Discovery: topic and practice issue
The topic and the nursing practice issue related to this topic
Topic: Workplace burnout.
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Nursing practice issue: Nursing burnout due to high workload.
The rationale for the topic selection. The scope of the issue/problem
The workforce of the United States is currently experiencing significant shortages of nursing staff. One of the main reasons behind the said shortages is the physical and emotional strength that the profession imposes on the practicians. Recent statistics have shown that 85% of nurses felt fatigued. 63% were on the verge of experiencing full-fledged burnout – a state of physical and emotional being characterized by exhaustion and cynicism (Kronos, 2018). Burnout impedes job performance and satisfaction and, in some cases, can account for increased turnover rates. The issue of nursing burnout should be investigated to make sure that nurses’ mental health is intact and they are capable of fulfilling their job roles.
Summary: evidence to support the need for a change
The practice problem and the PICOT question
Nowadays, nurses have diverse responsibilities that go well beyond merely conducting standard procedures. They emotionally engage with patients, continue education to improve their expertise and promote health within their communities. More often than not, the scope of duties appears to be fairly daunting, and nurses can become depressed and dissatisfied. The PICOT question for the present project goes as follows:
Will nurses (Population) that received therapeutic help and whose work environment was improved upon their requests (Intervention) as compared to other nurses who experienced none of that (Comparison) be less likely to have burnout (Outcome) in two months after intervention (Timeframe)?
The main findings from the systematic review and the strength of the evidence
Westerman, Kozak, Harling, and Nienhaus (2014) conducted a systematic search of burnout intervention studies conducted in databases such as Embase, Psycnet, and Medline over the time period spanning from 2000 to 2012. The researchers were able to identify 16 intervention studies, including workplace-oriented (n=2), person-oriented (n=9), and combined approaches (n=5). All the studies analyzed came from reputable peer-reviewed journals and were characterized by robust methodology. Westerman et al. (2014) concluded that person-oriented interventions reduced burnout in the short term, whereas work-related and combined measures yielded long-term positive results.
Evidence-based solutions for the trial project
Person-oriented and workplace-oriented interventions.
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Translation: Action Plan
Care standards, practice guidelines, or protocols to support the intervention planning
Some of the guidelines that may be useful for running the present project are provided by the American Nurses Association (ANA). In 2017, the ANA launched a program under the title of Healthy Nurse, Healthy Nation that promoted habits and behaviors aimed at enhancing nurses’ wellbeing. The guidelines concern activities, rest, nutrition, quality of life, and workplace safety (“About the HNHN GC,” 2019).
Stakeholders and their roles and responsibilities in the change process
- A nursing student (me) – project development;
- Registered nurses – data collection, participation, health promotion
- Workplace coach – interventions and therapeutic sessions.
The nursing role in the change process
My nursing role is collecting data regarding workplace burnout in fellow nurses and raising awareness. I outline the key milestones of the project, bind the stakeholders together, and track the progress.
Stakeholders by position titles
- A nursing student (me) has the vision and agenda;
- Registered nurses have hands-on experience with handling workplace stress;
- Workplace coach has the expertise to help struggling health workers.
Type of cost analysis needed prior to a trial
Cost allocation analysis by an in-house accountant for basic budget estimation and clarifying information about program participants and services delivered.
The process for gaining permission to plan and begin a trial
The project should be discussed with the nursing managers of a given hospital since it implies additional costs and extra hours spent in the workplace. The American Nurses Association can be involved to support the cause.
The plan for educating the staff about the change process trial
The plan realization may start with informal conversations about workplace issues. Further, the project manager may consider sending emails with an invitation to therapeutic sessions as well as leaving leaflets and placing posters in the workplace.
The implementation timeline for the change process
- Week 1: problem statement, literature review, deciding on the appropriate interventions, engaging stakeholders;
- Week 2: data collection, participant recruitment, hiring a coach;
- Week 3-5: a) intensive therapeutic sessions; b) testing workplace changes;
- Week 6: preliminary assessment;
- Week 7-13: therapeutic sessions upon request, workplace changes remain if proven efficient;
- Week 13: final assessment, data analysis, and new knowledge dissemination.
The measurable outcomes based on the PICOT
Reduced burnout rates using burnout measurement inventory (standardized self-report survey).
Recording during the pilot change process
Survey data logging using software such as Excel for further analysis.
Resources available to staff during the change pilot
ANA guidelines, studies used in preparation for the project, burnout measurement tools.
Meetings of certain stakeholders throughout the trial
The project manager, registered nurses, and workplace coach will meet one week and one month after the sessions have taken place and the changes are implemented.
Reporting the outcomes of the trial
Corporate email chain and scholarly publication if possible.
The next steps for the use of the change process information
Define which type of interventions was more efficient – person- or workplace-oriented and introduce changes accordingly.
Henry, B.J. (2014). Nursing burnout interventions: What is being done? Clinical Journal of Oncology Nursing, 18(2), pp. 211-214.
Rushton, C. H., Batcheller, J., Schroeder, K., & Donohue, P. (2015). Burnout and resilience among nurses practicing in high-intensity settings. American Journal of Critical Care, 24(5), 412-420.
Westermann, C., Kozak, A., Harling, M., & Nienhaus, A. (2014). Burnout intervention studies for inpatient elderly care nursing staff: Systematic literature review. International journal of nursing studies, 51(1), 63-71.