Patricia A. Patrician

This quality improvement project evaluated the impact of Community Resiliency Model® training on nurse wellness and job outcomes in a large academic medical center. Statistically significant improvements in burnout, perceived organizational support, and job satisfaction were observed among nurses who attended training. Staff development educators may find this practical, trauma-informed intervention helpful for supporting staff well-being, strengthening engagement, and improving nurse retention.

Aim: This project team aims to (1) evaluate the effectiveness of the Workforce Engagement for Compassionate Advocacy, Resilience, and Empowerment (WE CARE) program in improving the work environment, workplace mental health, and nurse outcomes, and (2) examine underlying factors influencing job satisfaction and intent to leave among staff nurses. Design: Quasi‐experimental designs with one‐group pre–post program design using online surveys. Methods: Pre‐program data were collected in June 2022 ( n = 706), followed by the implementation of multifaceted, evidence‐based interventions delivered by the WE CARE team, such as wellness rounding and resilience education. Post‐program data were collected in November 2024 ( n = 417). Mixed‐effects regression models were utilised for analysis. Results: The WE CARE program was associated with statistically significant improvements in the overall work environment, workplace mental health (excluding resilience), and nurse outcomes, including job satisfaction and intent to leave. Job satisfaction positively correlated with a supportive work environment, recognition, and trust in supervisors, and negatively correlated with burnout, compassion fatigue, and distress. Higher levels of burnout and distress significantly increased the likelihood of nurses intending to leave their jobs, while greater trust in leadership and perceived organisational support were protective factors against leaving the job. Conclusion: The project supports the effectiveness of evidence‐based workforce engagement interventions in real‐world healthcare settings to enhance the work environment, workplace mental health, and nurse outcomes. Interventions targeting emotional well‐being, recognition, burnout reduction, and leadership trust may improve job satisfaction and reduce nurses' turnover intentions. Impact: The program directly resulted in nurse leaders recognising the value of the WE CARE initiative and sustaining the team beyond the funding period. This project addresses a significant gap in the nurse well‐being literature by demonstrating the effectiveness of a nurse‐led, multifaceted wellness program designed specifically for nurses. Patient or Public Contribution: No patient or public contribution.

Nurse burnout remains a significant problem affecting the nursing workforce today. However, despite calls for changes that could reduce clinician administrative burdens due to their relationship with burnout, minimal opportunities for improvement have been identified. Therefore, the purpose of this study was to investigate the relationship between nurse burnout and nurse satisfaction with the electronic health record (EHR). A cross-sectional survey was administered in 2018 to nurses practicing in the state of Alabama in the United States (N = 950). The survey inquired about participants' burnout, EHR satisfaction, and the nurse work environment. In multiple regression models, years of experience, nurse satisfaction with the EHR, and the nurse work environment explained 20%-34% of the variation in nurses' work-related burnout. Although additional research is needed, the EHR may be one actionable area that organizations could modify to help reduce nurse burnout.

Aim: To determine outcomes measured following blood transfusion for the resuscitation of adult patients who experienced trauma-related hemorrhage and compare them based on the timeframe in which they occurred: short-, intermediate-, and long-term. Design: Systematic Review. Review methods: We included articles that met the following criteria: published in English between January 1, 2014 and December 31, 2023; with full text available; peer-reviewed; and adult population (≥ 19 years). Two authors reviewed each title, abstract, and full text for inclusion using the online review tool, Covidence; a third author adjudicated conflicts. A similar method was used for data extraction. Outcomes were categorized as those that occurred in the short-term (day of injury to < 30 days post-injury), intermediate-term (30 days to six months post-injury), and long-term (> six months to one year post-injury). The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was used to rate the quality and strength of the reviewed evidence. Data Sources: PubMED, CINAHL, Scopus, and Embase. Results: The final analysis included 50 articles. Outcomes were categorized as those related to mortality, pathophysiologic outcomes, indices of coagulopathy, and duration of treatment. All four outcome categories were reported in at least one study during the short-term timeframe. Mortality was reported in 12 articles, the duration of treatment was reported in four articles, and pathophysiologic outcomes were reported in one article during the intermediate-term timeframe. Two articles reported mortality during the long-term timeframe. Conclusion: Short-term outcomes of patients resuscitated with blood products following a trauma-related hemorrhage have been well studied. Future studies are needed to assess the intermediate- and long-term outcomes of patients following a trauma-related hemorrhage. Impact: Understanding patient outcomes following trauma-related hemorrhage may help guide clinicians in the provision of care beyond the initial resuscitation period, and ultimately improve patient recovery and rehabilitation.

As a consistent 24-hour presence in hospitals, nurses play a pivotal role in ensuring the quality and safety (Q&S) of patient care. However, a comprehensive review of evidence-based recommendations to guide nursing interventions that enhance the Q&S of patient care is lacking. Therefore, the purpose of our systematic review was to create evidence-based recommendations for the Q&S component of a nursing professional practice model for military hospitals. To accomplish this, a triservice military nursing team used Covidence software to conduct a systematic review of the literature across five databases. Two hundred forty-nine articles met inclusion criteria. From these articles, we created 94 recommendations for practice and identified eight focus areas from the literature: (1) communication; (2) adverse events; (3) leadership; (4) patient experience; (5) quality improvement; (6) safety culture/committees; (7) staffing/workload/work environment; and (8) technology/electronic health record. These findings provide suggestions for implementing Q&S practices that could be adapted to many healthcare delivery systems.

Poor well-being and burnout among the nursing workforce were heightened by the COVID-19 pandemic. The purpose of this study was to deliver, spread, and sustain an evidence-based wellness program, Workforce Engagement for Compassionate Advocacy, Resilience, and Empowerment (WE CARE), for nurse leaders, staff registered nurses (RNs), and patient care technicians (PCTs) to ameliorate or prevent burnout, promote resilience, and improve the work environment. The program included Community Resiliency Model (CRM) training provided by a certified 6-member wellness team. A baseline and 6-month follow-up survey included measures of well-being, moral distress, burnout, resilience, perceived organizational support (POS), job satisfaction, intent to leave (ITL), and work environment. A total of 4900 inpatient RNs, PCTs, and leaders of a 1207-bed academic medical center in the southeastern United States were analyzed. From baseline (n = 1533) to 6-month follow-up (n = 1457), well-being, moral distress, burnout, job satisfaction, and work environment improved; however, resilience, POS, and ITL did not. Although we have seen some improvements in well-being and mental health indicators, it is still early in the intervention period to have reached a critical mass with the training and other interventions. The mental health and work environment issues among nurses are so complex, no one-size-fits-all intervention can resolve.