Facilitating Positive Professional Practice Environments

Background:

Healthcare is challenged to reinvent itself to be quality driven, fiscally sound and evidence based, while its workforce is aging and the population of baby-boomers needing care, is growing.  A positive professional practice environment is vital to assure safety of patients and staff, improve professional staff recruitment and retention and sustain an organization’s financial viability.  Nurse Managers and Leadership are reported as the single greatest influence on the professional practice environment, either positive or negative.  This project was to review the literature for definitions, benefits and methods to facilitate positive professional practice environments.  Nurse Managers were reported as the single most influential factor on the professional practice environment.  Description of essential knowledge, effective skills and necessary attitudes for Nurse Manager development were then explored.

Design approach:

This presentation is a reporting of a summary of the literature on professional practice environments and the similar concept of healthy work environments.  CINAHL and PubMed were searched from 2003-present using key words including “professional practice environment,” “healthy work environment,” “workplace culture,” “Nurse-Friendly Hospital,” and “nursing practice climate.” 

Results:

Over 100 articles were initially reviewed rendering a meta-analysis, 8 interventional studies, 6 systematic reviews, over 50 descriptive and qualitative studies, 13 describing tool development and many expert opinion and editorial articles.  Discussion of the body of evidence will be organized into four areas:

Define and describe dimensions of professional practice environments concepts;

Discuss measurement of outcomes achieved in positive/healthy practice environments;  

Explore the knowledge, skills and attitudes reported as necessary for influencing the environment;

Provide recommendations for nurse manager development for best influence on the practice environment.

 Impact of positive professional practice environments included:

1. lowers preventable errors

2. increases employee satisfaction

3. decreases absenteeism

4. increases retention

5. increases patient satisfaction

6. increases employee engagement

Recommendations for key concepts to incorporate in development of Nurse Managers and Leaders include:

Knowledge: global thinking, national healthcare arena, QI, change from volume to value, finance/budgeting,  supporting evidence based practice

Skill: coaching, team building, giving feedback, handling problem behavior, relationship building

Attitude: self-reflection, recognize own behaviors and others, reward and recognition

 Conclusions/ value of this presentation:

In order to create a healthcare system with high quality care, high patient satisfaction and lower costs, professional practice environments need to support, engage, recognize and reward innovative best practices.  Since Nurse Managers are the largest single influence on the PPE, evidence on how to develop this key role is significant.