Digital Commons Network^™

Reforming The Work Environment: A Staffing Task Force Imperative, Sarah Delgado

Creating Healthy Work Environments (CHWE)

Purpose: Convened by national professional organizations, a task force representing diverse perspectives met over a 9-month period to address the nurse staffing crisis. Building on the foundational work of the Partners for Nurse Staffing Think Tank, the Nurse Staffing Task Force charge was to identify sustainable solutions to longstanding barriers to appropriate staffing.

Methods: The Task Force members represented a broad range of roles inclusive of direct care nurses, nurse scientists and health care leaders. Geographic diversity was addressed in the selection process which resulted in a team of 38 invited participants. The work was facilitated by two co-chairs, a …

Moving For Minutes! A Sustainable Self-Care Strategy In An Academic Workplace, Jan Michaelis, Ellen D'Errico

Creating Healthy Work Environments (CHWE)

The “6+1” standards of a healthy work environment in an academic setting, are described by Saunders et al. (2021) and include skilled communication, true collaboration, effective decision-making, appropriate staffing, meaningful recognition, authentic leadership, and self-care (the “plus one” standard). However, achieving work-life balance for faculty and staff at the school of nursing, who work long hours, can be challenging, often leading to the neglect of regular exercise, a crucial element of personal health and wellness. To address this issue, a staff member initiated the “Moving for Minutes" program (M4M) in 2009, aimed at encouraging weekly physical activities such as walking, …

Organizational Approach To Collecting, Monitoring, Analyzing Workplace Violence Data And Providing Support To Staff Affected, Brandi C. Bosley, Amanda L. Schweng, Shanan K. Sims

Creating Healthy Work Environments (CHWE)

Significance – Healthcare workers are five times more likely to experience workplace violence than other industries, and 73% all non-fatal workplace violence injuries resulting in missed days of work occur in healthcare settings (OSHA, 2021). WPV costs facilities an estimated $428.5 million nationwide (Van Des Bos et al., 2017). WPV is attributed to burnout, decreased employee morale, increased absenteeism, and increased staff turnover, negatively impacting patient care (Somani et al., 2021).

Background: The organization is a Level 1 Trauma hospital with 573 beds. The Workplace Violence Committee formed in 2018 in response to growing workplace violence incidents. The committee adopted …

A Positive Roi, Healthy Workforce, And Increased Retention Through Transition To Practice, Jamie Emery, Emily Calabro, Heather Coleman, Robin Peterson

Creating Healthy Work Environments (CHWE)

Background and Purpose: In 2023, 32.8% of all newly hired RNs leave within the first year, constituting more than a quarter of all RN separations. The average turnover cost for a bedside RN surpasses $52K, and each percentage shift in RN turnover will result in an extra cost/savings of approximately $380K annually for the average hospital. Further, the current national RN vacancy rate stands at a critical 15.7%.

The American Nurses Association (ANA) has called for a greater focus on recruiting and retaining nurses through residency or fellowship programs that transition nurses into new practice settings using evidence-based criteria.

In …

Enhancing The Professional Well-Being Of Us Nurses Through Healthy Nutrition, Emily Daly Matthews, Emma Kurnat-Thoma

Creating Healthy Work Environments (CHWE)

Poor diet is the leading cause of mortality in the U.S. due to the direct relationship with diet-related chronic diseases including cardiovascular disease (CVD) and type 2 diabetes (T2D) which disproportionally affects underserved communities and exacerbates U.S. health disparities. ^1,2,3 The U.S greatly needs effective, evidence-based policy solutions to significantly improve nutrition and foster an equitable and sustainable food system to improve health and reduce diet related chronic disease.⁴ Approximately half of nurses in the United States have poor diet according to a 2018 systematic review.⁵ Healthy nutrition policy solutions should be implemented in the nursing workplace to …

Fostering An Inclusive Culture Of Belonging For Internationally Educated Nurses, Kate Williams, Marlene Porter

Creating Healthy Work Environments (CHWE)

Purpose: The intent of the Ambassador program is to foster an inclusive culture of belonging for internationally educated nurses (IEN) to aid in their acculturation to the organization and community.

Relevance/Significance: COVID 19 exacerbated the already stressed nursing workforce. Recruitment of IENs is a strategy to supplement the nursing workforce. There has been a 26% increase of IEN transitioning to US practice in a single year. Culture shock is a challenge that IENs may experience during their transition. Support provided from an Ambassador to an IEN during their transition is a strategy to assist with their acculturation potentially minimizing culture …

Attitude Of Health Professions Students Regarding Interprofessional Education In Pakistan: A Scoping Review, Sumaira Khowaja-Punjwani, Afifa Tabassum, Shams Nadeem Alam, Syeda Kauser Ali, Lubna Baig

Creating Healthy Work Environments (CHWE)

Introduction: The secret to success in a fast-paced hospital setting where patients confront complicated concerns is interprofessional collaboration. Interprofessional collaboration could be achieved through interprofessional education (IPE). The objective of this study is to ascertain the quantity, variety, and breadth of research papers on Pakistani health professions students' (HPS) attitudes toward interprofessional education (IPE).

Methods: A scoping review was conducted from March 2022 to August 2022. PICO framework was used for developing research question. Iterative process for literature search was done by development of search terms using Mesh terminologies, Boolean operators and keywords to capture the studies of interest from …

Lessons From A Scoping, Librarian-Assisted Literature Review: How Lgbtq+ People Experience Institutions Of Health, Samuel S. N. Theesfeld, Erica Schorr

Creating Healthy Work Environments (CHWE)

Those that identify as a sexual and gender minority, that is, lesbian, gay, bisexual, transgender, queer, or any other appropriate term (LGBTQ+), experience life, health, and healthcare that is rich in multiplicity. As nurses and health professionals, the narratives of our patients are indeed paramount. Whether it’s the political marginalization of gay people, the increase in U.S. domestic hate crimes, or the fragility and minority stress in which sexual minority men in Tajikistan receive healthcare, our call to understand this population remains consistent.^1-5 This call was explored by the primary author in a scoping literature review that was conducted …

Autoimmune Encephalitis: The Psychological Impact Of Brain Inflammation, Ophelia Hyde

Creating Healthy Work Environments (CHWE)

Autoimmune Encephalitis (AE) is a disease in which the cells of the immune system attack the brain, causing inflammation also known as encephalitis. Brain Inflammation diminishes its proper functioning and can severely impact basic processing skills. The presentation of AE is difficult to identify, because it varies depending on the antibodies involved and the location of inflammation. Autoimmune encephalitis can gradually worsen over time, and can even be fatal. The disease is rare, but as diagnosis methods improve, more and more cases are being discovered. Autoimmune Encephalitis has been found to be more common in women than men. There …

Resilience In Young People Living With Hiv In Low To Middle-Income Countries: A Critical Review, Lily R. Bastian

Creating Healthy Work Environments (CHWE)

Background: According to the Joint United Nations Programme on HIV/AIDS (UNAIDS, 2023), 39 million people globally were living with HIV, and 1.3 million people became infected in 2022. Of those, 27% were young people (ages 15-24), including 210,000 young women and 140,000 young men. HIV is an expanding epidemic despite an overall reduction in the annual incidence percentage and the significant strides that have been made towards prevention of transmission and treatment with antiretroviral therapy (ART). Low to middle-income countries (LMICs) are especially vulnerable to the HIV/AIDs epidemic. The identification and promotion of resilience factors could play a crucial role …

Stress Management And Resiliency Program For Accelerated Bsn Students In A Dedicated Education Unit, Marcela Alvarez-Lazo

Creating Healthy Work Environments (CHWE)

Background: About 12-25% of newly graduated nurses will leave nursing within the first-year post-graduation. These statistics surrounding nursing retention are alarming and are not expected to improve, as 900,000 nurses are projected to depart from nursing by the year 2027. Addressing the underlying issues are critical in making a real impact to increase retention.

Aim: This quality improvement project aims to integrate a Stress Management and Resiliency. Program for accelerated BSN nursing students. The project aims to apply a CBT-based program to increase the knowledge of principles of stress and resilience for nursing students and preceptors, decrease stress, increase resilience, …

Caregiving Experiences Of Latino And Caucasian Dementia Caregivers Amid Pandemic, Alexis Ross

Creating Healthy Work Environments (CHWE)

More than 6.7 million American older adults are diagnosed with Alzheimer’s and related dementias (Alzheimer’s Association, 2023). Caregivers for community dwelling persons living with dementia (PWD) are usually family members such as a spouse or offspring. Resources such as adult day care centers, in-home supportive services, and family support groups were widely used before the COVID-19 pandemic. Following the California ‘Stay-At-Home’ administrative order during the early pandemic, such necessary support services were forced to close.

The purpose of this study was to identify similarities and differences in caregiving experiences between Latino caregivers and non-Hispanic White caregivers of community dwelling persons …

The Effects Of Patient Care In Relation To Toxic Workplace Environments, Kayla Fitzgerald

Creating Healthy Work Environments (CHWE)

Background: Bullying in the workplace setting is a significant issue that can severely impact one’s career. Bullying can be demonstrated in several forms- such as verbal abuse, isolation, intimidation, and physical harm. Specific to nursing practice, workplace bullying is shown to have negative effects on mental health, patient care, and overall job satisfaction. While there are no definite means that organizations will take complete action towards this ongoing issue, several implementations can be instilled to reduce the incidence of workplace bullying.

Methods: In this project, studies of negative work environments, specifically workplace bullying, and patient care were critiqued and synthesized. …

Exploring The Impact Of Intersectional Identity On Maternal Morbidity/Birth Outcomes Among Afro-Latinas In Florida, Alexa Parra, Cynthia Lebron, Michaela Larson, Yue Pan, Jonell Potter, Hudson Santos

Creating Healthy Work Environments (CHWE)

Background: The “Hispanic/Latina Paradox" is a phenomenon where Latina women and their infants have perinatal and birth outcomes similar to those of White women. This is often seen as a protective mechanism that helps reduce maternal health inequities. However, this paradox overlooks the fact that there are different subgroups of Latina women, including Afro-Latinas, who are often neglected when addressing racial disparities related to perinatal birth outcomes in the US. The intersectionality of multiple minority identities may put Afro-Latinas at a disadvantage in terms of perinatal health outcomes.

Objective: Determine differences in maternal morbidity, including pregnancy-related hypertension and diabetes, and …

Screening For Postpartum Depression At A Suburban Chiropractic Clinic, Emma Stedronsky, Mary Degrote Goering

Creating Healthy Work Environments (CHWE)

Background: The pregnancy and postpartum period are crucial times to evaluate for mental health conditions. The American College of Obstetrics and Gynecology (ACOG) recommends that providers screen for perinatal and postpartum depression (PPD) at least once during pregnancy and once during the postpartum period using a validated screening tool. A chiropractic clinic in the upper Midwestern United States identified an anecdotal increase in mental health concerns in their pregnant and postpartum patient population since the COVID-19 pandemic. This project utilized interprofessional collaboration by implementing PPD screening at a chiropractic office according to the recommended guidelines using the Edinburgh Postnatal Depression …

Critical Incident Stress Debriefing Situational Simulation Training To Prepare Debriefing Leaders, Jessica A. Borthwick

Creating Healthy Work Environments (CHWE)

Problem Statement: Critical incidents (CIs) occur, and healthcare provider (HCP) support is often insufficient. Upstream impact of this problem includes unease of identifying incidents as CI, lack of operational knowledge of illustrating and identifying second victim phenomenon, limited recommendations for support of second victims, and inadequately trained certified critical incident stress management (CISM) leaders. Critical incident stress debrief (CISD) practice to enhance certified CISM leaders’ skills has been identified as a gap.

Purpose: The impact of CIs are devasting to HCPs in addition to patients and families of patients. A CI is when harm reaches a recipient of healthcare …

Understanding The Meaning Of “Missed Nursing Care” Among Rn Staff Nurses In The Hospital Setting, Amanda P. Henson

Creating Healthy Work Environments (CHWE)

Missed Nursing Care (MNC) includes any incomplete or delayed care required for a patient during an inpatient admission (Kalisch, 2015). This phenomenon leads to costly consequences for patients and hospitals such as pressure injuries, falls, hospital-acquired infection, thrombosis, and other adverse events that increase patient length of stay, readmission rates, and mortality. Additionally, negative consequences for nursing staff exist, such as burnout, turnover, intent to leave their jobs or profession, moral distress, and compassion fatigue (Recio-Saucedo, et al., 2018; Kalisch, 2015). A quantitative study across 11 hospitals including 3,341 RNs and 976 nursing assistants (NA) revealed that MNC predicts nursing …

Anesthesia Agents And The Risk Of Postoperative Delirium In Noncardiac Surgical Adults An Integrative Review, Narah Latortue, Doreen Wagner

Creating Healthy Work Environments (CHWE)

Introduction: Surgical patients are given anesthetic agents that render them unconscious for surgery. When the surgical procedure is completed, these agents are discontinued. As patients recover from surgery, they may experience an acute onset of confusion or postoperative delirium (POD) that fluctuates and manifests as inattention with changes in perception or cognition, altered levels of consciousness, and changes in motor activity such as agitation or lethargy. At times, a mixture of these symptoms may occur when patients demonstrate a fluctuation between hyperactive and hypoactive motor forms of delirium. Hyperactive delirium is when patients are highly agitated and restless whereas the …

Home Health Nurse Perceptions Of Safety In The Workplace, Natalie Faybisovich

Creating Healthy Work Environments (CHWE)

Background: Home health nursing, a growing care model, caters to individuals seeking medical assistance within the comfort of their own homes. Predicted statistics indicate a 5% employment growth in this sector from 2014 to 2024, which necessitates a 48.6% increase in home health nurse employment. This surge underscores the need to address unique challenges faced by healthcare professionals in this field.

Purpose: This secondary analysis aims to explore and understand the safety concerns encountered by home healthcare nurses, emphasizing the importance of identifying and addressing these concerns to enhance safety and care provision in home settings.

Methods: This secondary analysis …

Examining How The Strive+ Intervention Affects Caregivers' Comfort Levels And Behaviors: A Quantitative Study, Nastacia Taylor

Creating Healthy Work Environments (CHWE)

Support To Reunite, Involve, and Value Each Other (STRIVE) is a five-session manualized psycho-educational family intervention that incorporates cognitive behavioral therapy strategies to facilitate communication skill development, problem solving, and creating a positive family atmosphere. This strengths-based dyadic intervention has been shown to reduce delinquency, drug use, and high-risk sexual behaviors among disadvantaged adolescents aged 13 to 17 years with lived experience of homelessness.

The updated STRIVE+ was tested to investigate the possibility for lowering youth risk factors for commercial sexual exploitation. Adolescent behavioral family treatments are an effective strategy to intervene to prevent adverse developmental consequences. The STRIVE+ intervention …

Implementation Of Adverse Childhood Experiences Screening In Pediatric Primary Care, Megan Nicole Waite

Creating Healthy Work Environments (CHWE)

Introduction: Adverse childhood experiences (ACEs) are potentially traumatic events that occur in childhood including abuse, neglect, and household dysfunction. They are highly prevalent among children, especially those that are racially, ethnically, or socioeconomically disadvantaged. ACEs are negatively associated with unfavorable health outcomes in children including behavioral problems, cognitive delays, and poor physical health. Various governing bodies recommend routine screening for ACEs in pediatric primary care, but some studies report screening rates as low as 4%.

Aims: The aim of this quality improvement doctor of nursing practice (DNP) project was to implement an evidence-based ACE screening protocol and referral to behavioral …

Fostering Civility Between Nursing Faculty, Students, And Clinical Partners To Promote Positive Patient Outcomes, Breanne N. Wilburn, Kathryn A. Osteen, Christine J. Oliver, Courtney K. Brandt

Creating Healthy Work Environments (CHWE)

Nurse educators contribute to healthy practice environments and positive patient outcomes in part by educating students on civil practice in didactic and clinical environments (Foreman, 2023; Naseri et al., 2022). Incivility among students, nursing faculty, and clinical partners is a growing concern in the nursing profession (Foreman, 2023; Hajira et al., 2022). Nursing educators serve as examples for students through participating in culturally inclusive civil discourse (Meires, 2018). Further, student incivility in the academic setting could lead to future workplace incivility and is tied to unhealthy practice environments and negative patient outcomes (Park & Kang, 2020; Wei et al., 2018). …

“It Takes A Special Person” --Exploring Undergraduate Nursing Students’ Emotional Needs While Providing End-Of-Life Care, Kalei H. Kowalchik

Creating Healthy Work Environments (CHWE)

Background: Navigating end-of-life (EOL) care as a nursing student can results in intense emotions such as grief and despair and there is limited research on undergraduate nursing students’ thoughts and experiences on the need for emotional support resources when caring for patients and families at the EOL.

Purpose: To explore undergraduate nursing students’ experiences and their perceived need for integrating emotional and psychological support services while caring for dying populations.

Theoretical Framework: The Nerstrom Transformative Learning Model was used to guide this research which identifies how adult learners interact in their environment with a limited worldview that is …

Device Manager: Bundle Implementation For Reducing Device-Related Pressure Injuries, Sierra Holloway

Creating Healthy Work Environments (CHWE)

Background: Pressure injuries (PIs) are a continuing global problem in healthcare and worse for critically ill patients, costing up to $30 billion annually in the United States and are not reimbursable. Medical devices provide life support and healing in hospitalized patients but can also cause harm. Approximately 30-60% of PIs come from medical devices, causing pain, discomfort, and patient dissatisfaction while worsening patient outcomes.

Problem: The practicum site saw increased MDRPIs over two years, over the hospital average, due to a lack of standardization and knowledge for preventing MDRPIs. This led to extended lengths of stay, increased healthcare costs, and …

Implementation Of A Dedicated Rapid Response Nurse, Brandie Kopsas-Kingsley

Creating Healthy Work Environments (CHWE)

Background/Significance of problem: Rapid Response Teams have been used to reduce the incidence of intrahospital decline. While these teams excel at providing emergent responses during times of critical illness, they generally lack a proactive approach.

Clinical question/project purpose: Is a dedicated Rapid Response Nurse role effective in improving the culture of safety and reducing Rapid Response Team activations? The purpose of this project is to implement a dedicated Rapid Response Nurse (RRN) role that aids nurses in identifying patients at risk of decline or who are currently declining.

Search of literature/best evidence: A literature search was completed for full-text, …

Screen And Intervene: Assessing Knowledge, Preparedness, And Confidence In Managing Postpartum Depression, Caroline Everly Quinn

Creating Healthy Work Environments (CHWE)

Postpartum depression (PPD) is a mental health condition where a parent experiences intense and ongoing depressive symptoms such as sadness, anxiety, lack of energy, suicidal thoughts and actions, and more. One in seven people who give birth will experience PPD. Furthermore, suicide is a leading cause of death in the perinatal period, accounting for 20% of postpartum deaths. Though PPD is common, there are many barriers to screening, managing, and treating this condition.

This evidence-based quality improvement (QI) project aimed to assess nursing students’ and nurses’ levels of knowledge and readiness to screen, intervene, and manage patients with PPD in …

Veterans’ Living To Create Healthy Environments And The Meaning Of Their Well-Being: A Phenomenological Inquiry, Cheryl L. Birmingham

Creating Healthy Work Environments (CHWE)

The Veterans reside in a unique environment influenced by past military experiences that may have positive and negative effects on their well-being as Veterans. With nearly half of the 18.4 million Veterans in the United States living beyond 61 years the physical and mental health conditions may desolate the Veterans’ well-being. Promoting Veterans’ well-being has been studied extensively but scant research has been done on the environmental influences and how it helps to define It is critical to understand how Veterans define well-being to inform future program development addressing mental health needs. The purpose of this study is to discover …

Implementation Of A Mindfulness Intervention Among Professional Firefighters And The Effect On Perceived Stress Levels, Rachel L. Mowry

Creating Healthy Work Environments (CHWE)

Problem Statement: Firefighters experience high levels of stress related to their occupation that negatively impacts their physical and mental health and can lead to loss of occupation, decreased work productivity, and suicide. Occupational stress in firefighters impacts firefighters as individuals, as well as their places of work and communities; therefore, this phenomenon should be investigated further. Mindfulness is a strategy which is shown to be effective in the reduction of occupational-related stress. Mindfulness-based strategies can be delivered through a variety of methods including mindfulness-based stress reduction, mindfulness-based cognitive therapy, virtual mindfulness interventions, and other structured programs. Increased mindfulness has been …

Understanding Treatment Adherence Among Patients With Pulmonary Hypertension, Justin Wilson, Jill Cox, Rula Btoush

Creating Healthy Work Environments (CHWE)

Several effective treatment options are currently available for patients with pulmonary hypertension (PH), including pharmacologic therapies such as breakthrough prostacyclin infusions, the use of durable medical equipment’s, and a myriad of lifestyle modifications. In spite of the availability of these treatment options, many patients remain unsure about their disease and the regular use of recommended treatment. Treatment adherence is defined as the extent to which a person's medication taking behavior, diet, and lifestyle changes corresponds with agreed health care providers recommendations (Burkhart & Sabaté, 2003). Even though a plethora of research has addressed treatment adherence among patients with various diagnoses, …

Perinatal Depression And Anxiety Among Adolescents: Knowledge, Perception, Care Preferences And Access To Pmh Care, Olajumoke Ojeleye

Creating Healthy Work Environments (CHWE)

Introduction: Pregnant and parenting adolescents (PPA) experience perinatal mental health (PMH) disorders, especially perinatal anxiety (PA) and perinatal depression (PND), 3 - 4 times more in comparison to adult mothers. Despite the burden of PND and PA in this population, most of the existing resources and interventions, are either not readily available or targeted to serve the PMH needs of this vulnerable population. This integrative review aims to capture the current state of the science of PND and PA in PPA, focusing on their PMH knowledge, perception of preventive practices, PMH needs, preferences for care, and access to available PMH …