• Jean Anne Connor, Sonja I Ziniel, Courtney Porter, Dennis Doherty, Marilyn Moonan, Patricia Dwyer, Laura Wood, and Patricia A Hickey.
• Jean Anne Connor is director of nursing research, cardiovascular and critical care patient services, Boston Children's Hospital, and a clinical instructor of pediatrics, Harvard Medical School, Boston, Massachusetts. Sonja I. Ziniel is an assistant research professor, Section of Pediatric Hospital Medicine, Department of Pediatrics, University of Colorado School of Medicine, Aurora, and senior survey methodologist, quality and patient safety, Children's Hospital Colorado, Aurora. Courtney Porter is a program administration manager, cardiovascular and critical care patient services, Dennis Doherty is a professional development specialist, clinical education and informatics, Marilyn Moonan is a professional development specialist, nursing patient services, Patricia Dwyer is a nurse scientist, satellite services, and Laura Wood is senior vice president, patient care operations, and chief nursing officer, Boston Children's Hospital. Patricia A. Hickey is vice president and associate chief nursing officer, cardiovascular and critical care patient services, Boston Children's Hospital, and an assistant professor of pediatrics, Harvard Medical School. Jean.Connor@childrens.harvard.edu.
• Am. J. Crit. Care. 2018 Sep 1; 27 (5): 363-371.

BackgroundHealth care work environments affect patient outcomes, staff satisfaction and retention, and organizational financial viability. The American Association of Critical-Care Nurses (AACN) Healthy Work Environment Assessment Tool (HWEAT) is a resource for patient care units and organizations to assess the work environment and track progress on their journey to excellence.ObjectiveTo validate interprofessional use of the AACN HWEAT across a large free-standing children's hospital.MethodsThe AACN HWEAT was administered to staff members across professional categories. Responses were averaged to achieve an overall score and a score for each standard included in the instrument. Nurses' and physicians' scores were further stratified. Test-retest reliability and internal consistency were assessed. Construct validity was measured by correlating the AACN HWEAT and the Agency for Healthcare Research and Quality (AHRQ) Hospital Survey on Patient Safety Culture (H-SOPS).ResultsOf 2621 AACN HWEAT surveys, 1030 (39.3%) were returned for review. The organization-wide HWEAT mean overall score was 3.58 (3.87 for physicians vs 3.54 for nurses, P= .02). Test-retest reliability was indicated by Spearman correlation coefficients of 0.50 to 0.68. Internal consistency was shown by a Cronbach α of 0.77 overall (range for standards, 0.77-0.81). Convergent validity between AACN HWEAT standards and AHRQ H-SOPS items was shown by correlation coefficients of 0.30 to 0.52.ConclusionThe AACN HWEAT was both reliable and valid, supporting its interprofessional use as an organizational measure. Active evaluation of health care environments is critical to achieving optimal patient outcomes.©2018 American Association of Critical-Care Nurses.

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