Digital Commons Network^™

Fostering A Healthy Work Environment: Frontline Leadership For Charge Rns Across An Integrated Healthcare System, Yasith Wickramarachchi, Lori S. Schultz, Ghada B. Dunbar

Creating Healthy Work Environments (CHWE)

This novel leadership program incorporates adult-learning principles, interactive-learning activities, performance improvement project application, dynamic role play and practice-based learning. Through peer support, emotional intelligence role play, interactive didactive content, completion of a self-assessment and transformational leadership elements.

Nursing unit leaders, (Charge RNs), are assimilated with professional development skills and behaviors through participating with highlighting the organizational mission, vision, values and their unique role contribution across the Professional Practice model They exemplify and translate the incorporation of a healthy work environment and culture to enhance quality care and safety in clinical practice directly. The inclusion of the American Nurses Association (ANA) …

Why We Work: Examining The Relationships Between Nurse Compensation, Burnout, And Intention To Leave Nursing, Jacqueline Christianson, Jill Guttormson, Maharaj Singh, Abir Bekhet, Norah Louise Johnson

Creating Healthy Work Environments (CHWE)

Purpose: The ongoing nursing shortage contributes to chronic nurse understaffing, which is associated with care rationing and adverse patient outcomes (Kiekkas et al., 2019 Tubbs-Cooley et al., 2019). Burnout-related attrition from the nursing profession is particularly problematic to the nursing workforce because it is both prevalent and preventable (Shah et al., 2021). Intention to leave the profession prior to anticipated retirement has been associated with burnout, however the nursing shortage has been observed to fluctuate in tandem with the availability of alternative economic opportunities (Benson, 2012). Additionally, many nurses self-report intention to stay in the profession despite burnout for financial …

Development Of A Resilience Training Program To Combat Burnout In Nursing Practice, Maggie Doherty Lynch

Creating Healthy Work Environments (CHWE)

In a recent advisory (2022), the Surgeon General of the United States put forth a call to build a thriving healthcare workforce and address conditions contributing to burnout, citing the many detrimental effects on patient care and safety as well as the financial burden when burnout contributes to turnover. Given the physical, emotional, and intellectual demands of nursing practice, nursing professionals are at risk and the implications for healthcare delivery are significant. Acknowledging the innate stressors of providing healthcare it is the responsibility of leaders in the industry to mitigate burnout to sustain the workforce critical to healthcare in the …

Implementation Of Event Debriefing To Improve Teamwork And Safety In Cardiac Surgery, Kendall Elizabeth Law, Megan Wanzer, Linda Costa

Creating Healthy Work Environments (CHWE)

Problem: The Cardiac Surgery Intensive Care Unit (CSICU) at an academic medical center is experiencing an increase in critical events. The 2022 Safe and Reliable Healthcare Safety, Communication, Operational Reliability, and Engagement (SCORE) Survey revealed that this unit scored in the lowest percentile for burnout climate and over seventy percent of the nursing staff left in a span of six months. The staff feels this has resulted in a lack of guidance and a chaotic environment. Incident reports have also shown an increase in near-miss events.

Purpose: The purpose of this quality improvement (QI) project is to utilize the institution’s …

Yoga For Stress Relief Program For Nursing Faculty And Staff, Julee Briscoe Waldrop

Creating Healthy Work Environments (CHWE)

The phenomenon of burn-out in nurses is not new, however, it has been exacerbated and brought to the forefront of our attention since the COVID pandemic. Nursing shortages exacerbate the problem (National Council of State Boards of Nursing, 2023). The increased need for nurses due to many leaving the workforce and the aging of the population has increased enrollment pressure on schools of nursing, and therefore their faculty and staff. Nursing faculty also have stressful roles, that include balancing multiple expectations of teaching, scholarship, research and service. The above pressure as well as an ongoing faculty shortage (also exacerbated by …

Interprofessional Collaboration: Nursing And Dental Medical Students Provide Oral Healthcare Education In A Community Setting, Geraldine M. Maurer, Betty J. Braxter, Shareen A. Milligan

Creating Healthy Work Environments (CHWE)

Most of the obstetrical care occurs in the community in an outpatient setting. Early pregnancy care should include oral healthcare education to diminish the potential of pregnancy complications such as infections of pregnancy and preterm labor as the pregnancy progresses. Good oral healthcare continues beyond pregnancy and through the lifespan. Providing a multidisciplinary approach can improve patient outcomes. The purpose of this experience in the undergraduate baccalaureate nursing curriculum and the education of dental medicine students at a large, urban, public university was to introduce an interprofessional collaboration education opportunity. Interprofessional education was introduced into the curriculum when the school …

Therapeutic Horsemanship For The Caregiver: Overview Of Results, Pinky Shani, Laura A. Espinosa, Rebecca Yarbrough

Creating Healthy Work Environments (CHWE)

Background: Healthcare professionals (HCPs) are prepared to care for illness and experience stressful situations including trauma and death. However, the overwhelming conditions during and after the pandemic can put many HCPs at risk of developing post-traumatic stress disorder (PTSD) and burnout. Previous research has reported a prevalence of PTSD among HCPs between 21.5% and 38% (Greene et al., 2021; Yan et al., 2021). In addition, 48% of ICU nurses experienced PTSD (Sanchez, Simon, & Ford, 2019). Furthermore, past research has indicated burnout levels of 55% to 86% among HCPs. It is essential that resources are provided for HCPs to cope …

Perception Vs. Reality: Assessing The Health Of Organizational Shared Governance, Tamara L. Dubose, Carliss D. Ramos, Nicole M. Fontenot

Creating Healthy Work Environments (CHWE)

Background & Purpose: Healthy Shared Governance contributes to a Healthy Work Environment.¹ Shared governance (SG) is derived from Kanter’s theory of structural empowerment. Organizations with structurally empowered nurses are provided access to information, resources, support, and opportunities for learning and development and have the capability to affect change.² Effective councils contribute to organizational safety, efficiency, and quality while reducing financial and patient loss.⁴ A large academic medical center in the Southwest United States has had SG since 2008. Council engagement and effectiveness are signals of healthy SG. This project aimed to assess the health of the organization’s …

Balancing Work And Life: Barriers And Facilitators For Working Caregivers Of Adults With Parkinson's Disease, Natalie Hellmers, Amy Witkoski Stimpfel, Jason Fletcher, Victoria Vaughan Dickson

Creating Healthy Work Environments (CHWE)

The purpose of this study was to explore family caregiver perspectives on the barriers and facilitators to work-life balance while caring for adults with Parkinson’s Disease. A convergent mixed methods design was used. An adapted version of the Work-Life Conflict Model by Greenhaus and Beautell guided the study. Participants were recruited through Parkinson's Disease support groups. Formal, paid caregivers were excluded from the study. Forty family caregivers completed surveys such as the Work-Life Balance survey, Job Content Questionnaire, Zarit Burden Interview and other measures on stress, wellbeing, and quality of life. Following completion of surveys, the same forty caregivers participated …

Virtual Journal Club- A Strategy To Improve Evidence Translation And Peer Collaboration, Rachel E. Wood, Joy Huston

Creating Healthy Work Environments (CHWE)

Nurses are a critical component of the healthcare delivery system, weaving together science, critical thinking, empathy, compassion, and empowerment to deliver relational, expert care (Wood et al., 2023). To translate current evidence into practices that transform healthcare, nurses need to have confidence in their ability to access, evaluate, and integrate evidence. To provide compassionate, relational care, nurses themselves need to be well. This project sought to address both goals: transforming healthcare delivery by improved nurse wellbeing through peer collaboration and enhanced confidence in evidence-based practice (EBP) skills.

EBP is the intentional use of current, relevant research combined with sound clinical …

"Wellness 2 U” Program To Promote Nurse Leaders' Loving- Kindness Toward Self And Others, Linda Y. Kim, Akal Khalsa, Jennifer Astasio

Creating Healthy Work Environments (CHWE)

Problem/Background: A 2021 study by the American Organization for Nursing Leadership reported that sustainment of staff emotional health and well-being were top priorities for 75% of the nurse leader respondents.¹ Compassionate caring of others begins with loving-kindness toward self.² Nurse leaders must practice self-care and loving-kindness for themselves and role model it as a means of empowering and promoting wellness for their staff. Holistic and integrative strategies aimed at promoting nurse leader and staff well-being consequently promote a healing environment for authentic caring presence for patients.

Purpose/SMART Aims: This project aimed to promote nurse leader wellness …

Nurse Resident Job Satisfaction With A Formal Mentorship Program, Jessica Hoehne

Creating Healthy Work Environments (CHWE)

Purpose: Job satisfaction is a predictor of nursing turnover and intent to stay. New nurses are especially vulnerable to turnover during their first year creating a significant barrier to building the nursing workforce. Research shows reasons contributing to the high attrition rates of new nurses include a lack of confidence, an inability to cope with work-related stress and a decreased sense of belonging. Several studies have shown that mentorship promotes personal and professional development, increases learning, and builds confidence. The goal of implementing a mentorship program is to create a culture of support for nurse residents resulting in increased job …

Baccalaureate Nursing Students Identify Positive And Negative Belongingness Behaviors In Clinical Practice: Lessons For Clinicians, Missy Ofe Fleck, Cathrin L. Carithers, Lynnette Leeseberg Stamler, Leeza A. Struwe

Creating Healthy Work Environments (CHWE)

Creating inclusive clinical learning environments in which students thrive is a priority in nursing education and practice to foster belongingness (Metzger & Taggert, 2020), address person-centered care needs (Marjadi et al., 2023), and prepare a diverse nursing workforce (Charania & Patel, 2022). Relationships nurtured among health care team members and nursing students provide the fundamental social context for acceptance and efficacious learning (Levett-Jones et al., 2007). Levett-Jones and Lathlean (2008) identified belongingness as a “deeply personal and contextually mediated experience that evolves in response to the degree to which an individual feels (a) secure, accepted, included, valued, and respected by …

Transforming Orthopedic Clinic Workplace Culture Using The Pdsa Cycle, Tania Mae Golo-Atkin, Jodie Mae B. Shiba, Daniel A. Collins, Chrystal Leigh Lewis

Creating Healthy Work Environments (CHWE)

BACKGROUND: Prior to the COVID-19 pandemic, the work environment was already associated as a contributing factor to nurses’ intention to leave the workplace (Nantsupawat et al., 2016; Shah et al. 2021). Additionally, peer-to-peer nursing isolation is a problem within ambulatory nursing (Allen, 2016). However, specific investigation into intent to leave in ambulatory nursing is limited. The National Database of Nursing Quality Indicators (NDNQI) survey was first used in this setting’s ambulatory clinics in 2021. The Orthopedic Clinic RN Coordinators (RNC) initial 2021 NDNQI scores on the specific metric exploring nurses’ intentions to leave their current workplace within 3 years was …

An Innovative Program: R3 Renewal, Resilience And Retention For Nursing Practice Starts In Nursing Education, Cynda Hylton Rushton, Vickie Hughes, Krysia Warren Hudson, Sandra Swoboda, Erin Wright, Nancy Reller, Ginger Hanson, Rita F. D'Aoust

Creating Healthy Work Environments (CHWE)

Burnout due to workload and work-life imbalance is reducing nursing capacity in Maryland and nationally. Faculty and staff burnout rate is 40% and new graduate nurse turnover rate is 19%. The R³: Renewal, Resilience and Retention Initiative (R³) is an educational initiative to build nurses' resilience and increase their well-being that will help sustain the workforce and bridge the gap between education and practice. Many sound initiatives have addressed this shortage which primarily focus on pipeline entry by increasing (a) enrollment in nursing programs and (b) the number of nursing faculty. Fewer initiatives have targeted …

Creating Climate Healthy Work Environments In Healthcare, Janice E. Hawkins, Beth Tremblay

Creating Healthy Work Environments (CHWE)

Climate change is not only detrimental to our planet but poses a serious threat to human health. The World Health Organization (WHO, 2021) named climate change the greatest threat to human health and, by 2030, predicts an increase of 250,000 deaths each year from climate-related causes. Incongruent with our pledge to do no harm, healthcare industries are significant contributors of carbon emissions that cause climate change. Healthcare systems produce almost 5% of heat-trapping gases released into the atmosphere. Hospitals generate 20 pounds of waste per patient each day, equating to 5 million tons of waste annually (Practice Greenhealth, 2022). As …

Empowering Nursing Through Reflective Practice: A Path To Resilience, Well-Being, And Healthful Workplace Cultures, Joanne P. Bosanquet

Creating Healthy Work Environments (CHWE)

In the UK's health and care system, the cornerstone is safe, effective, and evidence-informed person-centered care. The pursuit of consistent high-quality care is an imperative, demanding the unwavering commitment of healthcare professionals. However, the increasingly complexity of healthcare, coupled with escalating costs, uncertainties in the work environment, recruitment and retention challenges, and the alarming rise in staff sickness and burnout, pose formidable obstacles (Aiken et al., 2023; Villarante et al., 2023).

Registered nurses, despite their comprehensive theoretical knowledge and philosophical grounding, confront emotionally taxing work.

Reflection emerges as a transformative tool, enabling nurses to connect with their inner selves, nurturing …

Reporting Workplace Violence: Why Is It A Challenge?, Rebekah Powers, Carol Boswell

Creating Healthy Work Environments (CHWE)

The Occupational Safety and Health Administration (OSHA, n.d.) defines workplace violence to include "any act or threat of physical violence, harassment, intimidation, or other threatening disruptive behavior that occurs at the work site.” Workplace violence is a developing challenge within health care settings following the adversities encountered with behavioral issues acknowledged after the pandemic. Workplace violence includes physical episodes, verbal episodes, threats, and sexual harassment experiences, yet remains underreported (NIOSH, 2020). Nurses and nurse aides are two groups who are at the highest risk of becoming victims of violence due to their involvement with direct patient care. An acute care …

Clinical Coaches Igniting The Sparc To Improve Rn Retention, Kate Williams, Rachel Hutton

Creating Healthy Work Environments (CHWE)

Background: The shortage of Registered Nurses (RNs) in the healthcare workforce continues to be a major concern to healthcare executives. Department of Health and Human Services predict that Texas will face a shortage of most nurse types by 2032 as 16.3% of the projected demand for RNs in 2032 will not be met. Nurse preceptors use evidence-based practices to support the successful transition/orientation of newly hired nurses as it relates to quality patient care and retention of nurses. Clinical Coaches are foundational for the success of all orientation programming and have tremendous impact on our nurses. Coaching involves a mutual …

Enhancing Nurse-To-Nurse Relationships And Work Environments As Experienced Nurses Transition To New Clinical Specialties, Jennifer K. Chicca, Hope C. Hubbard

Creating Healthy Work Environments (CHWE)

Nurses interact with a variety of healthcare professionals, including fellow nurses with different levels of authority and/or experience, as part of their day-to-day practice. As they interact with their nursing peers, nurses develop connections with unique aspects, benefits, and challenges, and these relationships can have healthy and unhealthy elements and relations can change over time. Notably, healthy nurse-to-nurse relationships build teams, increase collaboration, and strengthen effective communications (Institute for Safe Medication Practices, 2021) and thus professional relationships heavily influence the work environment. Unfortunately, violations of healthy relationships and work environments are common and these issues threaten adverse outcomes such as …

Transforming Academic Nursing: Educating Nurses On The Health Challenges Of Climate Change, Clara Granda-Cameron, Lisa Whitfield-Harris

Creating Healthy Work Environments (CHWE)

Background: Climate change is a major public health threat for humanity. Over the coming decades, morbidity and mortality are expected to increase, particularly in vulnerable communities, due to increased heat, poor air quality, undernutrition, and vector-borne diseases. To care for populations who reside in these communities, undergraduate and graduate nursing students must be educated, which requires integrating climate change topics into the nursing curriculum.

Purpose: We piloted a course module about climate change and health and tested its effectiveness as a tool for educating nursing students.

Methods: Using a pre-post intervention design, 192 undergraduate and graduate nursing students enrolled in …

Promoting Wellness Early: Shifting The Culture To Embrace Self-Care In Nursing, Deborah Ambrosio-Mawhirter, Marilyn Klainberg

Creating Healthy Work Environments (CHWE)

Aim: Promoting an environment to embrace wellness and self-care. Does early education promote participation in self-care behaviors?

Background: According to the American Nurses Association (ANA), self-care is an ethical responsibility of all nurses. Provision 5 states: “The nurse owes the same duties to self as to others, including the responsibility to promote health” (ANA 2015). It is apparent in the literature that although nurses are advocates for their patient’s health promotion, it does not necessarily translate into their own self-care behaviors. Nurses must promote a culture of self-care to reduces stress, burn out, and improve patient safety and the quality …

Trauma-Informed Professional Development From Grassroots To System-Wide, Heidi Gilroy

Creating Healthy Work Environments (CHWE)

A recent meta-analysis revealed that nearly one-third of all working Registered Nurses have post-traumatic stress disorder. Nurses are also reporting high levels of depression, anxiety, and other physical and mental health consequences of traumatic stress exposure. While COVID-19 may have exacerbated some mental health conditions in nurses, many decades of research shows that nurses and other healthcare workers have long struggled with poor mental health. In order to address this issue, a group of Nursing Professional Development (NPD) practitioners at a multi-site healthcare system aimed to develop an evidence-based approach to addressing poor mental health in nurses and other healthcare …

Raising The Standard In Transition To Practice With Interprofessional Collaboration In A Healthy Work Environment, Grace Sekayan, Ghada Dunbar

Creating Healthy Work Environments (CHWE)

The success of the Perinatal Transition to Practice (TTP) Program across a multi-site integrated health system is built on the pillars of The Standards of Healthy Work Environments, American Nurses Credentialling Center (ANCC) Practice Transition Accreditation Program (PTAP)² domains, and Interprofessional Education Collaborative ⁴ (IPEC). This glimpse of the Perinatal TTP Program will provide insight on three of the six American Association of Critical-Care Nurses essential standards¹ that support communication, professional development, and the essence of nursing excellence. To support the transition of experienced nurse from novice to expert⁷ in a new specialty setting Skilled Communication, True …

[Excerpt From] Taking Action: Top 10 Priorities For Nurses To Protect Health In A Changing Climate, Susan B. Hassmiller

Sigma Publications: Book Excerpts

Taking Action: Top 10 Priorities for Nurses to Protect Health in a Changing Climate offers nurses a clear, evidence-based road map for responding to one of the most significant public health challenges of our time. Written as a practical and nonpolitical guide, the book translates the latest science into actionable strategies, helping nurses understand and address the ways climate-driven events affect the health of the public. Authors Sue Hassmiller and Katie Huffling—together with distinguished experts across nursing and environmental health—provide concrete recommendations for strengthening climate resilience, implementing effective clinical and community interventions, advancing sustainability within healthcare systems, and advocating for …

Nursing Education & Burnout: Secondary Analysis Of Nssrn, Bridget M. Webb, Jennifer Mallow

Creating Healthy Work Environments (CHWE)

Background: Burnout is a risk factor for nurse turnover and intent to leave. Burnout impacts nurse outcomes including incivility, fatigue, and decreased self-esteem, while patient outcomes are adversely impacted as well, including increased mortality, hospitalizations, and emergency department visits. The level of nursing education could impact nursing burnout and turnover.

Purpose: To examine the differences in self-reported burnout and level of education related to nurses:1) leaving their primary nursing position, 2) intent to leave primary position, 3) not working in nursing, and 4) employment change in the National Sample Survey of Registered Nurses (NSSRN).

Methods: The 2018 (pre-pandemic) NSSRN data …

Healthy Work Environment: A Positive Change In The Healthcare System, Rajveer Kaur, Jiji Andrews

Creating Healthy Work Environments (CHWE)

It empowered the nurses through structural and psychological infrastructure, paying attention to the detailed work, applying the knowledge from other disciplines to incorporate in the nursing science for evidence-based practice, and utilizing skills in the nursing practice for healthy work environment engagement. Due to the nursing shortage, nursing leaders must understand a healthy workplace for clinical nurses and drive a positive change in the environment by using educational programs. A study was conducted in the hospital on a medical-surgical unit to evaluate the effects of Authentic leadership and actions producing positive patient outcomes. The study results include psychological empowerment, improved …

Nursing Student Perceptions Of Clinical Experiences With Practicing Nurses: A Descriptive Research Study, Carolyn E. Smith, Jenna E. Davis

Creating Healthy Work Environments (CHWE)

Clinical education is an essential part of the nursing curriculum contributing to critical thinking skills and nursing judgment. The students’ experiences within the clinical setting sets a precedence for their future careers and how they interact with their peers and interprofessional team members (Mamaghani et al., 2019). Communication between the bedside nurses and the students is a key factor to student success and confidence at the bedside. The tone, topic, and timing of the conversation between students, nurses, and/or peers, may impact the student view of bedside nursing. Positive interactions and supportive feedback leads to improved patient care, clinical judgment, …

Student’S Experience With Cognitive Rehearsal To Address Incivility, Penny A. Sauer, Margaret M. Verzella

Creating Healthy Work Environments (CHWE)

Nurses need to be able to advocate for their patients, even if they face verbal abuse or incivility. Current literature indicates that 66.2%-95.1% of nurses experience verbal abuse (Dadfar & Lester, 2021) with younger, inexperienced nurses having higher levels of abuse (Zulfan et al., 2022). Nurses who face workplace violence, including verbal abuse, have higher levels of stress, impacting their mental and physical health (Sauer & McCoy, 2017).

A mixed-method study was conducted with undergraduate nursing students to determine their response to a simulation that included difficult communication with a healthcare provider. Students were provided with tools and strategies to …

Theoretical Contributions To A Positive Work Environment, Sharon Prawl

Creating Healthy Work Environments (CHWE)

Objectives: Examination of the success of nurse preceptors is moving toward the need for co-creation between nurse leaders and nurses in the role of nurse preceptors. The current nursing workforce has five generations in the cohort of healthcare workers: Silent Generation, Baby Boomers, Generation X, Millennials (Generation Y), and Generation Z (Bacon, 2023). Each group may have different characteristics and traits; supporting them can be challenging. As noted, the demographics of the workforce have changed. Therefore, Nurse Leaders (NL) must demonstrate inclusive leadership behaviors that result in practice environments where all individuals, diverse in their ages, experiences, and education, …