NRS 433 Research Critiques and PICOT Statement Final Draft

NRS 433 Research Critiques and PICOT Statement Final Draft

NRS 433 Research Critiques and PICOT Statement Final Draft

The nursing profession is awash with many problems that hamper patient care. Nurses encounter these problems in routine practice and should be centrally involved in addressing them comprehensively. Typically, nurses use the evidence-based practice (EBP) approach to address practice problems. The EBP approach recommends sourcing evidence from current, peer-reviewed scholarly studies to guide practice change. Quantitative and qualitative studies are both used to inform decision-making. The purpose of this paper is to analyze quantitative and qualitative articles, and determine the link between the PICOT question, the research articles, and the nursing practice problem.

Nursing Practice Problem and PICOT Question

The nursing practice problem identified for exploration through a PICOT approach is nurse burnout. It is among the prevalent problems in nursing practice stemming from numerous factors such as job dissatisfaction, increased workload, frustrations, and personal stressors outside of work (Dos Santos, 2020). The effects of nurse burnout are far-reaching and regrettable. They include apathy, fatigue, distraction, and increased vulnerability to committing medication errors (Kwon et al., 2021). Nurse burnout also increases the turnover rate among nurses. Such effects are detrimental to patient care hence the need for interventions.

PICOT Question: Among intensive care unit (ICU) nurses (P), can practicing stress management techniques like resilience, mindfulness, and yoga (I) compared to not practicing (C) lower burnout rates by 50% (O) within six months (T)?

Background

Different research studies explore nurse burnout from different dimensions. Uchmanowicz et al. (2021) conducted qualitative research on the challenges that nurses experience when providing care in under-resourced settings. The primary premise is that rationing nursing care leads to professional burnout among nurses working in critical areas like cardiovascular settings. The article is significant to nursing since it elaborates on the cause-outcome connection of nurse burnout. Its purpose is to evaluate the link between rationing of nursing care and nurse burnout. The objective is to determine the impacts of nurse rationing guided by the research question of whether rationing of nursing care leads to professional burnout in nursing staff.

In a different qualitative study, Dos Santos (2020) explored the relationship between nurses’ stress, burnout, and reduced self-efficacy levels. They further examined the leading sources of stress and burnout among nursing professions. The primary problems being explored include stress and burnout as leading causes of low self-efficacy. Understanding the causes is instrumental to addressing nurse burnout. As a result, the article is significant to nursing since it provides relevant information that can be used to reduce nurse burnout to improve patient care outcomes. The article’s purpose is to enhance understanding of the causes of nurse burnout to help address the problem by addressing the causes. The research question is, “what are the sources of burnout and stress lowering self-efficacy and lead to an unbalanced patient ratio?”

The quantitative articles primarily evaluate the solutions to nurse burnout in health care settings. Elkady (2019) studied how mindfulness and resilience can help nurses manage burnout and improve overall performance. The main problem that the article addresses is nurse burnout and how it continues to hamper health care delivery. Elkady (2019) assessed the beneficial effects of resilience and mindfulness as strategies to improve nurses’ health and well-being to cope with nurse burnout. The article is significant to nursing since it provides solutions to a prevalent nursing problem. The study’s research question is “what is the impact of mindfulness and resilience on nurse burnout?” Both interventions can be implemented through a training program.

Diehl et al. (2021) examined effective interventions based on social, personal, and organizational resources for protecting nurses from nurse burnout. When solutions to burnout are known, nurses and nurse leaders can liaise and implement them effectively. The article is significant to nursing since it explores the different solutions that can be implemented to mitigate the damaging effect of nurse burnout. Diehl et al. (2021) studied the protective role of resources on the workload-nurse burnout association. They examined how workload interferes with nurses’ ability to provide optimal care and the buffering effects of various resources. The research question is, “is the relationship between workload and burnout among nurses and the role of personal, social and organizational resources in protecting these providers?”

How the Articles Support the Nurse Practice Issue (Nurse Burnout)

The four articles will be used to answer the PICOT question since they provide the background, causes, effects, and effective solutions. They demonstrate how nurse burnout is a prevalent problem affecting care delivery and why it needs to be a priority area when addressing nursing problems. The articles further demonstrate the link between stress, burnout, and low self-efficacy among nurses. Issues such as workplace bullying, the lack of personal development and self-care opportunities, and dissatisfaction have been noted as the primary focus areas when nurse leaders and organizational management want to address nurse burnout (Dos Santos et al., 2020; Uchmanowicz et al., 2021). The different interventions proposed in the article can be used to mitigate nurse burnout and stress. They include mindfulness, resilience, and resources to minimize workload (Diehl et al., 2021; Elkady, 2019). The solutions can be implemented individually or jointly depending on the severity and causes of nurse burnout.

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The interventions and comparison groups share many characteristics with the study group in the PICOT question. To compare outcomes, researchers use an intervention group receiving the treatment and compare outcomes with a control group not receiving the treatment. Data collection varies depending on whether the study is qualitative or quantitative. As proposed in the PICOT question, the intervention group will practice stress management through mindfulness, resilience, and yoga and the results compared to a control group not receiving any stress management skills. The objective is to compare findings to rationalize the effectiveness of the nurse burnout intervention method.

Method of Study

Researchers use different approaches to explore different nursing problems. Uchmanowicz (2021) used the cross-sectional design to investigate the link between rationing and professional burnout. Data were collected via surveys. Diehl et al. (2021) used the same approach (a national cross-sectional survey) to investigate the buffering role of resources on the workload-burnout association among nurses. Elkady (2019) used quantitative survey research to evaluate the effects of mindfulness and resilience on job burnout. Dos Santos et al. (2020) invited nursing professionals for a qualitative inquiry based on a snowball sampling strategy.

Each method has different benefits and limitations. Cross-sectional studies are quick, inexpensive, and easy to conduct (Wang & Cheng, 2020). Researchers can also use them to generate hypotheses for future research. However, cross-sectional studies can miss crucial information about changes over time since they observe individuals at one point in time. A quantitative survey is a highly effective method for collecting data about multiple variables, including the study subjects’ opinions, behaviors, and demographics. However, surveys often rely on self-reported data (Fryer & Nakao, 2020). Unlike surveys, a qualitative inquiry allows researchers to investigate a problem in more depth and detail. However, researchers cannot quantify subjects’ responses.

Results of Study

The articles have different results helping to understand nurse burnout and how to address it in more detail. Uchmanowicz et al. (2020) found that the leading components of nurse burnout include emotional exhaustion, job dissatisfaction, and depersonalization. In the other study, Dos Santos (2020) found that factors within the nurses’ environment play a significant role in increasing stress and burnout, reducing nurses’ self-efficacy. Such factors include workplace incivility, lack of personal development, and family stress. Elkady (2019) found resilience and mindfulness to be effective buffers against nurse burnout. According to Diehl et al. (2021), personal, organizational, and social resources can effectively reduce nurse burnout. Such resources include a good working team and workplace recognition programs.

These studies have huge implications in nursing practice. Firstly, nurse burnout is a significant problem in today’s practice and worsens progressively. The articles can be used to understand its causes, manifestations, and possible solutions. Secondly, nurse burnout is associated with adverse outcomes, including increased absenteeism, turnover intention, and job dissatisfaction (Kwon et al., 2021). Since these outcomes hamper patient care, the articles can be used to guide practice change to prevent and buffer the damaging effects of nurse burnout. Mindfulness, resilience, and using resources such as workplace teams have been proposed as effective intervention programs. The articles can guide nurses in selecting and applying appropriate methods to address nurse burnout.

Ethical Considerations

Ethics is crucial in nursing research to ensure that studies are free from ethical and legal accusations. Two main ethical considerations guide nursing research- informed consent and confidentiality. According to Manti and Licari (2018.), informed consent involves apprising participants about the study’s details, including the nature, risks, and benefits, to enable them to participate willingly. Confidentiality involves protecting private information and not sharing it with anyone without the subjects’ approval. The four studies adhered to the ethical principles of informed consent and confidentiality. All the participants were informed about the nature of the study, and those unwilling to participate were excluded. Information obtained from the research was also kept confidential, as promised.

Outcomes Comparison

As hypothesized in the PICOT question, the anticipated outcome is that nurse burnout will decrease in nurses practicing stress management in six months. The outcomes of the four articles compare to the anticipated outcomes of the PICOT question since they focus on eradicating burnout among nurses. Stress management strategies emphasized in the articles include resilience, mindfulness, and organizational resources such as teamwork and recognition programs (Diehl et al., 2021). Stress management will help regulate nurses’ moods, reduce anxiety, and help them focus mentally and physically on their work.

Proposed Evidence-Based Practice Change

The PICOT question links strongly with the research articles and the nursing practice problem (nurse burnout). The articles provide useful information to answer the PICOT question. Using the information provided, nurses can apply resilience, mindfulness, and organizational resources to prevent and cope with burnout. To enable nurses to apply these strategies effectively, resilience and mindfulness training for nurses is important. Through such training, nurses should be taught stress management skills, including mindfulness breathing and resilience tips such as self-care, exercises, and working in teams.

Conclusion

Nurse burnout is among the prevalent problems hampering patient care in nursing practice. Like many other problems, an evidence-based approach is highly effective in addressing the problem. As discussed in this paper, stress management techniques can be used to address burnout among nurses. Addressing the problem will be instrumental in reducing nurse turnover and optimizing health outcomes. A nurse training in stress management is crucial to empower nurses experiencing burnout or at risk of burnout.

References

Diehl, E., Rieger, S., Letzel, S., Schablon, A., Nienhaus, A., Escobar Pinzon, L. C., & Dietz, P. (2021). The relationship between workload and burnout among nurses: The buffering role of personal, social and organizational resources. PloS One, 16(1), e0245798. https://doi.org/10.1371/journal.

Dos Santos, L. M. (2020). Stress, burnout, and low self-efficacy of nursing professionals: A qualitative inquiry. Healthcare, 8(4): 424. https://doi.org/10.3390/healthcare8040424

Elkady, A. A. M. (2019). Mindfulness and resilience as predictors of job burnout among nurses in public hospitals. International Journal of Psycho-Educational Sciences, 8, 14-21. https://perrjournal.com/index.php/per journal/article/view/167

Fryer, L. K., & Nakao, K. (2020). The future of survey self-report: An experiment contrasting Likert, VAS, Slide, and Swipe Touch interfaces. Frontline Learning Research, 8(3), 10-25. https://doi.org/10.14786/flr.v8i3.501

Kwon, C. Y., Lee, B., Kwon, O. J., Kim, M. S., Sim, K. L., & Choi, Y. H. (2021). Emotional labor, burnout, medical error, and turnover intention among South Korean nursing staff in a university hospital setting. International Journal of Environmental Research and Public Health, 18(19), 10111. https://doi.org/10.3390/ijerph181910111

Manti, S., & Licari, A. (2018). How to obtain informed consent for research. Breathe (Sheffield, England), 14(2), 145–152. https://doi.org/10.1183/20734735.001918

Uchmanowicz, I., Kubielas, G., Serzysko, B., Kołcz, A., Gurowiec, P., & Kolarczyk, E. (2021). Rationing of nursing care and professional burnout among nurses working in cardiovascular settings. Frontiers in Psychology, 12. https://doi.org/10.3389/fpsyg.2021.726318

Wang, X., & Cheng, Z. (2020). Cross-sectional studies: strengths, weaknesses, and recommendations. Chest, 158(1), S65-S71. https://doi.org/10.1016/j.chest.2020.03.012