Patient Safety Issue and PICOT Statement

Throughout the history of the healthcare industry, nurse burnout has been a critical issue. In this situation, nurses are emotionally, physically, and psychologically exhausted, resulting from a variety of factors. A recent study by the International Council of Nurses has found that the rate of nurse burns was 40 percent before the COVID-19 outbreak (Bergman et al., 2021). Since the pandemic, the prevalence of the disease has increased to 70% (Bergman et al., 2021).

NHS FPX 8030 Assessment 2 Evidenced Based Literature: Search and Organization

There is a shortage of nurses in the country, which results in nurses being overworked. As a result, nurses experience burnout due to excessive workloads. Finally, the increasing rate of stress among nurses led them to doing more errors with transcription and medications which led to patient adverse effects and deaths. The nursing profession must, therefore, find solutions to this increase in nursing challenges that we are faced with today, especially burnout. There are a variety of solutions that can be implemented in our health organization. These solutions focus on offering nurses stress management programs to help them cope with the stressful work environment.

An evidence-based approach is proposed in this paper to determine whether an intervention that promotes skills to decrease stress so that the rate of burnout is decreased and setting a target date of six months to reevaluate. Below is the PICOT question:

Does implementing a Stress reduction program assist in decreasing the percentage of nursing staff burnout in the next six months?

P- Nurses

I- Stress Coping Plan

C- No stress plan

O- Decrease in nurse burn syndrome.

T- Six Months

Revised PICOT question: In registered nurses working in hospital settings (P), does implementing a mindfulness-based stress reduction program (I), compared to no intervention or standard stress management programs (C), lead to a reduction in nurse burnout and improvement in job satisfaction (O) over a period of 6 months (T)?

P: Registered Nurses working in hospital settings 

I: Mindfulness-Based Stress Reduction Program 

C: No intervention or standard stress management programs 

O: Reduction in nurse burnout and improvement in job satisfaction 

T: Over a period of 6 months

The Literature Search Process

Identifying and finding a PICO (T) question related to the rate of nurse stress and burnout was used in the search for the review of the literature process. Examining nurse burnout and viable solutions was the first step. The search strategy was easily obtained after developing the PICOT question. The keywords, which are essential for literature searches in databases, have been identified. A literature search is conducted after identifying the databases to be used. Due to the nature of the topic, several sources were required to find information that is both dependable and relevant to the topic.

PICOT questions contained keywords that contributed to analyzing and finding a strategy to search for information. The top and primary word that was first put into the database to search was nurse burnout, stress among nurses, six-month time frame, and nurse. Scholarly information needs to come from a credible source and be researched in different search engines. The two engines used from the school’s resources were Google Scholar and CINAHL. It was also necessary to use inclusion-exclusion criteria in order to identify relevant articles.

They were peer-reviewed articles, and that was the inclusion criteria. The articles that were to be searched for could not have a date greater than five years old. This would be anything published before 2018 would be invalid. For ease of access, the full text was also to be made available online. The articles that were searched and read had to have explanations on nurse burnout rates and stress management programs. Based on the literature, only four articles were picked as being credible and relevant to the topic being used in the research. 

NHS FPX 8030 Assessment 2 Evidenced Based Literature: Search and Organization

Finding the right keywords was the first step in creating a search strategy for the PICOT question, for registered nurses working in hospital settings. Registered nurses, hospital settings, mindfulness-based stress reduction programs, no intervention, conventional stress management techniques, nurse burnout, job satisfaction, and six months were the keywords found (Corrin et al., 2022). Next, to limit or extend the search, we created a search strategy employing a mix of terms and Boolean operators (AND, OR, NOT). For example, we searched for “Registered Nurses AND Hospital Environments AND Mindfulness-Based Stress Reduction Program AND Nurse Burnout AND Work Satisfaction AND 6 MONTHS OR STANDARD Stress Management PROGRAMS OR No Intervention (Grames et al., 2019).”

Next, we looked through pertinent databases, including MEDLINE, CINAHL, PubMed, and Cochrane Library, which may provide reliable and peer-reviewed literature. We created a list of future articles using the detected keywords by using the search phrases in the relevant database fields, such as the title, abstract, and topic headers (Frandsen et al., 2019). We carefully examined the titles and abstracts of the retrieved articles to choose the most relevant and appropriate papers that answer the PICOT topic.

To ensure the selected documents met the requirements of the research question, we used inclusion and exclusion criteria based on the PICOT question. To evaluate the quality of the study and reduce the possibility of bias, we then retrieved and critically assessed the texts of the chosen publications. We gathered and summarized the pertinent data from the papers to ascertain the efficacy of a mindfulness-based stress reduction program in decreasing nursing burnout and enhancing job satisfaction among registered nurses working in hospital settings. Lastly, we analyzed and interpreted the results to provide reliable conclusions and suggestions for therapeutic practice. Overall, by guaranteeing fair and efficient research methods, this search approach may assist in identifying the best evidence to address the PICOT issue. It is crucial to record the search procedure to ensure openness and trust in the study results (Frandsen et al., 2019).

Articles Reviewed

The articles reviewed contained the following:

1. Dealing with emotional and physical fatigue: Evaluating the effects of a program to reduce burnout among mental health nurses (Alenezi et al., 2019).
2. Yoga exercises to reduce stress among nurses and healthcare professionals: : a systematic review (Cocchiara et al., 2019)
3. Coping Mechanism and cognitive therapy on the rate of nurse burnout (Bagheri et al., 2019).
4. Management skills to decrease stress among nursing students (Chesak et al., 2019).
5. Stress management for undergraduate nursing students: Integrated review approach. (McCarthy et al., 2018)

Keywords and Databases

Choosing the finest databases and keywords is essential in creating a search strategy for the most reliable evidence. The breadth and emphasis of the research issue should be considered while choosing a database. We looked for reliable, peer-reviewed literature for our PICOT query in pertinent databases. Strong keywords should be used to increase the specificity and relevance of the search results. Registered nurses, hospital settings, mindfulness-based stress reduction programs, nurse burnout, work satisfaction, no intervention, conventional stress management programs, and a six-month study period were some of the keywords associated with our research topic. Moreover, the search might be expanded or contracted using boolean operators like AND, OR, and NOT. We could return a list of probable publications addressing our study issue using suitable databases and strong keywords (Corrin et al., 2022).

Inclusion and Exclusion Criteria

Due to perfectly meeting the inclusion criteria, the articles listed above were retained. A special note should be made that they have detailed discussions about stress reduction and burnout rates among nurses. Furthermore, since they fall within a specified period, they contained current information. These peer-reviewed articles are beneficial for nurse burnout and stress management research because they are all peer-reviewed.

We retrieved several articles from different databases after conducting a search strategy for the PICOT question for registered nurses working in hospital settings. To ensure the publications were relevant and satisfied the requirements of the research topic, we used inclusion and exclusion criteria. The inclusion criteria included articles focusing on mindfulness-based stress reduction programs, registered nurses working in hospital settings, nurse burnout, job satisfaction, and a study period of at least six months. Articles, not peer-reviewed focused on other healthcare settings or professions or had no connection to the study issue were excluded from consideration.

After the application of the inclusion and exclusion criteria, a total of five articles were kept. These papers were chosen because they fulfilled the requirements for inclusion and offered insightful data pertinent to the research issue. They were all published in peer-reviewed journals, had a minimum six-month research period, and addressed topics such as registered nurses working in hospitals, nursing burnout, job satisfaction, and mindfulness-based stress reduction programs. According to the kept papers, using a mindfulness-based stress reduction program may lessen nurse burnout and increase job satisfaction among registered nurses working in hospital settings. Also, they spoke about how beneficial mindfulness-based stress reduction programs were compared to neither intervention nor conventional stress management programs (Green & Kinchen, 2021).

NHS FPX 8030 Assessment 2 Evidenced Based Literature: Search and Organization

References

Alenezi, A., McAndrew, S., & Fallon, P. (2019). Burning out physical and emotional fatigue: Evaluating the effects of a program aimed at reducing burnout among mental health nurses. International journal of mental health nursing, 28(5), 1045-1055.

Bagheri, T., Fatemi, M. J., Payandan, H., Skandari, A., & Momeni, M. (2019). The effects of stress-coping strategies and group cognitive-behavioral therapy on nurse burnout. Annals of burns and fire disasters, 32(3), 184

Bergman, L., Falk, A. C., Wolf, A., & Larsson, I. M. (2021). Registered nurses’ experiences of working in the intensive care unit during the COVID‐19 pandemic. Nursing in critical care, 26(6), 467-475.

Cocchiara, R. A., Peruzzo, M., Manock, A., Ottolenghi, L., Villari, P., Polimeni, A., & La Torre, G. (2019). The use of yoga to manage stress and burnout in healthcare workers: a systematic review. Journal of clinical medicine, 8(3), 284.

Chesak, S. S., Morin, K. H., Cutshall, S., Carlson, M., Joswiak, M. E., Ridgeway, J. L., & Sood, A. (2019). Stress management and resiliency training in a nurse residency program: Findings from participant focus groups. Journal for Nurses in Professional Development, 35(6), 337-343.

Corrin, L., Thompson, K., Hwang, G.-J., & Lodge, J. M. (2022). The importance of choosing the right keywords for educational technology publications. Australasian Journal of Educational Technology, 38(2), 1–8. https://doi.org/10.14742/ajet.8087

Frandsen, T. F., Gildberg, F. A., & Tingleff, E. B. (2019). Searching for qualitative health research required several databases and alternative search strategies: a study of coverage in bibliographic databases. Journal of Clinical Epidemiology, 114, 118–124. https://doi.org/10.1016/j.jclinepi.2019.06.013

Grames, E. M., Stillman, A. N., Tingley, M. W., & Elphick, C. S. (2019). An automated approach to identifying search terms for systematic reviews using keyword co‐occurrence networks. Methods in Ecology and Evolution, 10(10), 1645–1654. https://doi.org/10.1111/2041-210x.13268

Green, A. A., & Kinchen, E. V. (2021). The Effects of Mindfulness Meditation on Stress and Burnout in Nurses. Journal of Holistic Nursing, 39(4), 089801012110158. https://doi.org/10.1177/08980101211015818

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