ANCC's Pathway to Excellence Program

Ellen Swartwout, RN, MSN, NEA-BC


March 05, 2010

In This Article

Healthy Work Environments Make a Difference

The impact of healthy work environments on nurse satisfaction and retention is evident in the literature.[3,4,5] In addition, many studies have indicated a strong impact of a positive work environment on patient safety, patient satisfaction and quality care.[6,7,8]

Research has shown the nurse practice environment greatly influences many factors that affect both the nurse and patient. One key priority in healthcare is the safe delivery of nursing care. The Institute of Medicine’s (IOM) report indicated that between 44,000 to 98,000 deaths occur annually due to medical errors.[9] Nurses are among the healthcare professionals who practice in a complex environment and can affect patient safety through their clinical practice. At the core of the Pathway to Excellence program is a nursing practice environment that supports shared governance, interdisciplinary collaboration, leadership, quality, safety, professional development and work-life balance. Tested in Magnet environments, similar characteristics have translated into better patient outcomes, nurse satisfaction and quality care. [6,10,11]

The ability for nurses to problem solve, collaborate with other disciplines and handle conflict is critical to quality patient care. In a study by Siu, Laschinger & Finegan (2008),[12] positive work environments enhance nurses’ conflict management skills, thus influencing the unit effectiveness.

Work- life balance and recognition for one’s contributions in the workplace are important factors in the prevention of burnout. In a study that tested the Nursing Worklife Model, which measured the relationship between the nurse work environment and patient safety outcomes, it was demonstrated that the quality of the nurses’ work environment mediated with burnout and engagement, influenced patient safety outcomes.[13] Another study of the Nursing Worklife Model, indicated that a professional practice environment had an impact on predicting nurse burnout.[14]

Each Pathway to Excellence practice standard supports the essential components of a healthy work environment. The evidence indicates that organizations that embrace the elements of a positive nursing practice environment have a great impact on nurse satisfaction and retention, a key component of a Pathway to Excellence designation. Results have also demonstrated an influence on patient safety and quality care as well. It is evident that a healthy work environment does indeed matter for both nurses and patients.


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