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Healthy Work Environments and Staff Nurse Retention: The Relationship Between Communication, Collaboration, and Leadership in the Pediatric Intensive Care Unit

Blake, Nancy PhD, RN; Leach, Linda Searle PhD, RN; Robbins, Wendy PhD, RN; Pike, Nancy PhD, RN; Needleman, Jack PhD

doi: 10.1097/NAQ.0b013e3182a2fa47
Original Articles

Background: A healthy work environment can improve patient outcomes and registered nurse (RN) turnover. Creating cultures of retention and fostering healthy work environments are 2 major challenges facing nurse leaders today.

Specific aims: Examine the effects of the healthy work environment (communication, collaboration, and leadership) on RN turnover from data collected from a research study.

Methods: Descriptive, cross-sectional, correlational design. Pediatric critical care RNs from 10 pediatric intensive care units (PICU) completed the Practice Environment Scale of the Nursing Work Index Revised and a subscale of the Intensive Care Unit Nurse-Physician Communication Questionnaire. These staff nurses were asked whether they intend to leave their current job in the next 6 months. Statistical analysis included correlations, multiple linear regression, t tests (2-tailed), and 1-way analysis of variance.

Results: A total of 415 RNs completed the survey. There was a statistically significant relationship between leadership and the intent to leave (P < .05). There was also an inverse relationship between years of experience and intent to leave. None of the communication variables between RNs and among RNs and MDs or collaboration were significantly associated with PICU nurses' intention to leave.

Conclusion: Effective leadership in the PICU is important to PICU RNs and significantly influences their decisions about staying in their current job.

Critical Care Services, Children's Hospital Los Angeles, Valencia, California (Dr Blake); and UCLA School of Nursing (Drs Leach, Robbins, and Pike) and UCLA Fielding School of Public Health (Dr Needleman), Los Angeles, California.

Correspondence: Nancy Blake, PhD, RN, Critical Care Services, Children's Hospital Los Angeles, 25720 Oak Leaf Court, Valencia, CA 91381 (

No funding received from any of the listed sources.

The authors declare no conflict of interest.

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