Abstract

Background: A 2023 Premiere Inc. survey reported that greater than 40% of US healthcare professionals have experienced at least one episode of workplace violence during the past two years. Confounding issues position healthcare professionals at increased risk for experiencing daily stress inducing situations including but not limited to: staffing related deficiencies, increased incidences of workplace violence, and increased risk for secondary victim incidents that perpetuate wounded healers. Despite increases in stress inducing situations, current stress mitigating interventions remain reactive, antiquated, and fail to meet the emotional needs of healthcare professionals. Current stress and critical incident management models provide reactive support post-critical incident, placing healthcare workers at increased risk for stress related injury, moral distress, and professional burnout.

Clinical Question: P: In acute care healthcare professionals I: Evidence-based strategies to proactively reduce stress and promote well-being C: Traditional post critical incidence stress management interventions O: healthcare worker stress levels, levels of well-being, staff retention.

Literature Review and Analysis of Best Evidence: A thorough review and appraisal of current evidence identified three best practice models aimed to support healthcare professionals that experience a stress inducing event. Current evidence failed to identify comprehensive/proactive stress management models. This deficit of proactive stress management models prompted the inception of an innovative intervention combining salient concepts from the successful evidence-based stress management models including: Stress First Aid (SFA), Critical Incident Stress Management (CISM), and Animal Assisted Workplace Wellbeing (AAWW). The integration of these evidence-based models resulted in a comprehensive stress management peer support model that provides daily stress management while promoting sustainable levels of well-being for healthcare professionals.

Integration into Practice: Employing the SFA stress continuum to assess daily stress levels of healthcare professionals enables healthcare leaders to provide targeted, proactive interventions promoting health and well-being while simultaneously mitigating stress and preventing progression to stress illness and related sequela. In conjunction with the SFA stress continuum, a combination of the Critical Incident Stress Management defusing/debriefing and the Animal Assisted Workplace Wellbeing models, provide proactive stress management support in a routine and ad hoc manners. This innovative approach provides healthcare professionals daily access to stress mitigating interventions prompting emotional well-being. Additionally this model allows healthcare professionals to develop relationships with peer supporters and crisis response canines under normal circumstances. Relationships forged during wellness rounds serve to promote the effectiveness of post incident stress response efforts. This evidence-based model allows healthcare professionals to receive support from CISM/AAWW peers they met through wellness rounding opposed to receiving emotional support from peers that are strangers during times when their emotions and vulnerability are peaked.

Evaluation of Evidence-Based Practice Initiative: Incremental implementation of this innovative model was initiated within three urban university healthcare organizations. Initial observational outcomes suggest intervention success. Current efforts include developing an application to automate the SFA continuum to better track and trend daily stress levels of units and individuals. This application will provide robust and timely outcomes data enabling further development and dissemination to maximize the model’s reach and effectiveness.

Notes

Reference list included in attached slide deck.

Description

As workplace violence episodes surge and our nursing workforce continues to diminish, implementing a proactive approach to stress management is a vital imperative. A collaborative innovation pioneered a proactive stress management model that aligns key components from three impactful crisis response interventions, creating a successful approach to daily stress management.

Author Details

Shannon Patel DNP,NEA-BC,CPHQ - Post-Doc Fellow Helene Fuld Health Trust National Institute for Evidence-based Practice in Nursing and Healthcare The Ohio State University;

John Hunt MA, CHEC, CCISM Chief Operating Officer, Crisis Response Canines; 

Mary Law MSN,RN,CCISM Health Care Liaison, Crisis Response Canines

Sigma Membership

Eta Mu

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Other

Research Approach

Translational Research/Evidence-based Practice

Keywords:

Stress, Occupational -- Prevention and Control, Stress Management, Critical Incident Stress, Animal-Assisted Therapy

Conference Name

Creating Healthy Work Environments

Conference Host

Sigma Theta Tau International

Conference Location

Washington, DC, USA

Conference Year

2024

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Date of Issue

2026-02-23

Click on the above link to access the slide deck.

Share

COinS
 

Leveraging Best Practice Initiatives to Develop an Innovative and Proactive Approach to Stress Management

Washington, DC, USA

Background: A 2023 Premiere Inc. survey reported that greater than 40% of US healthcare professionals have experienced at least one episode of workplace violence during the past two years. Confounding issues position healthcare professionals at increased risk for experiencing daily stress inducing situations including but not limited to: staffing related deficiencies, increased incidences of workplace violence, and increased risk for secondary victim incidents that perpetuate wounded healers. Despite increases in stress inducing situations, current stress mitigating interventions remain reactive, antiquated, and fail to meet the emotional needs of healthcare professionals. Current stress and critical incident management models provide reactive support post-critical incident, placing healthcare workers at increased risk for stress related injury, moral distress, and professional burnout.

Clinical Question: P: In acute care healthcare professionals I: Evidence-based strategies to proactively reduce stress and promote well-being C: Traditional post critical incidence stress management interventions O: healthcare worker stress levels, levels of well-being, staff retention.

Literature Review and Analysis of Best Evidence: A thorough review and appraisal of current evidence identified three best practice models aimed to support healthcare professionals that experience a stress inducing event. Current evidence failed to identify comprehensive/proactive stress management models. This deficit of proactive stress management models prompted the inception of an innovative intervention combining salient concepts from the successful evidence-based stress management models including: Stress First Aid (SFA), Critical Incident Stress Management (CISM), and Animal Assisted Workplace Wellbeing (AAWW). The integration of these evidence-based models resulted in a comprehensive stress management peer support model that provides daily stress management while promoting sustainable levels of well-being for healthcare professionals.

Integration into Practice: Employing the SFA stress continuum to assess daily stress levels of healthcare professionals enables healthcare leaders to provide targeted, proactive interventions promoting health and well-being while simultaneously mitigating stress and preventing progression to stress illness and related sequela. In conjunction with the SFA stress continuum, a combination of the Critical Incident Stress Management defusing/debriefing and the Animal Assisted Workplace Wellbeing models, provide proactive stress management support in a routine and ad hoc manners. This innovative approach provides healthcare professionals daily access to stress mitigating interventions prompting emotional well-being. Additionally this model allows healthcare professionals to develop relationships with peer supporters and crisis response canines under normal circumstances. Relationships forged during wellness rounds serve to promote the effectiveness of post incident stress response efforts. This evidence-based model allows healthcare professionals to receive support from CISM/AAWW peers they met through wellness rounding opposed to receiving emotional support from peers that are strangers during times when their emotions and vulnerability are peaked.

Evaluation of Evidence-Based Practice Initiative: Incremental implementation of this innovative model was initiated within three urban university healthcare organizations. Initial observational outcomes suggest intervention success. Current efforts include developing an application to automate the SFA continuum to better track and trend daily stress levels of units and individuals. This application will provide robust and timely outcomes data enabling further development and dissemination to maximize the model’s reach and effectiveness.