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Friday, April 12, 2013
Learning Objective 1: Describe the strategies that have been utilized to enhance the nursing work environment and interdisciplinary collaboration of an acute care inpatient Bone Marrow Transplant Unit.
Learning Objective 2: Describe opportunities, threats, and barriers of implementation of this work environment.
In 2005, the American Association of Critical Care Nurses identified six essential standards for establishing and sustaining healthy work environments which include skilled communication, true collaboration, effective decision making, appropriate staffing, meaningful recognition, and authentic leadership. Healthy work environments for nurses are essential to improve patient and nurse satisfaction, ultimately leading to improved patient outcomes. Improved work environments and reduced ratios of patients to nurses have been associated with increased care quality and patient satisfaction (Aiken, et al., 2012). Patient satisfaction has been shown to be associated with better patient outcomes, such as lower 30-day hospital readmission rates (Boulding, et al. 2001). Beginning fiscal year 2013, hospital reimbursement by Medicare will be directly related to patient satisfaction and quality scores (US department of Health and Human Services, 2012). Further, nurse work satisfaction has been shown to have a significant effect on patient satisfaction with nursing care and overall patient satisfaction (Sengin, 2001). Additionally, effective collaboration between health care providers has been linked to decreased hospital stay, decreased costs, and improved staff satisfaction (Curley, 1998). The Shands at the University of Florida leadership team has designed their Adult Bone Marrow Transplant Unit (BMTU) to exemplify the six essential standards identified by AACN. Strategies such as multidisciplinary daily patient conferences, safe RN-patient ratios, thoughtful nursing assignments and nursing staff skill-mix, in-unit learning, meaningful recognition of clinical and professional excellence, standing nursing orders, walking rounds, and bedside handoff communication make this environment welcoming for patients and nurses. While this work is in constant evolution and re-evaluation, the purpose of this presentation is to describe strategies that have been used to foster a healthy work environment and enhanced collaboration utilizing the six essential standards in the BMTU and describe outcomes related to patient and RN satisfaction.