Date of Award

January 2023

Document Type


Degree Name

Doctor of Nursing Practice (DNP)


Yale University School of Nursing

First Advisor

Joan Kearney

Second Advisor

David Vlahov


The COVID-19 pandemic has exacerbated chronic stress environments across health care organizations across the United States. Organizational support that promotes psychological safety is associated with decreased levels of anxiety related to the COVID-19 pandemic. Psychological safety is especially important in healthcare environments, where employee and patient safety are crucial. Chronic stress and burnout, evidenced by high levels of emotional exhaustion, role conflict, and role overload, is shown to be negatively correlated to organizational commitment and increased nurse leader turnover. Organizational stress is estimated to cost more than $500 billion dollars and 550 million workdays each year in the United States. High turnover rates and projected shortages among nurse leaders is a significant problem for healthcare organizations across the United States. This DNP project utilized Lewin’s Change Management Theory to develop an educational program for nurse leaders to enhance psychological safety and wellbeing of teams during chronic organizational stress. The educational program involved a 1-hour, live, virtual training session focused on developing skills to enhance psychological safety on a team. There were 29 participants in the training program, participants were all health care leaders within a large urban health care system and were involved in quality improvement initiatives and the safety event process. Following the program, the participants demonstrated knowledge acquisition with an overall mean score of 88% (n=20). Overall, participants were very likely to utilize the concepts learned in the program (90%) and recommend to colleagues (95%). This project highlights the benefits of health care organizations to incorporate psychological safety education into nurse leader and Culture of Safety training.


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