Evidence-Based Intervention For Reducing The High Rate Of Nurse Burnout Research Paper

Evidence-Based Intervention For Reducing The High Rate Of Nurse Burnout Research Paper

EBP Guideline/Position Statement Paper

Nurse burnout is a significant clinical challenge facing nurses in the United States, especially during the COVID-19 pandemic. Jaber et al. (2022) reported a dramatic increase in mental health issues among healthcare workers, including stress, anxiety, depression, and burnout during the COVID-19 pandemic. The trend in mental health disorders is associated with a high workload due to increased demand for healthcare services or self-isolation among nurses who have tested positive for the Corona Virus. For this reason, the paper proposes an evidence-based intervention for reducing the high rate of nurse burnout Evidence-Based Intervention For Reducing The High Rate Of Nurse Burnout Research Paper.

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The phenomenon of Interest (POI)

The phenomenon of interest is the high rate of burnout among nurses. The prevalence of nurse burnout has increased dramatically during the COVID-19 pandemic due to the high workload and working hours among nurses. The high burnout rate among the nurses results in adverse events, including medication errors. Additionally, nurse burnout has resulted in high turnover rates among the nurse, leading to nursing staff shortage, which raises nurse to patient ratio, nurses’ workload, and working hours. According to Havaei and MacPhee (2020), high nurses’ workload compromises the quality of patient care, resulting in adverse health outcomes. Hence, the high nurse-to-patient ratio, increased workload, and long working hours contribute to poor-quality care and adverse patient outcomes in the practice area.

Significance of the high Rate of Nurses’ Burnout

The phenomenon of interest is significant to the acute care setting since it proposes interventions for reducing the high rate of nurse burnout. Providing psychological support and counseling will enable the nurses to cope with job-related stress during the COVID-19, preventing burnout. Consequently, the high rate of job turnover among nurses will decrease, reducing nurse to patient ratio, high workload among nurses, and long working hours, which will improve the quality and safety of care, prevent adverse events, optimize health outcomes, and reduce overall healthcare cost in the nursing practice. According to Lee Adler et al. (2018), healthcare organization incurs considerable costs in treating health complications associated with safety issues and medication errors. Hence, preventing safety issues and inpatient harm through appropriate workload among nurses will eliminate extra treatment costs in the acute care setting Evidence-Based Intervention For Reducing The High Rate Of Nurse Burnout Research Paper.

Differences among Process, Structural, and Outcome Measures

Quality indicators are categorized into the process, structural, and outcome. Process measures portray the degree of compliance with actions implemented to attain QI project goals (Lorini et al., 2018). An example of a process measure is administering thrombolytic therapy to a patient within 90 minutes following the onset of clinical symptoms. Outcome measures focus on the patient’s health status. For this reason, outcome measures are considered the most pertinent among the three indicators of quality of care (Lorini et al., 2018). Post-MI 30-day mortality is an example of an outcome measure. Lastly, structural measures portray an organization’s capacity to provide quality care, including processes and systems (Lorini et al., 2018). An example of a structural measure includes cardiac catheterization laboratory availability 24 hours a day. An example of a quality measure related to the high rate of nurses’ burnout is the patient-to–emergency nurse ratio. The type of measure in the provided example is structural since it reflects the organization’s capacity.

The Criteria for P.I.C.O.T. Framework

A PICOT framework provides the basis for resolving the high rate of nurse burnout in the practice setting. It was developed following a review of the existing literature on nurse burnout in various clinical settings. Thus, the PICOT framework was based on the evidence-based interventions presented in the reviewed articles. The proposed PICO framework is as follows.

Population (P): Nurses working in the acute care setting,

Intervention (I): Practicing stress management and accessing mental health resources safeguards,

Comparison (C): Compared to nurses that do not practice stress management or access mental health resources safeguards,

Outcome (O): Influence nurse burnout rates, care, and patient outcomes, and

Time (T): Within 30 days.

Clinical Question

The proposed clinical question is, “Among nurses working in the acute care setting (P), does practicing stress management and accessing mental health resources safeguards (I) compared to nurses that do not practice stress management nor accessing mental health resources safeguards (C) influence nurse burnout rates, care, and patient outcomes (O) within 30 days (T)?”

Critique of Guideline/Position Statement

The primary purpose of the position statement is clearly stated. The position statement was developed in 2019 to evaluate the burnout reporting rate. Hence, the guideline was recently published and is relevant to nurse burnout.
The main objective of preparing the guideline was to evaluate and report issues facing nurse leaders in acute care, including burnout, compassion satisfaction, and secondary trauma.

Highly competent and credible individuals developed the guideline. However, the authors did not receive funds to cater to guideline-related expenses, which were associated with biases in one healthcare system. The authors did not depict a valued interest in nurse burnout.

The information presented in the guideline is highly credible. It was authored by knowledgeable, competent, and experienced individuals. The authors are holders of Ph.D. in nursing and registered nurses assigned leadership roles in their respective clinical settings. Additionally, the authors were guided by the Professional Quality of Life Scale while studying nurse burnout. They also interviewed a co-investigator via the phone to get the required information. The SPSS version 23 was used to analyze data collected during the study.
Based on the John Hopkins Nursing EBP appraisal tool, this guideline’s evidence level is level IV. The authors collected data from 15 sources when conducting their research. They used mixed methods research design in their study. The strength of research that formed the guideline involves collecting data from recent peer-reviewed articles on various nursing-related topics.
The level of evidence of the guideline is level IV, which portrays good quality. This quality encourages the APNs to adopt recommendations proposed in the guideline to resolve nurse burnout, which is a significant challenge in clinical practice. On the contrary, the APNs would not adopt the recommended guidelines to prevent nurse burnout in their clinical practice if the quality of the personal statement was low Evidence-Based Intervention For Reducing The High Rate Of Nurse Burnout Research Paper.

The Impact of the Guideline on the Quality of Care

The guideline was primarily developed to provide nurse leaders and APNs with recommendations for resolving nurse burnout. According to Dall’Ora et al. (2020), nurse burnout is associated with reduced job performance, poor patient safety and quality of care, adverse events, and negative patient outcomes. The nurse leader would use recommendations proposed in the guideline to prevent nurse burnout and improve nurses’ job performance and motivation, which will result in high-quality healthcare services and positive health outcomes.

Additionally, preventing nurse burnout and improving the quality of care will contribute to adherence to ethical principles during care delivery. The first ethical principle is beneficence. This ethical guideline states that healthcare providers should focus on doing good to their patients. By providing high-quality care, nurses will be doing good for their patients. Another ethical principle influenced by preventing nurse burnout is nonmaleficence. The ethical principle of nonmaleficence holds that healthcare providers should harm their patients intentionally. Using the guideline to prevent burnout among nurses will prevent harm and safety issues that might occur when a nurse is experiencing burnout.

Conclusion

Burnout is a significant challenge facing registered nurses in their respective clinical settings. It compromises nurses’ job performance, resulting in poor quality care and adverse patient outcomes. Safeguards should adopt evidence-based interventions, mainly practicing stress management and accessing mental health resources, to prevent burnout among nurses in the acute care setting. Additionally, nurse leaders should adhere to the recommendations proposed in the guideline to resolve nurse burnout, which will improve the quality of care in their respective clinical settings.

References

Dall’Ora, C., Ball, J., Reinius, M., & Griffiths, P. (2020). Burnout in nursing: a theoretical review. Human Resources for Health, 18(1), 1-17. https://human-resources-health.biomedcentral.com/articles/10.1186/s12960-020-00469-9

Havaei, F., & MacPhee, M. (2020). The impact of heavy nurse workload and patient/family complaints on workplace violence: An application of human factors framework. Nursing Open, 7(3), 731-741. https://doi.org/10.1002/nop2.444

Jaber, M. J., AlBashaireh, A. M., AlShatarat, M. H., Alqudah, O. M., Du Preez, S. E., AlGhamdi, K. S., … & Abo Dawass, M. A. (2022). Stress, Depression, Anxiety, and Burnout among Healthcare Workers during the COVID-19 Pandemic: A Cross-sectional Study in a Tertiary Centre. The Open Nursing Journal, 16(1). DOI: 10.2174/18744346-v16-e2203140.

Lee Adler, D. Y., Li, M., McBroom, B., Hauck, L., Sammer, C., Jones, C., … & Classen, D. (2018). Impact of inpatient harms on hospital finances and patient clinical outcomes. Journal of patient safety, 14(2), 67. Doi: 10.1097/PTS.0000000000000171

Lorini, C., Porchia, B. R., Pieralli, F., & Bonaccorsi, G. (2018). Process, structural, and outcome quality indicators of nutritional care in nursing homes: a systematic review. BMC health services research, 18(1), 1-14. https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-018-2828-0

EBP Guideline/Position Statement Paper

The phenomenon of Interest (POI)

Significance of the high Rate of Nurses’ Burnout

Differences among Process, Structural, and Outcome Measures

The Criteria for P.I.C.O.T. Framework

Population (P): Nurses working in the acute care setting,

Intervention (I): Practicing stress management and accessing mental health resources safeguards,

Comparison (C): Compared to nurses that do not practice stress management or access mental health resources safeguards,

Outcome (O): Influence nurse burnout rates, care, and patient outcomes, and

Time (T): Within 30 days.

Clinical Question

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Critique of Guideline/Position Statement

The primary purpose of the position statement is clearly stated. The position statement was developed in 2019 to evaluate the burnout reporting rate. Hence, the guideline was recently published and is relevant to nurse burnout.
The main objective of preparing the guideline was to evaluate and report issues facing nurse leaders in acute care, including burnout, compassion satisfaction, and secondary trauma.

Highly competent and credible individuals developed the guideline. However, the authors did not receive funds to cater to guideline-related expenses, which were associated with biases in one healthcare system. The authors did not depict a valued interest in nurse burnout.

The information presented in the guideline is highly credible. It was authored by knowledgeable, competent, and experienced individuals. The authors are holders of Ph.D. in nursing and registered nurses assigned leadership roles in their respective clinical settings. Additionally, the authors were guided by the Professional Quality of Life Scale while studying nurse burnout. They also interviewed a co-investigator via the phone to get the required information. The SPSS version 23 was used to analyze data collected during the study.
Based on the John Hopkins Nursing EBP appraisal tool, this guideline’s evidence level is level IV. The authors collected data from 15 sources when conducting their research. They used mixed methods research design in their study. The strength of research that formed the guideline involves collecting data from recent peer-reviewed articles on various nursing-related topics.
The level of evidence of the guideline is level IV, which portrays good quality. This quality encourages the APNs to adopt recommendations proposed in the guideline to resolve nurse burnout, which is a significant challenge in clinical practice. On the contrary, the APNs would not adopt the recommended guidelines to prevent nurse burnout in their clinical practice if the quality of the personal statement was low Evidence-Based Intervention For Reducing The High Rate Of Nurse Burnout Research Paper.

The Impact of the Guideline on the Quality of Care

Conclusion

References

PICOT Question Paper

To provide higher quality, safe, and efficient patient care, healthcare facilities should be aware of the effects of nurse burnout and help implement safeguards in the critical care setting to ensure their nurses’ mental health is supported and that resources are offered and available to aid in reducing nurse burnout. To begin this process, both the nurse leadership and staff need to be aware of nurse burnout’s current effects on quality of care and care practice outcomes from both a facility and community standpoint. Once leadership and staff are educated on the importance of reducing or eliminating nurse burnout and resources are implemented like a stress management education practice and mental health support availability, nurse burnout safeguards are in place, that is leadership and facility supported, can promote a healthy work environment.

PICOT Statement

Nurses that work in the acute care setting (P), who practice stress management practices and have mental health resources safeguards in place (I) compared to nurses that do not (C) influence nurse burnout rates, care, and patient outcomes (O) over a 30-day period (T).

Evidence Based Solution

Now more than ever, due to the pandemic, nurse burnout is growing at an alarming rate. Nurse burnout is defined as “a syndrome that causes physical and emotional exhaustion, depersonalization, feeling of failure, reduction in the power of adaptation to stressors, negative attitude towards job, and low self-efficacy” (Aryankhesal et al., 2019). Critical care nurses are exposed to a higher volume of critically ill or injured patients, which requires extensive labor and mental exhaustion, making them amongst the highest population of nurses predisposed to burnout (Aryankhesal et al., 2019). Healthcare facilities and Critical Care Units (CCU) offer little to no education and resources for nursing mental health and stress management practices (Higgins et al., 2020). Therefore, there is a substantial potential for a higher rate of nurse burnout, nurse staff turnover, and poor patient care and outcomes. Implementing an educational program, including providing resources within healthcare facilities such as stress management practices and mental health safeguard resources like group therapy or post-care debriefings, as well as implementing a limit on overtime hours allowed, and ensuring nurses receive their 30 min lunch break daily, would all help to promote mental health wellbeing, workplace satisfaction, in return, reduce or eliminate nurse burnout while improving patient care and outcomes (Kelly et al., 2021).

Nursing Intervention

Errors and adverse events can occur as a result of nurses who have symptoms of burnout. The increasing number of nurses experiencing burnout has led to high nurse turnover rates, leading to lack of staff and poor nurse to staff ratios, causing patients to experience more prolonged hospital admissions, poor care, and outcomes. Medical errors, more prolonged hospital admissions, and staff training cost healthcare facilities millions of dollars every year (Shah et al., 2021). Additionally, these healthcare costs increase, which forces an increase in insurance premiums across the board (Shah et al., 2021). Therefore, nurses practicing stress management practices and who receive adequate resources to ensure mental health wellbeing and a positive work environment are more likely to provide safer, efficient, and higher quality care.

Patient Care

Nurses are accountable for patient safety and wellbeing throughout their hospital admission. Effective, safe quality care and communication are essential when considering both patients’ and their families’ satisfaction. It is evident to a patient when a nurse is stressed, overwhelmed, or has an unfulfilled demeanor, resulting in patient dissatisfaction, mistrust of the nurse-patient relationship, and medical errors (Melnyk, 2020). Moreover, improved nurse demeanor from stress management practices and resources that promote nurse workplace satisfaction and mental wellbeing will increase patient and family trust, safety, and satisfaction and reduce the incidence of error and poor patient outcomes (Melnyk, 2020).

Health Care Agency

Currently, there are no resources, education, or policy that ensures or dictates that nurses are provided mental health support and safeguards to prevent nurse burnout. The CCU nurses and leadership have been informed about the lack of resources and safeguards, and leadership has been pushing to implement these actions and resources. Some staff has been hesitant to these changes, like limiting overtime and practicing meditating and other mindfulness practices. If safeguards, like guaranteed 30-minute undisturbed lunch breaks, were supported and workplace satisfaction improved in others with evidence-based practice-supported information, some staff members may be persuaded.

Nursing Practice

Implementing these stress management practices is a significant conquest, primarily due to the time required from nursing staff and leadership. When a new policy, procedure, or intervention has not been present for an extended period, it is difficult to get a conglomerate to change its ways. Leadership will need to follow up and be regularly active in monitoring staff morale and utilization of resources and supporting the implementation of safeguards to ensure nurses do not experience burnout or help those experiencing burnout. They will encourage them to utilize stress management practices and resources available to them. Once these practices are in place, it can help reduce or prevent nurse burnout and promote a healthy work environment Evidence-Based Intervention For Reducing The High Rate Of Nurse Burnout Research Paper.

References

Aryankhesal, A., Mohammadibakhsh, R., Hamidi, Y., Alidoost, S., Behzadifar, M., Sohrabi, R., & Farhadi, Z. (2019). Interventions on reducing burnout in physicians and nurses: A systematic review. Medical Journal of The Islamic Republic of Iran. https://doi.org/10.47176/mjiri.33.77

Higgins, J. T., Okoli, C., Otachi, J., Lawrence, J., Bryant, E. D., Lykins, A., & Seng, S. (2020). Factors associated with burnout in trauma nurses. Journal of Trauma Nursing, 27(6), 319–326. https://doi.org/10.1097/jtn.0000000000000538

Kelly, L. A., Gee, P. M., & Butler, R. J. (2021). Impact of nurse burnout on organizational and position turnover. Nursing Outlook, 69(1), 96–102. https://doi.org/10.1016/j.outlook.2020.06.008

Melnyk, B. (2020). Burnout, depression and suicide in nurses/clinicians and learners: An urgent call for action to enhance professional well‐being and healthcare safety. Worldviews on Evidence-Based Nursing, 17(1), 2–5. https://doi.org/10.1111/wvn.12416

Redelmeier, D. A., Najeeb, U., & Etchells, E. E. (2021). Understanding patient personality in medical care: Five-factor model. Journal of General Internal Medicine. https://doi.org/10.1007/s11606-021-06598-8

Shah, M. K., Gandrakota, N., Cimiotti, J. P., Ghose, N., Moore, M., & Ali, M. K. (2021). Prevalence of and factors associated with nurse burnout in the us. JAMA Network Open, 4(2), e2036469. https://doi.org/10.1001/jamanetworkopen.2020.36469 Evidence-Based Intervention For Reducing The High Rate Of Nurse Burnout Research Paper