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American Journal of Critical Care. 2007;16: 458-468
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CE Article

Types of Intensive Care Units With the Healthiest, Most Productive Work Environments

By Claudia Schmalenberg, RN, MSN and Marlene Kramer, RN, PhD. Claudia Schmalenberg is president of nursing at Health Science Research Associates, Tahoe City, California. Marlene Kramer is vice president of nursing at Health Science Research Associates, Apache Junction, Arizona.

Corresponding author: Claudia Schmalenberg, RN, MSN, Health Science Research Associates, PO Box 7667, Tahoe City, CA 96145 (e-mail: claudializ{at}juno.com).

Background The quality of nurses’ work environments in hospitals is of great concern. The American Association of Critical-Care Nurses has specified 6 standards essential to a healthy (ie, satisfying and productive) work environment. These standards are sufficiently aligned to the Essentials of Magnetism processes to make this tool suitable for measuring healthy work environments.

Objectives To identify differences in staff nurses’ perceptions of the work environment by type of intensive care unit.

Methods A cross-sectional descriptive design with strategic sampling was used in this secondary analysis of data from 698 staff nurses working in 34 intensive care units in 8 magnet hospitals. Intensive care units were grouped into 4 types: medical, including coronary care; surgical, including trauma and cardiovascular; neonatal and pediatric; and medical-surgical. All nurses completed the Essentials of Magnetism instrument. Analysis of variance was used to identify initial differences; multivariate analysis of variance was used to control for covariates.

Results The intensive care nurses and units scored above the National Magnet Hospital Profile mean on process variables and on the Essentials of Magnetism outcome variables. Neonatal and pediatric units scored significantly higher than did the other types of intensive care units sampled.

Conclusions Intensive care unit structures supported care processes and relationships that resulted in job satisfaction among nurses and high-quality care for patients in this strategic sample. Systematic study of the structures and processes present in units reporting a healthy work environment can be used to assist other clinical units in improving work environments.

Notice to CE enrollees:A closed-book, multiple-choice examination following this article tests your understanding of the following objectives:
  1. Discuss 3 common trends in healthy work environments.
  2. Explain the relationship between the 8 essentials of a productive work environment identified by staff nurses in magnet hospitals and the 6 AACN standards of a healthy work environment.
  3. Discuss the relationship between healthy work environments and magnet hospitals.

To read this article and take the CE test online, visit www.ajcconline.org and click "CE Articles in This Issue." No CE test fee for AACN members.




This article has been cited by other articles:


Home page
 Crit Care NurseHome page
M. Kramer and C. Schmalenberg
Confirmation of a Healthy Work Environment
Crit. Care Nurse, April 1, 2008; 28(2): 56 - 63.
[Full Text] [PDF]

eLetters:

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Some Thoughts About Healthy Work Environments
Karen L Meskimen
AJCC Online, 8 Nov 2007 [Full text]
Re: Some Thoughts About Healthy Work Environments
Claudia Schmalenberg, et al.
AJCC Online, 9 Nov 2007 [Full text]

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