Digital Commons Network^™

Empowering Well-Being Advocates: Activating Peer Supporters To Build A Well-Being Focused Team, Joel R. Anderson

Creating Healthy Work Environments (CHWE)

Background: A large academic health system developed a Team Well-Being Advocate (TWA) training curriculum emphasizing proactive peer support and strategies to address stress injury, unnecessary stressors, and workplace challenges known to erode healthy work environments. Grounded in the research of Dr. Richard Westphal on the stress continuum and Dr. Peggy Plews-Ogan on wisdom practices, the program integrates structured peer support with team-specific data to guide evidence-based well-being interventions at the microsystem level.

Purpose: To describe the design and implementation of a scalable, peer-driven model that promotes healthy work environments across an academic healthcare system using data to identify and reduce …

Should Minimum Nurse Staffing Ratios Be Mandated?, Haley M. Gallup

DNP and Student Works

This paper argues that mandatory minimum nurse-to-patient staffing ratios are an ethical necessity within healthcare systems. Drawing on personal clinical experience, it is illustrated how inadequate staffing leads to rushed care, increased risk of errors, and diminished patient outcomes. The discussion is grounded in core healthcare ethics—beneficence, nonmaleficence, and justice—emphasizing that nurses cannot consistently uphold these principles when overwhelmed by excessive workloads. Evidence from research is used to demonstrate that higher patient loads are associated with increased mortality rates, preventable complications, and decreased quality of care, while improved staffing enhances patient safety and nurse satisfaction. The paper also addresses the …

Engaging Rural Adults With Type 2 Diabetes In Adaptation Of A Physical Activity Intervention For A Mobile App, Chelsea Howland

Sigma Foundation for Nursing Research Grant Reports

The purpose of this study was to 1) adapt a physical activity self-management intervention for a mobile app platform and 2) explore preferences for and understanding of graphically presented physical activity data in individuals aged 40 and older with T2D.

Aim 1: To engage end-users in adapting a physical activity self-management intervention for a mobile app delivery platform and explore acceptance.

Aim 2: To describe preferences for and understanding of graphically presented physical activity data.

Personal Healthcare Networks Of Transgender And Gender-Diverse Adults After Gender-Affirming Surgery, Tyler Gaedecke

Sigma Foundation for Nursing Research Grant Reports

The purpose of this study was to investigate access to healthcare among transgender and gender-diverse (TGD) individuals after gender-affirming surgery by using social network analysis to describe their “personal healthcare networks” of healthcare professionals. Our first aim was to characterize the content, function, and structure of the personal healthcare networks of TGD adults after gender-affirming surgery (N = 130) and examine associations with self-rated physical and mental health. Our second aim was to qualitatively explore TGD adults’ experiences of constructing, accessing, and engaging with those personal healthcare networks after surgery (N = 24).

[Excerpt From] Leading Academic-Practice Partnerships In Nursing And Healthcare, Doreen C. Harper, Maria R. Shirey, Cynthia S. Selleck, Michele H. Talley, Connie White-Williams

Sigma Publications: Book Excerpts

Leading Academic-Practice Partnerships in Nursing and Healthcare: A Paradigm for Change is a comprehensive guide for unlocking the power of partnerships—transforming healthcare by improving care processes, care coordination, and patient outcomes through collaborative partnerships among nursing academic and practice sectors. Written by experts immersed in this work for well over a decade, this indispensable resource shows how to develop robust partnerships focused on health systems, population health, and community care—and how to build the organizational structure needed to sustain and grow those partnerships.

This book provides:

• An understanding of why academic-practice partnerships are important, their benefits, and the nurses’ …

Development Of A Culturally Sensitive Traffic Light Food Labeling Intervention To Optimize Healthy Eating In Pregnant Individuals Of Color, Katherine Erbe

General Submissions: Clinical Settings Materials

Study Aim: To develop an evidence-informed, pragmatic nutrition intervention for pregnant Black and Hispanic/Latinx individuals that includes culturally relevant food choices and can be utilized by obstetric clinicians to increase patient engagement with nutrition counseling during pregnancy.

Perioperative Anxiety And Emergence Delirium In Veterans With Ptsd, Hallie H. Glassco, Nancy Westbrook

Group: Samford University Moffett & Sanders School of Nursing

Veterans are at higher risk for emergence delirium and emergence agitation due to the high rates of post-traumatic stress disorder (PTSD). Trauma-informed care (TIC) involves recognizing the widespread impact of trauma, the signs and symptoms, and integrating this awareness into all aspects of the patient's care to promote safety and patient empowerment while avoiding re-traumatization. The case presented here generated the following clinical question: In veterans with PTSD undergoing general anesthesia, does a trauma-informed anesthetic approach that includes midazolam, dexmedetomidine, and patient-directed adjustments reduce the incidence of perioperative anxiety and emergence agitation/delirium compared to standard anesthetic practices? The case involved …

Mental Health Focont Primary Care: A Continuing Education Initiative, Collin P. Mcdowell, Maddie Lozinski, Tristan Senenfelder

DNP and Student Works

Many primary care Advanced Practice Providers (APPs) lack access to continuing education (CE) tailored to managing mental health disorders. This quality improvement project evaluated changes in APP confidence before and after participating in an online, asynchronous CE program focused on behavioral health in primary care. The project was conducted through a higher education institution in northeastern Minnesota and included 21 APPs practicing in Minnesota (N = 21); however, only two participants completed at least two of the three courses during the implementation window. Paired t-tests and the Pearson correlation coefficient were used to evaluate changes in confidence using a validated …

Relocation Experience And Physical Activity And Sedentary Behavior: Newly Admitted Residents To Assisted Living Facilities, Jung Yoen Son

Sigma Foundation for Nursing Research Grant Reports

This study aims to determine the feasibility and acceptability of conducting a longitudinal study with newly admitted residents to ALF, establish a preliminary estimate of changes in PA and SB during the relocation from community to ALF, and identify predictors of relocation-related changes.

Addressing Anti-Black Racism In Nursing, Registered Nurse's Association Of Ontario

General Submissions: Organizations - Position Statements, White and Resource Papers

RNAO’s BPGs are systematically developed, evidence-based documents that include recommendations on specific clinical, healthy work environment and health system topics. They are intended for nurses, other members of the interprofessional team in direct care positions, educators, administrators and executives, policymakers and researchers in health and social service organizations and academic institutions. BPGs promote consistency, cultural humility and excellence in clinical care, administrative policies, procedures and education, with the aim of achieving optimal health outcomes for people, communities, and the health system. RNAO aims to meet international reporting standards for clinical practice guidelines, including the standards outlined in the Appraisal of …

The Experience Of Using Ai In An Undergraduate Evidence-Based Practice And Nursing Research Course, Christa E. Hartch

General Submissions: Academic Settings and Education-based Materials

As part of a university-wide, interdisciplinary initiative, faculty in our small, private liberal arts university have been engaged in a months-long Faculty Learning Community (FLC) exploring the use of artificial intelligence (AI) tools. Attending weekly online seminars throughout the Fall 2025 and Spring 2026 semesters presented by the Council of Independent Colleges, participating faculty, from undergraduate, masters, and doctoral programs across disciplines were asked to implement the use of generative artificial intelligence (GAI) into course assignments. GAI is defined as any type of AI that uses deep learning models to generate or create new content (Bowen & Watson, 2024). A …

Evidence-Based Practice Fellowship Program, Ilana I. Logvinov

DNP and Student Works

Objective: The aim of this project was to identify and describe nurses’ practices, attitudes, knowledge/skills, and identify gaps in educational materials’ delivery methods to build an evidence-based practice (EBP) fellowship program in an academic institution.

Methods: This was a quasi-experimental with pre- and post-assessment conducted between September 2016 and February 2017. A survey utilizing 24-item questionnaire was used to measure EBP practices, attitudes, and knowledge/skills among a convenience sample of over 700 nurses working in a single academic institution. Responses were scored on a one to seven rating scale. Gaps in educational materials’ delivery methods were measured using 3 questions …

Hardwiring Best Practice: Leveraging Teamwork And Technology For Clinical Transformation, Jenifer Ash, Cheryl Ficara, Anna-Rae Montano, Laura Bailey, Laura Dzurec

Creating Healthy Work Environments (CHWE)

In the absence of appropriate tools, efficient teamwork, and clinician skills, cardiac monitoring has no therapeutic value (New South Wales Agency for Clinical Innovation, 2022). This initially shocking notion speaks to vital aspects of cardiac monitoring—underlying clinical necessity, early recognition and intervention in response to clinical changes, and alarm mitigation to avoid alarm fatigue. As healthcare context and technology become increasingly complex, reliance on the skill of individual clinicians is inadequate and unreliable for maximizing patient safety and well-being and for achieving optimal outcomes (McLaney et al., 2022). This presentation describes how one hospital group leveraged teamwork excellence and cutting-edge …

Improving Immigrant Families Health: Screening For Adverse Childhood Experiences, Felicia Vanessa Zimmerman

Creating Healthy Work Environments (CHWE)

Objective: Adverse Childhood Experiences (ACEs) are associated with physical and mental health conditions and linked to chronic health conditions among adults who have experienced trauma or toxic stress. ACEs are associated with severe health and social difficulties among children and adults, such as low productivity, mental health, substance abuse, chronic diseases, and short life expectancy. One in four children in the U.S. between the ages of 12 and 17 has at least experienced two or more ACEs. ACEs are more prevalent among underserved and ethnic minority groups. Immigrant children are affected more than non-immigrants; 42% of Hispanic children have higher …

Incivility, The Impact, And The Ability To Overcome, Angela K. Gilbreth

Creating Healthy Work Environments (CHWE)

Incivility is a notorious issue in the nursing profession and has negative consequences for both nurses and patients. Research exists regarding the positive effects of implemented healthy work environment (HWE) initiatives on nurse satisfaction; however, research has not been expanded to evaluate the effect HWE initiatives have on incivility. The purpose of this project is to implement a HWE initiative at a community hospital to mitigate and prevent incivility. The implemented HWE initiative has the potential to positively influence nursing practice and patient outcomes.

Methodology: Selected floors experiencing significant change at a 144-bed community hospital were analyzed to determine the …

The ‘Culture Box’: A Promising Tool For Creating An Inclusive Space In Nursing, Kechi Iheduru-Anderson

Creating Healthy Work Environments (CHWE)

Introduction/Background: The CDC (2021) declared racism a serious threat to the Public's health. The Future of Nursing 2020-2030 called on nurses to strengthen nursing education curricula to prepare nurses to address health equity issues and social determinants of health in meaningful ways (National Academy of Medicine, 2021). To promote health equity and address the social determinants of health, nursing must confront racism and social identity meaningfully. However, many educators are wary of discussing cultural issues; others must learn how to address them or begin the conversation (Iheduru-Anderson & Wahi, 2022). Preparing nurses to address social determinants of health and health …

Creating A Culture Of Mattering In Academic Nursing: Curated Strategies From Faculty Exemplars, Natalie B. May, Julie Haizlip, Katy Marie Hall, Karen Marcdante

Creating Healthy Work Environments (CHWE)

Health professions students have higher rates of anxiety, depression, and burnout than their peers.^1-3 Prior research with undergraduates demonstrates that a sense of mattering is fundamental to student health and psychological well-being, and contributes to academic engagement and resilience.^4,5 Nursing organizations, as well as the US Surgeon General, are recognizing the value of this concept in the workplace.⁶ While research indicates that simple interventions can improve students’ sense of mattering,⁷ there is no literature identifying how students in academic healthcare communities experience mattering.

Mattering, the perception that one is significant to others, is essential for human …

Creating Supportive Learning Environments For Novice Nurse Educators: The Advanced Academy Experience, Judith M. Jarosinski, Tina P. Brown Reid, Lisa A. Seldomridge, Nicole Hall, Brad Hauck, Beverly Payne

Creating Healthy Work Environments (CHWE)

Purpose: The Faculty Academy and Mentorship Initiative of Maryland (FAMI-MD), a grant-funded collaborative of nursing programs, universities/colleges, and healthcare organizations, develops clinical faculty while promoting a healthy work environment during their transition from clinician to educator. FAMI-MD offers two curricula: an Introductory Academy providing foundational content for new educators; the Advanced Academy developed in 2019 for nurses with teaching experience.

This presentation explores how the Advanced Academy prepares experienced nurses for new roles as clinical teachers equipped with skills effective in reducing incivility and promoting a safe learning environment (Layne et al., 2019).

Background: There is a need to increase …

A Collaborative Approach To Supporting Nurses' Well-Being Across An Integrated Health And Care System, Grace M. Cook, Joanne P. Bosanquet, Chris Caldwell, Claire J. Shaw

Creating Healthy Work Environments (CHWE)

An Integrated Health and Care System in England with workforce priorities including staff wellbeing and equality, inclusion and diversity, together with the Foundation of Nursing Studies, wanted to develop a programme that supported the psychological wellbeing and development of resilience for nurses across the region.

Resilience-based Clinical Supervision (RBCS) is an evidence-based model of restorative clinical supervision (Stacey et al., 2017; Stacey et al., 2020) that is structured using compassionate mind theory (Gilbert, 2010; Gilbert and Simos, 2022). It is also underpinned by an ecological viewpoint on resilience which considers the roles of communities and systems as a response to …

Impact Of A Self-Care Intervention Program On Clinician Health And Well-Being, Melissa Rouse, Joanna Carrega

Creating Healthy Work Environments (CHWE)

Purpose: The health and well-being of healthcare clinicians has become a national priority. More than half of the nurses and health care clinicians report symptoms of burnout.^1-2 Burnout can lead to decreased overall wellness an increase in medical errors, and negative patient outcomes.^3-4 The purpose of this study was to evaluate the impact of the self-care management program on clinician health and well-being over six months. This study aimed to answer the following questions: 1) Among clinicians practicing in an acute care setting, does participating in a self-care management program impact perceived health and well-being at six months? …

Nursing Faculty Job Satisfaction During Covid-19: A Mixed Methods Study, Laura C. Sessions, Michelle M. Ness, Hayley D. Mark, Bo Kyum Yang

Creating Healthy Work Environments (CHWE)

Aim. To understand stress, resilience, and compassion satisfaction of nursing faculty during COVID-19 pandemic and identify factors related to their job satisfaction.

Background. The impact of COVID-19 on faculty stress, resilience, compassion satisfaction, and job satisfaction were unknown.

Methods. A mixed methods survey was distributed electronically to nursing faculty in the US. A convergent parallel mixed methods study design allowed us to measure and analyze quantitative and qualitative findings concurrently to support a fuller understanding of the results (Creswell & Plano Clark, 2017). A list of department leaders (chair, dean, or director) names and contact information was obtained from …

Evaluating The Impact Of Self-Care Strategies Incorporated Into Undergraduate And Graduate Nursing Curricula: A Systematic Review, Roseanne Moody Fairchild, Salena Tully

Creating Healthy Work Environments (CHWE)

Background/Significance: Self-care is defined as a person’s capacity to partake in preventative measures promoting emotional, physical, and spiritual health to maintain one’s well-being. Registered nurses represent a majority of the healthcare workforce, and a 2017 report by American Nurses' Association found nurses have elevated risk for: a) being overweight, b) lacking adequate rest and sleep and, c) experiencing high levels of stress. As effects of the Covid-19 pandemic rapidly spread, substantial proportions of nurses reported heightened levels of anxiety, depression, and burnout. Impact of the pandemic has brought forth increased awareness regarding the need to encourage self-care practices among nurses …

Relationship Between Gratitude And Job Satisfaction In Nursing Leadership, Tammy P. Aiken

Creating Healthy Work Environments (CHWE)

In the current healthcare climate, retaining our workforce has become increasingly important. Even more so the retention of nursing leadership has become even more crucial, as the need to have nurse leaders guide the profession during tenuous and difficult times is now even more apparent. Looking at ways hospital organizations can potentially increase their retention of leaders, which would assist in the retention of their staff, would be instrumental in easing labor shortage and therefore improve the quality of care. There has been a great deal of research that has shown that gratitude plays a significant role in a person’s …

Factors Contributing To Turnover Among Critical Care Nurses During The Transition To Practice Period, Paula M. Gellner

Creating Healthy Work Environments (CHWE)

Background: New nurses are the major source of hiring for most hospitals. They fill vacancies left by seasoned nurses. As a result, an experience-complexity gap is created. The turnover of new graduate nurses is as high as 85% in the first two years of employment. Despite previous efforts to improve the transition to practice, turnover at the local level remain high.

Purpose/Specific Aims: The purpose of this study was to determine the most important factors contributing to turnover and the opportunities to mitigate or reduce turnover in the critical care setting.

The specific aims were to evaluate the perceptions of …

Burned-Out By Example: A National Survey Of Academic Nurse Leaders’ Perceptions Of Staff Burnout, Adrienne S. Martinez-Hollingsworth, Linda Y. Kim, Jennifer L. Saylor, Jennifer Evans, Dawn Goodolf, Annette Hines, Delsa Richards, Nia Martin, Dajanae Gresham-Ryder, Uzo Nwankpa

Creating Healthy Work Environments (CHWE)

Purposes: Burnout is a challenge to health systems and clinical outcomes (Maslach & Leiter, 2016). Recently, negative impacts on clinical faculty and trainees have also been recognized (Low et al. 2019; Hammoudi, Soltani, Dalli, Alsarraj & Malki, 2023). While the US population increases, higher education struggles to meet a growing need for nurses over the next decade (Bureau of Labor Statistics, 2023). Downward trends in nursing program enrollment following the Covid-19 pandemic, insufficient number of faculty, clinical sites, and budget constraints (American Academy of Colleges of Nurses [AACN], 2023) have highlighted a need for explorations on how burnout may structurally …

Caring For Future Caregivers: Using The Faculty Toolkit Of Teaching Strategies To Support Well-Being For Health Sciences Students, Erica Sciarra, Alice M. Teall

Creating Healthy Work Environments (CHWE)

Current literature supports the positive impact creating a culture of wellness has in promoting individual and organizational wellbeing. Faculty and institutions of higher learning have a responsibility to create a physically and psychologically safe learning environment. Modeling effective ways for students to prioritize their mental health and wellness within the context of the ten dimensions of wellness is paramount. The National Wellness Action Alliance (NWAA) Workgroup recognized and responded to the need to provide faculty with valuable strategies to promote wellness among health sciences students that can be implemented by individual faculty members as well as serve as a springboard …

Effects Of Burnout And Resilience On Turnover Intention In Long-Term Care Nurses Post-Covid, Rosemary Fromer, Rhonda Oldham, Hannah G. Callaway

Creating Healthy Work Environments (CHWE)

Nurses constitute the most significant proportion of the healthcare workforce providing care for residents in long-term care (LTC) facilities (American Association of Colleges of Nursing, 2023, July). The number of licensed practical or vocational nurses who typically care for the most vulnerable populations in LTC has declined by 33,811 since the pandemic (Martin et al., 2023; National Council of State Boards of Nursing, 2023, April 13). LTC patients and staff accounted for 23% of COVID-19-related deaths in the United States (Chidambaram, 2022, February 3). A cross-sectional study conducted by Aiken et al. (2023) at magnet hospitals in the United States …

Creating A Healthy Work Environment To Improve Nurse Retention: An Evidence-Based Practice Project, Megan Hignight

Creating Healthy Work Environments (CHWE)

Background/Significance: Following the COVID-19 pandemic, a community emergency department (ED) faced a critical staffing shortage with nursing turnover rates as high as 46.2%. Strategies to mitigate the staffing shortage were primarily focused on recruitment methods without an intentional focus on evaluating why the nurses were leaving. Understanding the interdependent relationship between nurse attrition and the work environment, the ED Clinical Nurse Specialist (CNS) led an evidence-based practice project to improve the work environment. The purpose of the project was to create an environment in which nurses feel valued, respected, and fulfilled in their work; ultimately leading to decreased nurse turnover. …

Shifting The Paradigm Toward Intent To Stay: A Career Crafting® Program To Increase Nurse Engagement, Jaclyn E. Davis

Creating Healthy Work Environments (CHWE)

Nearly 50% of all RNs experience job disengagement, dissatisfaction, and signs of burnout during their career (National Academy of Medicine, 2019). RN burnout is largely associated with two predominant themes: perception of engagement in meaningful and motivating work and perception of personal ability to disconnect and decompress (Press Ganey, 2018). The techniques in this program guide people to experience work as a career and calling and find meaning in their work despite complex or difficult contexts. Through guided reflection on key elements of career success and available, but often unknown or under-utilized organizational resources, nurses learn to align their nursing …

Nurturing A Healthy Work Environment For New Graduate Nurses In A Large Multi-Site Healthcare System, Vanessa C. Lopez, Nicole M. Ferrer, Lori S. Schultz, Ghada B. Dunbar

Creating Healthy Work Environments (CHWE)

This innovative program began with the New Graduate Registered Nurse (NGRN) cohort completing an initial survey and reflection. In alignment with literature findings, program data revealed NGRNs experienced heightened levels of stress and anxiety related to academic disruptions, limited resources, sudden change, and uncertainty in the healthcare environment due to the pandemic^3,4. With guidance from evidence-based practice standards, key stakeholders identified an aim to enhance the well-being of NGRNs by adapting and incorporating the American Association of Critical Care Nurses (AACN) Six Standards of healthy work environment. The Six Standards include 1.) Skilled communication, 2.) True collaboration, 3.) …