Dawn Giardina

Date of Award


Document Type


Degree Name

Master of Science in Nursing (MSN)



Thesis Committee Chairperson

Diane Ryan, PhD, ANP-BC, FNP-BC, GNP-BC, CNE


Using action research, this study was conducted to identify perceived barriers and facilitators to a healthy work environment at the Buffalo Veterans Administration Medical Campus. John Kotter’s (1996) eight step process was the theoretical framework used to guide this research. A single focus group comprised of 6 licensed nurses was solicited for semi-structured interview on issues pertaining to barriers and facilitators to a healthy work environment. Following the focus group, content analysis was completed on the data collected. Three facilitators: (1) teamwork, (2) availability of supplies/equipment and (3) start of a meaningful recognition program, as well as, seven barriers: (1) inadequate staffing, (2) insufficient educational directives, (3) lack of established communication/collaboration, (4) unsafe/inefficient physical work design, (5) ineffective leadership, (6) lack of individual and organizational accountability, and (7) meaningful recognition were identified. Based on content analysis, suggestions from the study participants and a return to the literature, an action plan was developed and presented to BVAMC nursing leadership to improve the health of the work environment.