Leadership Agenda for Change Toward Healthy Work Environments in Acute and Critical Care

2008 ◽  
Vol 28 (5) ◽  
pp. 66-78 ◽  
Author(s):  
Maria R. Shirey ◽  
Mary L. Fisher
Keyword(s):  
Critical Care ◽  
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.

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.

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.

It Starts with a Conversation: A Community Approach to Creating Healthy Work Environments

2010 ◽  
Vol 42 (1) ◽  
pp. 27-35 ◽  
Author(s):  
Joy Longo ◽  
Amy Dean ◽  
Shelby Darlene Norris ◽  
Suzette W. Wexner ◽  
Leslie N. Kent
Keyword(s):  
Work Environments ◽  
Community Approach ◽  
Healthy Work ◽  
Healthy Work Environments

Authentic Leaders Creating Healthy Work Environments for Nursing Practice

2006 ◽  
Vol 15 (3) ◽  
pp. 256-267 ◽  
Author(s):  
Maria R. Shirey
Keyword(s):  
Work Environment ◽  
Authentic Leadership ◽  
Nursing Practice ◽  
Healthcare Delivery ◽  
Work Environments ◽  
Nursing Workforce ◽  
Healthcare Delivery System ◽  
Healthy Work Environment ◽  
Healthy Work ◽  
Healthy Work Environments

Implementation of authentic leadership can affect not only the nursing workforce and the profession but the healthcare delivery system and society as a whole. Creating a healthy work environment for nursing practice is crucial to maintain an adequate nursing workforce; the stressful nature of the profession often leads to burnout, disability, and high absenteeism and ultimately contributes to the escalating shortage of nurses. Leaders play a pivotal role in retention of nurses by shaping the healthcare practice environment to produce quality outcomes for staff nurses and patients. Few guidelines are available, however, for creating and sustaining the critical elements of a healthy work environment. In 2005, the American Association of Critical-Care Nurses released a landmark publication specifying 6 standards (skilled communication, true collaboration, effective decision making, appropriate staffing, meaningful recognition, and authentic leadership) necessary to establish and sustain healthy work environments in healthcare. Authentic leadership was described as the “glue” needed to hold together a healthy work environment. Now, the roles and relationships of authentic leaders in the healthy work environment are clarified as follows: An expanded definition of authentic leadership and its attributes (eg, genuineness, trustworthiness, reliability, compassion, and believability) is presented. Mechanisms by which authentic leaders can create healthy work environments for practice (eg, engaging employees in the work environment to promote positive behaviors) are described. A practical guide on how to become an authentic leader is advanced. A research agenda to advance the study of authentic leadership in nursing practice through collaboration between nursing and business is proposed.

Healthy Work Environments

2005 ◽  
Vol 25 (3) ◽  
pp. 72-71 ◽  
Author(s):  
Karlene M. Kerfoot ◽  
Ramón Lavandero
Keyword(s):  
Work Environments ◽  
Healthy Work ◽  
Healthy Work Environments
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