1. Healthy Work Environment For Nurses

2. What is Healthy Working Environment? “Healthy Working Environment (HWE) are healing, empowering environments that have been correlated with employee engagement and organizational commitment” (Kupperschmidt, 2010). Kupperschmidt, B., Kientz, E., Ward, J., Reinholz, B., (Jan. 31, 2010). A healthy work environment: It begins with you. OJIN: The Online Journal of Issues in Nursing Vol. 15, No. 1, Manuscript 3.

3. Healthy Work Environment: Explained ●HWE is achieved through the highest detail of trust between nursing management and unit nurses ●By employees that treat each other with respect and dignity ●Through a culture that supports skilled communication and collaboration ●Through a climate that nurses feel both emotionally and physically safe Kupperschmidt, B., Kientz, E., Ward, J., Reinholz, B., (Jan. 31, 2010). A healthy work environment: It begins with you. OJIN: The Online Journal of Issues in Nursing Vol. 15, No. 1, Manuscript 3.

4. How do we achieve a HWE? ●One of our Nursing Code of Ethics as nurses is to become exceptional communicators ●Magnet Status requires certain provisions of the work environment in order to achieve this ranking

5. Unsafe Work Environments ●Lifting patients exceeding desired weight limits ●Needle stick exposure ●Bullying/lateral violence ●Difficult/increased work schedules; i.e. mandatory overtime ●Inadequate staffing

6. HWE and Our Patients “Nurses’ ratings of quality of patient care directly correlate to quality of work environment” (Kramer, 2011). Kramer,M., Maguire, P., Brewer, B. (2011). Clinical nurses in Magnet hospitals confirm productive, healthy, unit work environments. Journal of Nursing Management, Vol 19, pgs 5-17.

7. Why was HWE created? Healthy Work Environment (HWE) was created to: –ensure patient safety –enhance staff satisfaction and retention –maintain an organization's financial viability American Association of Critical-Care Nurses (AACN). (2013). AACN healthy work environment assessment. In American Association of Critical-Care Nurses. Retrieved from http://www.aacn.org/hwehome.aspx?pageid=331&lastmenu=divheader_web_assessment_tool

8. Ways to ensure patient safety Having a healthy work environment helps to make sure every patient is safe. This helps to eliminate errors that could have been preventable. Some example are preventing medication errors and improving the care that is provided to all patients. Ensuring that all members of the team are working towards the same goal to improve the health of all patients.

9. Ways to enhance staff satisfaction and retention Trusting all members of the team Being respectful between staff members Having enough employees on staff to maintain a low stress level Employees feeling safe in their work environment Kupperschmidt, B., Kientz, E., Ward, J., & Reinholz, B. (2010). A healthy work environment: It begins with you. The Online Journal of Issues in Nursing Vol. 15, No. 1. DOI: 10.3912/OJIN.Vol15No01Man03

10. Ways to maintain organizations financial viability Nurses work their hardest to achieve all the facility goals Having a high quality of care provided by all members of the interdisciplinary team Maintaining patient satisfaction with all the care provided Following all the policies and procedures that the facility has in place

11. When was HWE created? Sentinel event alert identified intimidating and disruptive behaviors as a patient safety issue and the Joint commission stepped in and required new leadership standards to ensure a healthy work environment with zero tolerance for intimidating and disruptive behaviors. Effective January 1st, 2009 References The Joint Commission. (2008). Behaviors that undermine a culture of safety. retrieved from http://www.jointcommission.org/assets/1/18/SEA_40.PDF

12. When was HWE created? The leadership standards addresses disruptive and inappropriate behaviors in 2 ways. o JHACO spells out what they are requiring from hospitals/organizations. References The Joint Commission. (2008). Behaviors that undermine a culture of safety. retrieved from http://www.jointcommission.org/assets/1/18/SEA_40.PDF

13. When was HWE created? o The hospital/organization must specifically define disruptive and inappropriate behaviors as opposed to acceptable behaviors.  A clear definition and basis for comparison must be provided References The Joint Commission. (2008). Behaviors that undermine a culture of safety. retrieved from http://www.jointcommission.org/assets/1/18/S EA_40.PDF

14. When was HWE created? Leaders must create and implement a process for managing disruptive and inappropriate behaviors. o discipline! References The Joint Commission. (2008). Behaviors that undermine a culture of safety. retrieved from http://www.jointcommission.org/assets/ 1/18/SEA_40.PDF

15. Who Created HWE American Association of Critical Care Nurses created the healthy work environment standard in 2005. The nurses made a commitment to promote Healthy work environments wherever acute and critical care nurses practiced (AACN, 2013). American Association of Critical Care Nurses [AACN].(2013).History of American association of critical care nurses. Retreived from: www.aacn.org/wd/publishing/content/pressroom/historyofaacn.pcms?menu=publications

16. Creation of HWE Six elements were set forth to advocate a healthy workplace that will increase improved patient outcomes (AACN, 2013). 1.Skilled communication 4.True collaboration 2.Effective decision making 5.Appropriate staffing 3.Meaningful recognition 6.Authentic leadership American Association of Critical Care Nurses (AACN).(2013).History of American association of critical care nurses. Retreived from: www.aacn.org/wd/publishing/content/pressroom/historyofaacn.pcms?menu=publications

17. Creation of a Healthy Workplace AACN listed this creation as the highest priority. 2006 first Nurse survey- designed to help companies understand the environment nurses worked in (AACN, 2013). American Association of Critical Care Nurses (AACN).(2013).History of American association of critical care nurses. Retreived from: www.aacn.org/wd/publishing/content/pressroom/historyofaacn.pcms?menu=publications

18. Study Findings The study found that nurses were generally happy in their career. It was the environment that was unpleasant for them. The environment of the units were healthier than the organization as a whole (AACN, 2013). American Association of Critical Care Nurses (AACN).(2013).History of American association of critical care nurses. Retreived from: www.aacn.org/wd/publishing/content/pressroom/historyofaacn.pcms?menu=publications

19. Rebecca Williams Healthy work environment has influenced me greatly. I believe in this wholeheartedly. Having been in unhealthy work environments they only cause unneeded stress and resentment that results in nurses being distracted by unnecessary pressure. In my current position HWE influences by the team members working together for better outcomes for the patients. Communication is the key to a healthy relationship whether it is personal or professional. Acquiring a healthy footing is what makes this relationship great. Without this standard of practice a work environment is unhealthy for all involved. A poor work environment is the last thing a company needs, when trying to deliver top notch healthcare to patients. HWE is a standard that will improve not only the work place but how care is delivered to the patients.

20. Elaine Spencer In general, I use the practice standards as more of a check and balance. Meaning, in my personal nursing practice, they are used as a framework in which I work within. I fill in by exceeding the set standard for patient care. More specifically, in my current practice area of postpartum nursing, HWE practice standards influence my nursing practice by constantly correlating my work environment with my patient care. This may show itself in the form of constant communication with a resident if a patient is hemorrhaging, or if a baby becomes unstable, as they can quickly crash. Communication between nurses must be impeccable at change of shift. I also use HWE when performing minor procedures that involve sterile technique (even clean technique), as the risk for infection greatly increases when broken. HWE is directly related to our patients. My own nursing practice reflects the importance of a healthy work environment, through individualizing care, hand washing, maintaining HIPAA, preparedness, communication and collaboration with the medical team.

21. Jessica Copeland I wholeheartedly support the HWE initiative. It is not fair to anyone to have to practice in an environment where they feel intimidated. As a new nurse, I feel that doing my job is nerve wracking enough without feeling intimidated and belittled by my team members. Nurses should not ‘eat their young’ so to speak. As nurses we can provide our patients with the highest level of care possible only when we ourselves are in a healthy work environment, one where we do not feel intimidated or threatened by disruptive and inappropriate behaviors. Inappropriate and disruptive errors cause us to be distracted from the task at hand, patient care, and that is far too important of a task to be distracted from.

22. Brianna Rich Having great communication between all of my team members is how HWE has influenced me. Being respectful and listening to everyones opinion on the care delivered helps build trust between employees. When all the team members know the details about the patient's diagnosis and where they stand with their treatment, it makes for safe quality care. Even if it is not verbal communication, documentation is important. I think that when we maintain a HWE as nurses it makes for a healthy environment for our patients.

23. References American Association of Critical-Care Nurses (AACN). (2013). AACN healthy work environment assessment. In American Association of Critical-Care Nurses. Retrieved from http://www.aacn.org/hwehome.aspx?pageid=331&lastmenu=divheader_web_assessment_tool American Association of Critical Care Nurses (AACN).(2013).History of American association of critical care nurses. Retreived from: www.aacn.org/wd/publishing/content/pressroom/historyofaacn.pcms?menu=publications Kramer,M., Maguire, P., Brewer, B. (2011). Clinical nurses in Magnet hospitals confirm productive, healthy, unit work environments. Journal of Nursing Management, Vol 19, pgs 5-17. Kupperschmidt, B., Kientz, E., Ward, J., & Reinholz, B. (2010). A healthy work environment: It begins with you. The Online Journal of Issues in Nursing Vol. 15, No. 1. DOI: 10.3912/OJIN.Vol15No01Man03 The Joint Commission. (2008). Behaviors that undermine a culture of safety. retrieved from http://www.jointcommission.org/assets/1/18/SEA_40.PDF