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Healthy work environments and HAIs.

• The AACN Standards for Establishing and Sustaining Healthy Work Environments and a Web-based assessment tool are available at www.aacn.org/WD/HWE/Docs /HWEStandards.pdf and www.aacn.org/hwe. • The Agency for Healthcare Research and Quality’s Team Stepps – a teamwork system designed for health care professionals at www.teamstepps.ahrq.gov. • The Agency for Healthcare Research and Quality’s Web page, Using a Comprehensive Unit-based Safety Program to Prevent Healthcare-Associated Infections (CUSP), available at www.ahrq.gov/qual/cusp.htm. Critically ill patients are susceptible to health care–associated infections (HAIs) because of their illnesses and the need for intravenous access and invasive monitoring. In addition, the complex critical care health care environment requires strong interprofessional collaboration, expert communication, and authentic leadership. These strong team skills enable and sustain the collective decisionmaking process to identify and implement evidencebased interventions that eliminate HAIs. Kelly and colleagues found that nurses working in a more favorable work environment reported a lower incidence of HAIs. They used the Practice Environment Scale of the Nursing Work Index tool to evaluate the units involved in the study. They found that the areas with the highest scores were in the nursing foundations for quality of care and the collegial nurse-physician relationships. The lowest scores were related to nurse participation in hospital affairs, and staffing and resource adequacy. Nurse manager ability, leadership, and support scored low as well. Focusing on these areas is likely to result in a healthier work environment and more successful prevention of HAIs.