Transcript ACCN Practice Standards

ACCN Practice Standards
Healthy Work Environments
Ferris NURS 320 Practice Standards Assignment
Jessica Behrenwald, Cheryl Howard, & Laura Zwagerman
Background
• In 2001, the American Association of
Critical-Care Nurses (ACCN) made a
commitment to promote & create healthy
work environments.
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In 2005, six essential standards for
establishing and sustaining healthy work
environments were established by the ACCN
as a part of a call to action.
(Barden, 2005)
Healthy Work Environments
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Healthy work environments support and foster
excellence in patient care.
Unhealthy work environments contribute to
medical errors, ineffective delivery of care &
stress among health professionals.
AACN standards for establishing and sustaining
healthy work environment focus on 6 areas:
communication, collaboration, decisionmaking, staffing, recognition & leadership.
(Barden, 2005)
#1 Skilled Communication
"A culture of safety and excellence requires
that individual nurses and healthcare
organizations make it a priority to develop
among professionals communication skills including written, spoken, and non-verbal that are on par with expert clinical skills"
(Barden, 2005, p. 16).
#1 Skilled Communication
Application to practice:
Where I work as an inpatient pediatric nurse,
we are trained in using SBAR when
communicating with physicians (Situation,
Background, Assessment, Recommendation).
Classes are also offered on Crucial
Conversations and Crucial Confrontations.
Any intimidating or inappropriate behavior is
addressed immediately.
Laura Zwagerman RN
#2 True Collaboration
"True collaboration is a process, not an event.
It must be ongoing and build over time,
eventually resulting in a work culture where
joint communication and decision making
between nurses and other disciplines and
among nurses themselves becomes the
norm" (Barden, 2005, p. 20).
#2 True Collaboration
Application to practice:
On the inpatient pediatric oncology unit I work on,
nurses are included in daily rounds with the attending
physician, PA, resident, pharmacist, discharge
planner, and social worker. Our input is valued.
We collaborate among each other frequently when
something does not seem quite right or we have
something we aren't familiar with. We tell new staff
there are no dumb questions, and our behavior backs
that up.
Laura Zwagerman RN
#3 Effective Decision Making
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Nurses are part of the interdisciplinary team that make
important decisions about patient care. They are the
"vital link" in the decision making in the health care
team (Barden, 2005, p. 24).
Healthcare organizations have successfully implemented
professional care models in which nurses have the
responsibility and related authority for patient care
along with formal operational structures that support
autonomous nursing practice (Barden, 2005, p.24).
By creating systems where nurses are put in authority to
make decisions, we create healthy work environments.
#3 Effective Decision Making
Application to Practice:
In my current nursing role as a pediatric home
care nurse, the AACN practice standards of
effective decision making influences my nursing
practice by reminding me that I am truly the vital
link in patient decisions.
It is easy to become lackadaisical and forget
that I am the patient advocate. I need to stay
involved in nursing knowledge so I can make the
proper decision in providing patient care.
Jessica Behrenwald RN
#4 Appropriate Staffing
• "Staffing must ensure the effective match
between patients needs and nurse
competencies" (Barden, 2005, p. 28).
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Inappropriate staffing leads to nurse turn
over which can harm quality of care.
Staffing can not be based on a patient staff
ratio, it needs to be complex and patient
acuity must be put in prospective
(Barden, 2005).
#4 Appropriate Staffing
Application to Practice:
In my current position, my Agency tries to hire nurses that
have experience. They feel they can orientate a nurse to a
client in two hours. This can not always be done.
The AACN standard of appropriate staffing applies to my
area of practice. If the skill level of the nurse does not match
the needs of the child, errors can occur. The case worker
should be reviewing the documentation and doing home visits
to be sure the nurses are competent in caring for the childs
needs. As a staff nurse, I need to take the time to train a
nurse on a skill that she should know well. I need to tell my
Agency if I feel a nurse is not providing competent care.
Jessica Behrenwald RN
#5 Meaningful Recognition
"Nurses must be recognized and must recognize
others for the value each brings to the work of
the organization."
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Recognition is a fundamental human need & a requisite to
personal & professional development.
Lack of recognition leads to discontent, reduced
productivity & poor outcomes.
Meaningful recognition is a process, not an event.
Healthcare organizations need a comprehensive system
recognition which validates meaningfulness to recipients.
Team members understand that everyone is responsible for
playing an active role in the process.
(Barden, 2005, p. 32-33)
#5 Meaningful Recognition
Application to practice:
The AACN standard for meaningful recognition
influences my practice as an RN in a long term care
(LTC) because I always make sure to verbally encourage
team members such as LPN's, CNA's, and fellow RN's for
the diligent and good work that they do throughout the
day. A twelve hour shift in LTC can be hectic,
exhausting, and thankless work. Often, residents
complain and are not very appreciative. Consistently
recognizing contributions of team members can go a
long way to feeling like your efforts are worth it and
that what you do matters.
Cheryl Howard RN
#6 Authentic Leadership
"Nurse leaders must fully embrace the imperative
of a healthy work environment, authentically
live it and engage others in its achievement."
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All sectors of health care community strongly call for effective
measures to strengthen nursing leadership.
Properly trained & supported nurse managers are key to
retention of satisfied staff.
Nurse leaders must be positioned within an organization in order
to influence decisions that affect nursing practice.
Workers desire respect, high standard of management ethics &
honest communication between employees & management.
(Barden, 2005, p. 36-37)
#6 Authentic Leadership
Application to practice:
The AACN standard for authentic leadership influences
my practice by causing me to desire leadership qualities
within myself but also to look toward my supervisors and
nurse managers for leadership. Leadership is a core
component in the ANA's professional standards of nursing
practice (Nursing, 2010). Currently in the LTC facility
where I work there is not strong leadership which I believe
does contribute to a less than optimal work environment.
In the future, I plan to advocate and communicate the
need for authentic leadership in my workplace.
Cheryl Howard RN
Summary
AACN Healthy Work Environment Standards:
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"reaffirm that safe and respectful
environments are imperative"
"provide a functional yardstick for
performance and development of
individuals, units, organizations and
systems"
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"support the nine provisions of the
American Nurses Association Code of Ethics
for Nurses"
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"provide a framework to assist nurses in
upholding their obligation to practice in
ways consistent with appropriate ethical
behavior"
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"assure that acute and critical care nurses
have the skills, resources, accountability
and authority to make decisions that ensure
excellent professional nursing practice and
optimal care for patients and their families"
(Barden 2005, p.13).
Interdependence of Healthy Work Environment,
Clinical Excellence & Optimal Patient Outcomes
(Barden, 2005, p.14).
References
Barden, C. (2005). AACN standards for establishing and
sustaining healthy work environments [PDF document].
Retrieved from the American Association of Critical-Care
Nurses Web site:
http://www.aacn.org/WD/HWE/Docs/HWEStandards.pdf
Nursing: Scope and standards of practice (2nd ed.). (2010).
Silver Spring, Maryland: American Nurses Association.
Ferris State University ~ NURS 320 ~ December 6, 2011