Creating a Healthy Nursing Work Environment

Saturday, 23 February 2019: 8:50 AM

Laura L. Roberts, MSN, RN, C-EFM
Women's Services, Houston Methodist Clear Lake Hospital, Nassau Bay, TX, USA

Purpose: This poster outlines the progress of a low performing team (Tier III) to a high performing team (Tier I) in one year. Throughout this year, the team also faced significant changes and obstacles which were challenges for the leadership team.

Strategies: Leadership used several tools of transformational leadership techniques. In addition, leadership also utlized the AACN Healthy Work Environment Standards such as Strong Leadership Support, Staff Empowerment, Strong Communication, Staff Accountability, Staff Recognition. As a result of these efforts, goals were accomplished and morale and engagement Improved.

Results: The interventions during this project lead to increased morale, cohesiveness and team engagement. As a Result, our unit had increased nurse lead initiatives to improve patient safety goals and outcomes in the NICU and OB. In this team, the measured elements of Trust, Teamwork, Respect and Engagement increased between 40- 62% with the strategies described by the AACN HWE Standards. Our instrument used was the Press-Ganey Employee Opinion Survey. In 2016 our metrics measured as follows for the elements: Trust 19%, Teamwork 47%, Respect 47%, and Engagement 34%. The new Director took over the team and began the work of reorganization and alignment of vision and goals with the team. The team also had to overcome newfound challenges and newly established goals during this timeframe. The priority was working on team dynamics and working on the strategies described previously. After overcoming many obstacles, the Employee Opinion survey at the end of the year revealed the following metrics for the same elements: Trust: 81%, Teamwork 89%, Respect 91%, and Engagement 93%. In addition to the increase in staff satisfaction, our team accomplished all of our new goals and we refined a highly engaged team that had several nurse-lead initiatives for patient safety.

Conclusion: There is a strong correlation between the standards of a healthy work environment and high performing teams and high morale. Studies have documented that HWEs have a direct impact on the quality of patient care. “Furthermore, the literature supports a relationship between HWEs and nurse job satisfaction.” (Leslie & Trisha, 2013) A healthy nurse work environment is a critical component to ensuring that our patients are receiving the best care possible. According to Shirey, (2017) “Quality Leadership is the most important driver of a HWE.” Sustaining a healthy work environment is the responsibility of nursing leaders for employees to have all the necessary tools and resources to be successful. It is critical to be an authentic and genuine leader. “The most desirable leadership attributes entail authenticity and a style that’s visionary, visible, empowering, approachable and relational as opposed to being task focused.” (Shirey, 2017) It is important to note that according to Smith & Cunningham (2016), they stated that “transformational leadership is associated with lower levels of burnout and higher levels of engagement.” Through our journey, our most important goal that was reached with this project was a team that was more engaged, organized, and able to deliver exceptional patient care. In addition, we accomplished all of our goals which were given to our team. We are now poised to carry our unit forward to meet our new goals and meet the future with a positive outlook and know we will be able to face any future barriers or obstacles with a united front. Ultimately, our patients benefit from a more engaged and caring nursing team by receiving excellent evidence based nursing care led by nurse-based initiatives.

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