A study in American Journal of Critical Care compares survey results from four separate cohorts from the CTICU at Duke University Hospital to assess sustained implementation of healthy work environment interventions during a six-year period.
Newswise — Resources from the American Association of Critical-Care Nurses () served as a road map for a North Carolina hospital unit in its ongoing efforts to improve the work environment and address issues such as nurse turnover and staff satisfaction.
The 32-bed cardiothoracic intensive care unit (CTICU) at Duke University Hospital, Durham, North Carolina, used the evidence-based framework and tools from AACN to regularly evaluate the health of the unit’s work environment. Guided by the results, CTICU staff then developed and implemented strategies to improve the work environment.
“ (HWE) was first published in 2005 and updated in 2016. The six HWE standards are skilled communication, true collaboration, effective decision-making, appropriate staffing, meaningful recognition and authentic leadership. One of the resources AACN developed to support implementation is the free HWE Assessment Tool, an 18-item online survey that teams can use to assess and measure progress in establishing and sustaining HWEs.
“” compares the survey results from four separate cohorts to assess sustained implementation of the HWE interventions during a six-year period. The study is published in American Journal of Critical Care ().
Primary author Philip Parker, BSN, RN, CNML, is nurse manager of the CTICU.
“Our study offers encouraging insights into successful strategies that sustained HWE benefits during a six-year period and through the COVID-19 pandemic,” Parker said. “The pandemic did affect our HWE scores and turnover rates, but the unit quickly restabilized and now reports the highest HWE scores it has ever received.”
The initial survey was administered to all the registered nurses in the CTICU in July 2017, providing baseline data for the study and identifying opportunities for improvement. Postintervention surveys, with an area for optional, anonymous comments, were then conducted in April 2019, June 2021 and June 2023. Each group of respondents included more than 50 nurses. The study also looked at turnover rates, reasons for leaving, tenure, demographics and other factors.
The score for each standard and the overall score increased significantly from 2017 to 2023, consistently in the “good” category or better.
For each of the six HWE standards, the article describes specific activities and efforts designed to address them. For example, implementing structured handoffs between shifts and from the operating room was one of the interventions that addressed the standard for skilled communication.
To access the article and full-text PDF, visit the AJCC website at .
About the American Journal of Critical Care: The American Journal of Critical Care (AJCC), a bimonthly scientific journal published by the American Association of Critical-Care Nurses, provides leading-edge clinical research that focuses on evidence-based-practice applications. Established in 1992, the award-winning journal includes clinical and research studies, case reports, editorials and commentaries. AJCC enjoys a circulation of about 130,000 acute and critical care nurses and can be accessed at .
About the American Association of Critical-Care Nurses: For more than 50 years, the American Association of Critical-Care Nurses (AACN) has been dedicated to acute and critical care nursing excellence. The organization’s vision is to create a healthcare system driven by the needs of patients and families in which acute and critical care nurses make their optimal contribution. AACN is the world’s largest specialty nursing organization, with about 130,000 members and nearly 200 chapters in the United States.
American Association of Critical-Care Nurses, 27071 Aliso Creek Road, Aliso Viejo, CA 92656; 949-362-2000; ;; x.com/aacnme
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