Critical Care Nurse Work Environments 2018: Findings and Implications

Abstract

BACKGROUND The health of critical care nurse work environments affects patient and nurse outcomes. The results of the 2018 Critical Care Nurse Work Environment Study are reported here with comparisons to previous studies and recommendations for continued improvement. OBJECTIVE To evaluate the current state of critical care nurse work environments. METHODS An online survey was used to collect quantitative and qualitative data for this mixed-methods study. A total of 8080 American Association of Critical-Care Nurses (AACN) members and constituents responded to the survey. RESULTS The health of critical care nurse work environments has improved since the previous study in 2013; however, there are still areas of concern and opportunities for improvement. Key findings include documented absence of appropriate staffing by more than 60% of participants; an alarming number of physical and mental well-being issues (198 340 incidents reported by 6017 participants); one-third of the participants expressed intent to leave their current positions in the next 12 months; and evidence of the positive outcomes of implementing the AACN Healthy Work Environment standards. CONCLUSION Evidence of the relationship between healthy nurse work environments and patient and nurse outcomes continues to increase. The results of this study provide evidence of the positive relationship between implementation of the AACN Healthy Work Environment standards and the health of critical care nurse work environments, between the health of critical care nurse work environments and job satisfaction, and between job satisfaction and the intent of critical care nurses to leave their current positions or stay.

Instruments for assessing professional nursing practice environments: An integrative review

“…From the analysis to the studies, it was clear that unfavorable environments are associated with worse outcomes for patients and professionals (29)(30)36,42) . On the other hand, favorable environments for the nursing practice guarantee better results for professionals, patients and institutions (10,27,34) . Diverse authors have identified greater Rev Gaúcha Enferm.…”

“…Although the NWI-R is composed of 57 items, 15 of these items were distributed in three dimensions: autonomy (5 items); control over the practice environment (7 items), and relationship between nurses and physicians (3 items). Lee H et al, 2019 (9) China Nursing Practice Environment Scale: Chinese Version Ulrich B et al, 2019 (10) USA Healthy Work Environment Scale Zangaro G and Jones K, 2019 (11) USA Practice Environment Scale of the Nursing Work Index…”

“…The Healthy Work Environment (HWE) is a scale based on the standards defined by the American Association of Critical-Care Nurses, consisting of 32 items, distributed over six dimensions: qualified communication; true collaboration; effective decision-making; appropriate staff; meaningful recognition; and authentic leadership (10) . The responses, on a Likert scale, can take 4 options (strongly disagree, disagree, agree and strongly agree) (10) .…”

Take Control of Your Work Environment and Personal Well-being

“…According to Ulrich et al, 2 implementation of the AACN Healthy Work Environment Standards was associated with an increase in critical elements of the Healthy Work Environment Scale (skilled communication, incorporating patients and families into decision-making, true collaboration, and effective decision-making), yet more than half of the nurses surveyed indicated intent to leave their current position within the next 3 years. 2 Dissatisfi ers related to intent to leave included perceived lack of respect from administration and supervisors. Within a 12-month period, more than 198 000 incidences of physical and verbal abuse, discrimination, and sexual harassment occurred; most abuse incidents were caused by patients and families.…”

“…Within a 12-month period, more than 198 000 incidences of physical and verbal abuse, discrimination, and sexual harassment occurred; most abuse incidents were caused by patients and families. 2 Physical and verbal violence against health care workers is a prominent, unacceptable, and underreported issue that has recently been designated as a sentinel event by The Joint Commission. 3 The aim of the Sentinel Event Alert is to increase awareness and organizational acknowledgment and to educate health care workers on prevention techniques such as deescalation and crisis intervention.…”