Saturday, 23 February 2019
Healthy Work Environments are important to the welfare of nurses, for successful nurse recruitment and retention, and for the safety and quality of care provided to patients. The American Association of Critical-Care Nurses identified six essential standards necessary to create and ensure a healthy work environment (skilled communication, true collaboration, effective decision-making, appropriate staffing, meaningful recognition, and authentic leadership)( AACN, 2005). This evidence-based practice (EBP) project presents an innovative tool created by frontline leaders and staff to be used by unit-based nurse leaders across a complex 12 hospital health system to easily visualize the health of their unit ( Brunjes, 2014; Ritter, 2010; Shirey, 2017) . The goal of the project was to develop a simple to use instrument to classify nurse sensitive elements necessary to support and stimulate a healthy work environment. A common pie chart completed either electronically or hard copy was designed with healthy work environment labels. Pie chart wedges were standardized for the acute care hospital units with nurse- specific data sources including retention, nurse satisfaction, patient satisfaction, nurse-sensitive clinical indicators, professional development goals, and active engagement strategies. The coloring of each wedge is based on red, yellow, or green standards. Green indicates the indicator is meeting or exceeding goal, yellow is within ten percent of the goal, and red is below the desired goal by more than ten percent. Leaders color a pie chart based on data sources and identify areas of focus. The tool is used to prompt conversation between managers and directors to engage staff in work environment action planning at the unit level. Leaders were surveyed following the launch of this tool in mid-2017 for ease of use and effectiveness. 92% (n=254) of leaders had already used or planned to use the tool. Leaders rated the usefulness of the tool at 72.4% (n=199) somewhat or very useful. Following adoption across the 12 hospital acute care units, the tool was modified and adopted in the emergency departments and surgical services areas with applicable healthy work environment indicators. Staff nurse retention and turnover were measured prior to and following the project and demonstrated a significant improvement from 2016 year end to 2017 year end. Sustainability of the new tool remains a significant strategic imperative for ongoing success.