NRS-493-Professional Capstone and Practicum Assignment

Capstone Project Change Proposal

Nursing mental health and burnout have been an ongoing issue within the health care profession, primarily in the acute and critical care settings. In recent years the Covid-19 pandemic has increased nurse workload, stress, and overall burnout rates, leading to high staff turnover and employees dissatisfied with current work environments. This poor mental health and dissatisfaction lead to more adverse events, medical errors, and poor patient outcomes. With that being said, this paper will talk about nurse burnout rates within healthcare facilities, primarily in the acute care setting, including education, interventions, and safeguards to reduce nurse burnout, turnover and improve quality of care. NRS-493-Professional Capstone and Practicum Assignment

Problem Statement

Nurse burnout rates have become a rising concern as nurse turnover rates have increased, medical errors, adverse events, and decreased quality patient care.  One reason for nursing staff burnout and turnover is the increased workload, including patient care and lack of mental health resources. Critical care nurses are amongst the highest population affected by burnout, “54% of clinicians in the US experience burnout symptoms” (Shah et al., 2021). Burnout is a very relevant topic as more nurses leave staff positions and turnover rates continue to rise (Soto-Rubio et al., 2020).

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Healthcare facilities need to implement necessary safeguards and resources as a crucial requirement to nursing mental health and well-being nationwide. Burnout is rising; studies have shown that nurses who witness one death a month increase burnout exhaustion by 3.31 on the emotional exhaustion scale (Kelly et al., 2021). The implications this has or will have on critical care nurses who may witness upwards of 3 or more deaths per shift (Kelly et al., 2021). Staff mental health support has continued to become poor as resources and safeguards are not available. The nursing staff has made this abundantly apparent as “one-third of nurses leave their staff position in the first one to two years of employment” (Kelly et al., 2021). The amount of funding and training that is required to train staff prompts an increased need for nursing retention and primarily reducing or eliminating nurse burnout. Critical care nurses are more likely to perform substandard care and have inadequate communication efforts to interdisciplinary teams, leading to increased errors and patient adverse events, and safety issues (Eltaybani et al., 2021). NRS-493-Professional Capstone and Practicum Assignment

Purpose of Change Proposal

The main reason for this change proposal is to formally educate and propose a change to improve resource availability to nursing staff, enhancing the quality of care and nursing retention. Critical care nurses are subjected to an increased number of severely ill or injured patient populations, requiring extensive labor and mental fatigue, making them the highest population of nurses predisposed to burnout (Aryankhesal et al., 2019). As little to no resources are available, nurses experience nurse burnout including emotional and physical fatigue, exhaustion, depersonalization, feelings of failure, reduction in coping mechanisms, negative attitude towards the job, and low self-efficacy” (Aryankhesal et al., 2019). These symptoms have been shown to lead to high turnover and long-term depression and have been considered a form of Post-Traumatic Stress Disorder (PTSD) (Aryankhesal et al., 2019). The lack of proper education to staff on nurse burnout and its effects and resources and strategies to prevent, reduce, and eliminate it is not readily available or available at all.  Implementing a small change can reduce nurse burnout or eliminate it, leading to many positive impacts in the healthcare facility.

PICOT

The PICOT question statement for this capstone project change proposal is as follows:

Population: Nurses that work in the acute care setting.

Intervention: Who practice stress management practices and have mental health resources available and mental health safeguards in place.

Comparison:  Compared to nurses that do not practice stress management practices and have mental health resources and mental health safeguards in place.

Outcomes: Influence nurse burnout rates, nurse retention rates, quality of care, and patient outcomes.

Time: Eliminate or reduce nurse burnout rates over a 30-day period of implementing these resources, education, and strategies. NRS-493-Professional Capstone and Practicum Assignment

Therefore, the PICOT question statement is, Nurses that work in the acute care setting (P), who practice stress management practices and have mental health resources safeguards in place (I) compared to nurses that do not practice stress management practices and have mental health resources and mental health safeguards in place (C) influence nurse burnout rates, nurse retention rates, quality of care, and patient outcomes (O) over a 30-day period of implementing these resources, education, and strategies (T).

Literature Search Strategy Employed

Peer-reviewed scholarly articles dated between the years 2019 to 2021 were utilized to support this capstone change project. The search engine used included PubMed, EBSCOhost, and Grand Canyon University Library. Keywords used to find the correct articles included nurse burnout, nurse turnover, nursing errors, critical care nurse turnover, nurse job satisfaction, quality of care. The sample population utilized in these studies entailed critical nurses who work in various intensive care units across the United States and one study in Iran. The studies were performed before and during the Covid-19 pandemic due to increased nurse burnout rates and correlating nurse turnover rates. One study categorized nurses receiving appropriate mental health resources compared to one without and found that the outcome from the survey was nurse retention, staff satisfaction, improved patient care and outcomes, and reduced length of hospital admission (Kelly et al., 2021). Hospital and nursing attribute selections were randomized from a pool of higher-level acute care units to determine the effect of continued exposure to severely ill and injured patient populations. NRS-493-Professional Capstone and Practicum Assignment

Applicable Change or Nursing Theory Utilized

Evidence-based practice provides the most pronounced evidenced research that is supported by experts in the field (Abu-Baker et al., 2021). Evidence-based practice provides ideal informed health care interventions and intelligent decisions and is critiqued thoroughly and screened for inaccuracies (Abu-Baker et al., 2021). Evidence-based practice is designed to improve the quality of care and patient safety to improve overall health and outcomes, employing best-researched treatments and healthcare interventions that also intend to enhance nursing quality and clinical practice (Abu-Baker et al., 2021). A significant problem in health care facilities lacks in education and resources to support nursing staff mental health. To begin the evidence-based project, utilizing evidence research and implementing it in critical care units and potentially expanding outward throughout other departments is a principal objective.

Proposed Implementing Plan with Measured Outcome

Education for leadership and staff, including appropriate training to inform staff on nurse burnout and its effects on nursing staff environment, patient care, and nurse turnover. While educating, stress management techniques will be provided, and resource availability for mental health will be created. Implementing an educational program, incorporating resources in facilities like stress management strategies and safeguard resources such as group therapy or post-care debriefings, and limiting overtime hours permitted, and ensuring nurses receive their 30 min lunch break daily, promotes mental health wellbeing, staff workplace satisfaction, in return, prevents, reduces, and eliminates nurse burnout while improving quality of patient care and outcomes (Kelly et al., 2021). In addition to improved mental health, quality patient care, and outcomes, nursing retention will improve, reduce financial spending on training, educate new staff, and enhance the quality of care as nurses become more seasoned. NRS-493-Professional Capstone and Practicum Assignment

Identification of Potential Barriers to Plan Implementation, and a Discussion of How These Could be Overcome

This change project’s primary barrier has encountered willingness to change among management and feel that current mental health practices or lack thereof are satisfactory and not contributing to nursing burnout and turnover. Even though the current staff is experiencing a significant amount of burnout, with more than 60% of staff reporting nurse burnout is contributing to workplace dissatisfaction and an increase in nurse turnover, management believes that the primary issue is staffing leading to turnover, but the route issue is nurse burnout. Some nursing staff has also had pushback as they don’t believe that nurse burnout affects them, but education and strategies to improve deficient knowledge will aid in this issue. Staff leadership has changed views as the staff has decreased significantly, and staff satisfaction surveys have revealed more than half of the staff believes burnout is rising. It’s related to a lack of resources for mental health. NRS-493-Professional Capstone and Practicum Assignment

Conclusion

In summary, nurse burnout is only increasing as workload increases. Nursing mental health safeguards need to be implemented to reduce nurse burnout for the staff and the safety of patients. Simple changes such as the strategies described to reduce burnout will create a more positive work environment and improve staff morale, leading to nursing retention and improved quality of patient care and outcomes. The key to this project is to educate staff, follow and monitor those who utilize and practice mental health management practices, see if this implementation improved their mental health and job satisfaction, and compare turnover rates. Mental health in nursing and healthcare staff does not have the attention it needs despite other professions like police officers and military medical personnel requiring mental health. Educating, training, and promoting mental health will reduce burnout and improve the quality of care for the facility and, potentially, the community.  NRS-493-Professional Capstone and Practicum Assignment

References

Abu-Baker, N. N., AbuAlrub, S., Obeidat, R. F., & Assmairan, K. (2021). Evidence-based practice beliefs and implementations: A cross-sectional study among undergraduate nursing students. BMC Nursing, 20(1). https://doi.org/10.1186/s12912-020-00522-x

Aryankhesal, A., Mohammadibakhsh, R., Hamidi, Y., Alidoost, S., Behzadifar, M., Sohrabi, R., & Farhadi, Z. (2019). Interventions on reducing burnout in physicians and nurses: A systematic review. Medical Journal of The Islamic Republic of Iran. https://doi.org/10.47176/mjiri.33.77

Eltaybani, S., Yamamoto-Mitani, N., Ninomiya, A., & Igarashi, A. (2021). The association between nurses’ burnout and objective care quality indicators: A cross-sectional survey in long-term care wards. BMC Nursing, 20(1). https://doi.org/10.1186/s12912-021-00552-z

Higgins, J. T., Okoli, C., Otachi, J., Lawrence, J., Bryant, E. D., Lykins, A., & Seng, S. (2020). Factors associated with burnout in trauma nurses. Journal of Trauma Nursing, 27(6), 319–326. https://doi.org/10.1097/jtn.0000000000000538

Kelly, L. A., Gee, P. M., & Butler, R. J. (2021). Impact of nurse burnout on organizational and position turnover. Nursing Outlook, 69(1), 96–102. https://doi.org/10.1016/j.outlook.2020.06.008

Melnyk, B. (2020). Burnout, depression and suicide in nurses/clinicians and learners: An urgent call for action to enhance professional well‐being and healthcare safety. Worldviews on Evidence-Based Nursing, 17(1), 2–5. https://doi.org/10.1111/wvn.12416

Schlak, A. E., Aiken, L. H., Chittams, J., Poghosyan, L., & McHugh, M. (2021). Leveraging the work environment to minimize the negative impact of nurse burnout on patient outcomes. International Journal of Environmental Research and Public Health, 18(2), 610. https://doi.org/10.3390/ijerph18020610

Shah, M. K., Gandrakota, N., Cimiotti, J. P., Ghose, N., Moore, M., & Ali, M. K. (2021). Prevalence of and factors associated with nurse burnout in the us. JAMA Network Open, 4(2), e2036469. https://doi.org/10.1001/jamanetworkopen.2020.36469

Soto-Rubio, A., Giménez-Espert, M., & Prado-Gascó, V. (2020). Effect of emotional intelligence and psychosocial risks on burnout, job satisfaction, and nurses’ health during the covid-19 pandemic. International Journal of Environmental Research and Public Health, 17(21), 7998. https://doi.org/10.3390/ijerph17217998

Wei, H., Kifner, H., Dawes, M. E., Wei, T. L., & Boyd, J. M. (2020). Self-care strategies to combat burnout among pediatric critical care nurses and physicians. Critical Care Nurse, 40(2), 44–53. https://doi.org/10.4037/ccn2020621

The approved topic is nurse burnout. This topic was selected following dramatic increase in the rate of burnout among nurses. As little to no resources are available, nurses experience nurse burnout, including emotional and physical fatigue, exhaustion, depersonalization, feelings of failure, reduction in coping mechanisms, negative attitude towards the job, and low self-efficacy” (Aryankhesal et al., 2019). These symptoms have been shown to lead to high turnover and long-term depression and have been considered a form of Post-Traumatic Stress Disorder (PTSD) (Aryankhesal et al., 2019). The lack of proper education to staff on nurse burnout and its effects and resources and strategies to prevent, reduce, and eliminate it is not readily available or available at all. Implementing a small change can reduce or eliminate nurse burnout, leading to many positive impacts in the healthcare facility. NRS-493-Professional Capstone and Practicum Assignment

This change proposal aims at enhancing stress management among critical care nurses. This goal will be achieved by educating acute care nurses on stress management practices and advocating for increased accessibility to mental health resources and mental health safeguards among critical care nurses. This project is important since it will play a significant role in reducing the high rate of burnout among critical care nurses. The organization’s mission statement is; “To contribute to health and well-being of all healthcare staff. Additionally, the vision statement is; “To become leaders in the creation of a safe environment for all staffs and patients.”  The project aligns with the organization’s mission and vision statements. Critical care nurses are subjected to an increased number of severely ill or injured patient populations, requiring extensive labor and mental fatigue, making them the highest population of nurses predisposed to burnout (Aryankhesal et al., 2019). Implementing the project in the acute care unit will prevent burnout among nurses, improving their mental health and well-being. Critical care nurses will then provide high-quality care to patients, preventing adverse health outcomes and safety issues.

Dissemination is of result is done after evaluating the project. It aims at proving key stakeholders with the results of the implemented project. In disseminating the results of the proposed project, presentation will be used as the dissemination strategy. This approach is preferred since it will facilitate interaction between the project team and the targeted audience, including the management and staff especially nurses. The project team will informs the audience how the implemented project will leads to positive health outcomes since it will prevent nurse burnout, enabling nurses to provide high-quality care to their patients. Additionally, the project will increase organization’s revenue by reducing the high cost associated with nurse turnover. The audience will be allowed to seek clarification regarding the project during the presentation. NRS-493-Professional Capstone and Practicum Assignment

This is presentation I need completed but I’ll do the recording and I have a majority of the information that can be used I just don’t have time to complete it.

This is my topic approval

Business Case Topic
Problem Identification: Nursing mental health and burnout have been an ongoing issue within the health care profession, primarily in the acute and critical care settings. In recent years the Covid-19 pandemic has increased nurse workload, stress, and overall burnout rates, leading to high staff turnover and employee dissatisfaction with current work environments. This poor mental health and dissatisfaction lead to more adverse events, medical errors, poor patient outcomes, and increasing medical care costs for both patients and facilities.
Current Situation: The rate of nursing staff burnout and turnover increasing is due to the increased workload, including patient care and lack of mental health resources. Critical care nurses are among the highest population affected by burnout, “54% of clinicians in the US experience burnout symptoms” (Shah et al., 2021). Burnout is a very relevant topic as more nurses leave staff positions and turnover rates continue to rise (Soto-Rubio et al., 2020). NRS-493-Professional Capstone and Practicum Assignment
Proposed Evidenced Based Solution: Education for leadership and staff, including appropriate training to inform staff on nurse burnout and its effects on nursing staff environment, patient care, and nurse turnover. While educating, stress management techniques will be provided, and resource availability for mental health will be created. Implementing an educational program, incorporating resources in facilities like stress management strategies and safeguarding resources such as group therapy or post-care debriefings, limiting overtime hours permitted, and ensuring nurses receive their 30 min lunch break daily, promotes mental health wellbeing, staff workplace satisfaction, in return, prevents, reduces, and eliminates nurse burnout while improving quality of patient care and outcomes (Kelly et al., 2021). In addition to improved mental health, quality patient care, and outcomes, nursing retention will improve, reduce financial spending on training, educate new staff, and enhance the quality of care as nurses become more seasoned.

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Impact of Policy Change: Nurse burnout costs an additional $9 billion for hospitals annually and costs the entire healthcare system $14 billion each year (Kelly et al., 2021). Through the implementation of these mental health resources, facilities could not only save billions but could improve patient care outcomes. In addition to the disruption to patient care, the loss of a nurse leaving their position is also associated with significant financial costs, estimated from $11,000 to $90,000 per nurse with up to $8.5 million in associated wider costs (Kelly et al., 2021) The reduction of nurse burnout and turnover would reduce the cost of medical care for facilities and patients as well as reducing adverse or medical errors when providing care (Kelly et al., 2021).NRS-493-Professional Capstone and Practicum Assignment
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References
Kelly, L. A., Gee, P. M., & Butler, R. J. (2021). Impact of nurse burnout on organizational and position turnover. Nursing Outlook, 69(1), 96–102. https://doi.org/10.1016/j.outlook.2020.06.008
Shah, M. K., Gandrakota, N., Cimiotti, J. P., Ghose, N., Moore, M., & Ali, M. K. (2021). Prevalence of and factors associated with nurse burnout in the us. JAMA Network Open, 4(2), e2036469. https://doi.org/10.1001/jamanetworkopen.2020.36469
Soto-Rubio, A., Giménez-Espert, M., & Prado-Gascó, V. (2020). Effect of emotional intelligence and psychosocial risks on burnout, job satisfaction, and nurses’ health during the covid-19 pandemic. International Journal of Environmental Research and Public Health, 17(21), 7998. https://doi.org/10.3390/ijerph17217998 NRS-493-Professional Capstone and Practicum Assignment