Background: Like other countries in the world, Iran is facing the problem of a shortage of nurses. Meanwhile, many Iranian nurses migrate to other countries every year. The present study aims to ...assess the relationships between migration intention, workload, and a healthy work environment for nurses. Methods: This cross-sectional correlational study was conducted in 2020 using a proportional stratified sampling of 360 nurses working in the Iran University of Medical Sciences (IUMS) teaching hospitals. The study data were collected through a demographic questionnaire, the nurses’ intention to migrate questionnaire, the NASA task load index, and the American Association of Critical-Care Nurses Healthy Work Environment Assessment. In this study, we used the independent t-test, analysis of variance, and the Pearson correlation coefficient for data analysis at a significance level of <0.05 in SPSS software, version 16. Results: The Mean±SD intention to migrate score was 65.59±33.51. A weak but significant positive correlation existed between the intention to migrate and workload (r=0.166, P=0.002). There was an inverse and weak relationship between the intention to migrate and a healthy work environment (r=-0.160, P=0.002). There was also a significant relationship between the intention of nurses to migrate and their work experience (P=0.048) and employment status (P=0.001). Conclusion: The prevention of nurses’ migration must be investigated thoroughly to determine the reasons. But according to the results of this study, providing a healthy work environment and maintaining the current workforce by providing the indicators desired by nurses may partly prevent excessive migration of nurses.
The aim of the study was to develop recommendations for creating a healthy work environment based on current literature for nurses working within the US Military Health System (MHS). However, our ...findings would likely benefit other nursing populations and environments as well.
Systematic literature review.
We conducted a systematic literature search for articles published between January 2010 until January 2024 from five databases: PubMed, Joanna Briggs, Embase, CINAHL and Scopus.
Articles were screened, selected and extracted using Covidence software. Article findings were synthesized to create recommendations for the development, implementation and measurement of healthy work environments.
Ultimately, a total of 110 articles met the criteria for inclusion in this review. The articles informed 13 recommendations for creating a healthy work environment. The recommendations included ensuring teamwork, mentorship, job satisfaction, supportive leadership, nurse recognition and adequate staffing and resources. Additionally, we identified strategies for implementing and measuring these recommendations.
This thorough systematic review created actionable recommendations for the creation of a healthy work environment. Based on available evidence, implementation of these recommendations could improve nursing work environments.
This study identifies methods for implementing and measuring aspects of a healthy work environment. Nurse leaders or others can implement the recommendations provided here to develop healthy work environments in their hospitals, clinics or other facilities where nurses practice.
PRISMA 2020 guidelines.
No patient or public contribution.
Abstract
Aims and objectives
To examine demographic and work characteristics of interdisciplinary healthcare professionals associated with higher burnout and to examine whether the four domains of ...moral resilience contribute to burnout over and above work and demographic variables.
Background
Healthcare professionals experience complex ethical challenges on a daily basis leading to burnout and moral distress. Measurement of moral resilience is a new and vital step in creating tailored interventions that will foster moral resilience at the bedside.
Design
Cross‐sectional descriptive design.
Methods
Healthcare professionals in the eastern USA were recruited weekly via email for 3 weeks in this cross‐sectional study. Online questionnaires were used to conduct the study. The STROBE checklist was used to report the results.
Results
Work and demographic factors, such as religious preference, years worked in a healthcare profession, practice location, race, patient age, profession and education level, have unique relationships with burnout subscales and turnover intention, with the four subscales of moral resilience demonstrating a protective relationship with outcomes above and beyond the variance explained by work and demographic characteristics.
Conclusions
Higher moral resilience is related to lower burnout and turnover intentions, with multiple work demographic correlates allowing for potential areas of intervention to deal with an increase in morally distressing situations occurring at the bedside. Additionally, patterns of significant and non‐significant relationships between the moral resilience subscales and burnout subscales indicate that these subscales represent unique constructs.
Relevance to clinical practice
Understanding the everyday, pre‐pandemic correlations of moral resilience and burnout among interdisciplinary clinicians allows us to see changes that may exist. Measuring and understanding moral resilience in healthcare professionals is vital for creating ways to build healthier, more sustainable clinical work environments and enhanced patient care delivery.
Complexity in nursing practice creates an intense and stressful environment that may lead to moral distress (MD) and registered nurses (RNs) seeking other employment.
In 2020, the RN turnover rate ...was 8%, with postpandemic turnover projected to reach 13%.
The Measure of Moral Distress for Health Care Professionals (MMD-HP) was used to measure the frequency and level of RNs' MD.
t tests showed significant differences for 16 of 27 MMD-HP items in RN intent to leave. RNs had 2.9 times the odds of intent to leave (P = .019) due to perceived issues with patient quality and safety and 9.1 times the odds of intent to leave (P < .001) due to perceived issues with the work environment. Results explained 40.3% of outcome variance.
MD related to work environment or patient quality and safety were significant factors in RN intent to leave their position.
This article discusses the definition of moral distress, sources, and some questions staff can consider when dealing with moral distress issues. A fictitious scenario is included for discussion ...purposes.
•Paper defines moral distress and discusses common sources of it.•It is crucial to identify MD to create healthy work environments.•Radiology staff commonly experience MD.
The majority of the techniques in the building comfort monitoring state-of-the-art are based on local/manual measurements or on permanent sensor networks. These techniques entail imprecision and ...randomness (in the first case) and high-cost installations and a lack of flexibility to eventual changes in buildings (in the second). However, intelligent mobile platforms are becoming significantly more important as they perform data acquisition adapted to specific scenarios and schedules. In this paper, we present a robotic platform focused on performing the workplace occupant comfort-monitoring process. The soundness of our proposal compared to others lies on that it gathers most of the necessary properties of an effective monitoring platform: it collects a wider range of variables; it autonomously navigates in inhabited buildings managing occlusions and unexpected events; it conducts multiple monitoring sessions in one or several days; it provides comfort evaluations. Additionally, it can be very useful for energy engineers and construction professional as it provides valuable information in regard to comfort: it detects the best/worst results of the tested variables, locates discomfort in specific areas and moments, recognizes discomfort patterns and globally classifies zones into comfort classes. This robotic platform has been successfully tested in the interiors of buildings, providing significant and clear results in comfort terms (a case study is presented in this paper). However, some limitations and improvements should be addressed. Among other aspects, the computer-robot communication robustness for long distances and the procedure for detecting of small obstacles must be improved in the future.
•ComfBot is an autonomous (not commanded) mobile platform, which carries out a complete (not partial) monitoring of the scene.•ComfBot collects temperature, humidity, pressure, lighting, CO2 levels, TVOC levels and noise levels.•The system can conduct several scheduled monitoring sessions during a day, which are previously programmed by the user.•It is a portable and low-cost platform, which enhances the applicability and affordability of the system.•It has powerful visualisation tools, which allows the user to carry out an efficient analysis of the data collected.•The system is able to detect areas that may not be comfortable in specific locations and at specific times.
A healthy work environment (HWE) is an interrelated system of people, structures, and practices enabling nurses to engage in work processes and relationships identified by clinical nurses as ...standards of quality care to patients in hospitals. In HWEs, nurses can make a maximum positive contribution to their patients and the organization. According to AACN, the six standards of an HWE include skilled communication, true collaboration, effective decision-making, appropriate staffing, meaningful recognition, and authentic leadership. HWEs have been correlated with employee engagement and organizational commitment. Much of HWE literature findings are based on designs that assess the presence or absence of HWE and the outcomes of HWE. Few studies evaluate the impact of professional development interventions on HWE. The authors aimed to investigate the effect of an acute care professional development intervention for three nursing units on staff nurse perception of HWE.
This study aimed to administer a pre- and post-intervention assessment of the work environment among staff nurses working on acute care units in a Magnet® hospital in southeastern Louisiana.
This study used a pre-test and post-test single group study quantitative design where subjects completed online assessments before and after an educational intervention. The intervention included an educational presentation tailored for each hospital unit’s nursing specialty and patient population. Education topics reinforced the HWE standards and TeamSTEPPS® communication techniques to enhance teamwork. The online assessments included demographic questions and a valid and reliable AACN HWE survey. The HWE survey consists of 18 questions, 3 for each standard. The sample included staff nurses working in three acute care units. Demographic questions included gender, age, education, certification, participation in shared governance, career ladder participation, years in the current unit, hours worked per week, and years in nursing. Following the baseline assessment collection, an educational intervention was developed and delivered to the staff nurses. The intervention ranged from 4 to 8 hrs. It included specialty-focused education topics based on each unit’s patient populations (e.g., cardiac, pulmonary/sepsis, and stroke/renal care). The participants received information on certification, TeamSTEPPS® techniques for feedback, and conflict management. Following the intervention, electronic HWE surveys were sent to participants via e-mail for reassessment. Both the pre- and post-test participation was voluntary. No identifying information was collected, and the study was Institutional Review Board approved.
A total of 53 staff nurses (50 females; 3 males) working among three acute care inpatient units completed the pre/post-test and intervention. The results were analyzed using SPSS. There was a significant increase in the means for 9 of 18 HWE survey questions from the pre- to post-test (P < .05). These results demonstrated a positive impact of the professional development intervention on staff nurse perception of HWE.
Improving nurse work environments results in improved nurse empowerment, nurse satisfaction, and increased patient safety DiChiara, J. (2015); https://revcycleintelligence.com/news/how-the-nursing-work-environment-affects-patient-outcomes. This study demonstrated the benefit of a professional development that supported HWE standards on staff nurse perception of HWE in acute care work environments. This intervention study could serve as a strategy for units aiming to improve nurse perception of HWEs.
•In healthy work environments (HWE), nurses can make a maximum positive contribution to their patients and the organization. According to American Association of Critical Care Nurses, the six standards of an HWE include skilled communication, true collaboration, effective decision-making, appropriate staffing, meaningful recognition, and authentic leadership. Prior literature has established a correlation among HWEs, employee engagement, and organizational commitment.•The study intervention consisted of a professional development offered during the usual annual competency required for nurses working in three acute care units. The nurses and unit directors provided suggestions for the unit-specific professional development topics (e.g., cardiac, pulmonary/sepsis, stroke/renal). TeamSTEPPS® techniques were included (e.g., conflict management).•These results demonstrated a positive impact of the professional development intervention on staff nurse perception of HWE. This intervention study could serve as a resource for units aiming to improve nurse perception of HWEs.•Obtaining full nurse leader support represented a significant financial commitment by the hospital to supporting HWEs.
•CWS is persistent psychological, emotional, and physical strain experienced at work.•CWS negatively impacts personal well-being and workplace health.•Civility and resilience are effective strategies ...to address CWS in nursing academia.
Chronic workplace stress (CWS) is a root cause of burnout and defined as a prolonged and persistent state of psychological, emotional, and physical strain experienced by individuals in their work environment.
The related concepts of civility and resilience are introduced as effective strategies to address CWS in nursing academia. The authors define and describe the interconnected concepts of civility and resilience and offer evidence-based strategies to promote personal well-being and healthy work environments.
Because CWS can have a detrimental impact on faculty well-being and workplace health, evidence-based strategies are needed to improve individual wellness, workplace culture, civility, and resilience.
Civil and resilient responses to CWS include engaging in civil discourse, advocating for organizational change, exercising moral courage, cocreating cultural norms, and empowering individuals and academic leaders to positively impact system issues that lead to CWS. The authors provide insight, competencies, and strategies to transform the culture of nursing academia to promote healthy and sustainable work environments where all members can thrive.
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•Academia leaders can lead and create a healthy work environment (HWE) to promote recruitment and retention of nurse faculty.•The path to building an HWE begins with a workplace culture survey and ...strategic planning.•Sustaining an HWE requires a collaborative approach with established interventions stemming from all stakeholders.
The shortage of nurse faculty is a major barrier to addressing the growing nurse shortage. Despite recommendations to focus on creating a healthy work environment (HWE) in nursing academia, many nursing faculty attribute leaving the role to a negative workplace culture. Leadership at one school of nursing (SON) identified the need to detect workplace culture to guide planning aimed at building an HWE. The creation and implementation of a workplace culture survey are explained, and subsequent actions are explored. A workplace culture survey and targeted interventions have the potential to establish an HWE and should be considered by all SONs.
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