Implementing AACN's Healthy Work Environment Framework in an Intensive Care Unit

Area of Science:

• Nursing
• Healthcare Management
• Organizational Psychology

Background:

• High bedside nurse turnover (15.9%) in the US is linked to poor work environments.
• Healthy work environments enhance nurse satisfaction, retention, and patient outcomes.
• Unhealthy environments negatively impact these critical areas.

Purpose of the Study:

• Implement the American Association of Critical-Care Nurses (AACN) healthy work environment (HWE) framework.
• Evaluate staff satisfaction, turnover, and tenure in an intensive care unit (ICU) 2 years post-implementation.
• Assess the impact of HWE standards on the nursing work environment.

Main Methods:

• Utilized a pre-post study design in an ICU at a large academic medical facility.
• Implemented interventions targeting the 6 AACN HWE standards.
• Measured changes using the AACN HWE assessment survey in 2017 and 2019.

Main Results:

• Statistically significant improvements were observed across most HWE standards, excluding skilled communication and overall measures.
• Registered nurse turnover remained stable over the 2-year study period.
• Average nurse tenure increased by 79 days, indicating improved retention.

Conclusions:

• Interventions based on HWE standards are associated with enhanced staff satisfaction and retention.
• The AACN HWE framework demonstrates value in improving nurse retention within ICUs.
• Addressing HWE standards positively impacts key nursing workforce metrics.