NR 505 Week 2 PICOT Worksheet Assignment

Describe practice concern/problem?

  Burnout and fatigue are major issues. In the USA, the nursing shortage issue is leading to a higher turnover rate and increasing nurse-to-patient ratio. As a result, health care facilities use a scheduling process that affects the well-being of nurses (Gutsan, Patton, Willis & Coustasse, 2018). The current vacancy rate is 15%, and it is expected to increase in the coming years as burnout is making nurses leave jobs due to lower job satisfaction, and quality of life (Haddad, Annamaraju & Toney-Butler, 2020). Burnout includes emotional, physical, and psychological exhaustion. This further affects the care provided as nurses not in a state to provide the best possible care (Shin, Park & Bae, 2018). Nurses in the emergency department (ED) get tired quickly because of quick response needs and an increased number of visits from patients. In 2011, the turnover rate was 21.1%. From 2011 to 2015, it has increased to 35% (Roth, 2017).

Why is this concern/problem important to nursing and healthcare?

 The issue has importance at three levels. The first level is related to the nurses themselves. increasing burnout results in nurses getting exhausted quickly. This reduces the drive to practice effectively. As a result, errors are bound to happen. Also, burnout will increase both physical and psychological exhaustion, which results in nurses leaving the job. The second level is patient satisfaction (Chen et al., 2019). Burnout is directly associated with lower patient satisfaction as nurses fail to provide support and care. The third level of importance is at the administration level. The increasing number of errors, poor scheduling, and lower efficiency level lead to increased health care costs and lower reputation (Gutsan, Patton, Willis & Coustasse, 2018). Further, a higher turnover rate creates problems such as hiring new nurses, training them, and adapting to the demand quickly. NR 505 Week 2 PICOT Worksheet Assignment

What is the scope of the concern? 

Reducing burnout increases the physical and emotional competence of nurses. It also helps them to work effectively at better cognitive abilities (Bakhamis, Paul, Smith & Coustasse, 2019). It also reduces errors such as medication error, errors in decision-making, electronic health records maintaining errors, and other errors. Further, it increases the nurse’s job satisfaction and patients care satisfaction levels (Arrogante & Aparicio-Zaldivar, 2017). This results in reduced cost of care (Chen et al., 2019). Also, it reduces the turnover rate and nurses can live a better quality of life.

What evidence is there for the need for change?

  Arrogante & Aparicio-Zaldivar (2017) highlighted that burnout increases emotional exhaustion and depersonalization. Bakhamis, Paul, Smith & Coustasse (2019) concluded in their study that burnout decreases patient safety, quality of care provided, and efficiency of nurses. Chen et al. (2019) highlighted that increasing number of patients per nurse results in burnout, nurse’s intention to leave job, and poor quality of life. From 2011 to 2015, turnover rate has increased to 35% from 21.1% in 2011 (Roth, 2017).

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Include a minimum of 2 scholarly sources per APA format:

Arrogante, O., & Aparicio-Zaldivar, E. (2017). Burnout and health among critical care professionals: The mediational role of resilience. Intensive And Critical Care Nursing, 42, 110-115. doi: 10.1016/j.iccn.2017.04.010Bakhamis, L., Paul, D., Smith, H., & Coustasse, A. (2019). Still an epidemic. The Health Care Manager, 38(1), 3-10. doi: 10.1097/hcm.0000000000000243Chen, Y., Guo, Y., Chin, W., Cheng, N., Ho, J., & Shiao, J. (2019). Patient–nurse ratio is related to nurses’ intention to leave their job through mediating factors of burnout and job dissatisfaction. International Journal Of Environmental Research And Public Health, 16(23), 4801. doi: 10.3390/ijerph16234801Gutsan, E., Patton, J., Willis, W., & Coustasse, A. (2018). Burnout syndrome and nurse-to-patient ratio in the workplace. Marshall Digital Scholar, 196(01).Haddad, L., Annamaraju, P., & Toney-Butler, T. (2020). Nursing shortage (2nd ed., p. https://www.ncbi.nlm.nih.gov/books/NBK493175/). Treasure Island (FL): StatPearls Publishing.Roth, B. (2017). Correlation among competency, patient safety and nurse turnover rates?. Retrieved 10 July 2020, from https://blog.thesullivangroup.com/do-clinical-competency-patient-safety-and-nurse-turnover-rates-correlate#:~:text=Emergency%20Nurses%20have%20the%202,91.1%25%20of%20all%20hospital%20separations.Shin, S., Park, J., & Bae, S. (2018). Nurse staffing and nurse outcomes: A systematic review and meta-analysis. Nursing Outlook, 66(3), 273-282. doi: 10.1016/j.outlook.2017.12.002

P- Population and problem

– What is the nursing practice issue or problem and whom does it affect?
Increasing burnout levels in nurses working in ED is the practice issue. It affects nurses, patients, and the health care services.

I- Intervention – What evidence-based solution for the problem would you like to apply? 
There are two main EBP solutions selected. They are increasing nurse-to-patient ratio and applying an EBP staff scheduling technique.

C- Comparison – What is another solution for the problem?
Note that this is typically the current practice, no intervention at all, or an alternative solution.
The intervention is compared with practice where nurse-to-patient ratio is high and staff scheduling is based on need.

O- Outcome – Very specifically, how will you know that the intervention worked? Think about how you will measure the outcome. 
The outcome will be measured statistically by evaluating stress levels, nurse’s perception towards intervention, number of errors committed after the intervention, intention to leave job, patient satisfaction levels, work efficiency, and comparing cost of care provided before and after the intervention.

T- Time frame – For the purpose of this EBP project, you will want to keep the timeframe within 6-8 weeks.
The process takes two weeks to hire more nurses and create EBP schedule. Then four weeks of intervention analysis and outcome evaluation.

Separately:P:
RN nurses in EDI: Increasing nurse-to-patient ratio and implementing EBP staff schedulingC: Non-EBP staff scheduling based on needO: Burnout in nurses reduces significantlyT: Six weeks