Evidence Based Practice and Nursing Research.

C361 – MLM1 – Performance Assessment 1

Impact of the Problem on the Patient

Nursing burnout is the identified practice problem.  Burnout refers to a state of physical and mental exhaustion, which interferes with the nurses’ ability to provide high-quality care. It directly affects patients. The infection rate is higher among patients treated by nurses suffering from burnout than from patients whose nurses do not have burnout. Nurses with burnout have impaired memory, attention, and executive functioning. Evidence Based Practice and Nursing Research. ORDER  HERE A PLAGIARISM-FREE PAPER HEREThis minimizes their recall and attention to detail during their interactions with patients. Such diminished vigilance and cognitive functioning, coupled with increased safety lapses, place nurses at a higher risk of committing patient errors. Patient safety is also jeopardized as a result of nursing burnout.  Patient satisfaction is also lower among those who have had nurses assigned to them who exhibit burnout signs. Burnout also increases the rates of malpractice among healthcare professionals.Evidence Based Practice and Nursing Research.

Impact of the Problem on the Organization

The impact of nursing burnout on the hospital can be felt in an increase in absenteeism. Increased turnover rate is another problem seen in nurses suffering from burnout. Notably, increased rates of burnout are the significant consequence of burnout to the healthcare organization. Organizations experience issues related to turnovers, such as reduced care quality and increased costs. Evidence Based Practice and Nursing Research.These result from the training and orientation of new nurses to replace those leaving their jobs. The affected nurses’ job performance is often below the basic standards of care, resulting in errors and low patient satisfaction scores. All of these problems can be felt on the administrative level of the organization. Consequently, burnout negatively affects the reputation of the organization. Overall, burnout significantly affects the organization and the quality of care provided.Evidence Based Practice and Nursing Research.

Identify the PICO components

P – (Population [key stakeholder] or problem)                         Nursing staff

I – (Intervention / practice change)                               Implement education regarding nurse burnout

C – (Comparison)                                                        No education regarding nurse burnout

O – (Outcome indicator)                                              Decrease the number of vacant nursing position

Evidence-Based Practice Question

Among nursing staff (P), how effective is implementing education regarding nurse burnout (I) as compared to no education regarding nurse burnout (C) in decreasing the number of vacant nursing positions (O)? Evidence Based Practice and Nursing Research.

Research Article

Background Introduction

Wei et al. (2017) is the research-based article selected for evidence appraisal.  The authors have identified that approximately 65 percent of nurses and physicians perceive their jobs to be stressful. Burnout is known to impact the quality of care provided to patients negatively. Therefore, the authors’ primary aim was to assess whether active intervention effectively reduces job burnout and enhances performance among emergency department nurses. Evidence Based Practice and Nursing Research.

Methodology

Researchers conducted the study in three hospitals in the ED departments, which were randomly selected from eight high-level hospitals in China. A total of 102 nurses were enrolled in the research and assigned to control and treatment groups. Participants in the treatment groups were treated with ordinary treatment coupled with comprehensive management, while those in the control group were only treated with the usual treatment. The researchers used questionnaires to collect baseline data related to nursing burnout. Evidence Based Practice and Nursing Research.

Level of Evidence

The Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model is a robust problem-solving approach to clinical decision making. It is specifically designed to meet the unique needs of practicing nurses in a three-step process called PET; practice, question, evidence, and translation. Based on this model, the three levels of evidence are I, II, and III. The article by Wei et al. (2017) contains level I evidence as it is a randomized controlled trial. Evidence Based Practice and Nursing Research.

Data Analysis

In this study, the researchers analyzed data from SPSS 17.0 software. A p-value of less than 0.05 was considered statistically significant.

Ethical Considerations

The Ethical Committee of Qianfoshan Hospital, which is affiliated with Shandong University, approved this study. It is thus evident that all ethical considerations were followed. Evidence Based Practice and Nursing Research.

Quality Rating

This study has a high-quality rating characterized by consistent results, sufficient sample size, adequate control, definitive conclusion, and recommendations. The provided recommendations are highly based on a comprehensive literature review, which encompasses thorough scientific evidence.Evidence Based Practice and Nursing Research.

Analysis of the Results / Conclusions

Overall, this study found out that all emergency department nurses displayed symptoms of burnout and job dissatisfaction at different levels. Obtained data revealed that comprehensive management significantly decreased depersonalization and emotional exhaustion. The p-value was found to be 0.01, indicating that the results were statistically significant. Evidence Based Practice and Nursing Research.

Non-Research Article

            Background Introduction

The article ‘How Nurse Leaders Can Reduce Burnout: Focus on Mental Energy! Is the non-research article selected for this assignment. Its purpose was to identify the role of mental energy in reducing nurse burnout among nurse leaders. The article has identified that the human energy crisis continue to plague the US healthcare workforce. Focusing on nurses’ mental energy is thus an efficient way of reducing nurse burnout. Evidence Based Practice and Nursing Research.

Type of Evidence

This study is a clinical practice guideline. It contains statements that include recommendations aimed at optimizing nurses’ mental wellness and patient care. These proposals are informed by a systematic review of evidence. Evidence Based Practice and Nursing Research.

Level of Evidence

This study’s level of evidence is level III. The study is non-experimental.   

Quality Rating

Based on John Hopkins’s model, this study is rated of low quality. It is characterized by little evidence with inconsistent results and insufficient sample size. The results also cannot be drawn. Evidence Based Practice and Nursing Research.

Author’s Recommendations

Young et al. (2016) recommend that organizations measure employees’ mental energy and embrace initiatives that will efficiently improve the organization’s energy levels. Improved energy assessment tools will also assess physical energy, ultimately leading to the identification of burnout causes and effective solutions. Evidence Based Practice and Nursing Research.

Recommended Practice Change

Both the research and non-research articles appraised focus on active interventions to reduce the rates of burnout among nurses. The articles conclude that focusing on nurses’ mental energy and active intervention with comprehensive management is effective in reducing nurse burnout. The PICO question has identified nurse education as an intervention for the identified practice problem. Staff education falls under active interventions for nurse burnout. Evidence Based Practice and Nursing Research.

Key Stakeholders

According to research, engaging relevant stakeholders is crucial in garnering support for the change project. Three critical stakeholders in reducing nurse burnout include nursing staff, hospital administrators, and professional societies for nurses. The nursing staff is most affected by burnout. They, therefore, play a fundamental role in the identification of burnout reduction strategies. Hospital administration also plays a significant role in addressing the global crisis. It should provide education and other support services for nurses dealing with burnout. Professional organizations advocate for nurses and are vital in recommending solutions to nursing burnout. Evidence Based Practice and Nursing Research.

Barrier to Implementation

A significant barrier to implementing a program to reduce nursing burnout is insufficient to support the hospital’s leadership. Nurses’ behaviors and organizational characteristics that empower nurses to utilize their knowledge and skills can improve job satisfaction, quality of patient care, and reduce nurse burnout.Evidence Based Practice and Nursing Research.

Strategy to Overcome the Implementation Barrier

Provision of organizational support to nurses is a critical strategy for overcoming the identified barrier to implementing nurse burnout programs. Structural empowerment is crucial for nurses’ job satisfaction and quality of care as mediated by characteristics found in nursing practice environments. Additionally, structural and psychological empowerment are critical in reducing nurse burnout and increasing nurses’ intent to stay. Empowering leadership style, characterized by informing and displaying team concern, decreases feelings of emotional exhaustion for nurses and depersonalization through the mediation of trust in the leader and healthcare organization. Ensuring supportive leadership is vital as leadership is a critical factor in establishing workplace empowerment and positive work environments for nurses. Evidence Based Practice and Nursing Research.

Indicator to Measure the Outcome

Various indicators will be used to measure the outcome of a nurse burnout program. The outcome indicated in the PICO question is a reduced number of vacant positions. Nursing burnout is associated with increased intent to leave the profession and subsequent high rates of nursing turnover. As a result, the intervention described will increase the nurses’ intent to stay within the profession, and the rates of turnover will be reduced. Evidence Based Practice and Nursing Research.

Further, the Maslach Burnout Inventory (MBI) will evaluate nurses’ scores after the implementation of a nurse burnout program to gauge its effectiveness. Other indicators of the program’s success include increased job satisfaction for nurses, improved patient care quality, reduced medical errors and other adverse events, and increased morale and motivation for nurses. Evidence Based Practice and Nursing Research.