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Proposed Evidence-Based Practice Changes


Stress in the health care setting is one of the detrimental factors responsible for employees’ productivity and ‘quality of patient outcomes. The goal of the paper is to outline the evidence-based practice changes expected to alleviate the adverse effects of stress experienced by nurses working longer shifts.

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The link between PICOT, Research Articles, and the Identified Problem

Several intersection points can be identified between the identified problem of the excessive stress in nurses working longer shifts and the chosen research articles. First, both studies deal with the environments that possess characteristics similar to the setting of interest. Specifically, a study by Karadzinska‐Bislimovska et al. (2014) links the stressors contributing to poor performance to the transition period caused by socioeconomic reforms. The article by Duarte and Pinto-Gouveia (2016) deliberately focused on the audience that is already known to be exposed to the excessive amount of stress, with longer working hours being one of the chosen criteria. Second, both articles contain data that establishes a preliminary relationship between the components of the research question.

For instance, the study by Karadzinska‐Bislimovska et al. (2014) identifies a positive relationship between several workplace stressors, including longer working shifts, and the decline of the productivity and efficiency of the health professionals. This relationship allows us to assume that the alleviation of the said stress would allow for the increased quality of the delivered care and, by extension, the improved patient outcomes (the outcome of the project). The study by Duarte and Pinto-Gouveia (2016) further strengthens the initial assumption that the adverse effects of stress can be alleviated through a deliberate effort and that the proposed intervention can be expected to result in improvement. The scientific rigor and reliability of the study (e.g. the presence of the control group) confirms the appropriateness of direction taken by the project authors and outlines the expected results of the study at hand.

Proposed Evidence-Based Practice Changes

Considering the information provided by both qualitative and quantitative research available, several evidence-based practice changes can be suggested. First, several protective factors can be identified that are expected to decrease the amount of stress experienced by nursing practitioners. These factors include job satisfaction, teamwork, participation in the decision-making process, and supportive interpersonal relationship (Li et al., 2014). Since the combination of the said factors is expected to prevent the incidence of stress among health professionals, It is suggested to review the current policies of the health care organizations to identify the issues that compromise a healthy environment in the workplace.

Once these issues are identified, it would then be possible to adjust the existing policies so that the occurrence of conflicts could be minimized. Second, several intervention techniques should be developed that would decrease the gaps in productivity (e.g. the occurrence of nurse errors) and, by extension, improve patient outcomes. While the exact range of interventions will be determined after the completion of the project, it is reasonable to expect the improvement from a series of mindfulness-based group interventions that are known to produce positive results (Duarte & Pinto-Gouveia, 2016). It is also advised to introduce the assessment of changes’ efficiency before interventions’ introduction (as a baseline) and after three, six, nine, and twelve months.


The suggested evidence-based practice changes are expected to provide a much-needed stress alleviation for nurses and improved outcomes for the patients. While the project is yet to reveal the complete list of the effective stress reduction strategies, the combination of the highlighted changes has the potential to increase the quality of care.


Duarte, J., & Pinto-Gouveia, J. (2016). Effectiveness of a mindfulness-based intervention on oncology nurses’ burnout and compassion fatigue symptoms: A non-randomized study. International Journal of Nursing Studies, 64, 98-107.

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Karadzinska‐Bislimovska, J., Basarovska, V., Mijakoski, D., Minov, J., Stoleski, S., Angeleska, N., & Atanasovska, A. (2014). Linkages between workplace stressors and quality of care from health professionals’ perspective–Macedonian experience. British Journal of Health Psychology, 19(2), 425-441.

Li, A., Early, S. F., Mahrer, N. E., Klaristenfeld, J. L., & Gold, J. I. (2014). Group cohesion and organizational commitment: Protective factors for nurse residents’ job satisfaction, compassion fatigue, compassion satisfaction, and burnout. Journal of Professional Nursing, 30(1), 89-99.

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