laughter. Sessions last 20-30 minutes and include rhythmic clapping, gentle movement, deep breathing, and playful laughter exercises performed in groups. Research consistently supports LY as an effective, low-cost intervention to reduce stress and anxiety. Physiologically, LY lowers cortisol and …

Transforming Workers' Compensation Into A Workforce Optimization Strategy, Tina Marie Santos, Kathleen Jancek

Creating Healthy Work Environments (CHWE)

Purpose: The personal, physical, and financial toll of workplace injuries on workers is enormous, with many experiencing isolation and depressive symptoms.

Objective: This quality improvement project aimed to improve the Workers' Compensation (WC) program to enhance workforce retention, productivity, team member well-being and reduce liability.

Approach: The project implemented a structured, iterative process grounded in baseline data to inform and refine process improvement and outcomes. Strategies for improvement included: (1) foster professional well-being through an accommodation model that emphasized belonging and meaningful contributions during recovery; (2) creative and flexible solutions leveraging team members' abilities rather than limitations that aligned with …

New Beginnings: A Well-Being Program For The New Graduate Nurse, Adriana Rumoro

Creating Healthy Work Environments (CHWE)

Graduate nurses are valuable to an organization because they bring a fresh outlook, enthusiasm, and dedication to providing excellent patient care. It marks a new beginning in their professional development. However, along with these new beginnings, they also face feelings of inadequacy, uncertainty, and workload pressure during the transition from student nurse to registered professional nurse (Asseiri et al., 2025). Transitioning into the workplace presents a variety of stressors for new graduate nurses, who experience both psychological well-being and distress during their first year of practice (Jarde, et al., 2021). Starting a new career can be the best of times, …