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Publication Date



2021 prov rn or; 2021 prov rn poster; oregon; portland; psvmc




Background: With the appearance of the COVID-19 pandemic, nurse emotional well-being has suffered, with burnout being highly reported. Team resilience may mitigate feelings of burnout, and is defined as homeostasis among the healthcare team while experiencing continuous change. Strategies for enhancing resilience of individuals are prevalent, yet nurses often deliver care in a team setting. While some literature offers insight on nurse team resilience, no valid and reliable tools currently exist to measure this concept. Purpose: To develop and pilot test a tool to measure team resilience among nurses delivering direct patient care in an acute care hospital in the Pacific Northwest. Methods: Nurse leaders and direct patient caregivers at one large, urban hospital partnered to conduct a comprehensive review of the literature to develop a team resilience questionnaire. Using concepts from Gesalt theory, action change methodology, and incorporating components of the health care environment, the final tool consists of five domains. They are: 1) maintenance, defined as planned, scheduled cycles of process improvement; 2) community, defined as spirit of collaboration and engagement; 3) atmosphere, defined as department culture and behaviors; 4) structure, defined as shared views of workflow, expectations, roles and accountability; and 5) foundation, defined as behaviors and attitudes that underpin the unit. Each domain is measured with six questions (30 questions total) measured on a Likert like scale ranging from Never (0) to Always (4). Raw scores are summed to calculate a total for each domain (possible range: 0-24) and cumulatively for all domains (possible range 0-120). Higher scores indicate greater team resilience. To evaluate acceptability and feasibility of the assessment tool, a small pilot test was conducted on nurses working on a 20-bed post-anesthesia unit (PACU) from November 2019 to November 2020. Results: Twenty-four PACU nurses completed the initial assessment. At repeat assessments three, six, and nine months later, a total of nine, 17, and seven nurses participated, respectively. Responses analyzed using Chronbach’s Alpha supporting an internal reliability greater than 0.66 for each cycle. Informal assessments of nurses who completed our questionnaire revealed that they felt it provided them with a structure to work together as a team to address departmental concerns and that using it helped them achieve their goals. Discussion: A total of 24 nurses responded to our questionnaire and over a one-year span, between 29 and 71 percent of this cohort participated in repeat assessments. Next steps include administration of the tool among nurses across multiple specialties in the hospital to increase the sample size for validity and reliability testing. Implications: With rapid changes in healthcare, processes for assessing and supporting resilience among nurses delivering direct patient care in a team setting are necessary to support nurse emotional well-being and prevent negative outcomes such as turnover. Structured, validated tools such as the one developed by our project team may help measure and improve team resilience over time.



Conference / Event Name

2021 Providence RN Conference


Virtual Conference

Pilot Testing a Novel Tool to Assess Resilience among Nurses Delivering Direct Patient Care in Teams in the Hospital Setting

Included in

Nursing Commons