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Creating Healthy Work Environments Through Holistic Innovation
No full textPurpose: Holistic Certified Nurse Specialists (HCNS) with nurse leadership responded to clinical nurse feedback to support their ability to use available wellness and stress reduction resources. Together, they developed a scheduling system to maximize clinical nurse use of holistic support.Significance: An organizational well-being survey indicated that clinical nurses experienced higher stress and burnout than other clinical staff. Covid 19 and its aftermath significantly impacted the overall health of nurses who reported symptoms of stress, anxiety, and emotional exhaustion. Through transformational leadership, the HCNS leveraged the hospital’s person-centered care philosophy to create an environment for nurse wellbeing.Methods: Previously, the HCNS provided holistic care of nurses on the units; however, the lack of a private quiet space and nurses\u27 hesitancy to step away from their responsibilities to receive self-care impeded effectiveness. The HCNS collaborated with hospital administration and facilities management to create a healing space for meaningful support of all team members; however, nurses were underrepresented as they could not leave their units. The HCNS then developed an appointment system, working with Nurse Managers to schedule sessions for nurses and provide coverage for 35 minutes to free nurses of their patient care responsibilities while off the unit. HCNS offers Reiki, Reflexology and Meditation sessions. They created pre/post RedCap surveys to evaluate the quality and impact of sessions on stress and anxiety levels.Results: Program evaluation showed that nurses value Integrative Health services and identified their reasons for registering for appointments, including work stress (57.4%), life stress (51.2%), anxiety (27.1%), feeling overwhelmed (22.1%), and burnout (19%). Clinical nurse feedback (n=241) demonstrates that they feel less stress/anxiety after their sessions. Paired t-test and Cohen’s effect size d results show significant decreases in stress (p\u3c 0.001, d=1) and anxiety (p\u3c 0.001, d=.9).Implications for Nursing Practice: This innovation endures based on team members continued positive feedback and participation. The schedule is continually full, and requests are being met to expand hours of services. The holistic interventions transform nursing practice by significantly reducing stress and anxiety and improve nurses’ health and wellbeing. Nurses appreciate the holistic support they receive to improve their health and wellness
Supporting the Well-Being of Critical Care Nurses at a System-Level
No full textCritical care nurses (CCNs) are a crucial part of the health care system, however, the long-term stressors and traumatic stress they are exposed to affect their health, well-being, and create work environments that make it difficult to provide safe and quality patient care. A healthy work environment for nurses will maximize the health and well-being of nurses, decrease burnout, lower turnover, and improve the quality of patient care[1]. There is limited evidence from previous studies carried out that can inform the selection of interventions to foster healthy work environments for nurses and manage traumatic stress[2,3].Therefore, indicating a critical need to develop system-level interventions in healthcare tailored to CCNs addressing the negative impact nurse-specific traumas have on nurses’ well-being and patient care[4]. The overall objectives of this study are to 1) explore the situations that lead to traumatic stress, 2) assess the behaviors currently used to cope with traumatic stress, and 3) obtain feedback from key stakeholders regarding solutions to support nurses’ well-being and establish a healthy work environment at a system-level.
Foli’s middle range theory of nurses’ psychological trauma was used in this study to understand the impact nurse-specific and nurse-patient-specific traumas have on CCNs’ well-being [5].
This ongoing study uses a concurrent, mixed-methods design. The primary data methods are qualitative interviews, in combination with surveys. Thematic analysis is being used to explore core components of traumatic stress experienced by CCNs. Univariate descriptive approaches to statistical analysis will be used for quantitative data, and integration will occur through weaving of qualitative and quantitative findings to triangulate critical care nurses’ experiences.Preliminary results indicate critical care nurses experience high levels of burnout and traumatic stress. Current coping behaviors include compartmentalization, exercise, seeking family support, and dissociation from thoughts, feelings, and their work environment. Debriefing was identified as a potential solution to address traumatic stress and establishing a healthy work environment. Data collection is ongoing
Preventing Aggression in a Pediatric Inpatient Unit: A Best Practice Implementation Project
No full textIn pediatric settings, there has been an increase in patients with mental health problems, who experience aggressive and threatening behavior. Without proper policies, education, and means to identify triggers for aggressive behavior, nurses are unable to safely care for these children and are at risk of being injured. The objective of this project was to promote evidence-based practices regarding the prevention of aggression in hospitalized pediatric patients in medical-surgical units.Using the JBI Evidence Implementation framework, this project sought to optimize compliance with best practices for early identification of aggressive behaviors in pediatric inpatient units. Three barriers to best practice were identified after a baseline audit including the lack of an organizational policy to prevent aggressive behavior, the lack of identification of triggers that precipitate aggressive behavior, and the lack of utilization of an aggression prevention care plan. To address these barriers a unit protocol for prevention of aggression, documentation of triggers, and anaggression care plan were implemented.Continuing education can affect the quality of patient care and outcomes by offering opportunities to improve knowledge. More work is needed at an organizational level to develop a policy, more formal tools, and formal training
Rewind and Reflect: Using Video Elicitation to Enhance Virtual Patient Care
No full textBackground: Videoconferencing visits (VV) are an important medium for delivering healthcare worldwide, but clinicians remain uncertain about how to establish rapport in telehealth.1,2 Teaching rapport-building to practicing clinicians who must adapt established behaviors for VV, requires more than providing information. While simulation and debriefing are effective in prelicensure programs,3 they are less feasible for established practitioners. Reviewing video recordings of actual patient encounters, however, is a useful strategy for changing practice patterns.4-7 When clinicians view video recordings of their own patient interactions, it encourages them to discuss ideas not typically addressed and reveal tacit knowledge and skills which are challenging to identify or articulate.4,7 This technique, known as video elicitation, aligns well with Knowles8 andragogy principles for adult learners.Purpose: This research explores utilizing video elicitation as a key teaching strategy to help health professionals improve interpersonal skills in VV. This approach is consistent with the emerging pedagogy of cultural responsiveness and humanizing strategies in virtual environments.9,10Methods: This research is part of a grounded theory study at a U.S.A. academic cancer center. By showing nurses video clips of VV in which they participated in from a previous study, researchers are eliciting useful interview data while also exploring the impact of this technique on learning. Participants provide feedback on the impact of video elicitation on their practice by completing a survey immediately after and one-month post-interview. The survey includes four open-ended questions structured around Kirkpatrick’s four levels of evaluation.11Results: Preliminary results from participants to date (N=5) suggest video elicitation is well received and facilitates an intention to make specific changes in VV practices. The analysis of complete survey results will be reported at the conference.Conclusions: Recording virtual clinical encounters is feasible and acceptable to both clinicians and patients,12,13 making video elicitation a practical alternative for professional development. This method may provide tangible evidence of interpersonal challenges, encouraging clinicians to adapt their behaviors for virtual environments. The results of this study will inform the creation of educational modules on rapport-building in VV, enhancing global telehealth professional development
Implementation of the Healthy Work Environment Standards Through AACN’s National Collaborative
No full textThe American Association of Critical-Care Nurses (AACN) has developed a Healthy Work Environment (HWE) National Collaborative, a two-year education, mentorship, and co-learning program launched in April 2024. This initiative, the first of its scale, aims to create a lasting positive impact on the work environment. It guides hospital-based teams in creating HWEs, leading to improved quality indicators, job satisfaction, retention, and organizational outcomes. The primary purpose of this presentation is to highlight the benefits of participating in a national collaborative to implement and ensure the sustainability of HWEs. In the wake of the COVID pandemic, there has been a renewed focus on enhancing the work environment. The presentation will address the increased demand for HWE projects and how the collaborative can effectively meet this need. It will describe a hospital’s ongoing journey in AACN’s HWE National Collaborative, emphasizing the critical role of interprofessional collaboration, regional coaches, and stakeholder engagement in ensuring the sustainability and success of HWE improvement projects. The HWE initiative began with an in-person kickoff meeting, which set the foundation for aligning goals, expectations, and strategies among all participants. This underscored the importance of collaboration, highlighting how healthcare professionals can work together to achieve common goals, essential for the successful implementation and sustainability of HWE projects. Additionally, the collaborative provides the benefit of regional coaches who offer guidance, support, expertise and mentorship to local teams through the use of implementation science. Coaching ensures best practices are followed and teams remain motivated and focused. Sustainability is a critical aspect, with strategies discussed to optimize it through continuous program support, ensuring long-lasting benefits of HWE projects. This presentation will showcase how evidence-based practices can be translated into real-world applications, equipping teams to implement and sustain a healthy work environment. It will also provide a comprehensive overview of the start of a collaborative effort to improve the work environment in healthcare settings by fostering interprofessional collaboration, leveraging regional coaches’ expertise, advocating for active participation, and focusing on sustainability
The Retention of Nurses in the Post-COVID-19 Era
No full textThe COVID-19 pandemic had a tremendous impact on the nursing workforce, with reports of workforce shortages estimated at 100,000 RNs nationwide. And Georgia is a state the retention of nurses is an ongoing concern. While there is a robust literature that describes the workforce factors that contribute to nurse burnout and intention to leave and citing high rates of turnovers, little is known about the factors that contribute to nurse retention and intent to stay. The purpose of this study is to explore the characteristics of nurses reporting lower rates of burnout.Methods: The analysis leverages data from the 2022 National Nursing Workforce Survey, which was distributed by the National Council of State Boards (NCSBN) and the National Forum of State Nursing Workforce Centers. The survey captures burnout related measures and personal and professional characteristics of the nurses in Georgia and nationally. Sampling weights will be applied to increase statistical power. Univariable and multivariable binary logistic regression models will assess the relationship between respondents’ perceptions of stress and/or burnout, intent to leave, and workplace characteristics that could potentially contribute to nurses’ intention to stay in the workforce.Results: A total of 493 Georgia nurses completed and returned a survey for the 2022 National Nursing Workforce Survey. The data analysis is ongoing and will be completed in December 2024. Initial results suggest that nurse and work environment characteristics are associated with retention.Conclusion: Our findings will identify factors associated with retention of nurses in Georgia, and nurses in leadership positions may use these findings to develop strategies to optimize retention. Continuing to focus attention on the workforce factors that contribute to nurse retention and intention to stay can potentially support stabilizing an already fragile workforce and enable facilities to retain their most powerful resource – nurses
Acute Medical Surgical Peer Mentor Program
No full textBackground: New nurses experience stress and challenges transitioning from student to nurse (Crismon et al., 2021). Peer mentor programs provide emotional support for new graduate nurses during this time, helping to promote clinical competency, confidence, job satisfaction, and retention (Bowers, 2022; Maroone, 2023; Vidal & Olley, 2021). Despite the benefits, peer mentor initiatives are not widely adopted in healthcare settings (Reebals et al., 2021). Our program filled that gap by boosting morale and confidence by creating an emotionally supportive environment.Methods: Mentor leaders (n=3) sought evidence-based sources and consulted with organizational wellness experts. The leaders trained senior nurses (n=12) in mentorship, giving and receiving feedback, moral injury coaching, and resilience guidance. Each was then paired with a new graduate nurse mentee (n=15), utilizing a survey for compatibility. The pairs communicated weekly to discuss experiences and concerns.Monthly meetings were held for mentors and mentees to facilitate peer support, knowledge exchange, and an opportunity for feedback. The program also included newsletters highlighting aspects of mentorship and social outings fostering camaraderie with stress-relieving activities outside of the workplace.Feedback was collected through questionnaires distributed to mentees at baseline, one-month, three-months, and six-months post-implementation. Mentees were asked about their perceptions of mentor effectiveness using a Likert scale, true and false questions, and free text. The surveys and insights gathered during monthly meetings informed PDSA cycles for adjusting the program, ensuring the program effectively met the evolving needs of the new graduate nurses.Results: Launched in July 2023 with 12 mentor-mentee pairs, collecting mentee feedback for six months. Mentees reinforced mentors providing emotional support and safety, reporting this explicitly in 73% (11/15) of the free-text responses collected in project surveys. Mentees affirmed the mentor’s offered friendship, clinical guidance, and mental health support.
Conclusions/Implications: Peer mentor programs promote confidence and competence during the transition to practice, equipping new nurses to handle the stress of working at the point of care. The emotional, clinical, and social support seen during the program highlights the mentor’s integral role in the new nurse’s personal and professional growth
Investing in Well-Being: The Return on Investment of Nurse Renewal Retreats
No full textBackground: The COVID-19 pandemic exacerbated the already high rates of moral distress, trauma, and burnout among healthcare professionals. To address these challenges, the Nursing and Allied Health Resilience and Well-Being Program partnered with an external organization to offer overnight nurse renewal retreats. These retreats aim to empower nurses to rediscover their passion, purpose, and connection to their profession by providing a safe and nurturing environment for processing difficult experiences.Methods: This mixed-methods feasibility pilot study was conducted in two hospitals within a 12-hospital system in Washington state. Participants engaged in journaling, trauma-informed care, mindfulness, yoga, self-compassion, and healing circles to promote self-awareness, cognitive reframing, and healing. Qualitative data focused on satisfaction were collected to evaluate the program\u27s effectiveness.Results: The intervention cost 1,277,656.Qualitative data collected from participants revealed positive outcomes. Nurses reported feeling truly cared about for the first time in my life and safe and open to express my inner most feelings about work. These comments highlight the program\u27s ability to create a supportive and safe environment for processing difficult emotions and experiences.Despite initial challenges in filling the retreats, demand has exponentially increased, with 240 nurses requesting to attend for the currently available 48 spots. This surge in interest highlights the critical need for such programs to support the well-being of healthcare professionals.Limitations: The project over two years included a relatively small sample size and relied on self-reported data. Ongoing research is exploring the long-term impact of the intervention
Nurse-Led Advocacy for HIV and Hepatitis C: A Socioecological Approach Across Israel and the Philippines
No full textBackground: HIV and Hepatitis C Virus (HCV) remain global public health challenges, with millions of people still undiagnosed or untreated. Nurses play a critical role in combating stigma and leading advocacy interventions in diverse cultural contexts. In Israel and the Philippines, nurses are addressing infectious disease care using multi-level strategies informed by local epidemiology and global health goals.
Purpose: This project aimed to identify, implement, and evaluate nurse-led advocacy strategies to reduce stigma and improve education, community engagement, and policy development around HIV and HCV in both Israel and the Philippines.
Methods: A socioecological model guided the development of multi-level interventions, including health education, training programs, school-based peer initiatives, NGO partnerships, and collaboration with regulatory bodies. Data on national HIV and HCV incidence were reviewed, and interventions were tailored accordingly. Evaluation was conducted through training participation metrics, surveys, and outcome-based research.
Results: In Israel, over 15,000 patients were successfully treated for HCV, with active efforts ongoing in northern districts. In the Philippines, new HIV infections remain high despite low national prevalence. Nurse-led activities on World AIDS and Hepatitis Days, along with community outreach and social media campaigns, helped promote awareness. Education-based advocacy in schools and policy collaboration reinforced impact. Initial evaluations show increased knowledge, reduced stigma, and stakeholder engagement.
Conclusion: Nurse-led advocacy using a socioecological framework is effective in addressing infectious disease stigma and access disparities. Sustained advocacy, supported by evidence and policy, is essential for long-term success
Global Advocacy for Alzheimer’s Disease and Related Dementias
No full textBackground: Alzheimer\u27s disease and related dementias represent a growing public health challenge, significantly impacting individuals, families, and healthcare systems worldwide. The increasing prevalence highlights the urgent need for effective strategies to improve care and support for those affected, in alignment with key United Nations Sustainable Development Goals (SDGs), particularly SDG 3 on health and well-being, SDG 10 on reducing inequalities, SDG 11 on sustainable cities and communities, and SDG 17 on partnerships for sustainable development.
Aim: To improve the quality of life for individuals with Alzheimer\u27s disease and related dementias and their care partners through a multifaceted advocacy approach.
Methods: Using a multifaceted advocacy approach, we aim to advocate for training programs that enhance dementia care competencies among the healthcare and allied workforce. We will also advocate for policies to support the provision and expansion of dementia community-based services and resources. Additionally, we will hold community events and publications to increase awareness of risk factors and reduce stigmatization.
Expected Outcomes: By prioritizing the needs of individuals with ADRD and their care partners, this advocacy initiative seeks to improve evidence-based, quality dementia care and community-based services and resources. This effort will reinforce the commitment to the United Nations\u27 principle of leaving no one behind, ensuring that individuals with ADRD and their care partners have quality lives