STANDARDS FORESTABLISHING AND SUSTAININGHEALTHY WORK ENVIRONMENTS~A JOURNEY TO EXCELLENCE~

AMERICAN ASSOCIATION OF CRITICAL-CARE NURSES

Founded in 2001, AACN’s goal is to encourage dynamic, healthy work environments that grow and maintain quality patient care (AACN, 2005).

With the shortage of nurses in the early 2000s, it became apparent there was a need to regulate and promote excellent patient care and a positive health-care environment to increase recruitment efforts.

AACN provides practice and educational resources as well as professional support for members and is guided by its mission statement: Building on decades of clinical excellence, the American Association of Critical-Care Nurses provides and inspires leadership to establish work and care environments that are respectful, healing and humane (AACN, 2013).

This manual introduces six necessary standards to create and maintain the appropriate work environment.

And they are….

1) “Skilled Communication: Nurses must be as proficient in communication skills as they are in clinical skills.”

2)”True Collaboration: Nurses must be relentless in pursuing and fostering true collaboration.”

ESSENTIAL:“ABSOLUTELY REQUIRED; NOT TO BE USED UP OR SACRIFICED. INDISPENSABLE. FUNDAMENTAL.”

STANDARDS

3) “Effective Decision Making: Nurses must be valued and committed partners in making policy, directing and evaluating clinical care and leading organizational operations.”

4) “Appropriate Staffing: Staffing must ensure the effective match between patient needs and nurse competencies.”

Standards, cont..

STANDARDS, CONT.“AUTHORITATIVE STATEMENT ARTICULATEDAND PROMULGATED BY THE PROFESSION,

BY WHICH THE QUALITY OF PRACTICE,SERVICE OR EDUCATION CAN BE JUDGED” (AACN, 2005).

5) “Meaningful Recognition: Nurses must be recognized and recognize others for the value each brings to the work of the organization.”

6) “Authentic Leadership: Nurse leaders must fully embrace the imperative of a healthy work environment, authentically live it and engage others in its achievement” (AACN, 2005).

~AACN STANDARDS~The AACN Standards book is designed to promote education among nurses, fostering increased knowledge, maintaining core beliefs, making goals, critically thinking, decision making and effective communication.

These standards are a starting point and are not exclusive. They are here to increasereasoning skills and help build a nurse’s own practice standards.

Each facility that adopts the AACN Standards should decide the order of their importance,and to what extent they will be employed.

Every health-care environment needs a set of rules and guidelines that secure its safety and promote ideal patient care. These standards aim and accomplishing such a task (AACN,2005).

HEALTHY

WORK

ENVIRONMENTS

(HW

E)

• I N 2 0 0 1 , T H E A M E R I C A N A S S O C I A T I O N O F C R I T I C A L - C A R E N U R S E S ( A A C N ) “ M A D E A C O M M I T M E N T T O P R O M O T E T H E C R E A T I O N O F H E A LT H Y W O R K E N V I R O N M E N T S ” ( S H I R E Y & F I S H E R , 2 0 0 8 ) .

• D E V E L O P E D A N D P U B L I S H E D T H E A A C N S T A N D A R D S F O R E S T A B L I S H I N G A N D S U S T A I N I N G H E A LT H Y W O R K E N V I R O N M E N T S

HWE CONT…

• AACN “promotes these standards as essential to establishing and sustaining healthy work environments” (AACN, 2005)

• To actively promote excellence in patient care with the creation of healthy work environments

• To bring national attention to the importance of healthy work environments

TIMELINE

~1950: The first Intensive Care Units were created for complex care (AACN, 2013).

~1960: The need for specialized (ICU) nurses were becoming apparent (AACN, 2013).

TIMELINE, CONT…

~1967: The discussion of forming a national organization to increase education for specialized ICU nurses began(AACN, 2013).

~1969: The American Association of Cardiovascular Nurses was established.(AACN, 2013)

~1971: The association adopted the name The American Association of Critical Care Nurses(AACN, 2013).

WHY A HEALTHY WORK ENVIRONMENT?

• Better communication within the unit amongst managers, staff, and physicians.• Decreased medication administration

errors.• Improves leadership.• Staff and patient satisfaction increases.• Staff is under less stress.

Open Communication

A healthy work environment helps to promote open communication throughout the unit.

This open communication helps staff feel more comfortable discussing issues with managers.Discussing and seeking solving strategies to improve the issues within the unit will improve patient outcomes, giving patients the best care possible.Communicating openly between management and staff helps to unify the unit, creating a positive atmosphere to work in.

Hartung, S. & Miller, M. (2013). Communication and the healthy work environment: Nurse managers perceptions. The Journal of Nursing Administration. 43(5). 266-273.

Decreased Medication ErrorsA healthy work environment that shows open communication helps to decrease the amount of errors with medication administration.

Having an open communication with physicians helps to feel staff more comfortable discussing patient care with physicians. This can help staff feel as though they can ask for clarification on orders from physicians.Although this is not safe practice, it has been found that some nurses assume order dosages instead of seeking clarification, which leads to careless medication errors being made. These errors may be dangerous to patients.

American Association of Critical-Care Nurses. (2005). AACN Standards for Establishing and Sustaining Healthy Work Environments: A Journey to Excellence. AACN. Aliso-Vijo, CA.

A HEALTHY WORK ENVIRONMENT FOR NURSES

A work environment that is healthy is one with open communication, great leadership, decreased stress, and high patient satisfaction.

If staff feels less stress within their environment they will have an increased satisfaction with their jobs.

Nurses under stress may have decreased job performance, due to the lack of attention focused on the patient care they are providing. This careless mistake could potentially put the patient in harm.

KRISTEN’S PRACTICE STANDARDS

As a rehabilitation nurse, my job’s Practice Standards continue to encourage me to maintain a healthy and patient-safe work environment. These are some guidelines I try to live by… I call the physician to clarify an order if there is any doubt about its accuracy

(even if the Dr. is known to be verbally abusive or short-tempered). I meet with my CNA before the shift starts to communicate what I aspect from

her and what she needs from me. I also clarify what patients are q2hr turns, etc.

If I am caught up with my work and have a few extra minutes, I try to walk around the unit and help other nurses that just got a admit or have a crisis going on.

Every time I administer a medication or do a treatment, I fully explain it to my patient.

JILL’S PRACTICE STANDARDS

These practice standards have influenced my nursing practice by

• Allowing me to participate in “shared governance” which allows nurses to meet with management to discuss problems or issues that may arise in the workplace

• My employer has plans in place for staffing shortages so that nurses are not overburdened by patient loads

ANGELA’S PRACTICE STANDARDS

What guides me in my current nursing practice are my specific job duties depending on where I am working. I have had different dos and don’ts at each of my nursing jobs. I follow policy and procedure manuals and most importantly keep in tune to my moral instinct. I believe our goal is similar to anyone in healthcare, not to do harm. 

Because I work for the health department, I am governed by the Board of Health, Board of Commissioners, grant funding, and of course Medicare and Medicaid funding. A lot of the funding is dependent on following specific guidelines for certain diseases. Most commonly we are accountable for how we treat Asthma, STDs, BMI, and Depression.

ABIGAIL’S PRACTICE STANDARDS

After researching a healthy work environment and assessing the environment I work in I would say that my work environment is healthy.

Our managers are excellent leaders and strive to maintain an open form of communication.

In return staff is satisfied with their job and work well together improving the performance of the unit.

Patients are satisfied with their care and are at a decreased risk for potentially harmful errors.

References

American Association of Critical-Care Nurses. (2005). Standards for establishing and sustaining healthy work environments. Aliso Viejo, CA: AACN. American Association of Critical Care Nurses. (2013). History of AACN. Retrieved from www.aacn.org.Hartung, S. & Miller, M. (2013). Communication and the healthy work environment: Nurse managers perceptions. The Journal of Nursing Administration. 43(5). 266-273.Shirey, M. R., & Fisher, M. L. (2008). Leadership Agenda for Change Toward Healthy Work Environments in Acute and Critical Care. Critical Care Nurse, 28(5), 66–78. Retrieved from http://ccn.aacnjournals.org/content/28/5/66.short.