The State of Health, Burnout, Healthy Behaviors, Workplace Wellness Support and Concerns of Medication Errors in Pharmacists During the COVID-19 Pandemic.

OBJECTIVE: To describe the well-being and lifestyle behaviors of health-system pharmacists during the COVID-19 pandemic and to determine the relationships among well-being, perceptions of workplace wellness support, and self-reported concern of having made a medication error. METHODS: Pharmacist (N = 10,445) were randomly sampled for a health and well-being survey. Multiple logistic regression assessed associations with wellness support and concerns of medication error. RESULTS: The response rate was 6.4% (N = 665). Pharmacists whose workplaces very much supported wellness were 3x more likely to have no depression, anxiety, and stress; 10x more likely to have no burnout; and 15x more likely to have a higher professional quality of life. Those with burnout had double the concern of having made a medication error in the last three months. CONCLUSION: Healthcare leadership must fix system issues that cause burnout and actualize wellness cultures to improve pharmacist well-being.

Associations among infection prevention professionals' mental/physical health, lifestyle behaviors, shift length, race, and workplace wellness support during COVID-19.

BACKGROUND: COVID-19 added stress to infection prevention professionals' (IPs) work-life that may have impacted their well-being. This study aimed to describe IPs' mental and physical health and lifestyle behaviors during the pandemic and their associations with IP role, perceived worksite wellness support, shift length, and race and/or ethnicity. METHODS: A random sample of Association for Professionals in Infection Control and Epidemiology members (6,000) were emailed a survey assessing mental and physical well-being, lifestyle behaviors, and perceived worksite wellness support. RESULTS: A total of 926 IPs responded (15% response rate). Few met guidelines for sleep (34.1%), physical activity (18.8%), and fruit and vegetable consumption (7.3%). Rates of depression, anxiety, and burnout were 21.5%, 29.8%, and 65%. Front line and practicing IPs and IP administrators and directors had more negative mental health impacts than IPs in other roles. IPs with organizational wellness support were less likely to report negative COVID-19 impacts. IPs working 9-11+ hours/day were more likely to report worsening physical and mental health due to COVID-19. There were no significant differences in odds of negative COVID-19 impacts on lifestyle behaviors between white and racial and ethnically diverse IPs. CONCLUSIONS: IPs who worked shorter shifts and had more organizational wellness support had better well-being outcomes. Organizations must fix system issues that result in poor health and invest in workforce wellness.

Psychometric properties of the Organizational Culture and Readiness Scale for System-Wide Integration of Evidence-Based Practice.

BACKGROUND: Patient safety metrics declined due to COVID-19-related strains placed on hospitals and hospital systems. Because evidence-based practice (EBP) can improve patient outcomes and quality of care and empower clinicians, a renewed focus on organizational EBP culture is needed. The Advancing Research and Clinical practice through close Collaboration (ARCC©) Model describes how to use a system-wide approach to advance and sustain EBP in hospital systems to improve outcomes. EBP culture is a key variable that directly impacts EBP knowledge, beliefs, competency, and implementation. The ARCC© Model uses the Organizational Culture and Readiness Scale for System-Wide Integration of Evidence-Based Practice (OCRSIEP) to identify organizational characteristics that influence clinician and patient outcomes. Although the scale has been reported to have excellent reliability, a comprehensive psychometric analysis has yet to be performed that confirms its construct validity. AIMS: The aim of this study was to describe the OCRSIEP's construct validity and reliability via an in-depth psychometric analysis. METHODS: OCRSIEP assessment data were obtained from a prior national study with 2344 nurses from 19 hospitals and healthcare systems. Descriptive statistics summarized the sample and distributions of the 25 scale items. Construct validity was assessed via exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Cronbach's alpha assessed reliability. RESULTS: A one-factor model was supported by EFA with item Q17b excluded (i.e., to what extent are decisions generated from upper administration). Model fit indices for CFA indicated a good fit (CFI = 0.978, TLI = 0.973, RMSEA = 0.077, SRMR = 0.027). Cronbach's alpha was 0.96 for all items and 0.97 with item Q17b excluded, both indicating outstanding internal consistency. LINKING EVIDENCE TO ACTION: The OCRSIEP is valid and reliable and can be used to assess EBP culture and readiness in hospitals and healthcare systems at the organizational level.

Trends in mental health indicators among nurses participating in healthy nurse, healthy nation from 2017 to 2021.

BACKGROUND: American healthcare workers face unprecedented stress and trauma in the workplace during COVID-19, putting nurses at increased risk for poor mental health. Examining trends of mental health from before and during COVID-19 can illuminate the toll of the pandemic on nurses well-being. METHODS: Nurses enrolled in Healthy Nurse, Healthy Nation receive a prompt to take an annual survey (n = 24,289). Mental health was assessed by active diagnoses of anxiety and depressive disorder, and feeling sad, down or depressed for two or more weeks in the past year. Logistic regression models were used to calculate predictive probabilities of health outcomes in year 4 (May 1, 2020 - April 30, 2021) compared to years 1-3 (each from May 1 to April 30), controlling for age, sex, race/ethnicity, and nurse type. Models were also stratified by work setting and nurse type. RESULTS: In year 4, nurses had a 19.8% probability of anxiety disorder, significantly higher than year 3 (16.3%, p < .001), year 2 (13.7%, p < .001), and year 1 (14.0%, p < .001). Similarly, nurses had a 16.7% probability of depression disorder in year 4, significantly higher than year 2 (12.9%, p < .001) and year 1 (13.9%, p < .01). Year 4 nurses had a 34.4% probability of feeling sad, down or depressed for two weeks, significantly higher than previous years (year 1 = 26.8%, year 2 = 25.9%, year 3 = 29.7%, p < .001). Trends in probabilities of mental health indicators were similar among each nurse type and work setting. Nurses in medical/surgical work settings and those with licensed practical nurse and licensed vocational nurse titles consistently had the highest probability of poor mental health. LINKING ACTION TO EVIDENCE: In 2020-2021, nurses faced challenges unlike any experienced in previous years. Unsurprisingly, nurses reported increased instances of poor mental health indicators. Positive disruptive strategies are needed to systemically change organizational culture and policy to prioritize and support nurses' well-being.

Interventions to Improve Mental Health, Well-Being, Physical Health, and Lifestyle Behaviors in Physicians and Nurses: A Systematic Review.

OBJECTIVE: This systematic review focused on randomized controlled trials (RCTs) with physicians and nurses that tested interventions designed to improve their mental health, well-being, physical health, and lifestyle behaviors. DATA SOURCE: A systematic search of electronic databases from 2008 to May 2018 included PubMed, CINAHL, PsycINFO, SPORTDiscus, and the Cochrane Library. STUDY INCLUSION AND EXCLUSION CRITERIA: Inclusion criteria included an RCT design, samples of physicians and/or nurses, and publication year 2008 or later with outcomes targeting mental health, well-being/resiliency, healthy lifestyle behaviors, and/or physical health. Exclusion criteria included studies with a focus on burnout without measures of mood, resiliency, mindfulness, or stress; primary focus on an area other than health promotion; and non-English papers. DATA EXTRACTION: Quantitative and qualitative data were extracted from each study by 2 independent researchers using a standardized template created in Covidence. DATA SYNTHESIS: Although meta-analytic pooling across all studies was desired, a wide array of outcome measures made quantitative pooling unsuitable. Therefore, effect sizes were calculated and a mini meta-analysis was completed. RESULTS: Twenty-nine studies (N = 2708 participants) met the inclusion criteria. Results indicated that mindfulness and cognitive-behavioral therapy-based interventions are effective in reducing stress, anxiety, and depression. Brief interventions that incorporate deep breathing and gratitude may be beneficial. Visual triggers, pedometers, and health coaching with texting increased physical activity. CONCLUSION: Healthcare systems must promote the health and well-being of physicians and nurses with evidence-based interventions to improve population health and enhance the quality and safety of the care that is delivered.

Associations Among Nurses' Mental/Physical Health, Lifestyle Behaviors, Shift Length, and Workplace Wellness Support During COVID-19: Important Implications for Health Care Systems.

Work cultures supportive of wellness and shorter shift length have been associated with better mental/physical health outcomes in nurses, but how the coronavirus disease-19 (COVID-19) pandemic impacted such outcomes is not known. This study's aims were to (1) describe the mental/physical health, well-being, and healthy lifestyle behaviors of nurses during the pandemic; (2) explore the pandemic's impact on their health and healthy lifestyle behaviors; and (3) determine the associations of perceived workplace wellness support and shift length with nurses' health, well-being, and healthy lifestyle behaviors. A cross-sectional descriptive design was used with 264 nurses associated with Trusted Health. Nurses completed a survey containing valid and reliable scales measuring depression, anxiety, burnout and quality of life, perceived wellness culture, and healthy lifestyle behaviors. Results indicated that more than 50% of nurses had worsening mental/physical health relating to the pandemic. Compared with nurses whose workplaces provided little/no wellness support, nurses with workplaces that supported their wellness were 3 to 9 times as likely to have better mental/physical health, no/little stress, no burnout, and high quality of life. Nurses who worked longer shifts had poorer health outcomes. These findings indicate that workplace wellness support and shorter shifts positively impacted nurse mental/physical health and professional quality of life amidst the pandemic.

Beliefs, mental health, healthy lifestyle behaviors and coping strategies of college faculty and staff during the COVID-19 pandemic.

Objective: To assess faculty and staff beliefs about returning to campus as well as their mental health and healthy lifestyle behaviors. Participants: Faculty and staff at a large Mid-west public land-grant university. Methods: A survey was emailed to a random sample of faculty and staff (N = 6,000 faculty; N = 6,000 staff). Results: Response rate was 35.6% for faculty (n = 2,138) and 37.8% (n = 2,226) for staff. Participants who were working from home (>60%) had less confidence about returning to campus safely than those who had been working on campus. Eighteen to 27% of faculty and 25%-31% of staff met the cutoff for clinical anxiety and the rates of depression were 4.4%-8.3% and 9.7%-10.0% respectively. Conclusion: Institutions of higher education must build wellness cultures and accelerate access to mental health services, which should be evidence-based and include a focus on promoting and maintaining overall wellness.

A blueprint for nursing innovation centers.

BACKGROUND: The interest in and demand for healthcare innovation has heightened amid the COVID-19 pandemic. Organizations are challenged to balance the goals of daily operations with innovation to stay relevant and compete in the marketplace. Innovation is critical for not only the success and sustainability of organizations, but the well-being of the faculty, staff, and clients they serve. PURPOSE: In this article, we present an overview of several Nursing Innovation Centers in the United States as well as examples of colleges without formal innovation centers but who are addressing innovation in their programs. METHODS: We examined the subjective experience of nursing innovation in seven colleges of nursing using semi-structured intervieweds and thematic analysis. FINDINGS: We discuss four themes for creating an innovation center or innovation focus and six themes important for sustainability and impact. In addition, we provide a working model for these themes and provide lessons learned along with trends and recommendations for the future. DISCUSSION: This information provides guidance and a framework for academic and practice organizations aspiring to create opportunities for innovation to flourish in their institutions. We also encourage leadership to critically evaluate and address biases in faculty hiring, research evaluation, publication practices, educational opportunities and mentoring to overcome the diversity innovation paradox.

Clinician burnout: A mental health 'pandemic within a pandemic'

[...]the best way to thank our nations clinicians is to provide resources and programming that support improved quality of life with the goal of reducing clinician burnout, a critical problem that I call the mental health "pandemic within the pandemic. The Ohio State College of Nursing, Helene Fuld Health Trust National Institute for Evidence-based Practice in Nursing and Healthcare, and Health Policy Institute of Ohio released a comprehensive plan to improve clinician well-being. By improving the working conditions of those clinicians, hospital and health care systems can improve clinician and patient outcomes, as well as cut costs resulting from a higher quality and safety of care with a reduction in preventable medical errors.