Safe Practice Environments: Nurses' Perceptions of Stressors and Solutions

Abstract

Purpose: Nursing units include teams working to provide safe patient care. Without true partnerships, care is compromised due to decreased quality in communication and teamwork. Stressors impact the nursing practice environment and compromise safe practice. Identification of skills and behaviors that facilitate effective teamwork and foster safe practice environments will be enhanced by determining those stressors. Research questions are: a. What are nurses' perceptions of stressors that affect nursing practice on an intensive care unit? b. What are nurses' perceptions of behaviors that facilitate safety in the nursing practice environment of an intensive care unit? Methods: Setting for this qualitative descriptive study was a 26 bed ICU of a hospital in a small town in a southern state. Data was obtained from 8 focus groups of 6-8 nurses each. Interview questions focused on challenging disruptive factors, coping with difficult situations, communication and teamwork, and ways enhance safe practice. Transcripts were analyzed for themes that represent perceptions of stressors affecting nursing practice and perceptions of behaviors facilitating safety in the nursing practice environment. Data were reviewed the researchers independently. A primary limitation is the use of one unit in one hospital for the study. Results: Stressors were identified in areas of leadership, staff support / communication, critical thinking, resources, and nursing practice environment. Behaviors to facilitate safe practice were identified, and included administrator, nurse, and physician behaviors, as well as environmental factors. Conclusion: The results of this study identified interpersonal and environmental stressors that impact safe nursing practice in this ICU. Safety is a priority concern in our health care system, and this research will provide guidelines for facilitating the development of specific skills and behaviors to promote safety in the nursing practice environment.