Digital Commons Network^™

Your Workforce Sustainability Kit: Is Debriefing The Underutilized Tool For Safety And Well-Being?, Maggie Runyon, Tara Ryan Kosmas

Creating Healthy Work Environments (CHWE)

Purpose: To pilot a professional development offering providing a comprehensive debriefing model inclusive of quality, safety, and clinician well-being concerns. This is responsive to main gaps identified in recent systematic reviews exploring the evidence for debriefing to support emotional well-being of clinicians.

Theoretical Framework: Ajzen’s Theory of Planned Behavior guides this professional development and evaluation by examining behavioral beliefs, normative beliefs, and control beliefs.

Project: This program evaluation explored baseline gaps identified by 17 nurses who attended a comprehensive debriefing workshop in Maryland. Data was collected before the workshop to assess baseline exposure to debriefing behaviors and practice norms. The …

Empowering Nurse Educators Through Cognitive Rehearsal, Mary Kathryn Sanders, Teresa B. Bailey

Creating Healthy Work Environments (CHWE)

Background: Creating and sustaining healthy work environments in nursing education requires educators to be proficient in evaluation, feedback, and communication. Traditional preparation programs lack structured training in these areas⁶. Gaps in giving and receiving constructive feedback span health professions education, and early career nurse attrition is frequently linked to perceived bullying, inadequate preparation, and poor clinical support^1,4. These challenges affect psychological safety and professional development for students and new graduates.

Cognitive rehearsal has shown promise in preparing nurses to respond to incivility and enhancing self-efficacy^2,3. While used in faculty development, its integration into formal …

Empowering Seniors As Mentors: A Framework For Peer Development In Nursing Education, Kaitlin M. King, Jenna Davis

Creating Healthy Work Environments (CHWE)

Background: Many nursing education programs face ongoing challenges related to the transition of sophomore nursing students into professional nursing coursework and initial clinical experiences. The coursework and clinical experiences can bring significant academic, emotional, and professional challenges for students. Peer mentorship has been demonstrated as an effective strategy to improve mentee student confidence, retention, and academic success; however, many programs lack the formal preparation and structured framework for the senior students who serve as the mentors.

Purpose: This evidence-based practice project is aimed to develop a structured peer mentorship training program to help empower the senior nursing students as they …

Gratitude Is The Attitude: Increasing Meaningful Recognition And Staff Collaboration In The Nicu, Devin Angiulo, Catherine Michele Lawless, Jenna Matteo, Lauren Miller

Creating Healthy Work Environments (CHWE)

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 …

Bridging Two Worlds: A Qualitative Exploration Of Nurses Returning To Work Postpartum, Katherine Metz, Darlene Narca, Amanda Cortes, Michael Young, Nicole Bohr

Creating Healthy Work Environments (CHWE)

Introduction: Each percentage change in nurse turnover is associated with roughly $289,000 in organizational cost/savings annually.¹ Despite this increased focus and nurses being primarily women of childbearing age², little data exists on retention in nurses during the postpartum period. Supporting postpartum nurses is essential for workforce sustainability and organizational stability.

Purpose: The purpose of this study is to explore the lived experiences of nurses returning to bedside after childbirth. By examining their perspectives, this study seeks to identify key factors influencing job satisfaction, workplace well-being, and retention, and to inform the development of evidence-based organizational strategies that …

Mental Health Crisis Among Icu Nurses: A Global Study Across 65 Countries During Covid-19, Amal Mobarki, Hillary J. Dutton, Allison Squires

Creating Healthy Work Environments (CHWE)

Background: The COVID-19 pandemic imposed heavy demands on ICU nurses, who provided patient care while facing emotional exhaustion, staffing shortages, and limited resources(Boluarte et al., 2020; Shen et al., 2020). Evidence shows that working in critical care during pandemics greatly increases psychological distress among healthcare professionals (Azoulay et al., 2020). Given the significant differences in healthcare systems across countries, cross-national research is crucial for addressing the mental health of ICU nurses.

Aim: This study examines the prevalence of mental health symptoms and evaluates organizational supports provided to intensive care unit nurses throughout the COVID-19 pandemic across multiple international healthcare settings. …

From Burnout To Resilience: Evidence-Based Strategies To Promote Nurse Well-Being, Rachell Nguyen

Creating Healthy Work Environments (CHWE)

Purpose: To review and translate evidence-based interventions into practical strategies for promoting mental health, preventing burnout, and fostering resilience among nurses.

Background: Nurses are experiencing unprecedented challenges to mental health and well-being, calling for the systematic adoption of research-supported interventions to maintain the workforce and improve patient care outcomes.

Methods: A comprehensive review of evidence-based interventions was conducted across individual, interpersonal, and organizational levels, focusing on promoting nurses' mental health, preventing burnout, and building resilience.

Findings: Mental health promotion has strong empirical backing through mindfulness-based interventions, as shown by systematic reviews that consistently report reductions in stress and anxiety. Peer …

A Cross-Sectional Study To Explore Healthcare Providers’ Wellness: Current Challenges & Gut Health, Linda Liu, Simi Joseph

Creating Healthy Work Environments (CHWE)

Background: Healthcare provider well-being is essential for high-quality patient care. However, stress, burnout, and demanding work environments negatively impact physical and mental health, including gut health. The gut-brain axis underscores the link between gastrointestinal function, stress, and well-being, yet limited research has explored gut health among healthcare professionals.

Purpose: This study assessed the prevalence of gastrointestinal symptoms among healthcare providers and examined associations with stress levels, clinical environment, and quality of life in acute and outpatient settings.

Framework: Guided by the Biopsychosocial Model, this research explored how biological, psychological, and social factors influence the well-being and gut health of healthcare …

Fostering A Healthy Academic Environment In Nursing Education, Donna M. Hedges

Creating Healthy Work Environments (CHWE)

A healthy academic environment is foundational to the preparation of future nurses, the retention of faculty, and the overall success of nursing education programs. This presentation examines the multidimensional nature of a healthy academic environment, highlighting psychological safety, equity and inclusion, supportive infrastructure, academic integrity, and collaborative learning as critical elements. Drawing from relational-cultural theory and caring science, the presentation explores how these elements shape outcomes for students, faculty, and institutions. Common challenges—including incivility, limited resources, and faculty workload strain—are discussed alongside evidence-based strategies to foster resilience, collegiality, and organizational change. Implications for practice, policy, and research are identified, underscoring …

Integrating A3 Thinking To Drive Collaborative Clinical And Operational Improvements, Deltra Muoki, Sarah Fleming, Eliud Faz, Dan Hootman, Whitney Adams

Creating Healthy Work Environments (CHWE)

Introduction: Delivering high-quality care and achieving optimal outcomes rely on efficient clinical processes. Continuous improvement enhances care (Endalamaw et al., 2024), and staff should identify evidence-based solutions to drive change.

At this 350-bed Magnet-recognized hospital, clinical and operational teams worked in silos despite shared goals. Clinical staff used gap analyses, while operational teams applied A3 problem-solving to determine whether issues required kaizen events or quick fixes. A3 supports root cause analysis, targeted interventions, and outcome evaluation (Brennan & Wendt, 2021).

However, no standardized process existed for submitting or tracking gap analyses or A3s. In Q1 2025, only two A3s and …

Systematic Review Of Multi-Level Determinants And Equity Implications Of Mode Of Birth In The U.S., Abdul-Manaf Mutaru, Cynthia Nicole Lebron, Wonsuk Yoo, Alexa Parra, Lunthita Duthely, Thomas Mike O'Shea, Hudson P. Santos Jr.

Creating Healthy Work Environments (CHWE)

Background: Giving birth by surgical operation (cesarean birth) is linked to complications such as postpartum infection, rehospitalization, and respiratory issues in newborns. However, the cesarean rate remains high, accounting for 32.4% of all births in the United States (U.S.). Understanding the impact of factors beyond the individual level is crucial for developing interventions to reduce preventable cesarean births and promote health equity.

Purpose/Aim: This systematic review synthesized evidence from U.S.-based studies to identify factors beyond the maternal level that are associated with mode of birth (vaginal or cesarean).

Methods: We searched PubMed, Web of Science, PsycINFO, and CINAHL for studies …

Understanding Hospital-Based Nurses’ Perspectives On Workplace Well-Being, Frankie B. Hale, Holly B. Fontenot

Creating Healthy Work Environments (CHWE)

Purpose: Uncover nurses’ perspectives related to factors associated with well-being and garner opinions for interventions in the workplace.

Background: The COVID-19 pandemic profoundly impacted nurses and has led to a potential crisis in staffing. Poorer mental health and well-being stemming from personal and organizational issues have driven nurses to leave the profession. In a recent survey of nurses in Hawaii, individual factors such as working 36 hours or more per week, reports of burnout, having primary caregiving responsibilities outside of work, and lower self-reported physical health, along with organizational factors like the experience of workplace violence, all contributed to an …

Impact Of Stress On Novice Nurses During The Transition To Practice: A Literature Review, Ilona L. Ilyayev

Creating Healthy Work Environments (CHWE)

Background: The transition from being a student to a registered nurse is a challenging and stressful period for novice nurses. Stress is a universal human response to difficult situations, and it is important to recognize early on, as failure to do so can negatively impact nurses' well-being and decrease their long term ability to effectively function.

Purpose: The purpose of this literature review was to examine the impact of stress on novice nurses during the transition to practice.

Methods: An analysis of peer-reviewed literature from 2021 to 2025 was conducted using databases such as PubMed and CINAHL. The research studies …

Professional Commitment As A Mediator Between Proqol, Resilience And Turnover Among Filipino Nurses, Ejay H. Ignacio

Creating Healthy Work Environments (CHWE)

The current global nursing shortage is a significant issue with substantial implications for nursing practice. Increased nurse turnover will yield five percent of the total annual hospital operating costs, estimated to be around 5 trillion dollars annually, due to the cost of hiring and training new nursing staff. In the United States, Filipino immigrant nurses play an integral part in the healthcare systems to patch the critical staffing gaps. The changing landscape of healthcare system delivery in the US, threatens Filipino nurses to stay at their current jobs. This study aimed to explore the mediating effects of professional commitment in …

Baby-Friendly Hospital Initiative Movement In Healthcare Settings: What Are The Practical Solutions?, Shela Hirani

Creating Healthy Work Environments (CHWE)

Introduction: Implementation of the Baby-Friendly Hospital Initiative (BFHI) in all healthcare facilities is valuable to protect, promote and support breastfeeding and the well-being of young children. Besides prioritizing patient care, the BFHI movement in healthcare settings supports well-being, job satisfaction and productivity of healthcare providers working in those workplaces. Saskatchewan, Canada, has 70 healthcare settings, out of which only one healthcare facility implements the WHO’s ‘Ten steps to successful breastfeeding’ and has a BFHI accreditation. This preliminary study aimed at exploring facilitators and barriers surrounding the successful implementation of BFHI in healthcare settings of Saskatchewan and identifying practical solutions and …

How Ai-Enabled Hiring Affects Organizational Health? Challenges And Future Direction, Shiza Hirani

Creating Healthy Work Environments (CHWE)

In today’s competitive landscape of hiring, organizations are responsible to not only maintain ethical integrity, ensure fairness, and protect job applicants' privacy, but also uphold a more data-driven and streamlined approach to save time per hire. The integration of Artificial Intelligence (AI) into the workplace presents opportunities such as enhanced productivity, efficiency, and creation of new roles. However, the widespread implementation of AI also raises ethical and privacy challenges that can deteriorate organizational health. AI-driven systems can inadvertently introduce biases and black box properties in hiring decisions which can erode trust and transparency, compromise employee privacy, and increase psychological stress …

Psychological Safety In The Classroom: Effects On Nursing Student Well-Being And Academic Success, Erica Frost, Kelli D. Whittington, Glory Omole, Chloe Birchett

Creating Healthy Work Environments (CHWE)

In nursing education, fostering psychologically safe learning environments may support student well-being and academic achievement. Edmondson's Psychological Safety Framework (1999) provides the theoretical foundation for this study, framing classroom psychological safety as an environmental factor that influences student well-being and academic outcomes through its impact on learner engagement and interpersonal risk-taking. There is limited research exploring the relationship between classroom psychological safety and nursing student well-being, particularly in undergraduate face-to-face classroom settings.
The purpose of this study is to examine nursing students' experiences, perceptions, and academic outcomes to better understand how instructor behavior and the classroom teaching environment influence student …

Celebrating Ancillary Staff Achievement In The Hospital Setting, Lori Ischinger

Creating Healthy Work Environments (CHWE)

Clinical ladder programs have been available for decades to promote bedside nursing recognition and retention. They have been proven to increase the perception of being valued by an organization, which in turn increases job satisfaction and performance. There is limited research to support the use of these same types of programs for ancillary clinical staff. These staff are essential members of the care team and deserve recognition for the work that they do. The objective was to successfully develop, implement and maintain a clinical ladder program that is specifically tailored to recognize and reward the clinical excellence of this staff. …

Redefining Inclusion: The Lived Experience Of Physically Disabled Nurses In The United States, Vanessa Cameron

Creating Healthy Work Environments (CHWE)

Purpose: The purpose of this phenomenological study was to explore the lived experiences of inclusion among physically disabled nurses actively working in the United States, including how those experiences differ based on disability timing—before or after licensure. Current literature largely centers on sensory or learning disabilities within academic settings; thus, this study addresses a critical gap by focusing on inclusion within professional nursing practice.

Significance: Physically disabled nurses remain underrepresented and underexamined in nursing research and workforce discussions. Applying Critical Disability Theory (CDT)—a framework never before used in nursing—this study explores how ableism and inclusion shape workplace experiences and opportunities …

Reimagining Hwe: Preparing Graduate Nurses For Cultural And Safety Transformation, Shanna D. Chapman, Rose Nieves

Creating Healthy Work Environments (CHWE)

The healthcare landscape has undergone profound transformation in the wake of the COVID-19 pandemic, revealing critical vulnerabilities in workforce well-being and safety. Recent data indicate that 65% of nurses report high levels of stress and burnout, with 40% reconsidering their career choice, and 67% expressing concern over workload management. These challenges are compounded by staffing shortages, compensation concerns, limited organizational support, and a troubling rise in workplace violence—75% of nurses are likely to experience violence during their careers, with 77% reporting verbal abuse and 25% physical assault, contributing to 10,000 injuries annually and costing the industry $2 billion (Cross Country …

Improving Novice Nurses’ Assessment Proficiency With The Global Minded Three-Minute Assessment Tool, Anita G. Fennessey

Creating Healthy Work Environments (CHWE)

Purpose: Physical assessment is a core nursing competency, yet new graduates frequently struggle to apply these skills consistently in practice, contributing to missed care, documentation errors, and preventable adverse outcomes. This study evaluated whether structured education, coaching, and reinforcement of the Global Minded Three-Minute Assessment Tool (GM-3MAT) within a nurse residency program improved novice nurses’ assessment performance.

Methods: A quasi-experimental design compared intervention (n=21) and control (n=22) groups of residency nurses at an academic medical center. The intervention included live Zoom education with expert demonstration, reference materials, a pocket guide, individualized coaching, a 30-day practice challenge, and performance scorecards. Assessment …

Ehr Integration Of A Violence Risk Tool To Promote Safer Work Environments, Kirk Bradford

Creating Healthy Work Environments (CHWE)

In October 2022, a tragic act of workplace violence within our health system highlighted the need for a proactive, data-driven approach to staff safety. Workplace violence impacts nearly one in four nurses each year (McCollum et al., 2024); yet most organizations lack an objective tool to predict and prevent such incidents. The goal of this project was to implement and evaluate a systematic, evidence-based screening process to improve early risk detection and foster safer clinical environments—aligned with the AACN Healthy Work Environment Standard of Effective Decision-Making (AACN, 2016).

A multidisciplinary team of nursing, informatics, and security leaders integrated a modified …

Mitigating Burnout Syndrome Through Mindfulness-Based Stress Reduction, Rachel Kathryn Fajardo

Creating Healthy Work Environments (CHWE)

Burnout Syndrome (BOS) continues to affect critical care nurses, resulting in emotional exhaustion, disengagement, and threats to patient safety [1–4]. This Doctor of Nursing Practice (DNP) project evaluated the impact of a Mindfulness-Based Stress Reduction (MBSR) toolkit on BOS among nurses in a rural intensive care unit. Using a pre-post quality improvement design, baseline burnout was measured with the Maslach Burnout Inventory–Human Services Survey for Medical Personnel (MBI-HSS-MP) and custom Likert-scale surveys administered at three time points [5]. A convenience sample of ten nurses participated in asynchronous and live sessions supported by weekly education and QR-linked resources. The MBSR toolkit …

From Evidence To Action: Promoting Civility For Sustained Healthy Work Environments, Nicole Lynne Demeter, Erik Carter

Creating Healthy Work Environments (CHWE)

Background: Incivility and bullying erode psychological safety, belonging, and professional formation in nursing education (Ehsani et al., 2023). Harms fall disproportionately on historically marginalized students (Park & Kang, 2020) and occur across student–student, faculty–student, and faculty–faculty interactions (Clark & Kenski, 2022). Many students normalize bullying as a “rite of passage” (Hale & Phillips, 2019), further undermining respect (Birks et al., 2019). Reflecting the urgency, the ANA’s 2025 Code of Ethics links nurse well-being to ethical practice (ANA, 2025).

Purpose: Translate evidence into practice to reduce incivility within the College of Nursing through coordinated policy, reporting, education, and faculty development aligned …

Protecting Nursing Breaks To Reduce Burnout And Support A Healthy Work Environment, Jennifer Fabian, Hannah Kayuha Reed, Isabel Romero-Agsalda, Jachelle Braithwaite Pires, Lindsey Vandolah, Marni B. Kellogg

Creating Healthy Work Environments (CHWE)

Nurses on inpatient units frequently experience interrupted or missed meal breaks due to coworker requests, phone calls, alarm systems (such as equipment alarms and call lights), inadequate staffing to cover breaks, and a lack of a coordinated shift plan for meal breaks. Repeatedly forfeiting protected break time contributes to physical and mental fatigue and is a modifiable workplace stressor. Left unaddressed, this stressor may progress into burnout, a significant occupational risk for nurses.

Burnout in nurses has been defined as a gradual state of physical and psychological exhaustion characterized by anger, indifference, and reduced effectiveness, often accompanied by depression and …

Leadnursingforward.Org And A Focus On Nursing Retention: Advocating For Maryland’S Nursing Workforce, Kaynabess Freda, Lisa Seldomridge, Abigail Johnson

Creating Healthy Work Environments (CHWE)

Maryland’s Nursing Workforce Study identified critical shortages in registered nurses and nurse educators, emphasizing the urgent need for sustainable, equity-focused strategies to strengthen the workforce and academic pipeline (Global Data, 2022; Maryland Hospital Association, 2022; National Advisory Council on Nurse Education and Practice, 2020). To address these challenges, XXX was expanded as a statewide platform that advocates for healthier work environments through actionable, evidence-based resources. A team of academic content experts, GIS specialists, and marketers collaborated to design and implement new site features. The “Be a Maryland Nurse” page was developed to highlight statewide data and showcase successful retention strategies. …

Enhancing Nurse Preparedness And Safety In Home Health Through Simulation For Nursing Students, D'Ana Brooks, Christina Matousek, Kelli-Ann Mancini

Creating Healthy Work Environments (CHWE)

Background: Nurses working in the home health setting often work alone in isolated and uncontrolled environments, which increases their risk of experiencing violence or unsafe situations. Recent home health nurse experiences suggest that the severity of safety events has increased in violence and in some cases, led to death. In a recent survey by National Nurses United (2023), eight out of ten nurses reported experiencing workplace violence, including verbal abuse, physical threats, and being pinched or scratched.⁴ Nursing curriculum does not consistently focus on education for the home health setting or overall nurse safety, calling for a re-examination of …

Caring For Dying Patients: Implications For Wellbeing Of Registered Nurses, Danna Leigh Curcio

Creating Healthy Work Environments (CHWE)

Of the 4.7 million registered nurses working in the United States, 55% work in acute care hospitals, and one-quarter will leave the profession within five years (Smiley et al., 2023). To fill these vacancies novice nurses will be hired, caring for the sick and dying. This can be a challenge affecting wellbeing and creating diminished quality patient and family centered care (Akpinar et al., 2025). Domains, guidelines, and criteria were created addressing the emotional impact of caring for the dying while sustaining resilience, self-care, support, and adaptation (NCPQPC, 2018). Additionally, ten domains were developed (AACN, 2021), one aimed at commitment …

Preparing Nursing Students To Support Healthy Work Environments By Teaching Stress First Aid, Veronica Betts, Courtney E. Reinisch, Brenda Marshall

Creating Healthy Work Environments (CHWE)

Stress First Aid (SFA), is an evidence-based education program developed to address stress experienced by front line servicemen in the US military. This leadership and peer support model promotes mental wellness by teaching specific coping skills that build resilience an individual can access in times of stress (NJ NEW, 2025). The SFA training has been demonstrated to decrease stress in nursing staff. Nursing faculty have an ethical responsibility to provide education that promotes wellbeing, resilience, supporting prelicensure nursing students with skills to successfully transition into their roles as nurses (Sinmileoluwa et al., 2020).

Including SFA in nursing education prepares future …

Identifying Factors Influencing Nurses' Decision To Remain In The Clinical Setting, Shoug Alsobhi, Soud Sbehat, Naomi Tuifao

Creating Healthy Work Environments (CHWE)

Background: The healthcare industry, especially in clinical settings, is heavily reliant on the availability of skilled nursing professionals. Despite the increasing demand for nurses, many clinical settings face challenges related to nurse retention. High turnover rates not only affect the quality of care but also result in financial and operational inefficiencies for healthcare institutions. Understanding the factors that influence a nurse’s decision to remain in the clinical setting is critical to addressing these issues and improving retention strategies.

Aim: The aim of this study is to identify and analyze the key factors influencing nurses' decisions to remain in the clinical …