1. Healthy Work Environment Elizabeth Degelbeck, Justin Hacker, Kristine Lantz, and Courtney Wilson

2. What is the Healthy Work Environment?  In 2001, the American Association of Critical-Care Nurses initiated the promotion of healthy work environments (HWEs).  To ensure favorable working environments which in turn promotes safe and effective patient care and retention of nurses  Six Standards were established to sustain HWEs  Skilled Communication  True Collaboration  Effective Decision Making  Appropriate Staffing  Meaningful Recognition  Authentic Leadership

3. Skilled Communication  “A two-way dialogue in which people think and decide together.” (AACN, 2005, p. 16).  Effects of Poor Communication  Medical Errors  Sentinel Events  Stress, Mistrust, and Dissatisfaction with workplace  Ways to improve communication  Be aware of how you present yourself  Encourage discussion and negotiate  Be honest and open  Manage conflicts appropriately  Promote constructive and listening approach  Seek out formal and continuing education regarding communication techniques  Practice, Practice, Practice  Effects of Skilled Communication  Healthy collaborative relationships  Improved patient outcomes  Job satisfaction

4. True Collaboration  “Nurses must be relentless in pursuing and fostering true collaboration”(Goran & Mullen-Fortino, 2012).  Goran & Mullen-Fortino (2012), state “True Collaboration comes from the intense desire to understand and value the perspective of each member of the team.”

5. Effective Decision Making  In order to support a healthy work environment, nurses must be valued and committed partners in making policy, directing and evaluating clinical care and leading organizational operations.

6. Appropriate Staffing  As stated by Blake (2013), “Staffing must ensure the effective match between patient needs and nurse competency.”  Is necessary for patient safety

7. Meaningful Recognition  Nurses must be recognized and must recognize others for the value each brings to the work of the organization.

8. Authentic Leadership  Nurse leaders must be skilled communicators and agents for positive change (American Association of Critical-Care Nurses, 2005).  Nurse leaders should hold positions where they are able to influence decisions that affect nursing practice and environment (AACN, 2005).  Nurse leaders must lead the creation of systems to promote and sustain healthy work environments (AACN, 2005). They must also engage employees in common goals within these systems to encourage positive attitudes and behaviors in the workplace leading to healthy work environments (Shirley, 2006).

9. How the HWE Influences Our Individual Practice

10. Elizabeth Degelbeck, RN  A HWE is vital to the function of my place of employment and provides a positive working environment thereby influencing positive patient outcomes and increased morale.  This can be seen through specific examples in each standard of the HWE  Skilled Communication  We are open with each and foster communication among all health care professionals. We practice active listening and are free to voice any concerns that effect our professional performance.  True Collaboration  We make sure that all needed health care personnel are involved with the patient’s care and are informed of any concerns or changes. Each member of the team’s opinion is valued and taken into consideration when a plan of care is developed for a patient.  Effective Decision Making  We have a Nurse Practice Council in which we bring ideas and thoughts that are needed to ensure effective policies and successful patient outcomes  Appropriate Staffing  The RN is to have no more than six patients and the nurses aid is to have no more than nine patients. Based on the acuity of the inpatient setting at that time. If the acuity is high, other nurses and aides can be utilized. Teamwork ensures success.  Meaningful Recognition  We have nurse of the year awards,. We also utilize spotlight recognition for employees who provide “and then more” care.  Authentic Leadership  The Nurse Practice Council and unit staff meetings provide a means for the nurse to provide leadership and changes in areas that are weak within the system.

11. Justin Hacker, RN  In my current practice, HWE practice standards influence my nursing practice by collaborating with the interdisciplinary healthcare team through skilled communication and effective decision making. Through authentic leadership; advocating for staff and pushing for appropriate staffing to assure patient safety is essential for effective decision making and meaningful recognition.

12. Kristine Lantz, RN  In my current practice, HWE practice standards influence my nursing practice with the use of skilled communication to prevent medical errors, improve patient outcomes and my own personal satisfaction with my nursing position.  The HWE standard of meaningful recognition also influences my nursing practice. In long-term care it is important to recognize the work and value others bring to the organization. We all work together to provide safe and quality care to our residents in order to help them reach their health goals.

13. Effective Decision Making and Meaningful Recognition complement each other well at my place of employment. Some examples are listed below:  Nurses sit on committees that write and revise hospital policies.  Nurses sit on various teams that review nursing practices for effectiveness and safety.  Nurses devise and implement new practice procedures using best practice standards and evidence based practice standards. These procedures are recognized and respected by all practitioners.  Nurses work collaboratively with and are respected by physicians in planning patient care.  Multidisciplinary teams made up of nurses, Providers, Social Work, Pastoral Care, Dietary and housekeeping that meet daily to discuss each patients plan for the day. This team recognizes the importance of every team member and values each others input.  Nurses evaluate and maintain quality standards.  A Nurse holds the position of Chief Operating Officer at our facility.  A Nurse holds the position of Chief Quality Officer at our facility.  Nurse Practitioners are recognized as practicing providers a our facility.  Nurses at our facility are the catalysts, the implementers, the investigators, the regulators, the decision makers, the advocates, and the leaders of the daily activities of the hospital and are respected as such. Courtney Wilson, RN

14. References  Blake, N. (2013). Appropriate Staffing for a Health Work Environmnet. AACN Advanced Critical-Care, 245-248.  Goran, S., & Mullen-Fortino, M. (2012). Partnership for a Healthy Work Environment. AACN Advanced Critical-Care, 289-301  Hartung, S. Q. & Miller, M. (2013). Communication and the healthy work environment: Nurse managers’ perceptions. The Journal of Nursing Adminstration 43(5), pp.266-273. doi: 10.1097/NNA.0b013e31828eeb3c  American Association of Critical-Care Nurses. (2005). AACN standards for establishing and sustaining healthy work environments: A journey to excellence. Retrieved April 7, 2014 from: http://www.aacn.org/AACN/pubpoly.nsf/vwdoc/workenv.  Shirley, M.R. (2006). Authentic leaders creating healthy work environments for nursing practice. American Journal of Critical Care, 15(3). Retrieved April 7, 2006 from: http://ajcc.aacnjournals.org