| Primary Author: | Nancy T. Blake, PhDc, RN, CCRN, NEA-BC |
| Organization | Children’s Hospital Los Angeles |
Abstract
Purpose
To determine the relationship between healthy work environments, patient outcomes and nurse turnover in pediatric intensive care units (PICUs), Three key elements of (HWE), communication, collaboration and leadership will be examined to measure their influence on patient outcomes: risk-adjusted patient length of stay, central line infections, risk-adjusted mortality, ventilator-associated pneumonia and RN turnover.
Background
Medical errors cost the United States over $50 billion annually. Researchers have found a relationship between the nurses’ work environments and medical errors. The Joint Commission stated that communication failures are the leading cause of harm to patients in hospitals today. With an estimated shortage of 400,000 nurses identified in 2020, nurse leaders need to improve the work environment. This type of study has never been done in the PICU environment.
Materials & Methods
The study is a descriptive, cross-sectional, correlational design. The setting is the PICU in 10 childrens’ hospital across the nation, with an RN sample of 40 at each site. RNs will be surveyed about their perceptions of their work environment, communication and collaboration using the Practice Environment Scale of the Nursing Work Index Revised (PES-NWI) and the ICU Nurse Physician Questionnaire.. Hospital data will be obtained on RN turnover, ventilator-associated pneumonia, central line infections, risk adjusted length of stay and risk adjusted mortality. Statistical analysis will include correlation, multiple regression, t-tests (two-tailed) and one way analysis of variance (ANOVA).
Results
Data analysis will be completed in April 2012. Findings will be presented and this will be the first time these findings will be available.
Conclusion
PICU patients are a vulnerable population. Nurse leaders need to use research-based interventions to improve nurses’ work environments.. A better understanding of the relationship between RN-RN communication, RN-MD collaboration and the extent that nurse leadership contributes to a HWE and quality patient outcomes will add to the research demonstrating the importance of nurses and excellent nursing care on patient outcomes.
Bibliography
AACN. (2005). AACN Standards for establishing and sustaining healthy work environments: a journey to excellence. American Journal of Critical Care , 14 (4), 187-197.
Aiken, L., Clarke, S., Sloane, D., Lake, E., & Cheney, T. (2008). Effects of hospital care environment on patient mortality and nurse outcomes. JONA, 38 (5), 223-229.
Baggs, J., Schmitt, M, Mushlin, A., Mitchell, P., Eldredge, D. Oakes, D., & Hutson, A. (1999). Association between nurse-physician collaboration and patient outcomes in three intensive care units. Critical Care Medicine, 27(9), 1991-1998.
Knaus, W., Draper, E., Wagner, D., & Zimmerman, J. (1986). An evaluation of outcome from intensive care in major medical centers. Annals of Internal Medicine, 104, 410-418.
© Improvement Science Research Network, 2012
The ISRN published this as received and with permission from the author(s).