The American Association of Critical Care Nurses Standards for Establishing and Sustaining Healthy Work Environments: Off the Printed Page and into Practice

2008 ◽  
Vol 20 (4) ◽  
pp. 393-401 ◽  
Author(s):  
John F. Dixon
Keyword(s):  
Critical Care ◽  
American Association ◽  
Critical Care Nurses ◽  
Work Environments ◽  
Healthy Work ◽  
Healthy Work Environments

Changing the Work Environment in Intensive Care Units to Achieve Patient-Focused Care: The Time Has Come

2006 ◽  
Vol 15 (6) ◽  
pp. 541-548 ◽  
Author(s):  
Kathleen McCauley ◽  
Richard S. Irwin
Keyword(s):  
Critical Care ◽  
Work Environment ◽  
American Association ◽  
Care Delivery ◽  
Professional Community ◽  
Critical Care Nurses ◽  
Work Environments ◽  
Care Practice ◽  
Healthy Work ◽  
Healthy Work Environments

The American Association of Critical-Care Nurses Standards for Establishing and Sustaining Healthy Work Environments and the American College of Chest Physicians Patient-Focused Care project are complementary initiatives that provide a road map for creating practice environments where interdisciplinary, patient-focused care can thrive. Healthy work environments are so influential that failure to address the issue would result in deleterious effects for every aspect of acute and critical care practice. Skilled communication and true collaboration are crucial for transforming work environments. The American College of Chest Physicians project on patient-focused care was born out of a realization that medicine as currently practiced is too fragmented, too focused on turf battles that hinder communication, and too divorced from a real understanding of what patients expect and need from their healthcare providers. Communication as well as continuity and concordance with the patients’ wishes are foundational premises of care that is patient-focused and safe. Some individuals may achieve some level of genuine patient-focused care even when they practice in a toxic work environment because they are gifted communicators who embrace true collaboration. At best, most likely those efforts will be hit-or-miss and such heroism will be impossible to sustain if the environment is not transformed into a model that reflects standards and initiatives set out by the American Association of Critical-Care Nurses and the American College of Chest Physicians. Other innovative models of care delivery remain unreported. The successes and failures of these models should be shared with the professional community.

Nurse Managers Leading the Way: Reenvisioning Stress to Maintain Healthy Work Environments

2021 ◽  
pp. e1-e7
Author(s):  
Kimberly Dimino ◽  
Amy E. Learmonth ◽  
Christiam C. Fajardo
Keyword(s):  
Critical Care ◽  
Work Environment ◽  
Nurse Managers ◽  
American Association ◽  
Critical Care Nurses ◽  
Work Environments ◽  
The Real ◽  
Experience Of Stress ◽  
Healthy Work ◽  
Healthy Work Environments

Background Stress among nurses is well documented, and in the midst of the coronavirus disease 2019 pandemic, it has reached record highs. Problem Under normal conditions, nurse managers and frontline nurses face stressors that come with the territory of their profession, but the coronavirus disease 2019 pandemic has greatly added to their burden. Nurse managers are being called not only to help their organizations manage the crisis operationally, but also to help the nurses they supervise mentally, emotionally, and even ethically. Discussion This article provides recommendations for how nurse managers can use the American Association of Critical-Care Nurses Healthy Work Environment standards and make the experience of stress more productive. Conclusion Stress comes with the territory in nursing, but nurses can work together to make stress their ally and not their enemy. The real enemies are coronavirus disease 2019, burnout, and the aftermath of uncontrolled stress. When nurses keep stress in perspective and focus on what they can control, they contribute to developing healthier work environments.

Incivility and Professional Comportment in Critical Care Nurses

2017 ◽  
Vol 28 (4) ◽  
pp. 345-350 ◽  
Author(s):  
Kenneth John Oja
Keyword(s):  
Critical Care ◽  
Regression Analysis ◽  
Patient Outcomes ◽  
Critical Care Nurses ◽  
Work Environments ◽  
Critical Care Units ◽  
Healthy Work ◽  
Nurses Perceptions ◽  
Healthy Work Environments ◽  
The Relationship

Background: Civility among critical care nurses is important for achieving positive patient outcomes. Professional comportment refers to nurse behaviors that are respectful, knowledgeable, deliberate, and compassionate. Objective: To examine the relationship between perceptions of nurse-to-nurse incivility and professional comportment among critical care nurses, and the extent to which nurse characteristics influence their perceptions. Methods: Data were collected from nurses in 14 critical care units. Correlational analysis examined the relationship between nurses’ perceptions of nurse-to-nurse incivility and professional comportment. Regression analysis was used to identify predictors of nurse-to-nurse incivility. Results: Decreased perceptions of nurse-to-nurse incivility were associated with increased perceptions of professional comportment. Nurses’ reports of receiving education about professional comportment was a significant predictor of increased nurse perceptions of professional comportment. Conclusion: Professional comportment education for critical care nurses is important and may provide an option to decrease incivility and promote healthy work environments for nurses.

Compassion Fatigue and the Healthy Work Environment

2017 ◽  
Vol 28 (4) ◽  
pp. 351-358 ◽  
Author(s):  
Lesly Kelly ◽  
Michael Todd
Keyword(s):  
Critical Care ◽  
Work Environment ◽  
Compassion Fatigue ◽  
American Association ◽  
Medical Center ◽  
Academic Medical Center ◽  
Compassion Satisfaction ◽  
Critical Care Nurses ◽  
Healthy Work Environment ◽  
Healthy Work

Background:Burnout is a concern for critical care nurses in high-intensity environments. Studies have highlighted the importance of a healthy work environment in promoting optimal nurse and patient outcomes, but research examining the relationship between a healthy work environment and burnout is limited.Objective:To examine how healthy work environment components relate to compassion fatigue (eg, burnout, secondary trauma) and compassion satisfaction.Methods:Nurses (n = 105) in 3 intensive care units at an academic medical center completed a survey including the Professional Quality of Life and the American Association of Critical-Care Nurses’ Healthy Work Environment standards.Results:Regression models using each Healthy Work Environment component to predict each outcome, adjusting for background variables, showed that the 5 Healthy Work Environment components predicted burnout and that meaningful recognition and authentic leadership predicted compassion satisfaction.Conclusions:Findings on associations between healthy work environment standards and burnout suggest the potential importance of implementing the American Association of Critical-Care Nurses’ Healthy Work Environment standards as a mechanism for decreasing burnout.

Healthy Work Environments, Nurse-Physician Communication, and Patients’ Outcomes

2007 ◽  
Vol 16 (6) ◽  
pp. 536-543 ◽  
Author(s):  
Milisa Manojlovich ◽  
Barry DeCicco
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Work Environment ◽  
Intensive Care Units ◽  
Medication Errors ◽  
Work Environments ◽  
Physician Communication ◽  
Practice Environment ◽  
Healthy Work ◽  
Healthy Work Environments

Background Adverse events and serious errors are common in critical care. Although factors in the work environment are important predictors of adverse outcomes for patients, communication between nurses and physicians may be the most significant factor associated with excess hospital mortality in critical care settings. Objectives To examine the relationships between nurses’ perceptions of their practice environment, nurse-physician communication, and selected patients’ outcomes. Methods A nonexperimental, descriptive design was used, and all nurses (N=866) working in 25 intensive care units in southeastern Michigan were surveyed. The Conditions for Work Effectiveness Questionnaire-II and the Practice Environment Scale of the Nursing Work Index were used to measure characteristics of the work environment; the ICU Nurse-Physician Questionnaire was used to measure nurse-physician communication. Nurses self-rated the frequency of ventilator-associated pneumonia, catheter-related sepsis, and medication errors in patients under their care. Results A total of 462 nurses (53%) responded. According to multilevel modeling, both practice environment scales accounted for 47% of the variance in nurse-physician communication scores (P=.001). Nurse-physician communication was predictive of nurse-assessed medication errors only (R2=0.11). Neither environment scale was predictive of any of the patient outcomes. Conclusions Healthy work environments are important for nurse-physician communication. In intensive care units, characteristics of the work environment did not vary enough to be significantly predictive of outcomes, suggesting that even in various types of critical care units, characteristics of the work environment may be more similar than different.

Beginning the Journey to Skilled Communication

2006 ◽  
Vol 17 (3) ◽  
pp. 266-271
Author(s):  
Denise Thornby
Keyword(s):  
Clinical Skills ◽  
Error Rates ◽  
Critical Care Nurses ◽  
Work Environments ◽  
Self Assessment ◽  
Quality Outcomes ◽  
Healthy Work ◽  
Culture Of Silence ◽  
Healthy Work Environments ◽  
Difficult Situations

Intimidating behavior and deficient interpersonal skills create a culture of silence, where there can be a breakdown in team communications and an inability to collaborate and achieve high-quality outcomes. A study from VitalSmarts (Provo, Utah), Silence Kills: The Seven Crucial Conversations for Healthcare, described 7 crucial conversations healthcare professionals struggle with that contribute to patient harm and unacceptable error rates. The American Association of Critical-Care Nurses’ first standard (from AACN Standards for Establishing and Sustaining Healthy Work Environments: A Journey to Excellence), skilled communication, states: “Nurses must be as proficient in communication skills as they are in clinical skills.” Once it is accepted that being competent in skilled communication is essential to excellent patient care, it then takes skill development and added courage to hold crucial conversations and address difficult situations. The first step begins with a self-assessment to determine current effectiveness as a communicator and manager of conflict and to realize opportunities for growth. Three key strategies to begin the development of skilled communication include: (1) understanding the importance of a climate of safety, (2) acknowledging one’s mental stories, and (3) realizing that the only people we control are ourselves.

scholarly journals Critical Care Nurse Work Environments 2018: Findings and Implications

2019 ◽  
Vol 39 (2) ◽  
pp. 67-84 ◽  
Author(s):  
Beth Ulrich ◽  
Connie Barden ◽  
Linda Cassidy ◽  
Natasha Varn-Davis
Keyword(s):  
Job Satisfaction ◽  
Critical Care ◽  
Work Environment ◽  
Critical Care Nurses ◽  
Work Environments ◽  
Care Nurse ◽  
Critical Care Nurse ◽  
Healthy Work Environment ◽  
Healthy Work ◽  
Nurse Outcomes

BACKGROUNDThe health of critical care nurse work environments affects patient and nurse outcomes. The results of the 2018 Critical Care Nurse Work Environment Study are reported here with comparisons to previous studies and recommendations for continued improvement.OBJECTIVETo evaluate the current state of critical care nurse work environments.METHODSAn online survey was used to collect quantitative and qualitative data for this mixed-methods study. A total of 8080 American Association of Critical-Care Nurses (AACN) members and constituents responded to the survey.RESULTSThe health of critical care nurse work environments has improved since the previous study in 2013; however, there are still areas of concern and opportunities for improvement. Key findings include documented absence of appropriate staffing by more than 60% of participants; an alarming number of physical and mental well-being issues (198 340 incidents reported by 6017 participants); one-third of the participants expressed intent to leave their current positions in the next 12 months; and evidence of the positive outcomes of implementing the AACN Healthy Work Environment standards.CONCLUSIONEvidence of the relationship between healthy nurse work environments and patient and nurse outcomes continues to increase. The results of this study provide evidence of the positive relationship between implementation of the AACN Healthy Work Environment standards and the health of critical care nurse work environments, between the health of critical care nurse work environments and job satisfaction, and between job satisfaction and the intent of critical care nurses to leave their current positions or stay.

Critical Care Nurse Work Environments 2013: A Status Report

2014 ◽  
Vol 34 (4) ◽  
pp. 64-79 ◽  
Author(s):  
Beth T. Ulrich ◽  
Ramón Lavandero ◽  
Dana Woods ◽  
Sean Early
Keyword(s):  
Job Satisfaction ◽  
Critical Care ◽  
Work Environment ◽  
Critical Care Nurses ◽  
Work Environments ◽  
Care Nurse ◽  
Critical Care Nurse ◽  
Healthy Work ◽  
Nurse Work Environment

Background The health of critical care nurse work environments has been shown to affect patient care outcomes as well as the job satisfaction and retention of registered nurses. The American Association of Critical-Care Nurses (AACN) Critical Care Nurse Work Environment Survey was first conducted in 2006 following the release of the AACN Standards for Establishing and Sustaining a Healthy Work Environment and was conducted again in 2008. This article reports the results of the third AACN Critical Care Nurse Work Environment Survey conducted in 2013. Objective To evaluate the current state of critical care nurse work environments. Methods A total of 8444 AACN members and constituents responded to an online survey. Results The overall health of critical care nurses’ work environments has declined since 2008, as have nurses’ perceptions of the quality of care. Respondents rated their overall work environment and factors associated with healthy work environments including quality of patient care, staffing, communication and collaboration, respect, physical and mental safety, moral distress, nursing leadership, support for certification and continuing education, meaningful recognition, job satisfaction, and career plans. Although some factors improved, declines in any factors are a concern. Conclusions An increasing body of evidence has shown relationships between healthy nurse work environments and patient outcomes. The results of this 2013 survey identified areas in which the health of critical care nurse work environments needs attention and care, requiring the relentless true collaboration of everyone involved.

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