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  1. Heath, Janie MS, APRN, BC-ANP, ACNP
  2. Johanson, Wanda MN, RN
  3. Blake, Nancy MN, RN, CCRN, CNAA


Nursing leaders are under intense pressure to ensure that safety and quality exist at every point of service. Landmark reports set forth many calls to action to transform systems and processes of care to improve healthcare delivery. Evidence indicates that healthy work environments (HWEs) are at the heart of the solutions to significantly affect patient outcomes and professional nursing practice. Findings from an HWEs literature review and focus groups indicate that nursing leaders must prioritize efforts to improve the culture in the work environment. Three elements emerged to help nursing leaders set the tone and standard of practice for HWEs: (1) effective communication, (2) collaborative relationships, and (3) promoting decision making among nurses.