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Learning Objective 1: Describe how communication, collaboration, and leadership influence risk adjusted length of stay, risk adjusted outcomes, central line blood stream infections and ventilator associated pneumonias.
Learning Objective 2: Describe the processes of effective communication, true collaboration, and authentic leadership and their influence on RN turnover.
Rationale/Background Information/Conceptual Framework: Medical errors cost the United States over $50 billion annually. Researchers have found that there is a relationship between the nurses’ work environments and medical errors. The Joint Commission stated that communication failures are the leading cause of harm to patients in hospitals today. With an estimated shortage of 400,000 nurses identified in the year 2020, nurse leaders need to improve the work environment.
Methods: The study design was descriptive cross-sectional. Nurses from ten PICUs completed the Practice Environment Scale of the Nursing Work Index (PES-NWI), the Communication section of the ICU Nurse-Physician Questionnaire and a demographic questionnaire. In addition to the nurses completing the questionnaires, data was obtained from the hospitals regarding nurse turnover, central line infections, ventilator associated pneumonia, risk adjusted length of stay and risk adjusted mortality. A minimum of 415 nurses from ten PICUs completed the survey. Statistical analysis was done using SPSS 17.0. Statistical tests run included multiple regression, t-tests (two-tailed) and one way analysis of variance (ANOVA). The significance level was set at .05 for this study.
Results: There was an inverse relationship (p<.05) between central line infections, risk adjusted length of stay and risk adjusted outcomes and communication as well as collaboration. There was a significant relationship (p<.05) between leadership and nurses intent to leave their jobs.
Conclusions and implications: Nurse leaders need to use research-based interventions to improve the work environments. A better understanding of the relationship between communication, collaboration and the extent that nurse leadership contributes to a healthy work environment and quality patient outcomes will add to the research demonstrating the importance of nurses and excellent nursing care on patient outcomes.
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