The purpose of this proposal is to describe the main parts of the quality improvement project that is oriented to improving nurses’ practice, performance, and the quality of care while using effective stress management strategies to address possible burnout. The problem statement is presented in the proposal with a focus on potential outcomes of non-resolving the issue. The discussion of the problem, as well as the analysis of possible ways to address it, is supported by the review of the recent literature on the topic. To implement the project, it is necessary to focus on integrating the intervention into a working process of the selected facility and analyze the pre- and post-intervention data. A detailed discussion of the findings is required to make certain recommendations for nurses.
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EBP Quality Improvement Project Proposal
The number of nurses who experience stress associated with their working environments is very high (Khamisa, Oldenburg, Peltzer, & Ilic, 2015). Triggers of stress can include particular aspects of nursing practice, communication with patients, and the necessity of making decisions in problematic cases among other factors (Sarafis et al., 2016).
As a result, occupational stress often leads to nurses’ burnout, and it can be characterized by low concentration levels, low productivity, and general decreases in performance (Laschinger & Fida, 2014). Those nurses who experience emotional pressure and report stress are inclined to demonstrate the decreased quality of care. The purpose of this proposal is to discuss the problem identified for the quality improvement project, present a review of the recent literature on the issue, describe methods which will be used to implement the change, discuss methods to analyze changes in the quality of care, and predict potential outcomes.
While analyzing the situation in nurses’ workplaces, it is possible to identify the following problem: in spite of experiencing occupational stress on a daily basis, many nurses do not know how to cope with this challenge, and their burnout potentially leads to negative changes in their productivity, performance, and quality of care, resulting in adverse effects on patients’ outcomes.
If nurses cannot manage their stress, and organizations do not support nurses in their attempts to overcome the pressure and avoid burnout, it is possible to expect high turnover levels and significant decreases in the quality of the provided care (Laschinger & Fida, 2014; Mohamed, 2016). In order to guarantee that nurses are able to cope with stress and deliver high-quality care, it is important to educate them regarding the use of specific stress management techniques which are effective to reduce burnout, resulting in improved patients’ experiences and outcomes.
Review of Literature
To find scholarly articles that present the results of studies on the problem of nurses’ burnout and the use of stress management strategies, it was important to search such databases as PubMed, ScienceDirect, ProQuest, and EBSCOHost. The review of the retrieved articles indicates that studies can be divided into those which describe how nurses’ stress and burnout influence the quality of their care and those which explain how the use of stress management strategies can influence nurses’ performance.
According to Khamisa et al. (2015), many nurses experience fatigue in their workplace, and the quality of their care decreases because nurses do not realize how they can face everyday challenges without being exhausted. Moreover, Laschinger and Fida (2014) claimed in their research that nurses can experience so high levels of stress and fatigue that they become unable to provide effective care for patients, and this situation creates a range of challenges for healthcare facilities.
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Those nurses who suffer from emotional pressure and burnout are inclined to make more medical errors and cause delays in working with patients (Khamisa, Peltzer, & Oldenburg, 2013). Thus, studies show that nurses’ burnout and exhaustion are key causes of injuries and ineffective decisions made regarding patients’ treatments (Khamisa et al., 2013; Laschinger & Fida, 2014). In their study, Cañadas-De la Fuente et al. (2015) state that those nurses who work in emergency departments and intensive care units are at a high risk of experiencing stress which influences their performance. Therefore, it is important to focus on approaches that can be used to decrease stress levels in nurses.
In order to address the problems discussed in these studies, researchers also tested certain tools to help nurses cope with their stress. In her research, Mohamed (2016) stated that coping strategies which are used by nurses in order to adapt their behaviors and address occupational stress are effective to help nurses overcome challenges associated with their work. Cañadas-De la Fuente et al. (2015) also noted in their study that those nurses who apply stress management or coping strategies are inclined to demonstrate higher performance than those nurses who suffer from burnout and cannot cope with emotional pressure.
The ideas presented in the article by Sarafis et al. (2016) are also in line with the opinions of other researchers, and investigators paid attention to the fact that nurses require certain education on the problem of using stress management techniques in order to become able to overcome burnout. Researchers’ opinions regarding the effectiveness of stress management techniques are important to be taken into account while developing the project.
The PICO(T) standards are applied in this project in order to determine the question to answer: In nurses who experience stress and burnout in their workplace (P), how can the education regarding stress management techniques and their application (I) reduce burnout and increase productivity and the quality of care (C) compared to the lack of such education on stress management techniques. From this perspective, it is important to accentuate the idea that the intervention chosen to influence nurses’ experiences and the quality of care is the education on stress management strategies.
Nurses who work in the selected facility are to be divided into two groups: the nurses who will receive education regarding stress management techniques and who will apply them in their practice and the nurses who represent a control group. Levels of stress and possible signs of burnout will be assessed for nurses from both groups before and after the implementation of the determined intervention in order to identify any changes in nurses’ performance. The data collection will be realized with the help of questionnaires.
The data collected as a result of using questionnaires to determine pre- and post-intervention trends will be analyzed with the help of finding the mean, the frequency distribution, and the standard deviation. These numbers will be associated with possible changes in nurses’ productivity, performance, and care because of the implemented intervention. Furthermore, a paired t-test will be used to determine any possible relationships between the implemented intervention and the performance of nurses. An unpaired t-test will be used in order to compare and contrast the outcomes for two groups of nurses related to their levels of stress and changes in performance.
Discussion and Findings
It is possible to predict certain statistically significant differences in burnout levels, performance, and the quality of care for those nurses who are educated regarding stress management techniques and those nurses who do not use these strategies. Furthermore, it is possible to predict statistically significant differences in performance and the level of care observed before and after starting the quality improvement project and implementing the intervention.
In addition, after analyzing the data, it will be important to state whether the found results are statistically valid or whether the observed changes and differences in performance and stress are due to chance. The findings of the project need to be discussed in detail because they are important to decide regarding the provision of education on stress management techniques for all nurses on a regular basis.
The proposed quality improvement project is oriented to addressing the problem of high stress and burnout levels observed in relation to those nurses who work in different healthcare facilities. The development of this problematic situation often results in affecting the quality of the provided services and decreasing nurses’ productivity. The recent literature on the topic presents data regarding the effective use of certain coping or stress management strategies for nurses. From this point, the purpose of this project is to implement such intervention as a nurse education regarding stress management techniques in order to determine how this initiative can influence nurses’ experiences and performance. The received data will be analyzed with the help of determining statistical averages and completing t-tests.
Cañadas-De la Fuente, G. A., Vargas, C., San Luis, C., García, I., Cañadas, G. R., & De la Fuente, E. (2015). Risk factors and prevalence of burnout syndrome in the nursing profession. International Journal of Nursing Studies, 52(1), 240-249.
Khamisa, N., Oldenburg, B., Peltzer, K., & Ilic, D. (2015). Work related stress, burnout, job satisfaction and general health of nurses. International Journal of Environmental Research and Public Health, 12(1), 652-666.
Khamisa, N., Peltzer, K., & Oldenburg, B. (2013). Burnout in relation to specific contributing factors and health outcomes among nurses: A systematic review. International Journal of Environmental Research and Public Health, 10(6), 2214-2240.
Laschinger, H. K., & Fida, R. (2014). New nurses burnout and workplace wellbeing: The influence of authentic leadership and psychological capital. Burnout Research, 1(1), 19-28.
Mohamed, F. R. (2016). Relationship among nurses role overload, burnout and managerial coping strategies at intensive care units. International Journal of Nursing Education, 8(2), 39-45.
Sarafis, P., Rousaki, E., Tsounis, A., Malliarou, M., Lahana, L., Bamidis, P.,… Papastavrou, E. (2016). The impact of occupational stress on nurses’ caring behaviors and their health related quality of life. BMC Nursing, 15(1), 56-66.
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