Implementation of AACN Healthy Work Environment Components in Emergency Department Settings
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Date
2022-08
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The Ohio State University
Abstract
The prevalence of registered nurse (RN) turnover in the United States has substantially increased in the past year, with noticeable increases in specialty areas such as emergency nursing. It is reported that most emergency departments (ED) will turn over all RN staff every five years. The ED chosen for this project has had a large increase in RN turnover of 25% in a six-month period. Turnover, coupled with the department's 159 unplanned RN absences during the six months has caused increasing concern for patient safety and increased labor cost for the organization. These high rates of turnover and absence result in increased workload for nursing staff, increased fatigue, decreased patient flow for the organization, and higher levels of perceived staff burnout. Capacity constraints and consistently high rates of RN turnover can result in exorbitant costs for healthcare organizations and decreased quality of care delivery. Substantial literature indicates that creation of healthy work environments can address factors associated with turnover and absenteeism. Specifically, implementation of the American Association of Critical Care-Nurses (AACN) Healthy Work Environment (HWE) framework has demonstrated benefit on improving a unit's work environment, relationship with leadership, and can drive down the incidence of turnover. Therefore, the purpose of this project was to evaluate ED RN perceptions of a healthy work environment and implement evidence-based components of AACN HWE to address priority areas including personalized recognition, public display of recognition, thank you/birthday cards and highlighting special events. Ultimately the project aimed to improve rates of turnover and absenteeism over time within the ED setting through ongoing sustainability of these initiatives. Pre and post data collected showed statistical and clinical significance for meaningful recognition signifying that if used on a larger scale of culture development, this framework could significantly improve the health of the work environment.