Healthy Work Environment

1. Healthy Work Environment Ferris State Nursing 320 Group Presentation Kevin Doan, Maira Perez, Amy Lewis, Bethany Hesselink, and (Kyle) Kurt Freund

2. Unhealthy Work Environment No feeling of support. Each caregiver feels as if they are on their own. Hostility or not a safe and inviting atmosphere. Lack of direction or clear guidelines Lack of accountability-outcomes Lack of respected industry standards

3. Healthy Work Environment What is it? Who Created it? What for?

4. The American Association of Critical Care Nurses(AACN) Created six standards for a Healthy Work Environment in 2001 The establishment these standards are essential to ensure patient safety, improve staff recruitment and retention, and maintain an organization’s financial capability.

5. Standard One Skilled Communication "Nurses must be as proficient in communication skills as they are in clinical skills." (AACN, 2013)

6. Standard Two True Collaboration "Nurses must be relentless in pursuing and fostering true collaboration." (AACN,2013)

7. Elements of Collaboration Role of the Healthcare Organization 1. Provide educational programs that develop collaboration skills. 2. Define team members role in collaboration and how unwillingness to will be addressed. 3. Creates, and evaluates structures to ensure the decision making authority of nurses is acknowledged and incorporated as the norm. 4. Ensures access to forums, such as shared leadership, and allows staff time to resolve disputes that arise.

8. Elements of Collaboration Roles of the Team Members 1. Accepts collaboration as an ongoing process and aids in development. 2. Contributes to the achievement of common goals. 3. Acts with integrity. 4. Uses skilled communication. 5. Demonstrates competence in their role.

9. True Collaboration relating to an ICU experience 1. Accepting collaboration as an ongoing process. 2. Contributing to common goal. 3. Acting with integrity. 4. Using skilled communication. 5. Being competent.

10. Standard Three Effective Decision Making "Nurses must be valued and committed partners in making policy, directing and evaluating clinical care and leading organizational operations." (AACN, 2013) Policy Making Clinical Care Directing and Evaluation Organizational Operations Leaders

11. Policy Making "Evidenced based decisions creating policies that guide nursing practice beyond an individual's experiences." (AACN,2013) • Gives nurses confidence in the guidelines towards effective nursing practice. • Allows a collaborated effort of incorporating multiple views and disciplines.

12. Directing and Evaluating Clinical Care • Organizational Values • Patients and loved ones perspectives • Continued policy updating and reviews • Objective evaluations including delayed decisions and impact on positive outcomes

13. Organizational Operations The strategies that encourage effective leadership and appropriate delegation • Natural Leaders • Management styles based on Core Values • Accountability-in a safe (non-hostile environment) • Nursing to patients, peers staff and management

14. Greatest Challenges Are Conquered by Clear decisive directives that are respected, trusted, and necessary!!!!

15. Standard Four Appropriate Staffing Inappropriate staffing is one of the most harmful threats to patient safety and to the well-being of nurses. • Inadequate staffing leads to nurse dissatisfaction, burnout and turnover. • Can lead to being overworked,overstressed, and in short supply. • Jeopardizes quality of care, increases patient costs, and decreases hospital profitability.

16. Appropriate Staffing Staffing is a complex process with the goal of matching the needs of patients...with the skills and competencies of nurses. • Since the condition of critically ill patients fluctuates.. fixed nurse to patient ratios is obsolete. • Fixed nurse to patient ratios ignores patient needs and acuity. • Requires ongoing evaluation.

17. Appropriate staffing R/T an ICU/ Med-Surg experience. short staffing leads to... • A decrease in patient safety = more falls. • Nurses attempting to do 2 jobs at once...be a nurse and a nursing assistant. • Nurses picking up double the patient load. • Increase in medication errors.

18. Standard 5 Meaningful Recognition Nurses must be recognized and must recognize others for the value each brings to the work of the organization

19. Critical Elements 1. Organization should have a system that recognizes team members for contributions and value they bring to the organization. 2. Establishes a process for team members to learn the institution’s recognition system. 3. Ensures individuals receive recognition at every stage of their professional career.

20. Critical Elements Continued. 4. Recognition is meaningful to those being acknowledged. 5. Team understands that everyone is responsible for playing an active role. 6. Organization regularly evaluates its recognition system, ensuring program is effective.

21. Standard Six Authentic Leadership Nurse leaders must fully embrace the imperative of a healthy work environment, authentically live it and engage others in its achievement. • Embrace a healthy work environment • Authentically live it • Engage others

22. Standard Six Authentic Leadership • Education/mentoring for leaders. • Leaders must be able to convey vision to staff. • Enthusiasm!! • Management is the driving force for these standards. • Leaders have authority to make changes.

23. Standard Six Authentic Leadership • Resources must be available. • Nurse leaders as role models. • Performance evaluations dependent on units success. • Nurse leaders can advance if supportive of these standards. • Evaluation of progress-Who does it?

24. Authentic Leadership relating to an ICU experience • Cardiovascular ICU's have staffing and other structures that differ from other clinical units (Schmalenberg, 2007). • It is imperative that nurse leaders support the professional development of less experienced staff (Swinny, 2010). • Nurse leaders in an ICU that have a Healthy Work Environment will need to be engaged with their staff members, and be excellent role models promoting the AACN's standards at all times. • There should be recognition for both the leaders and staff, appropriate to their contributions (AACN, 2005).

25. Six Standards for establishing and sustaining healthy work environments are: Skilled Communication Nurses must be as proficient in communication skills as they are in clinical skills. True Collaboration Nurses must be relentless in pursuing and fostering true collaboration. Effective Decision Making Nurses must be valued and committed partners in making policy, directing and evaluating clinical care and leading organizational operations. Appropriate Staffing Staffing must ensure the effective match between patient needs and nurse competencies. Meaningful Recognition Nurses must be recognized and must recognize others for the value each brings to the workof the organization. Authentic Leadership Nurse leaders must fully embrace the imperative of a healthy work environment, authenticallylive it and engage others in its achievement.

26. References American Association of Critical-Care Nurses.(2005). AACN standards for establishing and sustaining healthy work environments (p. 11-42). Aliso Viejo, CA: AACN. Schmalenberg, C. & Kramer, M.(2007). Types of intensive care units with the healthiest, most productive work environments. American Journal of Critical Care,16(5), 458-468. Swinny, B.(2010). Assessing and developing critical- thinking skills in the intensive care unit. Critical Care Nursing Quarterly, 33(1), 2-9. doi:10.1097/CNQ.0b013e3181c83064