H 05 H 05 SPECIAL SESSION: 2018 AACN Critical Care Work Environment Survey Results: Implementing the HWE Standards Matters!

Saturday, 23 February 2019: 10:25 AM-11:10 AM
The American Association of Critical-Care Nurses’ (AACN) 4th national work environment survey revealed compelling data from over 8000 RNs related to the health of acute and critical care work environments. This presentation highlights these findings, particularly focusing on new data showing the impact of implementing the six essential HWE standards.
Registered nurses are uniquely positioned to evaluate and impact the environment in which patients are cared for in hospitals. At the interface of patient care, nurses spend more time in hands-on patient care than any other discipline. RNs, however, do not work in isolation. Serving as orchestrators, nurses coordinate timely contributions of members of the interprofessional healthcare team in an environment that is fast-paced and pressure laden. Therefore, it is important that hospitals intentionally implement effective processes that allow nurses and all healthcare professionals to work to their highest potential in work environments that are safe, healing, and respectful of the rights and contributions of all members of the team.

After extensively surveying the work environment in which acute and critical care nurses practice, the American Association of Critical-Care Nurses (AACN) boldly committed to advocating for work environments that promote excellence in patient care and support all members of the healthcare team in experiencing fulfillment from their work. In 2005, AACN released the AACN Standards for Establishing and Sustaining Healthy Work Environments: A Journey to Excellence. This seminal document describes essential standards that must be in place to achieve healthy work environments. The six standards are skilled communication, true collaboration, effective decision making, appropriate staffing, meaningful recognition, and authentic leadership. The second edition of the AACN standards, published in 2016, demonstrates the ongoing relevance of the six standards and additional substantiating evidence confirming the inextricable link between healthy work environments and optimal outcomes for patients, health care professionals, and health care organizations. The AACN healthy work environment standards, and their associated critical elements, have been identified as an important blueprint that organizations and nurses can use to foster a workplace that promotes optimal patient outcomes and where nurses and other members of the healthcare team are fulfilled in their work (AACN, 2016).

Evidence continues to mount demonstrating the relationship between healthy work environments and optimal outcomes for patients, nurses, and other healthcare professionals. Nurses who practice in unhealthy work environments consistently report a lower quality of patient care and a poorer hospital reputation (Lake et al., 2016; Wei, Sewell, Woody, & Rose, 2018). Unhealthy work environments are also associated with higher incidences of hospital acquired conditions, patient mortality, failure to rescue, and hospital readmission rates (Aiken et al., 2011; Buhlman, 2016; Lasater & McHugh, 2016; McHugh, et al., 2016). Equally disturbing, unhealthy work environments contribute to dissatisfaction, low morale, and staff turnover (McHugh & Ma, 2016). Furthermore, research indicates that spending more money on resources such as increased staffing has little benefit in the presence of an unhealthy work environment (Aiken et al., 2011). Despite mounting evidence confirming the importance of healthy work environments in the delivery of high quality patient care and staff well-being, nurses continue to report workplaces that are unhealthy at an unacceptable frequency. These unhealthy work environments contribute to stress, burnout, and moral distress in all members of the healthcare team as well as negative consequences for patients and families (Koy, Yunibhand, Angsuroch, and Fisher, 2015; Van Bogaert, et al., 2014). A bold, intentional and coordinated effort is needed to create and sustain healthy work environments that foster excellence in patient care and optimal outcomes for patients, nurses, and other members of the healthcare team.

This session provides an overview of the six essential AACN Healthy Work Environment Standards and the associated critical elements for implementation. Results from a large 2018 national work environment survey are discussed in conjunction with trends over time. Compelling evidence is described demonstrating the importance of implementing these standards. In addition, actionable suggestions are presented that can be readily implemented to help develop and sustain healthy work environments.

Organizers:  Linda Cassidy, MSN, EdM, CCNS, CCRN-K, Strategic Advocacy, American Association of Critical-Care Nurses, Aliso Viejo, CA, USA, Connie Barden, MSN, American Association of Critical-Care Nurses, Aliso Viejo, CA, USA and Beth Ulrich, EdD, RN, FACHE, FAAN, Department of Graduate Studies, Cizik School of Nursing, The University of Texas Health Science Center at Houston, Pearland, TX, USA
Moderators:  Maridulce Belen Santos Fortuno, MS, BSN, RN, CAPA, Department of Perioperative Services, PREP Center, University of Maryland Medical Center, Baltimore, MD, USA