Building nurse resilience in the workplace.

AIMS: The aims of the study were 1) to replicate the research based on the pilot study; 2) to increase resilience in nurses working on all units at four hospitals and 3) to determine which interventions were preferred and most effective. BACKGROUND: Work stress mediates resilience and resilience moderates work stress. Resilience building activities in the literature are often time consuming, complex and done outside work hours. This study investigated use of portable, accessible and brief interventions by nurses to decrease stress and increase resilience during work hours. METHODS: This study used a cross sectional, longitudinal, repeated measures survey design. The study took place in October 2018 to January 2019. Toolkits included written instructions for completing the study protocol, and six activities. Nurses completed surveys at baseline, at 10 time points over a four- to six-week period, and at study conclusion. RESULTS: Connor-Davidson Resilience Scale-10 instrument scores showed resilience increased significantly at four weeks and the effect continued at three months (p < .02). Self-reported stress levels decreased over the study period and nurses self-selected to continue use of the interventions. CONCLUSION: The interventions used during work hours decreased self-reported stress and increased resilience. Nurse leaders may easily adopt these options to promote a less stressed workforce. Resilience can increase the ability of nurses to tolerate high stress in the workplace, which may decrease burnout and turnover. In the pandemic, resilience is even more important as hospitals struggle to retain nurses.

Exploring Strategies to Build Resiliency in Nurses During Work Hours.

OBJECTIVE: This pilot study investigated increasing nurse resiliency utilizing a toolkit of stress-reducing interventions on medical-surgical units at 4 hospitals. BACKGROUND: Resiliency-building activities are time consuming and undertaken outside work hours. Although the activities show a positive impact on resilience, researchers investigated whether similar results could be achieved where nurses experience work stress. METHODS: This quasi-experimental pretest and posttest interventional study used a within-subjects design. Provided toolkits included written instructions to carry out the study. Nurses completed surveys at baseline, at 10 time points over a 6-week period, and at study conclusion. RESULTS: The Connor-Davidson Resilience Scale-10 scores increased significantly at follow-up (P < .02). Self-reported stress levels decreased over the 10 shifts with continued use of the interventions. CONCLUSION: Using stress-reducing interventions during work decreased stress and increased resiliency, thereby offering nurse leaders additional options to promote a healthy workforce at the bedside.

Operational Failures Detected by Frontline Acute Care Nurses.

Frontline nurses encounter operational failures (OFs), or breakdowns in system processes, that hinder care, erode quality, and threaten patient safety. Previous research has relied on external observers to identify OFs; nurses have been passive participants in the identification of system failures that impede their ability to deliver safe and effective care. To better understand frontline nurses' direct experiences with OFs in hospitals, we conducted a multi-site study within a national research network to describe the rate and categories of OFs detected by nurses as they provided direct patient care. Data were collected by 774 nurses working in 67 adult and pediatric medical-surgical units in 23 hospitals. Nurses systematically recorded data about OFs encountered during 10 work shifts over a 20-day period. In total, nurses reported 27,298 OFs over 4,497 shifts, a rate of 6.07 OFs per shift. The highest rate of failures occurred in the category of Equipment/Supplies, and the lowest rate occurred in the category of Physical Unit/Layout. No differences in OF rate were detected based on hospital size, teaching status, or unit type. Given the scale of this study, we conclude that OFs are frequent and varied across system processes, and that organizations may readily obtain crucial information about OFs from frontline nurses. Nurses' detection of OFs could provide organizations with rich, real-time information about system operations to improve organizational reliability. © 2017 Wiley Periodicals, Inc.