National Nurse Work Environments - October 2021: A Status Report.

BACKGROUND: The health of nurse work environments has been shown to affect both patient and nurse outcomes. In 2005, the American Association of Critical-Care Nurses published the AACN Standards for Establishing and Sustaining Healthy Work Environments: A Journey to Excellence, and a second edition was published in 2016. The American Association of Critical-Care Nurses conducted critical care nurse work environment studies in 2006, 2008, 2013, 2018, and, most recently, October 2021, which was expanded to include registered nurses in all areas of practice. OBJECTIVE: To report the results of the October 2021 study with comparisons to previous studies and recommendations for continued improvement and to evaluate the current state of nurse work environments. METHODS: An online survey was used. A total of 9862 registered nurses responded to the survey; 9335 met the study criteria of currently practicing as a registered nurse. RESULTS: The health of nurse work environments has declined dramatically since the 2018 study. However, as in 2018, evidence of a positive relationship exists between implementation of the American Association of Critical-Care Nurses Healthy Work Environment Standards and the health of nurse work environments, between the health of nurse work environments and job satisfaction, and between job satisfaction and the intent of nurses to leave their current positions or to stay. CONCLUSION: It is time for bold, intentional, and relentless efforts to create and sustain healthy work environments that foster excellence in patient care and optimal outcomes for patients, nurses, and other members of the health care team.

Critical Care Nurse Work Environments 2018: Findings and Implications.

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.

Driving Organizational Change From the Bedside: The AACN Clinical Scene Investigator Academy.

BACKGROUND: Staff nurses are pivotal in leading change related to quality improvement efforts, although many lack skills to steer change from the bedside. The American Association of Critical-Care Nurses (AACN) staff nurse leadership program, Clinical Scene Investigator (CSI) Academy, teaches and empowers staff nurses in leadership skills and change concepts to translate evidence into practice affecting patient outcomes. OBJECTIVES: To describe the curriculum of the AACN CSI Academy that provides staff nurses with the leadership skills required to create unit-based change projects that positively impact patient/family outcomes. METHODS: The curriculum of the Academy included leadership topics, communication, change concepts, quality improvement methods, project management, and data management and analysis. Each team of participants collected project data to show improvements in patient care. The program evaluation used many data sources to assess the program effectiveness, relating to the professional growth of the participant nurses. The participants assessed project patient outcomes, sustainability, and spread. RESULTS: The first cohort of CSI participants included 164 direct care nurses from 42 hospitals in 6 cities. They rated the Academy highly in the program evaluation, and they reported that the Academy contributed to their professional development. The individual hospital quality improvement projects resulted in positive patient and estimated fiscal outcomes that were generally sustained 1 year after the program. CONCLUSION: With the skills, tools, and support obtained from participation in the CSI Academy, staff nurses can make substantial contributions to their organizations in clinical and possibly fiscal outcomes.